H/o nad *Chief Complaints* Itching Redness Swelling For about one n half months off and on Tab atarax allegra medrol 16 citragin tab acyclovir oient luliconazole oient herpikind all these are used by pt for last one month But not get complete relief *Vitals* Non diabetic non hypertensive *History* H/o covid + one month back *Investigations* Hb-12 tlc -6700 esr-50 Sgpt -42 s creat 0.8 urea 30 Tsh 3.48

POST COVID PROBLEM AROUND EYE. PLEASE RULED OUT DISEASE. IS THIS IS A MUCORMYCOSIS ??

This non- covid pt with uncontrolled diabetes with palatal ulcers and sino rhinal mucosal swelling which on tissue biopsy confirmed Mucormycosis. Presented with multiple cranial nerve palsy, complete painful ophthalmoplegia including ipsilateral facial palsy and multiple embolic infarcts from left ICA occlusion

Suspected case of Graves disease r *Chief Complaints* A 36 yr old male attended Mopd with Palpitation and anxiety with diaphoresis since 1 month. O/E Pt was having Postural Tremors on outstretching his hand,Proptosis and increased PR of 116/min. No Neck swelling,No Dry eyes,No Diplopia or visual problem. Von graffe, mobius sign,stellwag sign and other signs are positive. Routine Ix was advised . Reports arrived showing Low TSH less than 0.05. ECG showing Sinus Tachycardia. Anti TPO ab and Free T4 and T3 reports are awaited. Symptomatic treatment has been started. *Diagnosis* https://youtube.com/shorts/dd_Q4rkYCJk?feature=share

48yrs/M Hospitlised for DKA with H/o Covid 19 Pneumonia 2mnths back. He received antiviral Remdesivir, Methyl prednisolone 40mg thrice daily for 5 days, 40mg twice daily for 5 days, 20 mg twice daily for 7 days was given rehabilitation care and discharged with a tapering dose of methyl prednisolone from 16mg.After that,the Patient presented with presented with left eye complete ptosis, facial pain for 5 days with left sided headache with no symptoms of rhinitis or sinusitis. Nasal swab for Covid 19 was sent found to be negative.HRCT chest done,Which shows 10/25 score.CEMRI Brain with PNS shows Cavernous sinus thrombosis with pansinusitis?Fungal. Admission Glucose was 450mg/dl with ketosis managed with Insulin infusion and Human Mixtard 30:70. *Chief Complaints* Headache,Left eye dropping,Facial pain *History* Covid 19 Pneumonia,Diabetes mellitus *Vitals* Spo2 -94 on RA *Physical Examination* Proptosis of left eye with chemosis and opthalomoplegia present,fixed pupil, GCS - 15/15 *Investigations* COVID 19 RT PCR NEGATIVE,CRP -40,D dimer -550,TLC - 22000. *Diagnosis* Mucormycosis *Management* Biopsy of nasal turbinate done report enclosed, Aggressive debridement were done. He was initiated on conventional amphotericin B (given for 11 days) with Broad spectrum Antibiotics and Ecosprin for Cavernous sinus thrombosis.