FUNGAL OSTEOMYELITIS OF FRONTAL BONE FOLLOWING COVID ASSOCIATED MUCORMYCOSIS (preprint)

Introduction: - The second wave of COVID 19 lead to resurgence of opportunistic infections due to injudicious use of steroids. Sinonasal Mucormycosis was declared as an epidemic during the pandemic. The mucormycosis was managed effectively by surgical debridement along with systemic amphotericin B. Now, following the initial treatment of mucormycosis there is a resurgence, in the form of fungal osteomyelitis of the frontal bone. Methods – the prospective study included the cases from ten patients with fungal osteomyelitis of frontal bone due to mucormycosis, all the patients underwent surgical debridement of sequestrum and involucrum with systemic antifungals. Results - The average duration of the recurrence was 22 days following the initial treatment Range (10 days to 33 days). Extracranial bossing following outer frontal cortex erosion in 30% of cases, bicortical erosion in 30%, bifrontal involvement (20%), dural involvement (30%), brain parenchymal involvement and prefrontal cortex (20%) case. All cases underwent debridement of entire sequestrous bone and involucrum till normal bone was identified. The mean duration of admission was 4 weeks (3 to 6 weeks). All treated patients are currently alive without disease, confirmed by CECT. Conclusion - The successful treatment of fungal osteomyelitis due to mucormycosis requires four pronged approach (1) early detection (2) multidisciplinary management of comorbidities (3) surgical debridement of necrotic bone and (4) adequate systemic antifungal therapy. Long term outcomes of fungal osteomyelitis of frontal bone are yet to be established

An Observational Study of COVID-19 Infection in Pregnant Women at a Tertiary Care Center

Background: COVID-19 infection is a disease caused by severe acute respiratory syndrome coronavirus 2. The manifestations, effects, and severity of the infection are varied in different waves, especially during pregnancy. Material(s) and Method(s): The study was conducted in two equal time periods during the first and second waves. During the first wave, the period of study was between June and August 2020 corresponding to the peak of the first wave, and in the second wave, the study period was between May and July 2021 corresponding to the peak of the second wave. Result(s): A total of 3,791 pregnant women was screened for COVID-19 infection during the first wave and second wave, the pregnant mothers with COVID-19 positive were 4.2 (n = 163) and 5.1% (n = 191), respectively. Around 60% were antenatal mothers and 37% were postnatal mothers who were COVID-19-positive. The predominant age group affected was between 20 and 25 years of age. Gestational diabetes mellitus (GDM), gestational hypertension, anemia, previous lower segment cesarean section (LSCS), postdated pregnancy, and past history of infertility were the high-risk factors observed during the study. Hypoxia was observed in 15% of patients in the second wave. About 49.7% (n = 95) of the COVID-19-positive mothers in the second wave required steroids, anticoagulants, and antiviral drugs. Conclusion(s): The incidence of COVID-19 infection was mild and asymptomatic during the first wave and symptomatic as well as with complications during the second wave. The disease severity, intensive care unit (ICU) admissions, duration of stay, LSCS delivery, and need for antivirals, anticoagulants, and steroids were more during the second wave of COVID-19.Copyright © The Author(s). 2023.

Outcomes of Open Fronto-Facial Resection for Fungal Osteomyelitis of Frontal Bone.

INTRODUCTION: The second wave of coronavirus disease 2019 (COVID-19) led to the resurgence of opportunistic infections due to the injudicious use of steroids. Sinonasal mucormycosis was declared an epidemic in India during the pandemic. Mucormycosis was managed effectively by surgical debridement along with systemic amphotericin B. Currently, a resurgence of mucormycosis following initial treatment, in the form of fungal osteomyelitis of the frontal bone, is being seen in India. METHODS: This prospective study included 10 patients with fungal osteomyelitis of the frontal bone due to mucormycosis. All patients underwent surgical debridement of the sequestrum and involucrum, with systemic antifungal pharmacotherapy. RESULTS: The average duration of time until mucormycosis recurrence was 22 days following initial treatment (range 10-33 days). Patients presented with extracranial bossing following outer frontal cortex erosion (n=3), bicortical erosion (n=3), bifrontal involvement (n=2), dural involvement (n=3), and involvement of the brain parenchyma and prefrontal cortex (n=2). All cases underwent debridement of the entire sequestrous bone and involucrum until normal bone could be identified. The mean admission duration was 4 weeks (range 3-6 weeks). All treated patients are currently alive and without disease, confirmed by contrast-enhanced computed tomography. CONCLUSION: Based on our experience, the successful treatment of fungal osteomyelitis due to mucormycosis requires a four-pronged approach: early detection, multidisciplinary management of comorbidities, surgical debridement of necrotic bone, and adequate systemic antifungal therapy.

Outcomes of Open Fronto-Facial Resection for Fungal Osteomyelitis of Frontal Bone

Introduction The second wave of coronavirus disease 2019 (COVID-19) led to the resurgence of opportunistic infections due to the injudicious use of steroids. Sinonasal mucormycosis was declared an epidemic in India during the pandemic. Mucormycosis was managed effectively by surgical debridement along with systemic amphotericin B. Currently, a resurgence of mucormycosis following initial treatment, in the form of fungal osteomyelitis of the frontal bone, is being seen in India. Methods This prospective study included 10 patients with fungal osteomyelitis of the frontal bone due to mucormycosis. All patients underwent surgical debridement of the sequestrum and involucrum, with systemic antifungal pharmacotherapy. Results The average duration of time until mucormycosis recurrence was 22 days following initial treatment (range 10–33 days). Patients presented with extracranial bossing following outer frontal cortex erosion (n=3), bicortical erosion (n=3), bifrontal involvement (n=2), dural involvement (n=3), and involvement of the brain parenchyma and prefrontal cortex (n=2). All cases underwent debridement of the entire sequestrous bone and involucrum until normal bone could be identified. The mean admission duration was 4 weeks (range 3–6 weeks). All treated patients are currently alive and without disease, confirmed by contrast-enhanced computed tomography. Conclusion Based on our experience, the successful treatment of fungal osteomyelitis due to mucormycosis requires a four-pronged approach: early detection, multidisciplinary management of comorbidities, surgical debridement of necrotic bone, and adequate systemic antifungal therapy.

COVID-19 PREDICTION THROUGH CHEST X-RAY IMAGE DATASETS USING DEEP LEARNING

The work aims at the prediction and analysis of COVID-19 from Chest X-Ray scan images using Pre-trained Deep Convolutional Neural Network models. Analysis is carried out using two open-source datasets, to identify and differentiate between the Chest X-Ray scans of non COVID person and COVID-19 affected person. A baseline model using LeNet-5 is implemented using the initial dataset collected, which gave 98.57 % accuracy. Further, pre-trained models such as AlexNet, ResNet 50, Inception V3, VGG16, VGG19 and Xception are used for COVID prediction and carryout comparative analysis. Using the performance measures viz. Accuracy, Confusion Matrix and ROC Curves, the result of study shows that for the first dataset used for analysis, Xception and for the second dataset Inception architectures respectively are most suitable for the prediction of COVID-19. © 2021 IEEE.