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1.
PLoS One ; 17(8): e0272042, 2022.
Article in English | MEDLINE | ID: covidwho-1978853

ABSTRACT

BACKGROUND: In the ongoing COVID-19 pandemic, an increased incidence of ROCM was noted in India among those infected with COVID. We determined risk factors for rhino-orbito-cerebral mucormycosis (ROCM) post Coronavirus disease 2019 (COVID-19) among those never and ever hospitalized for COVID-19 separately through a multicentric, hospital-based, unmatched case-control study across India. METHODS: We defined cases and controls as those with and without post-COVID ROCM, respectively. We compared their socio-demographics, co-morbidities, steroid use, glycaemic status, and practices. We calculated crude and adjusted odds ratio (AOR) with 95% confidence intervals (CI) through logistic regression. The covariates with a p-value for crude OR of less than 0·20 were considered for the regression model. RESULTS: Among hospitalised, we recruited 267 cases and 256 controls and 116 cases and 231 controls among never hospitalised. Risk factors (AOR; 95% CI) for post-COVID ROCM among the hospitalised were age 45-59 years (2·1; 1·4 to 3·1), having diabetes mellitus (4·9; 3·4 to 7·1), elevated plasma glucose (6·4; 2·4 to 17·2), steroid use (3·2; 2 to 5·2) and frequent nasal washing (4·8; 1·4 to 17). Among those never hospitalised, age ≥ 60 years (6·6; 3·3 to 13·3), having diabetes mellitus (6·7; 3·8 to 11·6), elevated plasma glucose (13·7; 2·2 to 84), steroid use (9·8; 5·8 to 16·6), and cloth facemask use (2·6; 1·5 to 4·5) were associated with increased risk of post-COVID ROCM. CONCLUSIONS: Hyperglycemia, irrespective of having diabetes mellitus and steroid use, was associated with an increased risk of ROCM independent of COVID-19 hospitalisation. Rational steroid usage and glucose monitoring may reduce the risk of post-COVID.


Subject(s)
COVID-19 , Diabetes Mellitus , Hyperglycemia , Mucormycosis , Orbital Diseases , Antifungal Agents/therapeutic use , Blood Glucose , Blood Glucose Self-Monitoring , COVID-19/epidemiology , Case-Control Studies , Diabetes Mellitus/drug therapy , Diabetes Mellitus/epidemiology , Hospitalization , Humans , Hyperglycemia/complications , Hyperglycemia/drug therapy , Hyperglycemia/epidemiology , India/epidemiology , Middle Aged , Mucormycosis/drug therapy , Mucormycosis/epidemiology , Orbital Diseases/drug therapy , Pandemics
2.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-306850

ABSTRACT

Background: - This study outlines the unique modifications to surgical tracheostomy procedure to combat the extraordinary situation the world has found itself in due to COVID 19 pandemic. We explain the modifications employed to the operative setup, anesthetic considerations and surgical procedure to enable us to provide timely and safe tracheostomy to the COVID ICU patients requiring it, while simultaneously maximally protecting our surgical personnel from the deadly exposure. Methods: - We conducted 55 surgical tracheostomies in severely sick ICU patients with the modifications deemed fit to achieve safe procedure for both the patient and the operating team. We analyzed the hospital record data of these patients and the surgical teams COVID 19 status to assesss the efficacy of our procedural modifications. Discussion: - The COVID 19 pandemic has thrown the entire medical fraternity into a dilemma as to how to provide the best possible care to the patients while protecting ourselves from its grip. Severely sick COVID patients often require tracheostomy for improved prognosis. We performed bedside open surgical tracheostomy and induced transient apnoea periprocedur along with carinal intubation. By making these simple and cost effective modifications to the procedure, we have ensured that patients get tracheostomised as and when required but not at the cost of the health and lives of our health care workers.

3.
Indian J Otolaryngol Head Neck Surg ; 74(1): 53-57, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1616248

ABSTRACT

Background This study outlines the unique modifications to surgical tracheostomy procedure to combat the extraordinary situation the world has found itself in due to COVID 19 pandemic. We explain the modifications employed to the operative setup, anesthetic considerations and surgical procedure to enable us to provide timely and safe tracheostomy to the COVID ICU patients requiring it, while simultaneously maximally protecting our surgical personnel from the deadly exposure. Methods- We conducted 55 surgical tracheostomies in severely sick ICU patients with the modifications deemed fit to achieve safe procedure for both the patient and the operating team. We analyzed the hospital record data of these patients and the surgical teams COVID 19 status to assesss the efficacy of our procedural modifications. Discussion- The COVID 19 pandemic has thrown the entire medical fraternity into a dilemma as to how to provide the best possible care to the patients while protecting ourselves from its grip. Severely sick COVID patients often require tracheostomy for improved prognosis. We performed bedside open surgical tracheostomy and induced transient apnoea periprocedur along with carinal intubation. By making these simple and cost effective modifications to the procedure, we have ensured that patients get tracheostomised as and when required but not at the cost of the health and lives of our health care workers.

4.
Indian J Otolaryngol Head Neck Surg ; : 1-4, 2020 Oct 23.
Article in English | MEDLINE | ID: covidwho-891925

ABSTRACT

In current scenario of Covid-19 pandemic spread of virus via aerosol generating procedures has become a special concern in otorhinolaryngology community. Motive of this study is to spread awareness of an ancient forgotten method of performing mastoidectomy through which risk of virus infection can be greatly reduced among otologic surgeons. Retrospective Observational study. Three patients of chronic otitis media with complication were operatively intervened with combined approach of otorhinolaryngology and neurosurgeons. Mastoidectomies were performed without drilling. Instruments used were small, medium and large size gouge, chisel and hammer, curettes, kerrison punches and other microscopic ear instruments. All three patients recovered well without any residual disease or cavity problems. Referring ancient practices like above in this COVID era may prove an important tool in addressing surgical urgencies while combating transmission risks at the same time. One should be vigilant and versatile in surgical techniques in order to serve the needy and save the saviours simultaneously.

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