Coronavirus-associated mucormycosis: different from sinonasal mucormycosis.

OBJECTIVE: To study unusual presentations of coronavirus-associated mucormycosis that are rarely seen in sinonasal mucormycosis cases. METHOD: The data of 400 rhino-orbito-cerebral mucormycosis patients admitted to Sawai Man Singh Hospital, Jaipur, from May 2021 to June 2021, were retrospectively collected. The diagnosis of mucormycosis was made by histological examination of biopsy samples. RESULTS: Out of 400 patients, 62 had symptoms other than common symptoms of rhino-orbito-cerebral mucormycosis. Thirty-four patients had facial palsy, 19 complained of gum ulcers, 6 developed a cheek abscess, 2 complained of maggots in the nose along with common rhino-orbito-cerebral mucormycosis symptoms, and 1 had a cerebellar infarct. CONCLUSION: Mucormycosis is a disease with various presentations, and coronavirus-associated mucormycosis has added unusual presentations to the existing list of manifestations of rhino-orbito-cerebral mucormycosis. In this coronavirus disease era, mucormycosis should always be considered as a diagnosis in patients with these unusual presentations.

Post coronavirus disease mucormycosis: a deadly addition to the pandemic spectrum.

OBJECTIVE: To study the possible association between invasive fungal sinusitis (mucormycosis) and coronavirus disease. METHODS: A prospective observational study was conducted at a tertiary care centre over four months, involving all patients with mucormycosis of the paranasal sinuses suffering from or having a history of coronavirus disease infection. RESULTS: Twenty-three patients presented with mucormycosis, all had an association with coronavirus disease 2019. The ethmoids (100 per cent) were the most common sinuses affected. Intra-orbital extension was seen in 43.47 per cent of cases, while intracranial extension was only seen in 8.69 per cent. Diabetes mellitus was present in 21 of 23 cases, and was uncontrolled in 12 cases. All patients had a history of steroid use during their coronavirus treatment. CONCLUSION: New manifestations of coronavirus disease 2019 are appearing over time. The association between coronavirus and mucormycosis of the paranasal sinuses must be given serious consideration. Uncontrolled diabetes and over-zealous use of steroids are two main factors aggravating the illness, and both of these must be properly checked.

Remote Concurrent Engineering: A-Team Studies in the Virtual World

NASA Jet Propulsion Laboratory's (JPL's) Architecture Team (A-Team) has nearly a decade of experience in maturing early formulation mission and technology concepts by combining innovative collaborative engineering methods with cutting-edge subject matter expertise and advanced analysis tools in an in-person environment. When COVID-19 forced JPL's workforce to work remotely in March 2020, ATeam had to quickly pivot from an in-person collaborative environment to a remote working environment. Through introspection, careful planning, and considerable practice, A-Team was able to develop new operating procedures to effectively continue early formulation studies in a virtual environment. A-Team has held over 57 remote studies in the 10 months since the start of mandatory telework at JPL in March 2020. In the remote setting, A-Team conducts studies in half-day sessions with clients and subject matter experts (SMEs) via videoconferencing, shared computer screens, and digital collaborative tools. The key lesson is that increased staffing and planning is needed to prepare and successfully run remote A-Team studies. Remote A-Team studies require careful selection of the appropriate tools for security, accessibility, and usability within the NASA/JPL environment. Knowledge capture methods and templates need to be thought out and agreed upon in advance as there is less room for improvising in a remote format. Various communication channels have to be monitored to allow for team coordination while maintaining fruitful participant engagement during a session. In addition, technical backup for all roles within the A-Team have to be identified to allow the study to continue even if a team member's connectivity is temporarily interrupted. Finally, careful thought has to be put into methods and processes to create a collaborative environment in a virtual space such that a group of experts who are only connected via the internet can experience the creative spark and flow of a great collaborative and innovative study.