Absence of Case of Mucormycosis (March 2020-May 2021) under strict protocol driven management care in a COVID-19 specific tertiary care intensive care unit.

Aims: With a sudden increase in cases of mucormycosis seen in Covid -19 patients, we conducted a retrospective analysis of all admitted patients in a tertiary care covid-19 hospital looking at incidence of mucormycosis.

Methods: Intensive care unit daily rounds data stored in an electronic format was retrieved by one of the consultants, looking for incidence of mucormycosis, diabetes mellitus, adherence to protocol for steroid use, glycemic control and use of monoclonal antibodies. Also, patients follow up data base of post covid Outpatients Department was searched for cases of mucormycosis.

Lumbar canal stenosis in "young" - How does it differ from that in "old" - An analysis of 116 surgically treated cases.

Objective: Patients treated for lumbar canal stenosis (LCS) were retrospectively analyzed to evaluate the differences in clinical management in those below (Group A) and those above (Group B) the age of 50 years. All patients were treated with the premise that instability is the nodal point of the pathogenesis of LCS and "only-stabilization" is the surgical treatment.

Materials And Methods: During the period June 2014 to June 2020, 116 cases were diagnosed to have LCS and surgically treated by the Goel modification of Camille's transarticular screw fixation technique.

Mucormycosis in COVID-19: A systematic review of cases reported worldwide and in India.

Background And Aims: There are increasing case reports of rhino-orbital mucormycosis in people with coronavirus disease 2019 (COVID-19), especially from India. Diabetes mellitus (DM) is an independent risk factor for both severe COVID-19 and mucormycosis. We aim to conduct a systematic review of literature to find out the patient's characteristics having mucormycosis and COVID-19.

Survey of the Impact of COVID-19 on Pediatric Orthopaedic Surgeons Globally.

Background: The coronavirus disease 2019 (COVID-19) pandemic required rapid, global health care shifts to prioritize urgent or pandemic-related care and minimize transmission. Little is known about impacts on pediatric orthopaedic surgeons during this time. We aimed to investigate COVID-19-related changes in practice, training, and research among pediatric orthopaedic surgeons globally.

A Web-Based Global Educational Model for Training in Semen Analysis during the COVID-19 Pandemic.

Purpose: In response to the COVID-19 pandemic, the American Center for Reproductive Medicine (ACRM) transitioned its annual training in assisted reproductive technology (ART) from a hands-on, laboratory-based training course to a fully online training endorsed by the American College of Embryology. Here we describe our experience and assess the quality of an online training format based on participant outcomes for the first three modules of a planned series of online ART training.

Materials And Methods: These modules included manual semen analysis, sperm morphology and ancillary semen tests (testing for leukocytospermia, sperm vitality, and anti-sperm antibody screening).

Relevance of Leukocytospermia and Semen Culture and Its True Place in Diagnosing and Treating Male Infertility.

The current WHO 2010 manual for human semen analysis defines leukocytospermia as the presence of peroxidase-positive leukocytes at a concentration >1×10/mL of semen. Granular leukocytes when activated are capable of generating high levels of reactive oxygen species in semen resulting in oxidative stress. Oxidative stress has been correlated with poor sperm quality, increased level of sperm DNA fragmentation and low fertility potential.

A Comprehensive Guide to Sperm Recovery in Infertile Men with Retrograde Ejaculation.

Retrograde ejaculation (RE) is a condition defined as the backward flow of the semen during ejaculation, and when present can result in male infertility. RE may be partial or complete, resulting in either low seminal volume or complete absence of the ejaculate (dry ejaculate). RE can result from anatomic, neurological or pharmacological conditions.

Cystic fibrosis transmembrane conductance regulator-related male infertility: Relevance of genetic testing & counselling in Indian population.

Background & Objectives: Due to limited information available on the frequency and spectrum of cystic fibrosis (CF) transmembrane conductance regulator (CFTR) gene mutations in congenital bilateral absence of vas deferens (CBAVD) in Indian population, it is difficult to provide accurate genetic counselling to couples. The present study was undertaken to investigate the spectrum and frequency of CFTR gene mutations in Indian men with CBAVD and to determine the female CF carrier status.

Methods: Direct DNA sequencing of the CFTR gene was carried out in eighty CBAVD men, their female partners and fifty controls from the general population.

The lateral cerebral peduncle approach to ventrally placed intra-axial midbrain tumors: A technical note.

We describe the anatomical landmarks and surgical feasibility of a novel 'safe' brainstem entry zone to approach ventrally placed intra-axial midbrain tumors. The anatomy of the brainstem was specifically studied to evaluate safe surgical entry zone in the midbrain on two formalin fixed silicon injected cadaver head specimens. A novel entry point through the lateral one - fifth of the cerebral peduncle was identified to be 'safe' to approach lesions of the ventral midbrain.

Multidisciplinary Management for Intestinal Obstruction by Gel Ball Ingestion.

Foreign body ingestion is common in young children. Very few cases require surgical exploration for removal. We report a case of superabsorbent gel ball ingestion causing intestinal obstruction, managed by a combination of endoscopic and open surgical removal under intraoperative ultrasound guidance.

"Flow Reversal" and Cure in a Case of Giant Intracranial Aneurysm: A Case Report.

We describe the case of an 11-year-old girl having a giant anterior circulation aneurysm. The ipsilateral internal carotid artery was entirely blocked and the aneurysm was supplied by posterior circulation. Following a high-flow bypass that connected the external carotid artery to the middle cerebral artery, the giant aneurysm thrombosed spontaneously.

Hangman's fracture: a clinical review based on surgical treatment of 15 cases.

This is a retrospective analysis of cases with hangman's fracture. The subject of 'hangman's fracture' has been elaborately evaluated in the literature. The authors propose an alternative format of surgical treatment that is based on modification of existing classification schemes.

An Unusual Case of Atrial Wall Cardiac Sarcoidosis Detected on Fluorine-18 Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography Scan.

Isolated cardiac sarcoidosis (ICS) accounts for 5%-10% of patients with sarcoidosis. It can involve atrioventricular node causing heart block, as well as the basal septum, papillary muscles, focal regions in the free wall, and the myocardium being more commonly involved. The diagnosis is achieved on magnetic resonance imaging (MRI) and endomyocardial biopsy.

Rare Fungal Infection in Arthritic Knee After Stem Cell Injection Managed by Novel Staged Primary Arthroplasty: A Case Report.

Case: A 72-year-old man with bilateral knee osteoarthritis treated elsewhere with bilateral intraarticular stem cell injections (SCIs) presented to us 2 months later with signs of infection in his left knee. Aspiration culture grew fungus Penicillium sp. First-stage total knee arthroplasty (TKA) included thorough joint debridement, lavage, standard bone cuts, and insertion of antibiotic-impregnated cement spacer.

Sperm DNA Fragmentation: A Critical Assessment of Clinical Practice Guidelines.

Sperm DNA fragmentation (SDF) is implicated in male infertility and adverse reproductive outcomes. With the publication of many studies regarding the etiologies and contributors to SDF, as well as the effects of SDF, guidelines are necessary to aid clinicians in the application of SDF for male fertility evaluation. Two recent clinical practice guidelines were published by Agarwal et al and Esteves et al.

Salmonella Typhi acquires diverse plasmids from other Enterobacteriaceae to develop cephalosporin resistance.

Background: Recent reports have established the emergence and dissemination of extensively drug resistant (XDR) H58 Salmonella Typhi clone in Pakistan. In India where typhoid fever is endemic, only sporadic cases of ceftriaxone resistant S. Typhi are reported.

Mediastinal Extension of Pancreatic Pseudocyst: A Rare Pediatric Presentation.

Pancreatic pseudocysts are cystic cavities which are localized collection of pancreatic secretions, rich in amylase and other enzymes, present in and around pancreas, encased in a false epithelial lining of fibrous or reactive granulation tissue. Extension of a pancreatic pseudocyst into the mediastinum is rare. We are reporting a case of a 5-year-old child with mediastinal pancreatic pseudocyst which was successfully drained by cystojejunostomy.

Is "" Tumor Resection a Safe Surgical Strategy for Low-Grade Gliomas? Feasibility Report on 74 Patients Treated Over Four Years.

Background: Gliomas are "confined" tumors arising from a named white fiber tract and displacing adjoining "normal" white fibers. The surgical strategy of "en masse" resection of gliomas based on this concept is evaluated.

Objective: We evaluate the feasibility of the surgical strategy of "en masse" tumor resection for low-grade gliomas arising from the short arcuate fibers.

Role of Double Inversion Recovery Sequence in Neuro-imaging on 3 Tesla MRI.

Double Inversion Recovery (DIR) is a robust sequence designed to suppress fat and water signals using two 180° inversion pulses to produce prominent gray matter contrast with high spatial resolution. It has proven to be more sensitive in delineating white matter signal abnormalities than conventional MR techniques. In our study, the highest image contrast with lesion load was observed using DIR over FLAIR and T2 weighted imaging.

Management of serious infections caused by metallo β-lactamases with or without OXA-48-like expressing Enterobacterales with aztreonam and ceftazidime/avibactam combination: Dosing strategy for better clinical outcome.

Serious infections caused by MBLs with or without OXA-48-like expressing Enterobacterales remain challenging to treat. Since aztreonam is stable to MBLs, it can be combined with ceftazidime/avibactam to protect against concurrently expressed ESBLs and class C β-lactamases in MBL pathogens. However, in the light of dose-limiting hepatotoxicity of aztreonam, short half life of avibactam, significant protein binding of aztreonam, appropriate dosing and method of administration to optimize PK/PD and toxicodynamics for this combination is being debated.