Objective: To provide a descriptive account of the challenges and administrative preparedness for establishing and sustaining safe obstetric services during the COVID-19

Caesarean section under local anaesthesia (CSLA) was performed on a patient with a diagnosis of gravida 2 para 1 living 1, with eight months amenorrhea and uncontrolled, refractory, complicated eclampsia with intrauterine fetal demise and a previous lower segment Caesarean section. As she was at very high risk (ASA Grade III) for main stream anaesthesia, i.e. general/regional, lidocaine (0.5%) was used. CSLA should not be seen as a primitive/retrograde step. Instead, it should be considered to be a life-saving procedure, especially for women in rural India. Anaesthetists are not dispensable but with them on standby one can avoid mainstream anaesthesia complications in high-risk patients.

The objective of the study was to study postoperative progress of modified extraperitoneal Caesarean section (MECS) technique (group A) and its comparison with standard transperitoneal Caesarean section (TCS) (group B). It is a prospective observational study with sample sizes of 93 and 105 for groups A and B, respectively, in the settings of Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, India, which see over 10,000 deliveries per annum. Five parameters were studied. Postoperative febrile morbidity was significantly lower in group A than in group B (6.5% versus 21%; P = 0.004). Gastrointestinal function recovery occurred earlier in group A than B (6 h versus 18.5 h; P < 0.01). Although the difference between skin incision to baby delivery time was significant (6.0 min versus 3.1 min; P < 0.01), there was no significant difference in Apgar score at 1 min (P = 0.3). There was no difference in intraoperative complications in two groups. MECS is associated with less febrile morbidity and early postoperative recovery than TCS.

Background: A growing body of evidence suggests that inflammation plays the key role in different cardiovascular diseases. But very study has been done so far in relation to serum interleukin-6 in heart failure patients.  The aim of the study was to measure serum interleukin-6 in heart failure patients.Methods: Total 22 heart failure patients and 22 age and sex matched controls were included in this study from August 2015 to June 2016 for serum analysis of interleukin-6.Results: serum interleukin-6 was significantly [median(IQR) 14.3(26.2) pg/mL] increased in heart failure patients compared to age and sex matched controls [median(IQR) 0(2.4) pg/mL].Conclusions: Even though little is known about function of interleukin-6 in heart failure patients, this study shows that increased level of IL-6 in heart failure patients plays an important role as a pro-inflammatory marker in development of cardiovascular disease i.e. heart failure.

Background: Hysterectomy is one of the most common operations performed in the world. The aim of this study was to determine prospectively the influence of hysterectomy on ovarian function by measuring gonadotrophin levels and studying ovarian doppler over a two-year period.Methods: Authors conducted a prospective cohort study at the department of obstetrics and gynecology in study tertiary care center. The study was carried out over a period of two years November 2012-November 2014. Serum FSH, ovarian PI and questionnaire data were obtained at baseline and at 6 and 12 months postoperatively.Results: There was significant difference in the mean FSH and mean PI at follow-up visits of 6 and 12 months. Patient characteristics did not contribute to the changes that were observed during the follow-up.Conclusions: Authors conclude that hysterectomy affects ovarian function by affecting blood supply (reducing blood supply). This is reflected by increased FSH levels and increased PI values on ovarian Doppler.