Epidemiology, Clinical Features and Management of Rhino Orbital Mucormycosis in Post COVID 19 Patients.

COVID 19 infections may be associated with a wide range of bacterial and fungal co-infections. Mucormycosis is a fungal infection primarily affecting immunocompromised individuals. We have observed sudden rise of mucormycosis cases in post COVID 19 patients. Here we have reported 100 cases of mucormycosis associated with COVID 19. To study epidemiology and clinical features of rhino orbital mucormycosis in post COVID 19 patients. To evaluate efficacy of medical as well as surgical treatment in such patients. This was an observational mixed (retrospective + prospective) study with a duration of 2 months. After noting demographic data, necessary radiological investigation was advised and representative tissue was sent for KOH and histopathological examination. Medical and surgical treatment was planned accordingly. Most patients (55%) presented with complaint of headache and facial pain. Hard palate involvement was observed in 45% patients. Unilateral presentation (68%) was more common. Only 25% patients who presented early had normal vision. We reported 22 patients with complete loss of vision. Eye movements were restricted in 58% patients. Diabetes mellitus is most common predisposing factor (65%). 9 patients required orbital exentration. Only 18% patients required Amphotericin for more than 14 days. Immune dysregulation caused by COVID 19 infection in addition to widespread use of steroids and broad-spectrum antibiotics may lead to the development mucormycosis. Diabetes Mellitus type II is another important risk factor and the presence of both have additional effect in causing mucormycosis. Headache and facial pain should be considered highly suspicious of mucormycosis. Early diagnosis with efficient treatment can improve prognosis.

A Clinical Study of ENT Manifestations in Cases of Head Injury Patients Coming to Tertiary Care Centre of South Gujarat.

Head injury is the leading cause of morbidity, mortality and disability in India. Many such cases present with ENT injuries. ENT manifestations are often associated with varying degree of physical and functional damage. The aim of the study is to determine proportion of ear, nose and throat manifestations in head injury patients and its impact on Quality of Life (QOL). This is an observational prospective study of 98 patients with head injury. Most commonly involved site of injury is nose (38.8%). In ear most commonly affected site is external ear (16.3%). Facial palsy is observed in 5.1% patients. The most common type of injury is abrasion (29.6%). The most commonly fractured facial bone is maxilla (13.3%). At 1 month post injury, 6.5% patients feel their routine activity is limited while 54.4% patients feel depressed. 41.3% patients feel their external appearance has changed and 6.5% patients reported limitations in doing heavy activity. After 3 months limitation in routine activity, feeling of depression and feeling of change in external appearance of face has improved in most patients. Limitation of doing heavy activity has persisted even after 3 months in 6.5% cases. Young male adults are most commonly involved in head injury with nose being the most common site involved and maxilla is the most common bone fractured in ENT manifestations. QOL is affected in almost 50% cases as reported at the end of 1 month which improve in many by 3rd month.

Critical factors affecting cell encapsulation in superporous hydrogels.

We recently showed that superporous hydrogel (SPH) scaffolds promote long-term stem cell viability and cell driven mineralization when cells were seeded within the pores of pre-fabricated SPH scaffolds. The possibility of cell encapsulation within the SPH matrix during its fabrication was further explored in this study. The impact of each chemical component used in SPH fabrication and each step of the fabrication process on cell viability was systematically examined. Ammonium persulfate, an initiator, and sodium bicarbonate, the gas-generating compound, were the two components having significant toxicity toward encapsulated cells at the concentrations necessary for SPH fabrication. Cell survival rates were 55.7% ± 19.3% and 88.8% ± 9.4% after 10 min exposure to ammonium persulfate and sodium bicarbonate solutions, respectively. In addition, solution pH change via the addition of sodium bicarbonate had significant toxicity toward encapsulated cells with cell survival of only 50.3% ± 2.5%. Despite toxicity of chemical components and the SPH fabrication method, cells still exhibited significant overall survival rates within SPHs of 81.2% ± 6.8% and 67.0% ± 0.9%, respectively, 48 and 72 h after encapsulation. This method of cell encapsulation holds promise for use in vitro and in vivo as a scaffold material for both hydrogel matrix encapsulation and cell seeding within the pores.

Micellar nanomedicine of human neuropeptide Y.

Human neuropeptide Y (NPY) is an important biologics that regulates a multitude of physiological functions and could be amenable to therapeutic manipulations in certain disease states. However, rapid (within minutes) enzymatic degradation and inactivation of NPY precludes its development as a drug. Accordingly, we determined whether self-association of NPY with biocompatible and biodegradable sterically stabilized phospholipid micelles (SSM) improves its stability and bioactivity. We found that in saline NPY spontaneously aggregates; however, in the presence of SSM it self-associates with the micelles as monomers. Three NPY molecules self-associate with 1 SSM at saturation. This process stabilizes the peptide in α-helix conformation, abrogates its degradation by dipeptidyl peptidase-4 and potentiates NPY-induced inhibition of cAMP elaboration in SK-N-MC cells. Collectively, these data indicate that self-association of NPY with SSM stabilizes and protects the peptide in active monomeric conformation, thereby amplifying its bioactivity in vitro. We propose further development of NPY in SSM as a novel, long-acting nanomedicine. FROM THE CLINICAL EDITOR: Human neuropeptide Y (NPY) regulates a multitude of physiological functions and could be amenable to therapeutic manipulations, which is currently limited by its short half life. Self-association of NPY with spherically stabilized micelles (SSM) protects and stabilizes the peptide in active monomeric conformation, thereby amplifying its bioactivity in vitro, enabling future therapeutic considerations.