ABSTRACT
The currently prevalent COVID-19 infection, its line of treatment, resultant immunosuppression, and pre-existing comorbidities have made patients exposed to secondary infections including mucormycosis. Mucormycosis is a rare but in invasive fungal infection (IFI) due to several species of saprophytic fungi, occurring in patients with underlying co-morbidities which include diabetes mellitus, organ transplant, immunosuppressive corticosteroid therapy. The maxilla rarely undergoes necrosis due to its rich vascularity. Rare but not uncommon is the incidence of mucormycosis associated maxillary osteomyelitis occurring post COVID-19 infection. Fungal osteomyelitis is a life-threatening infection which may further spread from maxilla to the nose and paranasal sinuses within the orofacial region. It is an aggressive infection that needs to be addressed promptly to prevent fatal consequences.
ABSTRACT
Objective: Coronavirus pandemic is a human respiratory disease caused by the severe acute respiratory syndrome (SARS-CoV-2). The objective of the present study was to evaluate the type of mask, frequency of change, difficulties in breathing, dryness of mouth, hazards, and treatment taken for skin allergies if any due to use of facial masks in the present Coronavirus pandemic. Materials and Methods: The present survey was carried on dental practitioners for evaluating knowledge and attitude among 1640 participants. The anonymous survey was carried among different groups of age, gender, and qualifications among dentists all around the globe. SPSS 23.0 statistical software was used for statistical analysis. GraphPad Prism 6 was used for statistical analysis and visualization using Chi-square test, one-way ANOVA and post hoc test. The validity of the questionnaire was pilot tested and measured. The Chron bach's alpha value was 0.71. Results: Among the participants 46.3% used respirators such as N95, filtering facepiece respirators 2, or the equivalent. Surgical masks were used by 43.9% and the remaining used cloth masks. When inter group comparison was done for different age groups, it was found that there was a statistically significant for the type of mask used. Sixty-six percent participants reported oral malodor after using the facial masks while dryness of the mouth was reported in 41.5 and 9.1% reported acne. Conclusion: The use of face masks has become mandatory ornament along with social distancing to avoid transmission. Hypercapnia and breathing difficulties reported were less. For treating the face after long use of facial mask many of the participants reported that no treatment was taken while, others hydrated the face frequently with water, moisturizer and very few used antifungal agent.
ABSTRACT
Background and Aim: Colonoscopic surveillance is undertaken at regular intervals (typically 3 or 5 years) to reduce the incidence of colorectal cancer (CRC) in people with an elevated risk (personal or family history of neoplasia). Pathology findings at index and each surveillance colonoscopy determine recall intervals. Due to coronavirus disease 2019, hospital services around the world have been limited, resulting in some surveillance colonoscopies being delayed beyond the recommended time frames. Previous studies suggest that delays to colonoscopy might increase the incidence of advanced neoplasia (advanced adenoma/CRC). However, it is possible that this risk could be reduced by ensuring that individuals are maintained in a CRC screening program with an immunochemical fecal occult blood test (FIT) in the interval between surveillance colonoscopies. Our aim was to determine whether risk of advanced neoplasia increases if surveillance colonoscopy is delayed in people with elevated CRC risk who perform and have a negative FIT result in the interval between colonoscopies. Methods: We performed a retrospective cohort study using data from the Southern Cooperative Program for the Prevention of Colorectal Cancer on people at elevated risk because of family history or personal history of adenoma or CRC. People with at least two consecutive colonoscopies of a 3- or 5-year surveillance interval and who had at least one negative interval FIT result were included in the study. They were stratified based on a previous colonoscopy finding of advanced adenoma, non-advanced adenoma, or no neoplasia. People with early colonoscopies (3 months before the recommended due date), poor bowel preparation, previous CRC, or hereditary CRC syndromes were excluded from the study. Colonoscopy was defined as 'delayed' if it did not occur within 6 months after the recommended recall interval and was further subdivided into delays of 6-12, 12-24, and >24 months. The incidence of advanced neoplasia was calculated for all groups. The relative risk (RR) and 95% confidence intervals estimated from a robust multivariable modified Poisson regression were used to assess the association between surveillance colonoscopy delay and risk of advanced neoplasia. Results: A total of 1748 public hospital surveillance colonoscopies (in 1516 participants) were included in the analysis. More than half of the colonoscopies (56.86%, 994/1748) were delayed by at least 6 months because of system and/or patient factors. In people with delayed colonoscopies, the incidence of advanced neoplasia was higher in those with previous advanced adenoma (16.72%, 48/287) and previous non-advanced adenoma (15.23%, 37/243) compared with those with no neoplasia (6.25%, 29/464) (P < 0.001). However, relative to on-time colonoscopy, delay of surveillance colonoscopy was not associated with an increased risk of advanced neoplasia for people who had at least one negative interval FIT result, regardless of previous colonoscopy finding (previous advanced adenoma: RR, 1.01;95% CI, 0.70-1.46;non-advanced adenoma: RR, 1.41;95% CI, 0.85-2.33;and no neoplasia: RR, 0.96;95% CI, 0.55-1.66) (Table 1). Conclusion: In an elevated-risk cohort undergoing FIT screening between surveillance colonoscopies, delays to colonoscopy did not increase risk of advanced neoplasia. These results suggest that surveillance colonoscopy could be safely extended in people at elevated CRC risk by participating in FIT testing between colonoscopies within a surveillance program.