Panel discussion on ‘Mucormycosis: A post-Covid Sequalae’

Aligarh: “Steroids are not new for medical fraternity, they have been used for many years for treatment of rheumatoid arthritis, but we have never seen a case of Mucormycosis. It may be because of thrombosis, over treated Covid patients, self-treated Covid patients, or patients treated by unqualified staff using giving multiple drugs”, said Aligarh Muslim University (AMU) Vice Chancellor, Prof Tariq Mansoor.

He was delivering the presidential address of the online international panel discussion on ‘Mucormycosis – a post Covid Sequalae’ organised by the Association of Oral and Maxillofacial Surgeons of India, UP Chapter (UPAOMSI) in collaboration with the Department of Oral Maxillofacial Surgery, Dr Z A Dental College (ZADC), AMU.

Prof Mansoor added: “There is a need for further research and study to come down to the exact cause of black fungus. The Jawaharlal Nehru Medical College (JNMC) of AMU is also a centre for Mucormycosis and we are treating a number of cases. Doctors at JNMC are ready for challenges that lie ahead and we are trying to procure in high quantity, Amphotericin B, the primary medicine for Mucormycosis management”.

He also stressed the need for Standard Operating Procedures (SOPs) for the management of black fungus.

Adept experts from across the globe further discussed how the potentially serious condition of Mucormycosis or black fungus causes blurred or double vision, chest pain and breathing difficulties and its treatment methods.

Prof Mohammad Shahid (Department of Microbiology, College of Medicine, Arabian Gulf University, Kingdon of Bahrain) delineated the routes of black fungus and its clinical types.

He also elaborated on the microbiological and histopathological laboratory tests.

Prof Mohammad Shameem (Department of Pulmonary Medicine, JNMC) discussed why there is a sudden increase in Mucormycosis cases and how diabetic people on longer steroid courses and patients on increasing flow of oxygen through contaminated water in humidifiers are at a high risk.

Prof Vijay Kumar Girhe (Department of Oral Maxillofacial Surgery, ZADC) talked about the clinical signs and symptoms of patients with different types of Mucormycosis depending upon the site of involvement.

Prof Aditya Mishra (Department of Radiodiagnosis, Rama Medical College and Hospital, Kanpur) advised the use of contrast MRI of paranasal sinus and base skull to determine the level of soft tissue invasion and contrast CT for bony involvement.

Dr Ashish Chandra (Department of Otorhinolaryngology, RML, Lucknow) discussed nasal endoscopy as a diagnostic tool to visualise the skull base sand medial wall of orbit.

Prof Syed Ziaur Rehman (Department of Pharmacology, JNMC) delineated medical management with use of systemic antifungals.

Prof Himanshu Reddy (Department of Medicine, King George Medical University, Lucknow) elaborated the pharmacological aspects of Amphotericin B.

Dr Ashish Agarwal (ENT Surgeon, RML, Lucknow) spoke on the role of retro bulbar Amphotericin B for non-thrombosis cases.

Prof Mohammad Kaif (Department of Neurosurgery, RML, Lucknow) discussed the 8 -16 % intracranial extension.

Prof Sandeep Sahu (Department of Anaesthesiology and Critical Care, SGPGI, Lucknow) spoke about various ways of intubations and possible complications in post Covid Mucormycosis.

Prof Naresh Kr Sharma (Head, Department of OMFS, BHU) emphasised the need for SOPs and multi-disciplinary teams of ENT surgeons, maxillofacial surgeons, ophthalmic surgeons, medicine experts, pulmonary medicine experts, anaesthetists and neurosurgeons for the better care management of post Covid black fungus.

Prof R K Tewari (Principal, ZADC) delivered the welcome address, Prof Gaurav Singh (President, UPAOMSI) welcomed the participants and panellists and Prof G S Hashmi (Hony Secretary, UPAOMSI) extended the vote of thanks.

Dr Tabishur Rahman moderated the panel discussion.