COVID-19-Associated Rhino-Orbital Mucormycosis in a Tertiary Health Care Center in Odisha, India.

Background Mucormycosis is an opportunistic infection that mainly affects immunocompromised individuals, including those with uncontrolled diabetes, malignancies, or those who have exposure to high-dose corticosteroids for a long time. Western Odisha, India, witnessed a significant rise in post-COVID-19 rhino-orbital mucormycosis (ROM), which created a need for comprehensive research on post-COVID-19 ROM. Objective This study aimed to investigate the prevalence, clinical characteristics, and outcomes of post-COVID-19 ROM in a tertiary care hospital in Western Odisha, India, with the objective of understanding ROM as a nationally notifiable disease. Subjects and methods A prospective hospital-based study was conducted. Mucormycosis cases were reported within the period, from May 17, 2021, to July 31, 2021, including all post-COVID-19 patients who exhibited clinical manifestations of mucormycosis. Patients with histopathologically negative reports of mucormycosis were excluded. Results Of the 35 included, 25 were diagnosed with ROM. The age group of 46-50 years showed a predominance (n=6), with a mean age of 50.53 years. The male-to-female ratio was 2:1. Specifically, 88% of the patients included had diabetes mellitus, 8% had chronic kidney diseases, 8% had sepsis, and 4% had hypertension. ROM was the predominant manifestation (60%, n=15), with the majority presenting with orbital cellulitis (80%), followed by unilateral orbital apex syndrome (12%), bilateral orbital apex syndrome (4%), ophthalmic vein involvement (4%), and osteomyelitis of the maxillary sinus (4%). Irrigation of the wound was performed, and all 25 ROM patients received IV liposomal amphotericin B (L-AMB). Conclusion Post-COVID-19 status with elevated blood sugar levels was a major risk factor for ROM. Early diagnosis, debridement, L-AMB, retrobulbar AMB deoxycholate, and exenteration are the possible solutions.

[3D modeling for planning of minimally invasive approach to the orbit]. / Ispol'zovanie 3D-modelirovaniya dlya planirovaniya minimal'no invazivnogo dostupa k oblasti orbity. Sluchai iz praktiki i obzor literatury.

OBJECTIVE: To demonstrate own experience in 3D modeling for planning of minimally invasive approach to the orbit and anterior skull base. MATERIAL AND METHODS: A 17-year-old patient admitted to the Department of Pediatric Neurosurgery with complaints of decreased visual acuity of the left eye, lacrimation and exophthalmos. MRI revealed a tumor of the left orbit. We have preoperatively modeled frontoorbital region, anterior skull, as well as eyeball and tumor within the same model. Considering young age and potentially favorable prognosis of disease, we preferred a minimally invasive intervention (microsurgical resection of tumor through minimally invasive frontoorbital access). RESULTS: Total resection of tumor was followed by examination of anterior skull base. There was postoperative regression of visual disturbances, lacrimation and exophthalmos. Sutures were removed after 5 days, and the patient was discharged. CONCLUSION: Minimally invasive frontoorbital access is adequate for approach to the orbit, anterior and middle cranial fossa, adequate resection of orbital tumor and examination of anterior skull base. 3D modeling is an additional preoperative tool to improve the quality of preoperative planning and facilitate intraoperative navigation.

[Skull defect repair in children using a 3D-printing technology]. / Kranioplastika defektov cherepa u detei s ispol'zovaniem tekhnologii 3D-pechati.

Currently, 3D-printing technologies are increasingly used in neurosurgery. Active development of this approach is valuable to improve preoperative planning, intraoperative navigation, and manufacturing of realistic training models. In this manuscript, the authors report an experience of the pediatric neurosurgical department of the Almazov National Medical Research Center regarding 3D-printing technologies in manufacturing of individual implants for skull defect closure. The main aspects of this technology, advantages and disadvantages are considered. Moreover, the authors describe several cases of creating individual implants for children with skull defects of various origins, dimensions and complexity.

COVID-19 Lab: A Whistlestop Journey at a Tertiary Health Care Center.

Purpose Right now, our world is in the grip of the COVID-19 pandemic. The global spread of COVID-19 (SARS-CoV-2) has dramatically increased the number of suspected cases with an expanding geographical area. The rapid identification of asymptomatic and mildly symptomatic contacts is the priority for clinical management and outbreak control. Suspected cases should be screened for the virus with a nucleic acid amplification test (NAAT) such as real-time reverse transcriptase-polymerase chain reaction (RT-PCR) under the guidance of laboratory experts. Materials and methods This manuscript details the process of the establishment of a COVID-19 lab, which is a medical college virology lab (Viral Research Diagnostic Lab), in less than a months' time. Detailed data of the tests were studied over the initial one month and reported. Results Within one and a half months of the start of the lab, 3196 tests were conducted, which caters to five adjoining districts in Western Odisha. These included both symptomatic and asymptomatic cases (contacts with a travel history from affected areas), and six COVID-19 positive cases were detected. Conclusion Though the establishment of a COVID-19 lab in a short time is a challenge, it can be achieved through determination, teamwork, and support from the authorities.