DT News - India - An epidemic within the pandemic- Dr. B.M. Rudagi

Dr. B. M. Rudagi

Sun. 20 February 2022

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COVID-19 is still an ongoing pandemic that has put the world in gridlock since 2020. In the mortifying second wave of COVID-19, India witnessed rattling cases of post-COVID Mucormycosis putting the medical facilities into turmoil. Jawahar Medical Foundation ACPM Medical College and the OMFS department of ACPM Dental College, Dhule, have set up a center dedicated to treating and managing post-COVID mucormycosis cases. This editorial comes from Dr. B. M. Rudagi, Prof & Head, Dept of OMFS, ACPM Dental College, Dhule, Maharashtra.

Post-COVID mucormycosis soon became an epidemic in the country, affecting the majority of the population. As an institute, we have been witnessing & treating 2-3 cases of mucormycosis annually. The graph reached its peak in the 2020 Pandemic, treating 6-7 cases daily. We operated over 150 cases nearly in less than three months. The mycotic infection was rapidly killing people within a day of its possession.

Where most of the colleges and medical schools were shut due to the pandemic, we as a department were working day in and out for the dire situation. Most of the patients that we treated were in the active stage of COVID-19. People were sinking more from the deadly fungus than from COVID-19. It was a race against the two most deadly diseases.

It is a cascade of multiple reasons during COVID such as Low immunity, cytokine storm causing an extreme inflammatory reaction and micro thromboembolism, heavy dosage of steroids, increased blood sugar levels, Poor oral and upper airway hygiene. This leads to opportunistic fungal infection and its rapid spread from the paranasal sinuses cephaly.

On the occasion of International Oral and Maxillofacial day on 13th February, we celebrated by organizing a workshop on Basic Life Support (BLS), basic suturing, and IV & IM catheterization for the undergraduate and post-graduate students. Keeping the theme ‘Metamorphosis of face – Combating Mucormycosis and transforming lives’ in mind we put forward the various ways for rehabilitating post-COVID mucormycosis patients.

Post-mucormycosis the major challenge arising currently is rehabilitation, due to its extensive facial defect. We have currently started with rehabilitating the patients with patient-specific sub-periosteal titanium implants. These implants distribute the occlusal force along all the vertical buttresses. Extensive facial defects can be reconstructed using PSI subperiosteal titanium implants. We operated two cases with orbital floor reconstruction with these implants and further continue to help post-mucormycosis patients to get them their lost smile.

Fig.1 International OMFS Day celebration

Fig.2 Basic Life Support Wrokshop

Fig 3. IV catheterization Workshop

Fig 4. Basic suturing workshop

Fig 5. 3D planning with patient specific subperiosteal implants

Fig 6 3D planning for patient specific subperiosteal implants

Editorial note:

Jawahar Medical Foundation ACPM Medical College and the OMFS department of ACPM Dental College, Dhule, have set up a center dedicated to treating and managing post-COVID mucormycosis cases. Dental Tribune South Asia had covered their work earlier too in a separate article.