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COVID-19 infection caused by the novel severe acute respiratory syndrome coronavirus 2 may be related to an extensive range of disease patterns encompassing from mild to deadly pneumonia. At present COVID-19 pandemic situation, mucormycosis is spreading very fast and has become a severe problem for people who suffered and recovered from COVID-19. For the present study, databases of PubMed, Scopus, and Google Scholar were searched and summarized. Low immunity, high use of corticosteroids, haematological malignancy and chemotherapy, poorly controlled diabetes, solid-organ transplant recipients on immunosuppressive therapy, on peritoneal dialysis, extensive skin injury, HIV infections predominantly provide suitable condition for infection of mucormycosis. This is especially challenging for people with hyperglycemia who are unable to manage their sugar levels during COVID-19. During the second wave of COVID-19, two forms of mucormycosis, rhino-orbito-cerebral mucormycosis and pulmonary mucormycosis, have frequently been reported in active, recovering, or postdischarge COVID-19 patients. In maximum cases, lavage surgery may ultimately be mandatory to eradicate necrotic material on the skin. It can be treated with a proper antifungal treatment if the condition is detected at an early stage. In India, more than 51,775 cases of post-COVID-19 secondary infection of mucormycosis have been reported. There is no significant published data regarding coinfection in COVID-19 patients with systemic mycoses that led to serious difficulty and mortality till date. For general awareness of people, the present articles deal with COVID-19-associated high-risk coactive fungal infection, their mode of transmission, systemic position, symptoms, invasion type, and protocol use for the treatment.

Background: Touch imprint cytology of image guided core needle biopsy implies gentle rolling of core needle biopsy obtained with the aid of imaging modality from various organs. The aim of the study was to measure the diagnostic accuracy of touch imprint cytology of image guided core needle biopsy in comparison to histopathological diagnosis. Materials and Methods: A prospective descriptive cross-sectional study was conducted among 47 touch imprint cytology of image guided core needle biopsy in the department of pathology of a tertiary care centre between 1st October 2021 to 30th September 2022 after receiving ethical approval from the institutional review committee. The Papanicolaou and Giemsa-stained slides of touch imprint smear and haematoxylin - eosin-stained slides of core needle biopsy was analysed for adequacy and categorization as non-neoplastic, benign, atypical and malignant. Convenience sampling was done. Results: The most frequent site of image guided core needle biopsy was lung (40.4%). The adequacy rate of touch imprint cytology of image guided core needle biopsy was 85.1%. Among 40 cases of adequate touch imprint smear, 28 cases (70%) were categorized as malignant. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of touch imprint cytology for categorizing a malignant lesion was 91.18%, 95.45%, 96.88%, 87.5% and 92.86% respectively. Conclusion: The touch imprint cytology of image guided core needle biopsy is a useful modality for the rapid preliminary diagnosis of lesions of various organs with decreased turnaround time for diagnostic workup and ancillary studies.

Conclusions: The current study concluded a sufficient level of concordance between clinical and histopathological diagnosis. A high completion rate of biopsy forms indicated that the clinicians/operating surgeons perceive the significance of clinical information in histopathological diagnosis. We also recommend, irrespective of the type of suspected oral lesions, submitted for biopsy, a detailed clinical information is the backbone for accurate and timely reporting of the histopathological diagnosis.

Adenoid ameloblastoma with dentinoid had been perceived as a rare odontogenic tumor with bridging histopathological features between ameloblastoma and adenomatoid odontogenic tumor. Due to the mixture of histopathological features of two separate and well-recognized entities, adenoid ameloblastoma was also regarded as a hybrid lesion. The diversity in the histopathological presentation among the cases has disaccorded the nature, behaviour, and prognosis of this pathology. Despite the literature acknowledging the histopathological diversity, categorizing all these variations into one and addressing them as a single entity was lagging till the 5th edition of the odontogenic tumor classification by the WHO was forwarded. With the establishment of the new terminology of adenoid ameloblastoma and the enlistment of its diagnostic criteria, the scientific literature has advocated updating, contributing, and redefining the various aspects of this pathology. Here, we present a case of a 34-year-old male who presented with a chief complaint of swelling in the lower front region of his jaw in the past one month. The swelling was associated with pain that was sudden in onset with a progressive increase in size. The swelling was also associated with discharge that resembled pus. A panoramic radiograph showed a mixed radiopaque and radiolucent area, extending from the distal aspect of 32 up to the distal aspect of 43. The entire cystic lining along with the growth was excised and sent for histopathological examination. Correlating clinically, the histopathological features are suggestive of adenoid ameloblastoma. Scientific literature has stood as a boon to evidence-based practice. The diagnosis for the present case report is truly an outcome of the literature-based update which helped the diagnosis of the case as a separate entity rather than as a hybrid pathology. The goal was to enhance the understanding of the lesions in terms of their clinical characteristics and diverse histopathological morphology.

Key Clinical Message Langerhans cell histiocytosis (LCH) is a rare hematological disorder characterized by abnormal proliferation of Langerhans cells. Head and neck region is commonly involved with oral manifestations appearing first in many instances. A thorough knowledge of the disorder and an interdisciplinary approach warrant for the better outcome of the condition.

Basaloid squamous cell carcinoma (BSCC) is a rare, distinctive, and aggressive variant of squamous cell carcinoma (SCC) primarily seen in the upper aerodigestive tract with epiglottis, soft palate, and base of the tongue being site of high preference in head and neck region. It differs from conventional SCC histologically and immunologically, is most frequently found in males in their sixth and seventh decades, and is frequently linked to alcohol and tobacco use. High stage disease with distant metastases, a high recurrence rate, and a dismal prognosis is how BSCC typically manifests. In the present article, we report four cases of BSCC.

Abstract POF represents a separate entity with diverse histological presentation. Considerable overlapping of clinical and histological features are present among different reactive gingival lesions, which warrant a meticulous review for the diagnosis of POF.

Flexible bronchoscopy (FB) is commonly performed by respiratory physicians for diagnostic as well as therapeutic purposes. However, bronchoscopy practices vary widely across India and worldwide. The three major respiratory organizations of the country supported a national-level expert group that formulated a comprehensive guideline document for FB based on a detailed appraisal of available evidence. These guidelines are an attempt to provide the bronchoscopist with the most scientifically sound as well as practical approach of bronchoscopy. It involved framing appropriate questions, review and critical appraisal of the relevant literature and reaching a recommendation by the expert groups. The guidelines cover major areas in basic bronchoscopy including (but not limited to), indications for procedure, patient preparation, various sampling procedures, bronchoscopy in the ICU setting, equipment care, and training issues. The target audience is respiratory physicians working in India and well as other parts of the world. It is hoped that this document would serve as a complete reference guide for all pulmonary physicians performing or desiring to learn the technique of flexible bronchoscopy.

Obstetric hemorrhage is a leading cause of maternal mortality and morbidity. Uterine atony is the major cause of postpartum hemorrhage (PPH) accounting for 79% of all cases besides genital trauma, placental causes and coagulation disorders. We present a case of massive obstetric hemorrhage secondary to uterine atony that was referred to our center in a state of hemorrhagic shock with severe metabolic acidosis, hypothermia and coagulopathy. Prompt activation of massive transfusion protocol, use of thromboelastography guided correction of coagulopathy and early hysterectomy to control hemorrhage played a vital role in successful patient management. Postoperative intensive management of ventilatory function, haemodynamics, kidney function and sepsis led to a favourable outcome. This case highlights the importance of multi-disciplinary team management involving anesthesiologist, emergency medical personnel, obstetrician, blood transfusion services and critical care team in optimizing the clinical condition of the critical patient.

Lumbar spinal drain placement is being done with increasing frequency either to reduce intracranial pressure or facilitate view of surgical field in neurosurgical procedures. Complications due to fracture of catheter and/or retained catheter are rare and underreported but are of concern. The management of such a complication, surgical or conservative, depends on location of retained fragment of catheter, patient condition, or resulting complications due to catheter shearing. In this case, the position of the retained catheter fragment does not explain the subsequent paraparesis, which resolved with conservative management. Since there are no guidelines to handle such cases, it is important to individualize patient management. Proper positioning, technique and expertise, and some changes in Tuohy needle tip are required to reduce complications due to broken spinal drains. This case report emphasizes on the measures that can be taken to prevent shearing of spinal catheter.

Congenital soft-tissue tumors of oral cavity are mostly hyperplastic and benign in nature. This article presents an unusual case of congenital subcutaneous hamartoma of incisive papilla in a 2-year-old female child causing feeding and breathing difficulty. Total excisional biopsy was done under local anesthesia. Histopathology of tissue in reticulin-stained slide showed the presence of immature muscle fibers whereas Masson's trichrome stain revealed collagen fibers and smooth muscles confirming the diagnosis of oral midline subcutaneous smooth muscle (leiomyomatous) hamartoma of incisive papilla. It is important for dental professionals to be aware of this oral lesion present from birth mimicking overgrowth of incisive papilla, by its presentation, differential diagnosis, histopathology, and management.

A 35-year-old lady was seen in the outpatient clinic owing to fever, cough with mucopurulent expectoration, and breathlessness for the duration of 1 month. She had history of similar episodes treated with antibiotics four times during last 2 years. There was no history of recurrent sinusitis, diarrhea, and skin or soft tissue infection. She had no history of diabetes mellitus or steroid intake. She denied any history of facial trauma or dental infection in the past. There was no history of tuberculosis in her or in the family. Radiograph and CT scan of the chest revealed right upper lobe consolidation. Flexible fibreoptic bronchoscopy revealed multiple nodules at opening of right upper lobe bronchus. This clinicopathological conference describes the details of differential diagnoses, difficulties in achieving the final diagnosis and management of such patient.

Idiopathic pulmonary hemosiderosis (IPH) is a rare cause of recurrent diffuse alveolar hemorrhage (DAH) with no specific treatment. Herein, we discuss a case of hemoptysis, who had IPH and other rare associations. A 19-year-old man presented with recurrent hemoptysis, generalized weakness and progressive dyspnea for 3 years. Earlier, he was diagnosed with anemia and was treated with blood transfusions and hematinics. On examination he had pallor, tachycardia and was underweight. Investigations revealed low level of hemoglobin (7.8 g/dl) and iron deficiency. An electrocardiography (ECG) showed sinus tachycardia, interventricular conduction delay and T-wave inversion. Echocardiography revealed dilated cardiomyopathy with left ventricular dysfunction. Computed tomography of the chest demonstrated bilateral diffuse ground glass opacity suggestive of pulmonary hemorrhage. Pulmonary function tests showed restrictive pattern with increased carbon monoxide diffusion. Bronchoalveolar lavage and transbronchial lung biopsy showed hemosiderin-laden macrophages. Patient could recall recurrent episodes of diarrhea in childhood. Serum antitissue transglutamase antibodies were raised (291.66 IU/ml, normal

Background: Soil is well known to support the transient or ongoing existence of keratinophilic fungi and potential source of infection for human and animalsMethods: Samples were collected from 67 sites of university campus like PG study centers, playgrounds, gardens, hostels, administrative blocks, library, bank, canteen and road side for the estimation of keratinophilic fungi using the hair baiting technique.Results: Totally, 192 isolates belonging to 14 genera and 21 species were reported. Soil pH range varies from 6.5 to 9.0 pH. Most of the fungi isolated from neutral to slightly alkaline soil. Chrysosporium tropicum (20.83%) was the most predominant fungi reported from all sites. Trichophyton mentagrophytes (15.10%) was the second most commonly reported fungi. Chrysosporium indicum (11.45%), T. simii (9.37%), C.evolceanui (8.83%) T. terrestre (4.68%) and Cephaliophora irregularies (4.68%) were frequently reported. Microsporum audouinii, Paceliomyces sp., Cladosporium sp. and Sporothrix schenckii were isolated for the first time from Jaipur.Conclusion: Road sides were found most suitable for the occurrence of all most all keratinophilic fungi. Higher incidence of keratinophilic fungi was found in hostel sides followed by road sides, PG study centers and play grounds.

Purpose: The purpose was to evaluate the performance of a commercially available chromogenic Candida speciation media and the Vitek 2 ID system for the identification of medically important yeasts and yeast-like organisms in a routine clinical microbiology laboratory. Materials and Methods: A total of 429 non duplicate, consecutive yeast strains were included during the 3.5-year study period. The performance of the Vitek 2 ID system and a chromogenic agar medium was evaluated against the gold standard conventional phenotypic and biochemical identification method for speciation of yeast isolates from trauma patients. Results: Candida tropicalis (64%) was the most common Candida species, followed by Candida albicans (14%), Candida rugosa (7%), and Candida parapsilosis (6.5%). Of the 429 isolates, 183 could be identified to species level by all the three methods. Agreement between the chromogenic agar method and conventional methods was 80% for Candida tropicalis, 100% for Candida rugosa, 89% for Candida albicans, and 77% for Candida parapsilosis. Vitek 2 had lower sensitivity, with agreement of 49% for Candida tropicalis, 100% for Candida rugosa, 39% for Candida albicans, and 31% for Candida parapsilosis. Conclusion: Thus, in long-term ICU patients, an increasing trend of isolating nonalbicans Candida spp. continues. The chromogenic agar medium is a convenient and economic method to identify commonly isolated species in busy clinical microbiology laboratories.

We consider the type I generalized half-logistic distribution and derive some new explicit expressions and recurrence relations for marginal and joint moment generating functions of upper record values. Here we show the computations for the first four moments and their variances. Next we show that results for record values of this distribution can be derived from our results as special cases. We obtain the characterization result of this distribution on using the recurrence relation for single moment and conditional expectation of upper record values. We obtain the maximum likelihood estimators of upper record values and their confidence intervals. Also, we compute the maximum likelihood estimates of the parameters of upper record values and their confidence intervals. At last, we present one real case data study to emphasize the results of this paper.

Background: Soil is well known to support the transient or ongoing existence of keratinophilic fungi and potential source of infection for human and animals. Methods: Samples were collected from 67 sites of university campus like PG study centers, playgrounds, gardens, hostels, administrative blocks, library, bank, canteen and road side for the estimation of keratinophilic fungi using the hair baiting technique. Results: Totally, 192 isolates belonging to 14 genera and 21 species were reported. Soil pH range varies from 6.5 to 9.0 pH. Most of the fungi isolated from neutral to slightly alkaline soil. Chrysosporium tropicum (20.83%) was the most predominant fungi reported from all sites. Trichophyton mentagrophytes (15.10%) was the second most commonly reported fungi. Chrysosporium indicum (11.45%), T. simii (9.37%), C.evolceanui (8.83%) T. terrestre (4.68%) and Cephaliophora irregularies (4.68%) were frequently reported. Microsporum audouinii, Paceliomyces sp., Cladosporium sp. and Sporothrix schenckii were isolated for the first time from Jaipur. Conclusion: Road sides were found most suitable for the occurrence of all most all keratinophilic fungi. Higher incidence of keratinophilic fungi was found in hostel sides followed by road sides, PG study centers and play grounds.

We report a case of a 14-year-boy who presented to us with a low-grade fever with evening rise for 9 months. Along with this, the patient also reported a reduction in his appetite and body weight. He had a mild dry cough but no respiratory symptoms otherwise. There was no other localization for fever on history. He received antitubercular therapy, based on abnormal chest radiograph. However, there was no relief in his symptoms. General physical examination revealed mild fever. Systemic examination was unremarkable. Blood investigations done for fever were noncontributory. Computed tomographic (CT) scan of the chest revealed a mediastinal mass compressing the trachea. The possibilities of lymphoma or germ cell tumour were considered. A biopsy from the mass under CT guidance was performed. The histopathology revealed multiple epithelioid cell granulomas with necrosis, and the diagnosis of tuberculosis was made. The clinical course of this patient and the relevant literature is presented in this paper.