Mucormycosis in COVID-19 patients

Mucormycosis, commonly known as ‘Black Fungus’ which was then a rare fungal infection, has suddenly come to light post the COVID-19- pandemic, more so during the second wave in India. It thus becomes important not only for the medical fraternity but also the general population to build awareness about the same. The present review will focus on the pathophysiology, etiology, outcomes of some case studies, and current treatment methods of mucormycosis infection. Major focus of the current article is on rhino-orbital-cerebral mucormycosis. All the studies included in the present review article was extracted from the PubMed database.     

Evaluation of retinal nerve fiber layer,ganglion cell layer,and optic nerve head morphological parameters in patients with obstructive sleep apnea and comparison with normal population

Purpose:To compare the retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), and optic nerve head (ONH) morphological parameters between obstructive sleep apnea (OSA) patients and age-matched controls using spectral domain optical coherence tomography (SD-OCT).Methods:This case control study was conducted in a multi-specialty tertiary care hospital from 2014 to 2016. Patients diagnosed to have OSA by overnight polysomnography were included in the study. Fifty eyes of 25 OSA patients with clinically normal optic disc were compared with 50 eyes of age-matched controls. The study population underwent detailed ophthalmological evaluation including SD-OCT.Results:There was significant thinning of the superior, inferior, and average RNFL in the OSA group when compared to controls. GCL analysis also showed a significant thinning of the six sectors as well as average and minimum ganglion cell layer + inner plexiform layer in OSA patients. The optic nerve head rim area was significantly decreased in OSA patients when compared to controls.Conclusion:OSA patients even with clinically normal optic disc showed significant decrease in the RNFL thickness, GCL thickness, and rim area when compared to age-matched controls. Hence, these patients constitute a high-risk population who need to be regularly screened and followed up for ocular co-morbidities.     

Impact of diabetes status on immunogenicity of trivalent inactivated influenza vaccine in older adults

Individuals with type 2 diabetes mellitus experience high rates of influenza virus infection and complications. We compared the magnitude and duration of serologic response to trivalent influenza vaccine in adults aged 50–80 with and without type 2 diabetes mellitus. Serologic response to influenza vaccination was similar in both groups: greater fold‐increases in antibody titer occurred among participants with lower pre‐vaccination antibody titers. Waning of antibody titers was not influenced by diabetes status.     

Cancellation of elective oral and maxillofacial operations

Our aim was to assess whether the Commission for Health Improvement Performance Indicator value of 0.5% of cancellations on the day of operation or less had been achieved. We reviewed 912 consecutive elective operations, both day case and inpatient over an 8-month period (January–August 2003). A total of 117 procedures (13%) were cancelled for non-clinical or logistical reasons, of which 39 (4%) were cancelled on the day of the operation. Only 3 of the 39 patients who wanted a new admission date within 28 days of cancellation could not be accommodated. The performance indicator value of 0.3% was below the target threshold. An additional 60 (7%) patients had their admissions cancelled the day before operation and 18 (2%) had their operations deferred for a day before they were cancelled. However, these patients have been specifically excluded from the performance indictor.     

Imaging features of low-grade central osteosarcoma of the long bones and pelvis

Purpose To determine the age and gender distribution and imaging features of low-grade central osteosarcoma (LGCOS) of the long bones and pelvis and to discuss our findings in the context of lesions for which LGCOS has been mistaken.Materials and methods We reviewed 99 cases of LGCOS collected between 1919 and 2002 from our institution and pathology consultation files. Adequate imaging was available in 70 cases (36 radiographs only, 17 radiographs/CT, 12 radiographs/MRI, 2 radiographs/CT/MRI, 2 CT only, 1 MRI only, 5 bone scans).Results Patient average age was 30.1±14.2 years, with a slight female predominance. The femur and tibia were the most common long bones involved (29 and 20 each) with the majority of these tumors arising around the knee, followed by the fibula, radius, humerus and ulna (four, three, two and one case each). Flat bones were involved in six cases (three pelvis, one rib, two scapulae). Short tubular bones were involved in five cases (two metatarsal, two phalanges, one clavicle). The lesion extended to the end of the affected long bone in 22 of 59 cases. Lesions were large at presentation (mean 7.9±4.6 cm, range 2–24). Four radiographic patterns were identified: lytic with varying amounts of thick and coarse trabeculation (n=22), predominantly lytic with few thin, incomplete trabecula (n=21), densely sclerotic (n=17) and mixed lytic and sclerotic (n=10). Lesions were benign-appearing overall with focally aggressive features. CT or MRI demonstrated cortical breech or extension into the soft tissues in all cases.Conclusions LGCOS has a variable appearance on radiographs. A frequent pattern is a slow-growing large intracompartmental fibro-osseous lesion with varying amounts of septal ossification associated with focal areas of aggression. A homogeneously sclerotic pattern was also noted. Imaging with CT or MRI was helpful in every instance in our series in identifying areas of soft tissue extension or cortical disruption suggestive of a low-grade malignancy.     

Abdominal wall abscess due to spilled gallstone presenting 11 years after laparoscopic cholecystectomy

Gallstone spillage during laparoscopic cholecystectomy may be a source of significant morbidity. In this report, we describe the clinical course of a patient who presented with a tender right subcostal swelling. She had had a laparoscopic cholecystectomy 11 years earlier. Imaging revealed a dumbbell-shaped abscess in the perihepatic area with communication into the subcutaneous tissue with a stone inside the cavity. The patient underwent abscess drainage and the stone was retrieved. During laparoscopic cholecystectomy, every effort should be made to remove spilled gallstones to prevent further complications but conversion is not mandatory.     

Tribological properties of Ti-based alloys in a simulated bone–implant interface with Ringer’s solution at fretting contacts

The wear properties of oxidized and non-oxidized gamma-TiAl (a potential biomaterial) as well as Ti–6Al–4V and CP-Ti disks were studied and characterized by means of standard wear tests using a custom made bone pin arrangement. The Ti-based disks were oxidized in air at 500 and 800 °C for one hour. The tribological properties of the oxides formed over the disks were studied using a linear reciprocating wear testing machine under both dry and simulated biological conditions using Ringer’s solution. Loss of metal oxide and coefficient of friction values were determined from wear testing. From the results, abrasion and adhesion were the primary wear mechanisms in each of the three alloy–bone pairs. Specifically, the oxide formed on gamma-TiAl possessed the highest COF and wear resistance of the three materials which were studied. Also, as expected, bone wears down faster than the Ti-based metal oxide.     

Fast human brain magnetic resonance responses associated with epileptiform spikes

Neuronal currents produce local electromagnetic fields that can potentially modulate the phase of the magnetic resonance signal and thus provide a contrast mechanism tightly linked to neuronal activity. Previous work has demonstrated the feasibility of direct MRI of neuronal activity in phantoms and cell culture, but in vivo efforts have yielded inconclusive, conflicting results. The likelihood of detecting and validating such signals can be increased with (i) fast gradient‐echo echo‐planar imaging, with acquisition rates sufficient to resolve neuronal activity, (ii) subjects with epilepsy, who frequently experience stereotypical electromagnetic discharges between seizures, expressed as brief, localized, high‐amplitude spikes (interictal discharges), and (iii) concurrent electroencephalography. This work demonstrates that both MR magnitude and phase show large‐amplitude changes concurrent with electroencephalography spikes. We found a temporal derivative relationship between MR phase and scalp electroencephalography, suggesting that the MR phase changes may be tightly linked to local cerebral activity. We refer to this manner of MR acquisition, designed explicitly to track the electroencephalography, as encephalographic MRI (eMRI). Potential extension of this technique into a general purpose functional neuroimaging tool requires further study of the MR signal changes accompanying lower amplitude neuronal activity than those discussed here. Magn Reson Med, 2010. © 2010 Wiley‐Liss, Inc.