Decreased mortality in coronavirus disease 2019 associated mucormycosis with aspirin use: a retrospective cohort study.

OBJECTIVE: Rhino-orbito-cerebral mucormycosis is a rapidly progressive disease with high mortality rates of about 60 per cent. The increasing incidence of rhino-orbito-cerebral mucormycosis in coronavirus disease 2019 patients in India and worldwide has become a matter of concern owing to the case fatality rate. This study explored the use of low dose aspirin in decreasing the mortality rate of coronavirus disease 2019 associated mucormycosis. METHOD: This was a retrospective observational study. Patients suffering from post-coronavirus disease 2019 mucormycosis were included in the study. Each patient was treated with surgical debridement and systemic amphotericin B. Low dose aspirin was added, and mortality rates were compared with the patients who did not receive aspirin. RESULTS: The demographic data and rhino-orbito-cerebral mucormycosis staging between the two groups were not significantly different. There was a statistically significant difference in mortality outcomes between the two groups (p = 0.029) and a 1.77 times higher risk of dying for patients not receiving aspirin. Kaplan-Meier survival indicated that patients receiving aspirin had better survival rates (p = 0.04). CONCLUSION: Low dose aspirin improves survival rates in coronavirus disease 2019 associated mucormycosis.

Teddy bear simulation to teach clinical skills during COVID-19 lockdown

Introduction: The pandemic has been specially challenging for developing countries where simulated teaching and training is not a norm. Teaching practical skills was a daunting task with no patients to examine due to lockdowns and the risk of transmission of infection. Students, however, need to be trained in clinical skills required as part of their health care training in different subjects. An ear, nose, and throat department planned to train undergraduate students in clinical skills on a hybrid simulator using inexpensive and readily available materials. Method: During the COVID-19 pandemic lockdown, a 1-month observational study was conducted. The medical education of seventh-semester students was examined. Students taught clinical skills with a teddy bear, glass, and balloon. Feedback and scores were given to students for work in stations during a professional examination. Results: The difficulty index of otoscopy was 23/84 (0.27), and the difficulty index of tuning fork was 2/84 (0.02). The high score index/performance index for the tuning fork test was 79/84 (94%), and the high score index for otoscopy was 37/84 (44%). In total, 28 of 84 students (33.33%) provided feedback on the training, and 18 of 28 (64.3%) students liked the innovative way of training. However, most students who answered in the affirmative stated that this was the best possible way of getting trained considering the pandemic situation. For tuning fork tests, 22 of 28 (78.6%) were confident that they would be able to transfer the skill learned on the hybrid simulator to a real-life scenario, 4 of 28 said they were not sure if they would be able to transfer the skill, and 2 of 28 students said they would not be able to. For otoscopy simulation, 11 of 28 (39.3%) were confident that they would be able to transfer the skill learned on the hybrid simulator to real-life scenarios;8 of 28 (28.6%) were not sure if they would be able to transfer the skill, while 9 of 28 (32.1%) students said they would not be able to. On a scale of 1 to 10, the average rating for the teddy bear simulation was 7.3 ± 1.7, and the average rating for the otoscopy simulation was 5.5 ± 2.4. Conclusion: Difficult times call for innovative measures. Using simple materials to create an accessible, inexpensive simulator for teaching clinical skills did help in training the students.