Analysis of COVID-19-associated rhino-orbital-cerebral mucormycosis patients in a tertiary care center in Northern India

Purpose:An unprecedented surge has been noted in rhino-orbital-Cerebral mucormycosis (ROCM) in times of current COVID-19 pandemic. The present prospective study aims to evaluate clinico-epidemiological profile, risk factors, management, and outcome of the cases of ROCM that presented to our tertiary care center during the study period from April to June 2021.Methods:All patients were subjected to complete history taking, ophthalmological examination, and imaging studies. The patients were staged and were treated with intravenous liposomal amphotericin B (AMB) and sino-nasal debridement of local necrotic tissue. Transcutaneous retrobulbar AMB (TRAMB), orbital decompression, and exenteration were instituted as indicated. All patients were followed up for a minimum of 6 months before arriving at the final outcome. Statistical analysis was performed.Results:A total of 49 patients presented during the study period, with a mean age of 42.2 years. The major risk factors included uncontrolled diabetes (89.8%), COVID-19 positivity (51.02%), and concurrent steroid use (38.77%). The most common presenting symptom was facial pain/swelling (43.65%), while the most common presenting sign was deterioration in vision (75.51%). Intravenous liposomal AMB was given to all patients along with sino-nasal debridement (85.71%), TRAMB (57.14%), orbital decompression (14.28%), and exenteration (12.24%). Overall, mortality at 6 months was 22.45% (11 patients). Age more than 60 years, intracranial extension, and HbA1c of more than 8.0% were observed to be statistically significant indicators of mortality.Conclusion:Early suspicion and timely diagnosis of mucormycosis at rhino-orbital stage is warranted in order to salvage life as well as visual function. TRAMB may prove as potentially favorable treatment modality in cases with limited orbital involvement.     

Phosphorus Solubilization and Plant Growth Promotion Ability of Rhizobacteria of <Emphasis Type="Italic">R. communis</Emphasis> L Growing in Assam,India

Castor (Ricinus communis L) is the primary host plant of eri silkworm and its rhizosphere harbours diverse group of microbial community with biofertilizer potentiality. Phosphate solubilizing bacteria (PSB) render available phosphate (P) in agricultural soil by P mineralization process through enzyme mediated reaction. In search for PSB strains, 15 castor rhizobacteria were isolated and characterized for morphological and biochemical properties. The isolates were screened in vitro for P solubilization efficiency both qualitatively and quantitatively. Isolate MAJ PSB12 produced highest soluble P concentration (322.20 µmol/l) in National Botanical Research Institute Phosphate medium after 96 h of incubation with a maximum drop in pH to 5.4 from 7.0. Among the isolates, maximum content of IAA (24.6 mg/l) and GA₃ (3.921 mg/l) was also found to be produced by the same strain. The most potential isolate was identified as Bacillus firmus MAJ PSB12 by 16S rRNA gene homology analysis and the sequence was submitted to National Centre for Biotechnology Information GenBank. Although many species belonging to the genus Bacillus are efficient P solubilizer, application of native rhizobacteria is easier for adaptation and succession during biofertilization process. B. firmus MAJ PSB12 can be utilized as potential biofertilizer to promote sustainable castor cultivation in sericulture for upliftment of rural livelihood.     

Screening of Nutritionally Important Gut Bacteria from the Lepidopteran Insects Through Qualitative Enzyme Assays

Proceedings of the National Academy of Sciences, India Section B: Biological Sciences - Lepidopteran insects are the most dominant and diversified group among phytophagous pests and economically...     

Cavernous sinus haemangioma: systematic review and pooled analysis relating to a rare skull base pathology

Neurosurgical Review - Cavernous sinus haemangiomas (CSHs) are rare malformations of the microcirculation arising from the cavernous sinus. A systematic review and pooled data analysis of the...     

Cerebellar involvement in legionellosis

The involvement of the cerebellum in Legionnaires' disease has been noted in occasional case reports, but there have been no reviews on this subject to date. We report a previously healthy patient who contracted Legionella pneumonia and developed profound cerebellar dysfunction during his illness. He was treated with antibiotics with improvement of his pneumonia, but his cerebellar symptoms persisted. We review 29 case reports of cerebellar dysfunction in Legionnaires' disease and summarize the clinical course, cultures, cerebrospinal fluid analyses, and neuroimaging. Finally, possible methods of pathogenicity are discussed including data regarding direct bacterial invasion, toxin production, and immune-mediated mechanisms.     

Multi-objective blood glucose control for type 1 diabetes

For people with type 1 diabetes, automatic controllers aim to maintain the blood glucose concentration within the desired range of 60–120 mg/dL by infusing the appropriate amount of insulin in the presence of meal and exercise disturbances. Blood glucose concentration outside the desired range can be harmful to an individual’s health but concentration below 60 mg/dL, a state known as hypoglycemia, is considered to be more harmful than the concentration above 120 mg/dL, a state known as hyperglycemia. In this paper, two techniques to address this issue within a multi-parametric model based control framework are presented. The first technique introduces asymmetry into the objective function to penalize the deviation towards hypoglycemia more than the deviation towards hyperglycemia. The second technique is based upon placing higher priority on satisfaction of constraints on hypoglycemia than on satisfaction of constraints on hyperglycemia. The performance of both the control techniques is analyzed and compared in the presence of disturbances.