Survival benefit of exenteration in COVID-19-associated rhino-orbital mucormycosis.

PURPOSE: There has been a sudden increase in the number of rhino-orbital mucormycosis cases, primarily affecting patients recovering from COVID-19 infection. The local health authorities have declared the current situation an epidemic. In this study, we assess the role of exenteration in preventing disease progression and improving survival in patients with rhino-orbital mucormycosis. METHODS: The patients undergoing exenteration were grouped into the exenteration arm and those denying exenteration were grouped into the nonexenteration arm. The patients were followed at 1 month and 3 months. The 6-month survival data were collected telephonically. Continuous data were presented as Mean ± SD/Median (IQR) depending on the normality distribution of data, whereas the frequency with percentages was used to present the categorical variables. Kaplan-Meier survival curves were created to estimate the difference in survival of patients with exenteration in rhino-orbital mucormycosis versus those without exenteration. RESULTS: A total of 14 patients were recruited for our study based on the inclusion and exclusion criteria. All the patients were qualified for exenteration; however, only eight patients underwent exenteration and six patients did not consent to exenteration. At the end of 3 months in the exenteration group, four (50%) patients died. Two patients died within a week of exenteration, whereas two patients died after 2 weeks of exenteration. The deaths in the first week were attributed to septic shock and the deaths happening beyond 2 weeks were attributed to severe meningitis. The Kaplan-Meier survival analysis showed the cumulative probability of being alive at 1 month in the exenteration arm to be 85%, and it decreased to 67% by 53 days and subsequently remained stable until the end of 3 months. CONCLUSION: The Kaplan-Meier survival analysis did not show a survival benefit of exenteration at 3 months and 6 months in COVID-associated rhino-orbital mucormycosis.

Quality of life in patients treated for COVID-19–associated mucormycosis at a tertiary care hospital

Objectives@#Coronavirus disease 2019 (COVID-19)–associated mucormycosis (CAM) has emerged as a formidable infection in patients with COVID-19. The aggressive management ofCAM affects quality of life (QOL); thus, this study was designed to assess the QOL in patients with CAM at a tertiary healthcare institution. @*Methods@#This cross-sectional study of 57 patients with CAM was conducted over 6 monthsusing a semi-structured standard questionnaire (the abbreviated World Health Organization Quality of Life questionnaire [WHO-BREF]) and a self-rated improvement (SRI) scale ranging from 0 to 9. Cut-off values of ≤52 and < 7 were considered to indicate poor QOL and poor improvement, respectively. The correlations of QOL and SRI scores were evaluated using Spearman rho values. @*Results@#In total, 27 patients (47.4%; 95% confidence interval [CI], 34.9%–60.1%) and 26 patients (45.6%; 95% CI, 33.4%–58.4%) had poor QOL and poor SRI scores, respectively. The overall median (interquartile range) QOL score was 52 (41–63). Headache (adjusted B, −12.3), localized facial puffiness (adjusted B , −16.4), facial discoloration (adjusted B, −23.4), loosening of teeth (adjusted B, −18.7), and facial palsy (adjusted B, −38.5) wer e significantly associated with the QOL score in patients with CAM. @*Conclusion@#Approximately 1 in 2 patients with CAM had poor QOL and poor improvement.Various CAM symptoms were associated with QOL in these patients. Early recognition is the key to optimal treatment, improved outcomes, and improved QOL in patients with CAM.

An evaluation of music perception, appreciation, and overall music enjoyment in prelingual paediatric cochlear implant users utilizing simplified techniques: An Indian study.

INTRODUCTION: This study was aimed to evaluate the speech abilities, music habits, ability to perceive and enjoy music in prelingual paediatric cochlear implantees between the age group (18-84 months). Testing paediatric CI recipients for their music habits is challenging. This study offers some unique yet simplified tools to test musical parameters in paediatric CI recipients. MATERIAL METHODS: Twenty-seven paediatric CI recipients who had received at least one year of auditory verbal therapy post-implantation were selected. They were tested for their speech abilities using the CAP (Category of Auditory Performance) and SIR (Speech Intelligibility Ratings) score. Music habits (Musicality Rating Scale/MRS), music perception (Pitch, timbre, melody) and music enjoyment (Subjective Assessment of Music Enjoyment/SAME) were assessed using various tools. All these parameters were compared with age and sex-matched controls who had normal hearing. RESULTS: Simple pitch discrimination, timbre recognition, and melody identification was observed in 29.60%, 37.03%, and 37.03% of implantees, respectively, compared to 88.88%, 81.48% and 88.88%, in normal-hearing children. The mean scores of CAP, SIR and MRS in cochlear implant users who perceived pitch timbre and melody differed significantly from those who did not. The mean SAME score of the normal-hearing group [4.37 ± 0.74] differs significantly from the paediatric cochlear implant user group [2.59 ± 1.47]. (p < .000). CONCLUSION: This study offers some novel, simplified tools to assess music habits in paediatric cochlear implantees. These can be utilized in low resource settings and can be helpful for rehabilitationists training these children.