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Background: A recent increase in the prevalence of mucormycosis of the head and neck in patients who have recovered from COVID-19 following hospitalization has been reported. A Majority of the cases have been reported from India. Conditions such as diabetes mellitus, use of corticosteroids for other autoimmune conditions, organ transplant, immunosuppression, immunodeficiency, and malignancies especially hematologic ones, are all known risk factors for mucormycosis. Recently, hospitalization for COVID-19 has been added to the list of risk factors for opportunistic mucormycosis infection. This is likely attributable to the high doses and prolonged use of corticosteroids in the treatment of hospitalized COVID-19 patients. Case Description: Two patients with post-COVID-19 associated rhinocerebral mucormycosis presented with profound unexplained dental disease including tooth mobility and dental abscess mimicking periodontal disease. The patients were previously hospitalized for COVID-19 and received prolonged treatment with high doses of corticosteroids. The patients responded well to the surgical debridement with or without antifungal therapy. Conclusion: Oral healthcare providers including oral and maxillofacial surgeons, dentists, dental hygienists, and other dental practitioners can play a vital role in the recognition and early diagnosis of rhinocerebral mucormycosis given the large number of patients with severe COVID-19 infection who have recovered following hospitalization and/or received long-term high doses of immunosuppressive treatment.

Objective: Adenomatoid odontogenic tumor (AOT) is a benign odontogenic tumor with an excellent prognosis, often seen in children and young adults. The aim was to examine the spectrum of clinical, radiographic, and histologic attributes of AOT and assess clinician recognition of this entity. In addition, diagnostic considerations and treatment modalities were explored. Method and materials: With Institutional Review Board approval, archival cases of AOT from the University of Florida Oral Pathology Biopsy Service (1994-2019) were examined. Clinical and demographic data along with accompanying radiographs and original slides were reviewed. Results: A total of 28 cases of AOT were identified. These were all solitary in nature, with a mean age of 20.6 years (range 12-67 years). Most patients were under 20 (75.0%) with a definite female predilection (64.3%). Anterior jaws remained the most common location (85.2%), with a higher maxillary predilection (57.1%). Clinical impression included odontogenic lesions such as dentigerous cyst, lateral periodontal cyst, and odontogenic keratocyst. Conclusion: The spectrum of features of AOT is described. As clinicians were unfamiliar with AOT, highly characteristic features of AOT and more unique variants are discussed extensively to improve diagnostic aptitude. Clinicians must remain aware of this entity, as treatment is minimal compared to other odontogenic entities. [ABSTRACT FROM AUTHOR]

Introduction: The bone marrow examination is an essential investigation in the diagnosis and management of many haematological disorders. The integration of all investigations, including peripheral blood analysis, bone marrow aspirate, and trephine biopsy findings, along with supplementary tests such as immunophenotyping, cytogenetic analysis, and molecular genetic studies, is crucial for arriving at a final diagnosis. Aim: To assess the presence of reticulin fibres in bone marrow biopsy sections in haematological malignancies, to evaluate the grade of BMF associated with haematological malignancies and to assess the role of angiogenesis using IHC markers in various haematological malignancies. Materials and Methods: A cross-sectional study was conducted in the Department of Pathology at the National Institute of Pathology, Safdarjung Hospital, New Delhi, India in 2009 for a duration of 18 months. Thirty-eight patients with a diagnosis of Acute Myeloid Leukaemia (AML), Acute Lymphoblastic Leukaemia (ALL), Chronic Myeloid Leukaemia (CML), and Chronic Lymphoproliferative Disorder (CLPD) were studied. Bone marrow biopsies were taken, fixed in 10% formalin, and decalcified in 10% Ethylene Diamine Tetraacetic Acid (EDTA). Routine paraffin embedding was performed, and serial sections of 4 μm were obtained on poly-L-lysine-coated slides for Immunohistochemistry (IHC) {Vimentin, Vascular Endothelial Growth Factor (VEGF), CD-34, Smooth Muscle Actin (SMA)}. The presence of reticulin fibres in the bone marrow biopsy sections was assessed using two special stains: Gomori’s Silver Impregnation and Masson’s Trichrome. Fibrosis was quantified according to the Baurmeister 0-4 grading system of Bone Marrow Fibrosis (BMF). Results: The results of the present study suggest that Endothelial to Mesenchymal Transition (EndMT) may play a role in the pathogenesis of BMF. Various grades of fibrosis were observed, with 15 cases (39.47%) in Grade 3, followed by 11 cases (28.95%) in Grade 2, 8 cases (21.05%) in Grade 1, and 4 cases (10.53%) in Grade 4. Conclusion: BMF was a significant finding even in the early stages of the majority of the lesions studied and was closely linked with angiogenesis. This study showed that angiogenesis plays an important role in the pathogenesis of haematological neoplasms and that VEGF is a prominent stimulus in the majority of these disorders. Additionally, this study suggests that EndMT has a possible role in the pathogenesis of BMF.

Used cooking oil (UCO) is a waste, and creates environmental issues due to its hydrophobic property. UCO, with its high content of fatty acid, can be used as source material for animal feed. However, high unsaturated fatty acid in UCO is harmful to the ruminant's microflora. This can be resolved by transforming UCO into functional product such as ruminant's protected fat (PF). In the present work, the production of used cooking oil protected fat (UCOPF) using fusion method via saponification process was investigated. Response surface methodology (RSM) was used to evaluate the effect of calcium oxide concentration (CaO), initial temperature (iTemp.), and percentage of water (H2O) on the solidification score and free fatty acid (FFA) content of PF. Results showed that all the studied parameters significantly affected the responses. The coefficient of determination (R 2) for solidification score and FFA were high at 0.9433 and 0.9599, respectively. The optimum condition to produced UCOPF by fusion method was CaO (20%), iTemp. (80°C), and percentage of water (30%), which yielded solidification score and FFA of 5.33 ± 0.53 and 0.85 ± 0.07%, respectively. The FFA content of the optimised PF was lower than permitted; thus, it can be used as animal supplement. In conclusion, the UCO can be converted into PF by using calcium fusion method. However, the property and stability of the produced PF should be assessed prior to commercialisation. [ABSTRACT FROM AUTHOR]

Boerhaave syndrome is the spontaneous rupture of the esophagus, most commonly the left lower third of the esophagus, mainly due to increased intraluminal esophageal pressure after straining. The classic triad of symptoms includes vomiting, lower thoracic pain, and subcutaneous emphysema. A 45-year-old male patient presented with vomiting and lower chest pain after heavy alcohol intake. He was diagnosed with Boerhaave syndrome by contrast-enhanced computed tomography. The patient was given a bronchial blocker with an ambuscope as a backup for one-lung ventilation. An emergency operation was done with resection of the perforated part with esophagogastric anastomosis.

Miliary tuberculosis (TB) can occasionally lead to acute respiratory distress syndrome (ARDS) and disseminated intravascular coagulation (DIC). In this case report, we present the case of an 18-year-old male who was diagnosed with miliary TB based on miliary shadows on X-ray and computed tomography of the chest, as well as positivity for mycobacterium TB in endotracheal aspirate by cartridge-based nucleic acid amplification. The patient’s hospital stay was complicated by ARDS and DIC, which was successfully managed with ventilatory support, administration of antitubercular treatment, systemic corticosteroids, and blood products.

Background: The American Society of Anesthesiologists (ASA) physical status classification system was created to give doctors an easy way to categorize a patient's physiological status to forecast their risk for surgery. The study aimed to assess whether preoperative arterial blood gas analysis (ABG) in these patients affects the postoperative ventilation status regarding the number of patients intubated, needing oxygen support, or on room air. Subjects and Methods: This prospective observational study was conducted on 100 patients over one year of ASA-Grade III & IV. An arterial blood sample was drawn under all aseptic precautions. An ABG analyzer was used to evaluate blood gas parameters. The quantitative variables were expressed as mean and standard deviation. All quantitative variables were analyzed using the independent students test, and categorical variables were analyzed using the chi-square test. Results: Parameters evaluated were patients' postoperative ventilation status, a comparison of preoperative and postoperative ventilation status, an association of preoperative PH, PaO2, PCO2, bicarbonate, and lactate with postoperative ventilation status, the percentage of patients with serum electrolyte abnormalities, the preoperative mean blood glucose level, and the postoperative ventilation status of the patients. It was statistically significant (P=0.002) that the patients on acidosis before surgery were already intubated. Most preoperative acidotic patients needed postoperative mechanical ventilator support, which is statistically significant with P=o.oo8. Conclusions: Our study observed a statistically significant association of preoperative PH, lactate, and blood glucose in ABG with patients requiring mechanical ventilation postoperatively. Higher preoperative mean blood glucose levels were associated with more intubated patients postoperatively.

Background: Years after SARS recovery, residual pulmonary abnormalities may still exist. This raises the question of whether or not Covid-19 could have comparable late consequences. Structural changes in the Lungs after recovery can be better visualized using CT-Thorax. Objectives: To study the Covid CT changes during hospitalization and after four months follow-up of infection, and to correlate with the volumetric HRCT thorax indices and Biochemical parameters. Material and Methods: This is a hospital based Cross-sectional study, with a follow-up among 100 Hospitalized clinically moderate to severe Covid- 19 patients who recovered after four months. Results: The biochemical markers such as d-Dimer and C-Reactive Protein (CRP) were significantly reduced. The values of NL (L) and NL (%) had a significant negative correlation with d-Dimer and C-Reactive Protein (CRP). The individuals’ average ages in years, which ranged from 24 to 80, were 48.56 ± 13.87. Conclusion: Biochemical indicators, including d-Dimer and CRP, were greatly decreased. The NL (L) and NL% values exhibited a strong negative connection with d-Dimer and C-reactive protein (CRP) both during and after Covid. Hence the different CT indices (NL, NL%) can be used along with Biochemical parameters (CRP and d-Dimer) for structural and functional recovery in Covid-19 patients.