Diagnostic Performance and Clinical Utility of Conventional PCR Assay in Early Diagnosis of COVID-19 Associated Rhino-Orbito-Cerebral Mucormycosis

Early diagnosis and treatment of rhino-orbital-cerebral mucormycosis (ROCM) are crucial. Potassium hydroxide with Calcofluorwhite (KOH + CFW) smears can demonstrate the fungal hyphae, but mixed infections caused by both mucorales and non-mucorales pose a diagnostic challenge. Polymerase chain reaction (PCR) can detect mixed infections and differentiate mucorales from non-mucorales. This study aimed to evaluate the utility of a single reaction PCR in the diagnosis of ROCM and the efficacy of nasal biopsy and endonasal swab in the detection of fungus. Sixty-six clinical samples were collected from 33 patients and were subjected to KOH + CFW smear, culture and PCR. PCR was performed using pan-fungal primers targeting the 28S large subunit rRNA gene, and the amplified products were further sequenced to identify the fungi. KOH + CFW smear, culture and PCR detected mucorales in 54.6%, 27.3% and 63.6% patients, respectively. PCR detected mixed infection in 51.5% patients compared to 9.1% by KOH + CFW smear. PCR detected fungus in 90% of nasal biopsies and 77.8% of endonasal swabs. Rhizopus spp. was the most common fungi identified in 43.2% of PCR-positive samples. PCR is effective in detecting mixed infection and in the diagnosis of ROCM. Nasal biopsies had better fungal detection rates than endonasal swabs

Strength and Stiffness Evaluation of a Fiber-Reinforced Cement-Stabilized Fly Ash Stone Dust Aggregate Mixture

The utilization of waste fly ash in road construction is primarily confined to its use in embankment filling or as a stabilizer when combined with lime and cement. Its application in structural pavement layers, such as the base and subbase, faces a challenge due to the high volume of fine particles, which renders it brittle when stabilized. In this study, fly ash was blended with stone dust and aggregated to enhance its gradation. Subsequently, it was stabilized with cement to bolster its strength, rendering it suitable for pavement use. Additionally, polypropylene (PP) fibers were introduced to mitigate the brittleness of the mixture. An extensive experimental investigation was conducted to assess the strength and stiffness properties, including compressive strength, indirect tensile strength, flexural strength, cyclic indirect tensile modulus, and flexural modulus of fiber-reinforced cement-stabilized mixtures of fly ash, stone dust, and aggregate. The experimental results reveal that the addition of PP fibers up to 0.25 wt.% enhances compressive strength, but any further increase in fiber content leads to a reduction in strength. However, indirect tensile strength and flexural strength show improvement, with an increase in fiber percentage up to 0.5 wt.%. It was observed that cement content plays a dominant role in stabilizing these materials. Appropriate relationships have been established between strength and modulus parameters for stabilized mixtures. Based on the strength and stiffness study, a combination of 70% fly ash and 30% stone dust aggregate with 6% cement can be considered for the base layer. Regarding the behavior of indirect tensile strength and flexural strength, an optimum fiber percentage of 0.35% is recommended