ABSTRACT
BACKGROUND: An ectoparasitic disease, scabies, caused by the mite Sarcoptes scabiei var hominis. Some of the predisposing factors are overcrowding, unhygienic surroundings, immunocompromised status, dementia, homelessness, and sexual contact. In this study, we wanted to evaluate the changed distribution of lesions of scabies during pandemic. METHODS: A cross sectional study was performed on 600 patients attending the skin department of our tertiary care hospital over a period of 6 months. The sites of the scabies lesions were noted along with types of lesions. Demographic data and history of regular hand washing and sanitization were also documented. RESULTS: Our study revealed an important correlation between change in pattern of distribution of scabies lesions from being less frequent on finger webs (19%) to being more frequent on abdomen (periumbilical area) (73%) and groins (67%) due to regular hand washing and frequent sanitization, in this pandemic era. CONCLUSIONS: A significant change in distribution of skin lesions in scabies can be noticed during this COVID-19 pandemic.
ABSTRACT
OBJECTIVE: Mucormycosis is a rapidly progressive and fulminant fungal infection mainly affecting the nose and paranasal sinuses and often requiring aggressive surgical debridement, which commonly includes inferior maxillectomy. Conventional inferior maxillectomy involves removal of the bony hard palate and its mucoperiosteum. This can lead to formation of an oroantral fistula and thereby increase the morbidity in these patients leading to prolonged rehabilitation. Subperiosteal inferior maxillectomy involves sparing of the uninvolved mucoperiosteum of the hard palate. This flap is used for closure of the oroantral fistula, which preserves the functional capabilities of the patient, such as speech, mastication and deglutination. METHOD: This case series describes the experience of using the technique of mucosa-preserving subperiosteal inferior maxillectomy in five patients with mucormycosis. RESULTS: With the technique used in this study, complete oronasal separation was achieved in all six patients. The overall surgery time was also decreased when compared with free tissue transfer. Patients also did not have to bear the weight of prosthesis. CONCLUSION: Mucoperiosteal palatal flap-preserving subperiosteal inferior maxillectomy is an excellent approach for all patients with mucormycosis and healthy palatal mucosa.
ABSTRACT
Importance: There is a need to identify the implications of the loss of smell and taste in cases of coronavirus disease-2019 (COVID-19). Objective: To determine whether severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is causing isolated anosmia in adult population and whether there is a role of intranasal corticosteroids (INCs) in cases of olfactory dysfunctions (ODs). Design: This was a prospective, cross-sectional, questionnaire-based study of 416 patients diagnosed with COVID-19 in a single institute. Setting: Dedicated COVID-19 facility. Participants: All patients had been tested for COVID-19 using a reverse transcription–polymerase chain reaction (RT-PCR)-based test. Patients who were hospitalized were approached in person. All patients who were discharged were then contacted by telephone up to two times to complete the study. Patients who were not reachable with two telephone calls were excluded. Demographic characteristics of the participants—age, sex, and smoking history—were collected. A standardized questionnaire was given to participants. Result: Olfactory dysfunctions (ODs) was observed in 58 patients and isolated anosmia in 3.6% of patients;82.7% showed complete recovery of smell, and 6.9% had partial recovery following INCs. Conclusion: Patients reporting recent onset of anosmia should be considered positive for SARS-CoV-2 infection until proven otherwise by a screening polymerase chain reaction test. Also, ear, nose, and throat (ENT) surgeons in particular who see patients with new-onset anosmia during the COVID-19 pandemic must take safety measures to reduce the risk of exposure and infection of healthcare workers and recommend such patients for RT-PCR test. Females and young adults are more prone to SARS-CoV-2 infection. Early intervention by INCs could be beneficial in improving olfactory and taste dysfunctions (OTDs) and other post-viral neurological manifestations. It could be beneficial in improving the quality of life of elderly patients who are at a higher risk of permanent OTDs. Smokers are at a higher risk of OTDs, but this could be reversible after smoking cessation. There is a need to put SARS-CoV-2 as a differential diagnosis in cases of sudden isolated OTDs.
ABSTRACT
BACKGROUND: It is an incontrovertible fact that the Rhino Orbital Cerebral Mucormycosis (ROCM) upsurge is being seen in the context of COVID-19 in India. Briefly presented is evidence that in patients with uncontrolled diabetes, a dysfunctional immune system due to SARS-COV-2 and injudicious use of corticosteroids may be largely responsible for this malady. OBJECTIVE: To find the possible impact of COVID 19 infection and various co-morbidities on occurrence of ROCM and demonstrate the outcome based on medical and surgical interventions. METHODOLOGY: Prospective longitudinal study included patients diagnosed with acute invasive fungal rhinosinusitis after a recent COVID-19 infection. Diagnostic nasal endoscopy (DNE) was performed on each patient and swabs were taken and sent for fungal KOH staining and microscopy. Medical management included Injection Liposomal Amphotericin B, Posaconazole and Voriconazole. Surgical treatment was restricted to patients with RT PCR negative results for COVID-19. Endoscopic, open, and combined approaches were utilized to eradicate infection. Follow-up for survived patients was maintained regularly for the first postoperative month. RESULTS: Out of total 131 patients, 111 patients had prior history of SARS COVID 19 infection, confirmed with a positive RT-PCR report and the rest 20 patients had no such history. Steroids were received as a part of treatment in 67 patients infected with COVID 19. Among 131 patients, 124 recovered, 1 worsened and 6 died. Out of 101 known diabetics, 98 recovered and 3 had fatal outcomes. 7 patients with previous history of COVID infection did not have any evidence of Diabetes mellitus, steroid intake or any other comorbidity. CONCLUSION: It can be concluded that ROCM upsurge seen in the context of COVID-19 in India was mainly seen in patients with uncontrolled diabetes, a dysfunctional immune system due to SARS-COV-2 infection and injudicious use of corticosteroids.