Journal of Evidence Based Medicine and Healthcare最新文献

{"title":"Spectrum of Imaging Findings in Rhino-Orbito-Cerebral Mucormycosis (ROCM) in Post COVID Patients - A Pictorial Review with Clinico-Radiological Correlation","authors":"Devarajan Ellezhutil, Sajeeth Kumar Govindan Keeriyatt, Sunil Kumar Kunhiparambath, John Jimmy Nalappat","doi":"10.18410/jebmh/2021/649","DOIUrl":"https://doi.org/10.18410/jebmh/2021/649","url":null,"abstract":"BACKGROUND Rhino-orbito-cerebral mucormycosis (ROCM) is a devastating fungal infection with very high rates of mortality. Many patients post corona virus disease (COVID) infection are increasingly being diagnosed with mucormycosis (black fungus). Imaging being central to the early diagnosis of the infection, the study aims to characterize the major radiological patterns of involvement of mucormycosis. Computed tomography (CT) & magnetic resonance imaging (MRI) findings of 10 patients who were subsequently conformed to have mucormycosis were analyzed and 7 major patterns of involvement were detected. Imaging plays a vital role in the early diagnosis of ROCM. Knowledge about the common patterns of spread helps in picking the subtle signs of infection. KEYWORDS Mucormycosis, Post COVID, Fungal Sinusitis, ROCM","PeriodicalId":15779,"journal":{"name":"Journal of Evidence Based Medicine and Healthcare","volume":"428 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86478684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comparative Study of Endoscopic Coblation Adenoidectomy and Regular Curettage Adenoidectomy in a Tertiary Care Hospital in Kerala","authors":"Abdul Salam R. T., Shahul Hameed A., Meera Rajan","doi":"10.18410/jebmh/2021/645","DOIUrl":"https://doi.org/10.18410/jebmh/2021/645","url":null,"abstract":"BACKGROUND An ideal surgery to remove hypertrophied adenoid mass should be safe, with less bleeding and operation time along with post-operative improvement in the eustachian tubal ventilation and normal respiration. It should also have low morbidity and mortality. Among the various methods described for its removal, the two commonly used methods are conventional cold curettage method and coblation technique. The purpose of this study was to collate the safety and efficacy of endoscopic coblation adenoidectomy with the conventional curettage adenoidectomy. METHODS A prospective comparative study with fifty patients was studied who underwent adenoidectomy. Twenty five patients underwent endoscopy assisted coblation adenoidectomy and twenty five patients underwent regular adenoidectomy by curettage. RESULTS Patients who underwent coblation adenoidectomy showed better results during follow up in terms of completeness of removal. 80 % of children undergoing regular adenoidectomy by curettage method showed remnant adenoid tissue in the nasopharynx at the end of the procedure. But it was 6 % among the children undergoing endoscopic assisted coblation adenoidectomy. The mean duration of operation was higher for endoscopic assisted coblation adenoidectomy which was significant statistically. The mean blood loss was 30.36 ml in regular curettage adenoidectomy; 10.6 ml with endoscopic coblation adenoidectomy. The grading of pain was significantly lower in endoscopic assisted coblation adenoidectomy. There was no significant difference between two groups in terms of eustachian tube function after surgery. CONCLUSIONS Coblation adenoidectomy has significant advantages over conventional adenoidectomy in terms of completeness of removal, reduced blood loss, and lower post-operative pain grade. KEYWORDS Coblation, Adenoidectomy, Curettage, Haemorrhage and Complications","PeriodicalId":15779,"journal":{"name":"Journal of Evidence Based Medicine and Healthcare","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75372521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comparative Evaluation of the Anaesthetic Properties of Bupivacaine Hydrochloride and Ketamine Hydrochloride with Dextrose Given Intrathecally for Inguinal Hernia Repair - A Randomized Controlled Study in a Tertiary Centre in South Kerala","authors":"R. Sebastian, Remani Kelan Kamalakshi, Jamsheena Muthira Parambath, Praseetha Vallomparambath Kuttiparambil","doi":"10.18410/jebmh/2021/638","DOIUrl":"https://doi.org/10.18410/jebmh/2021/638","url":null,"abstract":"The above article has been withdrawn on authors’ request. Original CitationSebastian R, Kamalakshi RK, Parambath JM, et al. A comparative evaluation of the anaesthetic properties of upivacaine hydrochloride and ketamine hydrochloride with dextrose given intrathecally for inguinal hernia repair – a randomized controlled study in a tertiary centre in south Kerala. J Evid Based Med Healthc 2021;8(31):2830- 2834. DOI:10.18410/jebmh/2021/518","PeriodicalId":15779,"journal":{"name":"Journal of Evidence Based Medicine and Healthcare","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79223927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Profile and Outcome in Patients with Snake Bite in a Tertiary Care Centre in Kerala","authors":"Satish K. S. Kumar, Sanghamithra Prabhakaran","doi":"10.18410/jebmh/2021/646","DOIUrl":"https://doi.org/10.18410/jebmh/2021/646","url":null,"abstract":"BACKGROUND The clinical profile and outcome of snake bite varies from place to place and depends on a number of factors including the type of snake bite, place of snake bite, time of bite, season, and duration of presentation after bite. The clinical profile, factors affecting the outcome and the outcome have not been previously well studied. METHODS This is a cross-sectional observational study conducted for a duration of six months from January 2021 to June 2021. Subjects meeting inclusion criteria were enrolled in the study group after obtaining written consent. Patients were evaluated based on the standard pro-forma with detailed history and clinical examination. All relevant investigations to assess systemic envenomation, treatment and outcome were documented in all the patients. RESULTS In the study, 204 (68 %) were male patients and 96 (32 %) were female patients. 108 (36 %) were admitted with venomous snake bite and 192 (64 %) were with non-poisonous snake bite. 52 patients had snake bite on the upper extremities, 234 had snake bite on the lower extremities, 8 patients had snake bite on the trunk whereas 6 patients had bite on other areas of the body. 202 patients had swelling at the bite site, 222 had pain at the site of bite, 86 patients had oozing of blood and 6 patients had vague somatic symptoms. 132 patients had local oedema, 148 had local tenderness, 66 patients had skin necrosis and 16 patients developed blisters at the site of bite. 124 patients had systemic manifestations of which 24 patients had vomiting, 12 patients developed abdominal pain, 10 patients developed anuria/oliguria, 14 patients developed hypotension, 12 patients developed bleeding manifestations, 10 patients developed neurological symptoms and 2 snakebite patients had syncope. Complications and mortality in poisonous snake bite due to renal failure was observed in 38 patients with a mortality of 1 patient, 10 patients developed intravascular haemolysis, 8 patients developed unexplained hypotension, 18 patients developed secondary infection, 4 patients developed intra-cerebral bleeding and 15 patients developed neurotoxity with a mortality of 2 patients. CONCLUSIONS Snake bite is a common problem encountered in tertiary care centres and the most common encountered type of snakebite was haemotoxic bite. Pain at the bite site was the commonest symptom and tenderness at bite site was the commonest sign in patients with snake bite. Mortality in venomous bite was 3.7%. Prolonged bite to needle time, development of renal failure, leukocytosis, neurotoxicity and severe degree of coagulopathy were factors associated with adverse outcome. KEYWORDS Clinical Profile, Outcome, Snake Bite, Tertiary Care Centre","PeriodicalId":15779,"journal":{"name":"Journal of Evidence Based Medicine and Healthcare","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74140688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Educational Interventions on Internship Training in Community Medicine in a Tertiary Care Centre in Alappuzha District of Kerala, South India; A Quasi-Experimental Study","authors":"J. Ramesh, R. Ramachandran","doi":"10.18410/jebmh/2021/634","DOIUrl":"https://doi.org/10.18410/jebmh/2021/634","url":null,"abstract":"BACKGROUND India has been facing various challenges in the past decade, which include outbreaks of different communicable diseases and the rising of slow pandemics of non-communicable diseases. The current COVID 19 pandemic brings to light the need to revamp the training in public health during the internship. A standardized and outcome-based approach to internship training is the need of the hour for the Indian medical graduate (IMG). The internship program in community medicine should train the Indian medical graduate to develop patient management and administrative skills to promote health care through a health facility. The training provided is not standardized or evaluated across the medical colleges. Hence, it was aimed to study the effectiveness of educational interventions on internship training during the posting at the rural training health centre (RTHC). METHODS A quasi-experimental study was conducted among the interns posted in the rural training health centre using a validated semi-structured questionnaire as a pretest followed by a post-test after two weeks of training on the primary health care system. The perception of the students towards the training was assessed using the Likert 5 point scale. RESULTS The pre-test score was 5.30 (SD 2.105) and the post-test mean score was 9.35 (SD 2.033) [P < 0.01]. The gender-based analysis also showed significance within genders. Student perception revealed 80 % found the training useful, 90 % agreed that the guidance provided by the field staff helped them and 90 % agreed that the intervention changed their outlook towards the internship training in community medicine. CONCLUSIONS The study has brought a positive outlook towards giving adequate guidance to acquire knowledge and skills to interns by the active involvement of faculty. Rethinking and re-implementation of the existing internship training in the community is the need of the hour. KEYWORDS Internship Training, Community Medicine, Medical Education, Kerala, GMR 2019","PeriodicalId":15779,"journal":{"name":"Journal of Evidence Based Medicine and Healthcare","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84878048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Prospective Clinical Study on Chronic Subdural Hematoma with Special Reference to Its Surgical Management at a Tertiary Care Hospital in North-East India","authors":"D. Kurmi, A. Yadav, Rocket Chandra Brahma","doi":"10.18410/jebmh/2021/632","DOIUrl":"https://doi.org/10.18410/jebmh/2021/632","url":null,"abstract":"BACKGROUND Chronic subdural hematoma (CSDH) is one of the commonest disease that affects elderly people. Presentation mimics many other diseases of elderly. Timely diagnosis and prompt surgical intervention is the key to favourable outcome. This study was done to obtain baseline data on its various modes of presentation and management in a tertiary care hospital in north east India. METHODS This prospective observational study was conducted at Assam Medical College and Hospital, Dibrugarh, Assam from June 2016 to end of May 2017. All radiologically confirmed patients with CSDH were included fulfilling the inclusion and exclusion criteria. All patients underwent surgical intervention as per indication. All patients were evaluated in regard of presenting clinical features, radiological findings, treatment received, peri-operative complications, outcome and other clinical variables during hospital stay and follow up. RESULTS A total of 52 patients were included in the study. Male and female ratio was 3: 1 and 73.08 % patients were aged more than 50 years. Headache was the most common symptom followed by altered sensorium, limb weakness, intermittent vomiting, convulsions and others. History of recent trauma was found in 67.31 % and chronic alcoholism in 28.85 % of patients. Most of the patient (63.46 %) had Glasgow coma scale (GCS) score 13 - 15. Pure CSDHs were found in 19.23 % and mixed density CSDHs in 80.77 % of patients. Burr hole was done in 48 patients (92.30 %) and craniotomy in 7 (13.46 %). Electrolyte imbalance was observed in 17.31 % of patients followed by seizures, pulmonary complications and others. Four patient had moderate disability at the time of discharge and at the end of one month all discharged patient had good recovery. CONCLUSIONS Chronic subdural hematoma is one the common benign disease of old age which requires high level of suspicion for diagnosis and early radiological investigation. Timely surgical intervention carries minimal risk of complications with good recovery for most of the patients. Burr hole is the preferred surgical procedure for CSDHs with craniotomy reserved for some selected cases. KEYWORDS Chronic Subdural Hematoma, Surgical Management, Burr Hole, Craniotomy","PeriodicalId":15779,"journal":{"name":"Journal of Evidence Based Medicine and Healthcare","volume":"78 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84658785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical, Demographic, and Aetiological Profile of Liver Abscess in Children Admitted at a Tertiary Care Hospital - North India","authors":"Navya Sree Manugu, Narayana Lunavath, Ramu Pedada","doi":"10.18410/jebmh/2021/629","DOIUrl":"https://doi.org/10.18410/jebmh/2021/629","url":null,"abstract":"BACKGROUND Amoebic liver abscess is the commonest extra intestinal site of invasive amoebiasis which mainly affects infants and young children. The incidence of pyogenic liver abscess is much higher among children in developing countries than those in developed countries. Diagnosis of liver abscess can be challenging and is often delayed; a high index of suspicion is necessary in children with risk factors. Children have unique set of predisposing causes for liver abscesses. The purpose of this study was to assess the clinical, demographic, and etiological profile of liver abscess in children between 1 month to 12 years of age. METHODS This is a prospective observational study conducted in the Department of Pediatrics, Chacha Nehru Bal Chikistalaya (An Autonomous Institute under Govt. of NCT (National Capital Territory) of Delhi, affiliated to University of Delhi), Delhi from July 2016 to August 2017. All children aged 1 month to 12 years admitted with liver abscess (included consecutively) were enrolled after considering inclusion and exclusion criteria. Written and informed consent was taken from parents/guardians of children aged less than 7 years. Informed assent was taken from children aged more than 7 years, along with written and informed consent from their parents/guardians. Their clinical characteristics, radiological features and laboratory data were analysed. RESULTS Most common age group suffering from liver abscess was 5 - 10 years with male preponderance. Majority of the children belonged to lower socio-economic class and half of them were suffering from malnutrition. Most common clinical presentation of children suffering from liver abscess was fever with pain abdomen and tender hepatomegaly. Majority of the children had leucocytosis, high level of C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Deranged liver function test with coagulopathy was noted in more than half of the children suffering from liver abscess. Commonest bacterial pathogen was methicillin resistant Staphylococcus aureus followed by Salmonella typhi, Stenotrophomonas maltophilia, coagulase negative Staphylococcus aureus and Staphylococcus hominis. Entamoeba histolytica is a common parasitic agent causing liver abscess in children. CONCLUSIONS Liver abscess should be considered in children presenting with fever and abdominal pain. Most cases involve a single lesion on right lobe of the liver. Methicillin resistant Staphylococcus aureus followed by Salmonella typhi are the two most common pathogens. KEYWORDS Paediatric Liver Abscess, Amoebic Liver Abscess, Pyogenic Liver Abscess, Children","PeriodicalId":15779,"journal":{"name":"Journal of Evidence Based Medicine and Healthcare","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90397409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Introduction of Problem Based Learning (PBL) as a Supplementary Tool to Enhance Active Learning in Physiology – A Study in a Medical College of Southern Kolkata","authors":"P. Narhare, Padmakar Sasane, Revathi Mohanan, Mriganka Baruah","doi":"10.18410/jebmh/2021/631","DOIUrl":"https://doi.org/10.18410/jebmh/2021/631","url":null,"abstract":"BACKGROUND The motivation to learn begins with a problem. The ideology of problem-based learning (PBL) is to encourage the students to think beyond the books and apply the basic knowledge to various clinical scenarios. Problem based learning has been a concept in existence for decades, yet its implementation in medical education is limited. So the study on PBL was taken up to know analytical skills, comprehensive understanding of disease process and inculcate the practice of self-directed learning in physiology. METHODS This was an educational interventional study carried out on 60 first MBBS students chosen by simple random sampling. Students were further randomly divided into two groups containing 30 students in the control group and 30 students in the study group. Control group was taught by didactic lectures. 10 clinical scenarios were given to study group and discussions were conducted under the moderation of faculties. Objective evaluation was performed using pre-test and post-test examination for both groups. Subjective evaluation of attitude in study group towards PBL was recorded using self-developed questionnaire using Likert’s scale. Data was analysed by using paired students t test. RESULTS The mean pre-PBL (9.83±4.88) and post-PBL scores (15.61 ± 2.99) in study group were significant (p < 0.00001). The comparison of mean scores of postdidactic lectures (12.88 ± 3.13) in control group and post-PBL (15.61 ± 2.99) in study group were significant (p < 0.001). Subjective evaluation using Likert’s scale revealed increased interest in active learning, better confidence, communication, comprehension, and motivation amongst the PBL group. CONCLUSIONS From the results of this study, it can be concluded that problem-based learning is a good supplementary tool in teaching physiology, and it can be included in the regular medical teaching programmes so that the students have a better understanding of the various challenges in the field of medical education and research so that newer strategies for better health care provision can be planned. KEYWORDS Active Learning, Medical Education, Problem Solving, Self-Directed Learning","PeriodicalId":15779,"journal":{"name":"Journal of Evidence Based Medicine and Healthcare","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84524252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison between Optical Coherence Tomography and Fundus Fluorescein Angiography in the Detection of Cystoid Macular Oedema in a Tertiary Eye Care Centre in Nagpur, Maharashtra","authors":"K. A. Dhabarde, Karuna Radhakishan Painjane, A. Madan","doi":"10.18410/jebmh/2021/627","DOIUrl":"https://doi.org/10.18410/jebmh/2021/627","url":null,"abstract":"BACKGROUND Fundus fluorescin angiography (FFA) has been traditional gold standard for detection of cystoid macular oedema (CME) but nowadays optical coherence tomography (OCT) is used more often by to detect CME due to various conditions. Although FFA can assess CME qualitatively, OCT provides quantitative measurement of foveal thickness. The purpose of this study is to compare sensitivity of FFA and OCT for detection of CME and know the etiological distribution of CME and the ability of FFA and OCT in diagnosing CME in different aetiologies. METHODS A hospital based prospective observational diagnostic study was conducted in tertiary eye care centre in central India on 143 eyes of 103 patients. FFA and OCT findings in patients of CME diagnosed provisionally on fundus examination were studied. RESULTS Of total 103 patients studied, maximum patients 20 (19.42 %) were in age group of 55 - 59 years whereas minimum 6 (5.83 %) were in age group of 40 - 44 years. In 103 patients, 61 (59.22 %) were males and 42 (40.78 %) were females. Both eyes were involved in 41 (40.78 %) cases. Most common cause of CME was nonproliferative diabetic retinopathy (NPDR) 52 eyes (35.86 %), followed by branch retinal vein occlusion (BRVO) 32 eyes (22.06 %), then proliferative diabetic retinopathy (PDR) 14 eyes (9.6 %), central retinal vein occlusion (CRVO) 13 eyes (8.96 %). CME on OCT was seen in maximum of retinal vein occlusion patients - CRVO (84.61 %) and BRVO (84.37 %). Of 145 eyes, 114 (78.32 %) eyes had CME. CONCLUSIONS Most common cause of CME was NPDR followed by BRVO, PDR and CRVO. Sensitivity of OCT in comparison with FFA was 100 % with diagnostic accuracy of 81.38 %. Hence, one can use OCT as first modality investigation for diagnosis of CME. KEYWORDS Optical Coherence Tomography, Fundus Fluorescein Angiography, Cystoid Macular Oedema, NPDR","PeriodicalId":15779,"journal":{"name":"Journal of Evidence Based Medicine and Healthcare","volume":"331 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76575369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study of Clinical Findings and Treatment Outcomes of Rhino-OrbitalCerebral Mucormycosis at a Tertiary Care Center in Central India","authors":"K. A. Dhabarde, Pallavi Doble, Nehali Sureshchandra Pant, N. Rahul","doi":"10.18410/jebmh/2021/628","DOIUrl":"https://doi.org/10.18410/jebmh/2021/628","url":null,"abstract":"BACKGROUND Mucormycosis is a potentially lethal angioinvasive fungal infection. Increasing incidence of rhino-orbital-cerebral mucormycosis in setting of corona virus disease-19 (COVID-19) during second wave in India and elsewhere has become a matter of immediate concern. This study was done to assess the clinical findings and treatment outcomes of rhino-orbital-cerebral-mucormycosis presenting to a tertiary care center in central India. METHODS This is a longitudinal study. We observed 38 COVID-19 associated mucormycosis cases. Their demographic data, clinical manifestations, underlying systemic conditions, microbiological and radiological reports, medical treatments and surgical interventions were recorded and analysed. RESULTS Common ocular presenting features were ophthalmoplegia (68 %), proptosis (44 %), periorbital swelling (13 %), diminution of vision (37 %), central retinal arterial occlusion (2.5 %), optic atrophy (2.5 %). Visual acuity at 1 month after surgery was compared with that at presentation and was found unchanged in 27 patients, improved in 3 patients and deteriorated in 6 patients. Functional outcome was evaluated in terms of ocular movements, and it was found that ocular movements were same as presentation in 30 patients, improved in 3 patients and deteriorated in 3 patients at follow up one month after surgery. Radiological outcome was evaluated, and it was found that residual disease was present in 4 patients and absent in 32 patients. Mortality was found in 2 patients at 1 month follow-up period. CONCLUSIONS Early diagnosis, blood sugar levels control, urgent systemic antifungal therapy and sinus debridement surgery are lifesaving in cases of COVID-19 associated mucormycosis. KEYWORDS Mucormycosis, COVID-19, Diabetes Mellitus, Ophthalmoplegia, Orbital Apex Syndrome, Orbital Cellulitis, Proptosis","PeriodicalId":15779,"journal":{"name":"Journal of Evidence Based Medicine and Healthcare","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81062085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}