ABSTRACT
Objective: To describe clinicoradiological features and surgical outcomes in a series of nine patients with rhino-orbito-cerebral mucormycosis (ROCM) who presented with Pott's puffy tumor (ROCM-PPT). Methods: The records of nine patients with ROCM-PPT seen between March 2020 and December 2021 were analysed. Clinical features, radiology, histopathology, operative findings, management and outcome were noted. Frontal sinus pneumatisation and outflow tract configuration was compared between patients and controls with ROCM and no PPT. Results: ROCM-PPT was diagnosed in 9 of 284 (3.2 %) patients with ROCM seen during the study period. There were six (66.7 %) males and the median age was 54 (IQR 46-60) years. Eight (88.9 %) patients had diabetes mellitus and seven (77.8 %) had been COVID-19 positive. Radiological features of osteomyelitis, subperiosteal abscess formation and dural enhancement were seen in all patients. No significant differences in pneumatisation or frontal sinus outflow tract configuration were noted between patients and controls. All patients underwent a craniectomy with frontal bone debridement and frontal sinus exteriorisation. All patients were treated with anti-fungal agents for several months. All patients had symptomatic improvement at a median follow-up of 21 (IQR 18-23) months. Repeat CT/MRI scans showed disease regression/resolution in six out of eight (75 %) patients with follow-up imaging, and stable disease in two others. Conclusions: ROCM-PPT is a rare, delayed complication of mucormycosis that was seen in larger numbers during the recent COVID-19 pandemic. Aggressive debridement of osteomyelitic bone and antifungal therapy results in a good outcome.
ABSTRACT
AIM: The aim of the study was to compare the cariogenicity of human breast milk (HBM), bovine milk, and infant milk formulas. PATIENTS AND METHODS: Ninety children of 1-4 years were randomly selected according to the type of milk they consume and were divided into five groups: Group I - HBM, Group II - cow milk, Group III - buffalo milk, Group IV - Lactogen 2, and Group V - Dexolac 4. Three parameters were assessed (salivary pH, plaque pH, and Streptococcus mutans count). Baseline salivary pH was measured, plaque sample was collected from children before feeding, and then, children were fed with milk. The second sample was collected after 45 min of feeding and the third sample after 3 h of second sample collection. Collected plaque samples were assessed for plaque pH and were sent to microbiological laboratory and cultured on blood agar. The intergroup comparison was done by one-way analysis of variance (ANOVA) and Tukey test. Intragroup comparison was done by one-way anova and Bonferroni test. P < 0.05 was considered statistically significant. RESULTS: No statistically significant difference in intra- and intergroup comparisons of salivary pH was noted. However, with regard to plaque pH, there is a statistically significant difference in the second sample in Groups III, IV, and V. There was an increase in colony-forming units of S. mutans in plaque samples from baseline to the third sample in Groups IV and V. CONCLUSION: Lactogen 2 and Dexolac 4 showed greater cariogenic activity, buffalo milk is mildly cariogenic, whereas HBM and cow milk showed least cariogenicity.
