A report of successfully treated rhino-orbital mucormycosis

Rhino-cerebral mucormycosis is a rare life-threatening infection caused by fungi from the order Mucorales. The disease occurs mostly in association with diabetic ketoacidosis. Because of its rapid progression and high mortality, early recognition and aggressive treatment offer the only chance to increase the survival rate. We report a case of invasive mucormycosis in a 55 year old diabetic male, who presented with diabetic ketoacidosis and sinusitis. The patient came with complaints of swelling in right side of face, pain in right eye, right orbital swelling and numbness right cheek. An ENT examination revealed right facial swelling and proptosis. Nasal swabs were sent to microbiology for fungal culture. Material from the swab was inoculated on Sabaraud’s dextrose agar and incubated at 37°C and 25°C. The culture was identified as mucor species. Material sent for histopathology showed presence of chronic inflammatory polyp with broad aseptate hyphae suggestive of mucormycosis. On the third day, bilateral middle meatal antrostomy, bilateral anterior and posterior ethmoidectomy and bilateral wide sphenoidotomy was done. Fungal debris were noticed in both maxillary antrum. In the post-operative period, patient was started on inj. amphotericin B. On the 11th post-operative day, patient developed palatal mucosal necrosis. Under general anaesthesia, extensive surgical 2nd look and debridement was done. The necrotic palatal mucosa was completely removed. In addition to IV amphotericin B, topical douching of both nasal cavities and antrum with amphotericin B was done for 20 days. Patient improved, became completely asymptomatic and was discharged.

Optimisation of intramuscular dosage of dexmedetomidine for hypotensive anesthesia in functional endoscopic sinus surgery- a prospective randomized double blind study

Background of the study: Dexmedetomidine, a selective alpha-2 agonist which is being used widely in anesthesia and critical care practice. It has both sedative and analgesic property. The studies on intravenous usage of dexmedetomidine are numerous but not with intramuscular route. With this background we conducted a study on optimisation of intramuscular dosage of dexmedetomidine in patients undergoing functional endoscopic sinus surgery. Aim and objectives:To optimize the dosage of intramuscular dexmedetomidine in patients undergoing functional endoscopic sinus surgery for providing bloodless field for the surgeon. Materials and methods: We enrolled a total of 50 patients who have planned to undergo functional endoscopic sinus surgery under general anesthesia. After randomization, group D1 patients received intramuscular dexmedetomidine at the dosage of 0.5mcg/kg and group D2 1mcg/kg respectively. Hemodynamic parameters like blood pressure (MAP) and heart rate were recorded at regular intervals. The surgical field score was done by the operating ENT surgeon using Boerzaart scale. The targeted mean arterial blood pressure was kept between 55-65mmHg. The other parameters like additional requirement of opioid, usage of other vasodilators, time to emergence along with other side effects were noted peri-operatively. Results:After statistical analysis, the mean duration of surgery in both groups were 92±21.8 and 85±22.15 minutes respectively. The targeted mean arterial blood pressure was achieved in the patients who have received 1mcg/kg of dexmedetomidine (Group D2) intramuscularly. The surgeon felt satisfied with bloodless operating field in the patients who received 1mcg/kg of dexmedetomidine. Conclusion:From our study we concluded that 1mcg/kg of dexmedetomidine will be the adequate intramuscular dose for both premedication and hypotensive agent in functional endoscopic sinus surgery

Abstracts of National Conference on Research and Developments in Material Processing, Modelling and Characterization 2020

This book presents the abstracts of the papers presented to the Online National Conference on Research and Developments in Material Processing, Modelling and Characterization 2020 (RDMPMC-2020) held on 26th and 27th August 2020 organized by the Department of Metallurgical and Materials Science in Association with the Department of Production and Industrial Engineering, National Institute of Technology Jamshedpur, Jharkhand, India. Conference Title: National Conference on Research and Developments in Material Processing, Modelling and Characterization 2020Conference Acronym: RDMPMC-2020Conference Date: 26–27 August 2020Conference Location: Online (Virtual Mode)Conference Organizer: Department of Metallurgical and Materials Engineering, National Institute of Technology JamshedpurCo-organizer: Department of Production and Industrial Engineering, National Institute of Technology Jamshedpur, Jharkhand, IndiaConference Sponsor: TEQIP-