ABSTRACT
Our aim was to discuss rhino-orbital mucormycosis developing after coronavirus disease-2019 pneumonia treatment. A 45-year-old man presented with visual loss, headache, and numbness in the palate and the left mid-face. The patient had been administered methylprednisolone for coronavirus disease-2019 disease at another hospital. The head and neck examination revealed ophthalmoplegia and chemosis in the left eye and hypoesthesia in the site under the left orbit. Endoscopic nasal examination revealed a black eschar tissue on the left inferior turbinate and the middle meatus. Liposomal amphotericin B was promptly administered with a dose of 5 mg/kg with a preliminary diagnosis of mucormycosis. Urgent endoscopic medial maxillectomy and orbital decompression were performed. Once total visual loss was seen in the patient in the follow-up period, orbital exenteration was performed. The diagnosis of mucormycosis was made based on the histopathological examination, which revealed non-septate hyphae causing invasion in the tissues and the blood vessels. There was no growth of specific fungal microorganisms in the tissue cultures. The patient has been alive during the 2 months follow-up periods and no complications were observed. Patients with coronavirus disease-2019 should be closely monitored in terms of the underlying disease and mucormycosis. Corticosteroids should be administered carefully in coronavirus disease-2019 patients. Copyright@Author(s).
ABSTRACT
The main purpose of this applied research paper is to optimize the probabilities of the false negative (FN) error, β, and the false positive (FP) error, α in a pandemic healthcare setting. The overall objective is to estimate the number of those patients falsely declared uninfected, and those falsely declared infected, aiming to recalibrate the overall count of cases aligned with the world’s mobilization and vaccination efforts. Incomplete FN results can have devastating impacts on current efforts to contain the SARS-CoV-2 (COVID-19) outbreak as infected patients are mistakenly given the go-ahead to return to normal life, likely infecting others. The whole world experienced in 2020 that the number of deaths were undercounted due to existence of false negatives or asymptomatic carriers. But there did not exist universally unbiased scientific methods other than controversial comparisons with the past seasonal death records. This game-theoretic research effort fills a void to replace guesswork and judgment-calls by employing data-scientific health informatics. This article reasons by citing real-data examples why von Neumann’s mixed-strategy game-theoretic feasible solutions to predict the FN cases are noteworthy to prevent more fatalities by facilitating timely pandemic mobilization. FP counts are however not so critical other than causing panic and waste of resources. In the wake of vaccination relief efforts, this research topic is still valid and invaluable for the future unprecedented pandemics such as a hypothetical COVID-35. A fringe benefit of the article is to transform hypothesis testing from subjective to objective for scientific, medical and engineering decisions. Evolutionary game theory may be incorporated for evolving and mutating pandemic variants e.g. OMICRON and DELTA for further research tips. Copyright © 2022 by the authors.
ABSTRACT
Coronavirus disease 2019 (COVID-19) has caused an on-going pandemic since March 2020. It has been shown with clinical studies that patients with chronic illnesses, notably diabetes mellitus, are under high risk of complications including death. Mucormycosis is invasive and fulminant even though it is rare. Although there are numerous studies existing in the literature about COVID-19 cases with invasive Aspergillosis, there are a couple of studies reported about COVID-19 cases with mucormycosis. In this study, it was aimed to present two cases of COVID-19 with diabetes and acute rhino-orbital-cerebral mucormycosis. Early diagnosis and treatment of mucormycosis is crucial to decrease morbidity and mortality.
ABSTRACT
Objective: Health workers are on the frontlines in the fight against coronavirus disease-2019 (COVID-19) and are unfortunately the occupational group with the highest risk of infection. For this reason, as in all surgical branches, neurosurgery organisations have recommended postponing or limiting surgeries during the pandemic to reduce the risk of transmission. In our literature review, no study reported the number of neurosurgeons infected with COVID-19 following surgeries performed during the first 3 months of the pandemic. This study examined surgeries performed during the first 3 months of the pandemic in Turkey and COVID-19 transmission to neurosurgeons involved in these cases. Methods: Records of 188 patients who underwent surgery in our neurosurgery clinic during the first wave of the pandemic in Turkey (March 11-31 May 2020) were examined retrospectively. Characteristics of the operations performed, COVID-19 tests performed and results, intraoperative measures taken and frequency of COVID-19 symptoms among neurosurgeons after the surgery were determined. Results: Of the 188 patients included in the study, none had a definitive diagnosis of COVID-19 at the time of surgery. However, 25 patients (13.29%) had a history of unsafe contact or symptoms suggestive of COVID-19. Moreover, 9 (36%) patients had a positive result from the COVID-19 polymerase chain reaction test. A total of nine neurosurgeons who participated in surgeries were included in the study and none of them exhibited COVID-19 symptoms during the 3-month pandemic period. Conclusion: Although many surgeries were performed during the first wave of the pandemic in Turkey, with some simple precautions, none of the neurosurgeons developed COVID-19. We think that this is a pioneering study since this quantitatively demonstrates the extent of COVID-19 transmission to neurosurgeons during surgery.