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Introduction:Mandibular involvement in mucormycosis is rare, and only a few cases of post covid-19 mandibular mucormycosis have been reported to date. Materials & methods: This is a retrospective descriptive case series study conducted at a tertiary care centre.We report the clinico-epidemiological profile and management of 5 cases of post covid mandibular mucormycosis. All patients received intravenous antifungals at the earliest and underwent surgical debridement of the infected bone. Results: 4 patients were managed satisfactorily. 1 patient succumbed to the disease. Extent of debridement was based on the clinical, radiological and intraoperative assessment of the mandible. Conclusion: Mandibular mucormycosis is rare and early recognition of symptoms and treatment is imperative in reducing the spread of disease, decreasing the extent of resection and postoperative reconstruction.

Introduction: Mucormycosis is opportunistic fungal infection characterized by extensive inflammation, necrosis and infarction of the involved tissues. It is associated with rise in levels of inflammatory markers [Erythrocyte sedimentation rate (ESR) , C-reactive protein (CRP)]. This study was done to know the role of ESR, CRP as prognostic indicators in the treatment of covid-19 associated mucormycosis (CAM). Materials and Methods: : A retrospective descriptive study was conducted between May 2021 and December 2021 at a tertiary centre. 315 patients with post-covid ROCM (Rhino-orbito-cerebral mucormycosis) were included in study. ESR and CRP were sent for all patients at the time of admission. Postoperatively the same were repeated on post-op (POD) day 7, day 14, and day 30 during follow-up. Results: 243 (77.14%) patients were male and 72 (22.86%) were female. 6 patients with stage IV ROCM had recurrence of the disease in the postoperative period. Mean ESR values in these patients at the time of admission, POD-7, 14, 30 were 98.17, 68.17, 44.00, 80.33 respectively. Mean CRP values in these patients at the time of admission, POD-7, 14, 30 were 58.50, 48.17, 26.33,37.83 respectively. Conclusion: Serial measurements of inflammatory markers (ESR, CRP) levels helps in the diagnosis and prognostication of ROCM along with clinical evaluation and imaging.

Objectives: To determine the long-term outcomes among a cohort of patients with Kawasaki disease (KD) and a history of giant coronary artery aneurysms (CAAs) at a single US center., Study Design: Medical records for all patients with KD and giant CAAs at a pediatric academic institution were reviewed. Primary outcomes included major adverse cardiovascular events (MACE) and normalization of CA luminal diameter, using Kaplan-Meier analyses., Results: There were 60 patients with KD and giant CAAs identified between 1989 and 2023. The majority of patients were male (71.7%) with a median age at diagnosis of 0.9 years (range, 0.2-13.3 years). Patients were followed for a median of 11 years, up to 34.5 years. MACE occurred in 13 patients (21.7%) at a median of 1.4 years (range, 0.04-22.6 years) after KD diagnosis. The 10-, 20-, and 30-year MACE-free rates were 75%, 75%, and 60%. Patients with maximal CA z scores of ≥20 or bilateral CAA were more likely to have MACE. During follow-up, 26.7% of CAA regressed to a normal luminal diameter at a median of 3.6 years (range, 0.6-12.0 years). The 10-, 20- and 30-year likelihood of CA regression to normal luminal diameter was 36%, 46%, and 46%., Conclusions: Over 30 years, MACE occurred in nearly 22% of patients, more often in those with bilateral CAA or CA z scores of ≥20. Despite regression to a normal luminal diameter in >25% of CAAs, patients with a history of KD-associated giant CAA require ongoing surveillance for cardiac complications, even years after the initial disease., Competing Interests: Declaration of Competing Interest The authors declare no conflicts of interest., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Infants with heart disease are at high risk of feeding difficulties and complications. Feeding practices amongst acute care cardiology units are not standardized. This study aims to describe feeding practices for infants at the time of discharge from a Pediatric Acute Care Cardiology Collaborative (PAC 3 ) center and practice variation between centers. Discharge encounters for infants in the PAC 3 registry between February 2019 and October 2021 were included. Nutrition type and feeding route at discharge were summarized with descriptive statistics and a modified bump plot. Center variation was assessed using funnel plots with control limits set at the 99.9% confidence interval from the group mean. A total of 15,414 encounters across 24 PAC 3 centers were recorded from 8313 unique patients (median encounters 1, range 1-25). Nutrition at discharge consisted of standard formula in 8368 (54%), human milk in 6300 (41%), and elemental formula in 3230 (21%), either alone or in combination. Feeds were fortified to ≥ 24 kcal/oz in 12,359 (80%). Discharge supplemental tube feeding was present in 7353 (48%) encounters with 4643 (63%) receiving continuous feeds, 2144 (29%) bolus feeds, and 566 (8%) a combination. Funnel plots demonstrated variability in nutrition type and feeding route at discharge. Infants with heart disease commonly require high calorie nutrition and supplemental tube feedings at discharge. Feeding strategies at discharge vary widely between PAC 3 centers. Collaborative approaches to identify best practices in feeding strategies are needed., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Storage temperature fluctuation is a major problem faced in food and pharmaceutical industry, apart from prevailing fraud in marketing frozen products as fresh. The present work aimed to study the effect of intrinsic properties of chitosan on synthesis and performance of gold nanoparticles as smart packaging devices. Different types of Chitosan from shrimp waste were used as reducing and capping agent in the synthesis of metal nanoparticle. Time is taken to reduce gold atom to gold nanoparticles varied with the type of reducing agent, between 6 min 40 s to 15 min 02 s. The maximum absorbance (λ max) for AuNPs was observed between 517 and 530 nm. An increase in the concentration of chitosan resulted in smaller and uniform size AuNPs with size ranging from 8.09 to 9.95 nm compared with 14.44 to 19.88 nm for lower concentration of chitosan. Visible ruby red colour of AuNPs synthesised using trisodium citrate (TSC) and lower concentration of chitosan (0.1%) changed to colourless and grey to blue, respectively upon exposure to frozen condition (−18 °C ± 1 °C). UV Visible spectra indicated distinctly different (broader) spectrum with reduced peak intensity. A visible change in colour from ruby red to bluish and colourless state indicates that irrespective of the properties of available chitosan, it can be used for synthesis of gold nanoparticles as smart packaging to distinguish packed fresh/chilled/refrigerated products from frozen ones. [ABSTRACT FROM AUTHOR]

Complex queries on trajectory data are increasingly common in applications involving moving objects. MBR or grid-cell approximations on trajectories perform suboptimally since they do not capture the smoothness and lack of internal area of trajectories. We describe a parametric space indexing method for historical trajectory data, approximating a sequence of movement functions with single continuous polynomial. Our approach works well, yielding much finer approximation quality than MBRs. We present the PA-tree, a parametric index that uses this method, and show through extensive experiments that PA-trees have excellent performance for offline and online spatio-temporal range queries. Compared to MVR-trees, PA-trees are an order of magnitude faster to construct and incur I/O cost for spatio-temporal range queries lower by a factor of 2-4. SETI is faster than our method for index construction and timestamp queries, but incurs twice the I/O cost for time interval queries, which are much more expensive and are the bottleneck in online processing. Therefore, the PA-tree is an excellent choice for both offline and online processing of historical trajectories.