AMC MET Medical College

Sudden upsurge in cases of COVID-19 Associated Mucormycosis (CAM) following the second wave of the COVID-19 pandemic was recorded in India. This study describes the clinical characteristics, management and outcomes of CAM cases, and factors associated with mortality. Microbiologically confirmed CAM cases were enrolled from April 2021 to September 2021 from ten diverse geographical locations in India. Data were collected using a structured questionnaire and entered into a web portal designed specifically for this investigation. Bivariate analyses and logistic regression were conducted using R version 4.0.2. A total of 336 CAM patients were enrolled; the majority were male (n = 232, 69.1

Objective In this study, our goal was to understand the comparative impact of humming, physical activity, emotional stress, and sleep on several heart rate variability (HRV) parameters, including the stress index (SI), and to assess the effectiveness of humming (simple Bhramari) as a stress buster based on the HRV parameters. Methods This pilot study assessed the long-term HRV parameters of 23 participants in terms of four activities: humming (simple Bhramari), physical activity, emotional stress, and sleep. The single-channel Holter device measured the readings, and data was analyzed using Kubios HRV Premium software for time and frequency-domain HRV parameters, including the stress index. Regarding statistical analysis, single-factor ANOVA followed by paired t-test was used to compare the results of HRV parameters "during" the four activities to understand if humming generates the outcome to enhance the autonomic nervous system. Results Our findings revealed that humming generates the lowest stress index compared to all three other activities (physical activity, emotional stress, and sleep). Several additional HRV parameters also supported the positive impact on the autonomic nervous, equivalent to stress reduction. Conclusions Humming (simple Bhramari) can be an effective stress-buster based on the assessment of several HRV parameters during its practice and in comparison with other activities. A regular daily humming routine can help enhance the parasympathetic nervous system and slow down sympathetic activation.

During COVID pandemic, with schools being closed, digital platforms are being extensively used for online teaching and learning. Children are being exposed to video display units (VDU) for prolonged durations making them susceptible to ocular problems and development of the Computer Vision Syndrome. Through this study, we attempted to study the effect of this added use of VDUs through online teaching on eyes of school going children. A Google survey of 18 questions was prepared assessing the pattern of online teaching sessions, type of devices used, use of protective accessories and presence of ocular symptoms. The form was floated on social platforms for parents of school going children. Data was collected and analysed using Microsoft Excel and percentage and p value calculated using chi square test. Out of 982 children, 494 (50.3%) had one or more ocular symptoms. Headache was found in 205(41.49%), excessive rubbing of eyes in 178 (36.03%), pain in 155 (31.37%), redness in 135 (27.32%), watering in 132 (26.72%), blurring of vision in 67 (13.56%) and changes in glass prescription in 42 (8.50%) children. We found total duration of online class and continuous use of VDUs to be statistically significant influencing factors. Online teaching learning should be cautiously conducted as the use of VDUs can affect the ocular health of the children.

Abstract Background: Cholecystectomy specimens are very frequently examined in a surgical pathology practice and reveal a myriad of lesions. Cholelithiasis is a major risk factor for most of the gallbladder diseases. Gallbladder is one of the most common organs where the incidental carcinoma is commonly reported in published literature. This study was intended to evaluate the histopathological spectrum of gallbladder lesions and to assess the utility of histopathological examination of cholecystectomy specimens to diagnose the incidental carcinoma. Materials and Methods: This observational and descriptive study was carried out on a total 400 cholecystectomy specimens by conventional histopathological methods. Results: Cholecystectomy specimens comprised of 4.70% all surgical pathology specimens. The mean age of patients was 41.84 ± 13.74 years. A striking female preponderance (F: M = 3.49:1) was noted. Most cases were associated with gallstones (83.5%). Non-neoplastic and neoplastic lesions comprised 97.5%, and 2.5% respectively. Chronic cholecystitis was the most frequent pathology (67.5%). Adenocarcinoma was observed in 2.25% cases and 88.89% of all malignant lesions were reported as an incidental finding. Conclusion: Gallstones are consistently observed in both neoplastic as well as non-neoplastic lesions of gallbladder. Many premalignant and malignant lesions may masquerade as chronic cholecystitis; both on clinical and radiological parameters and so, histopathology proves to be a gold standard tool for the correct diagnosis. This study affirms the importance of routine histopathological examination of each and every cholecystectomy specimen; as incidental detection of gallbladder carcinoma is very high. Key words: Histopathology, Cholecystectomy, Gallstones, Cholecystitis, Adenocarcinoma

Abstract Background Increased occurrence of mucormycosis during the second wave of COVID-19 pandemic in early 2021 in India prompted us to undertake a multi-site case–control investigation. The objectives were to examine the monthly trend of COVID-19 Associated Mucormycosis (CAM) cases among in-patients and to identify factors associated with development of CAM. Methods Eleven study sites were involved across India; archived records since 1st January 2021 till 30th September 2021 were used for trend analysis. The cases and controls were enrolled during 15th June 2021 to 30th September 2021. Data were collected using a semi-structured questionnaire. Among 1211 enrolled participants, 336 were CAM cases and 875 were COVID-19 positive non-mucormycosis controls. Results CAM-case admissions reached their peak in May 2021 like a satellite epidemic after a month of in-patient admission peak recorded due to COVID-19. The odds of developing CAM increased with the history of working in a dusty environment (adjusted odds ratio; aOR 3.24, 95% CI 1.34, 7.82), diabetes mellitus (aOR: 31.83, 95% CI 13.96, 72.63), longer duration of hospital stay (aOR: 1.06, 95% CI 1.02, 1.11) and use of methylprednisolone (aOR: 2.71, 95% CI 1.37, 5.37) following adjustment for age, gender, occupation, education, type of houses used for living, requirement of ventilatory support and route of steroid administration. Higher proportion of CAM cases required supplemental oxygen compared to the controls; use of non-rebreather mask (NRBM) was associated as a protective factor against mucormycosis compared to face masks (aOR: 0.18, 95% CI 0.08, 0.41). Genomic sequencing of archived respiratory samples revealed similar occurrences of Delta and Delta derivates of SARS-CoV-2 infection in both cases and controls. Conclusions Appropriate management of hyperglycemia, judicious use of steroids and use of NRBM during oxygen supplementation among COVID-19 patients have the potential to reduce the risk of occurrence of mucormycosis. Avoiding exposure to dusty environment would add to such prevention efforts.