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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. [ABSTRACT FROM AUTHOR]

Purpose: To report the clinico-demographic profile of rhino-orbito-cerebral mucormycosis (ROCM) in patients during the "second wave" of the COVID-19 pandemic in eastern India, and their ophthalmic manifestations at presentation to our tertiary institute. Methods: Cross-sectional study amongst patients presenting to our center based on their hospital records. Demographic information, history related to COVID-19, records of detailed ocular examination, and microbiological, radiological, and histopathological investigation were entered into an online worksheet and analyzed using SPSS 26.0. Results: A total of 219 patients with ROCM were treated from May to September 2021, and 110 of these had ocular manifestations at presentation (50.2%). The age of patients ranged from 22 to 83 years and the mean ± standard deviation (SD) age was 49.9 ± 12.9 years. Ninety (81.8%) patients had been diagnosed with diabetes mellitus, 31 (34%) had hypertension, and 10 had other comorbidities. The duration between the onset of COVID-19 and mucormycosis symptoms was 0 to 60 days with a mean ± SD interval of 20.9 ± 12.6 days. Fifty-six (50.9%) patients had a history of steroid use. Unrelenting ocular or facial pain was the most common presenting symptom, ptosis was the most common anterior segment manifestation, and ophthalmic artery occlusion was the most common posterior segment manifestation. Conclusion: Our data from eastern India reinforces the relationship between COVID-19, diabetes, corticosteroid use, and ROCM. Knowledge of various presenting anterior and posterior segment manifestations of the disease as described in the present study will guide clinicians to recognize the disease early and make every effort to prevent complications. [ABSTRACT FROM AUTHOR]

The integration of an E-slot within the conventional microstrip patch antenna structure offers improved radiation characteristics and bandwidth. This research presents the design and analysis of a rectangular microstrip patch antenna with an E-slot. The proposed antenna is designed to operate at a specific frequency in the microwave range. The design process involves determining the dimensions of the rectangular patch, feedline, and E-slot to achieve the desired resonance frequency. The simulation and optimization are carried out using electromagnetic simulation software, considering the dielectric substrate properties and other relevant parameters. The E-slot is strategically placed within the patch structure to enhance the antenna's performance. It acts as an additional resonating element, contributing to increased bandwidth and improved radiation characteristics, such as gain and directivity. The integration of the E-slot modifies the current distribution on the patch, resulting in enhanced radiation properties. The performance of the proposed antenna is evaluated through various parameters, including return loss, radiation pattern, and bandwidth. Overall, the rectangular microstrip patch antenna with an E-slot presents a promising solution for achieving enhanced performance in terms of bandwidth and radiation characteristics. The proposed design opens up possibilities for further advancements in microstrip antenna technology, facilitating the development of an efficient and compact antenna structure for modern wireless applications. [ABSTRACT FROM AUTHOR]

Urban road traffic noise is a major concern in developing as well as developed countries. Often it is difficult to identify the most noise impacting vehicular type especially in urban region with mixed vehicular flow. Herein, we analysed in a systematic way to identify the most noise impacting vehicular type at Hyderabad city of India. The road traffic noise across the corridor-3 metro line known as the blue line metro was chosen in the present study because, it stretches from north to south connecting 23 stations comprising major residential and commercial locations of the city. The noise levels were analysed as per CPCB guidelines. The noise pollution quantifying parameters such as Noise Climate (NC), Noise Pollution Level (LNP), and Traffic Noise Index (TNI) were analysed across the lane. A systematic analysis revealed that, the twowheelers are the most noise impacting vehicles in the daytime whereas four-wheelers in the nighttime. Noise map generated using the IDW spatial interpolation method shows the noise impacted regions across the metro lane stretching ~27 km of the city. The methodological pattern in the present investigation can be useful tool in identifying the most noise impacting vehicular type in any region with a mixed vehicular flow. [ABSTRACT FROM AUTHOR]

Background: A healthy lid‑wiper is an important component of a healthy ocular surface. Any abnormality or irregularity of the lid wiper can potentially damage a relatively healthy ocular surface. Stevens–Johnson syndrome, toxic epidermal necrolysis, and ocular cicatricial pemphigoid are some of the examples that can result in lid‑margin keratinization during the course of the disease. These permanent changes at the lid margin mechanically abrade the corneal surface and facilitate corneal neovascularization. The corneal clarity is lost over time, and the patients have corneal blindness. Purpose: This video discusses the role of a healthy lid‑wiper, conditions causing lid‑margin keratinization and subsequent lid‑wiper keratopathy, and surgical technique in mucous membrane grafting. Synopsis: The video demonstrates the technique of restoration of a healthy lid margin by doing a mucous membrane graft for lid‑margin keratinization and its role in the prevention of corneal blindness. Highlights: Lid‑margin keratinization is essentially a chronic sequela and is often ignored till irreversible corneal changes develop. Early intervention in the form of mucous membrane grafting can prevent corneal vascularization and loss of corneal clarity. [ABSTRACT FROM AUTHOR]

An in vitro system using Ri T-DNA transformed carrot roots as the host bearing simultaneously different arbuscular mycorrhizal (AM) fungi belonging to two genera Glomus intraradices (Smith and Schenck) and Gigaspora margarita (Becker and Hall) was developed. Co-existence appeared healthy and harmonious, as both the generic species showed extensive hyphal proliferation and sporulation. The co-culture model under the in vitro system appears especially appropriate for further investigations on the competition and on the interaction mechanism involved in such types of associations occurring in nature and also as a model approach towards mass production of multiple mycorrhizal fungal isolates. This is a first report of successful co-culture of two genera of AM fungi under in vitro conditions. [Copyright &y& Elsevier]