COVID-19 associated rhino-orbital-cerebral mucormycosis: An observational study from Eastern India, with special emphasis on neurological spectrum.

AIMS: 1: Describe the epidemiology and determine risk factors for COVID-19 associated mucormycosis. 2: Elaborate the clinical spectrum of Rhino-Orbital-Cerebral Mucormycosis (ROCM), pattern of neuroaxis involvement and it's radiological correlates. METHODS: Observational study. Consecutive, confirmed cases of mucormycosis (N = 55) were included. A case of mucormycosis was defined as one who had clinical and radiological features consistent with mucormycosis along with demonstration of the fungus in tissue via KOH mount/culture/histopathological examination (HPE). Data pertaining to epidemiology, risk factors, clinico-radiological features were analysed using percentage of total cases. RESULTS: Middle aged, diabetic males with recent COVID-19 infection were most affected. New onset upper jaw toothache was a striking observation in several cases. Among neurological manifestations headache, proptosis, vision loss, extraocular movement restriction; cavernous sinus, meningeal and parenchymal involvement were common. Stroke in ROCM followed a definitive pattern with watershed infarction. CONCLUSIONS: New onset upper jaw toothache and loosening of teeth should prompt an immediate search for mucormycosis in backdrop of diabetic patients with recent COVID-19 disease, aiding earlier diagnosis and treatment initiation. Neuroaxis involvement was characterized by a multitude of features pertaining to involvement of optic nerve, extraocular muscles, meninges, brain parenchyma and internal carotid artery.

A Radiological Evaluation of Bone Healing in Postextraction Sockets Following Bone Grafting Using Beta-Tricalcium Phosphate and Calcium Phosphosilicate: A Controlled Comparative Study.

BACKGROUND: Healing unbinds a well choreographed array of cellular, physiologic, biochemical, and molecular processes directed toward restoring the integrity and functional capacity of the damaged structures. The rate and degree of healing vary among individuals but is greatest during the first few months or years after tooth loss. Evidence suggests that alveolar bone ridge resorption may be prevented, initially by reconstructive surgical techniques using several materials which are employed at the time of extraction. This droves to the development of bone substitutes materials such as hydroxyapatite, beta tricalcium phosphate (ß TCP), and bioactive glasses. These regenerative materials not only act as an osteoconductive scaffold but also interact with the surrounding tissues and impart an osseostimulatory effect. METHODS: Twenty adult patients who required bilateral removal of homologous tooth, were informed and described regarding post extraction socket grafting using ß TCP and CPS followed by covering with Collagen Membrane. Radiographic densitometry evaluation of postoperative visits of immediate; 1st month; 3rd month; and 6th month using orthopantomograph was done. RESULTS: The Karl Pearson's Correlation coefficient was used to determine the degree of bone density with adjacent bone preoperatively and postoperatively. The statistical evaluation, CPS was more superior to ß TCP, with a difference of 58.75 and P value showed more significance (<0.0001). CONCLUSION: This article evaluates radiographically quality and quantity of bone formation in the socket, following extraction and bone grafting using Calcium Phosphosilicate (CPS) and ß TCP, it is concluded that the two modalities of treatment were efficient in improving the clinical outcome parameters as well as showed comparable regenerative effects when used in the treatment of "socket grafting" while between them CPS more superior to ß TCP biomaterials by Osteogenic properties.

Labial hydatid cyst - A rare entity.

Hydatid cyst is a parasitic infestation by tapeworm Echinococcus. This endemic disease is prevalent in the Middle East and Southeast Asian populations. This zoonotic disease is mainly transmitted by cattle and dogs. Few studies have been reported in the head-and-neck region. There are very few isolated cases have been reported within the oral cavity region. No case until now has been isolated from the labial mucosa. We now present one such case here.