Background: Teenage or adolescent pregnancy is a major public health problem worldwide. Studies show that teenage mothers are more likely to experience pregnancy-related complications and maternal death compared to adult mothers. Hence, this study was conducted to study the socio-demographic profile and the maternal and fetal outcomes associated with teenage pregnancy and compare it with those of mothers aged 20-30 years.Methods: A cross-sectional comparative study was conducted in Government General Hospital, Guntur from April 2016 to October 2016. 50 adolescent mothers aged <19 years and 50 mothers aged 20-30 years were respectively selected as cases and controls. Data on socio-demographic profile, obstetric complications and fetal outcome was collected using a pre-designed, pre-tested, semi-structured questionnaire by face-to-face interview. Data was analysed by entering it in MS Excel worksheet.Results: Mean age was 18.2 years in adolescent mothers and 23.2 years in controls. Mean age at marriage was 17.3 years in adolescent mothers and 19.9 years in adults. Among teenage mothers 48% were Hindus, 72% upper lower socio-economic class, 88% from rural areas, 32% illiterates, 72% housewives and 32% had consanguineous marriages. Prevalence of under-nutrition (36% vs 14%, p<0.05), PROM (20% vs 4%, p<0.05), PPH (20% vs 4%, p<0.05) was significantly higher in adolescent mothers compared to adults. Prevalence of PIH was significantly lower in adolescent mothers compared to adults (8% vs 28%, p<0.05).Conclusions: Complications like maternal under-nutrition, PROM, PPH, preterm delivery and low birth weight babies were higher in teenage mothers compared to adult mothers. PIH was higher in adult mothers compared to adolescent mothers.

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Cardiovascular involvement is one of the end-organ complications commonly reported in coronavirus disease 2019 (COVID-19). It has also been postulated to be an independent risk factor for increased mortality in COVID-19-infected patients. With such a significant effect of COVID-19 on the cardiovascular system and vice versa, it is pivotal for physicians to observe this association closely for improving management and understanding prognosis in these patients. Here, we present three patients and describe their baseline cardiac risk factors, the cardiac complications they developed in association with COVID-19 infection, and their varying outcomes.

Introduction: Intramural esophageal hematoma is a rare condition presenting with dysphagia, nausea and mid epigastric or retrosternal chest pain. We present a unique case of spontaneous esophageal hematoma in a patient anticoagulated with apixaban for atrial fibrillation. Case presentation: An 88-year-old woman with history of hypertension, hypothyroidism, persistent atrial fibrillation on apixaban presented to emergency department with sudden onset epigastric pain, dysphagia and nausea without vomiting while having dinner. Physical examination was unremarkable except for mild tenderness in the epigastric region. Initial workup including complete blood count, complete metabolic panel, lipase, troponin was unremarkable. EKG showed atrial fibrillation with no ischemic changes. CT chest showed abnormal hyperdense mass-like thickening approximately 4 x 3 x 12 cm involving the mid/distal thoracic esophagus with possible differentials being food bolus, esophageal hematoma or mass. Prothrombin complex concentrate (Kcentra) was given as patient was on apixaban and gastroenterology was consulted for upper endoscopy which showed a large hematoma occupying most of the esophageal lumen at the entire length of esophagus. After family discussion on stroke-versus-bleeding risk with anticoagulation, cardiology recommended holding anticoagulation for at least a month and future evaluation for WATCHMAN device. With stable hemoglobin and gradual advancement to a soft diet, patient was discharged home with repeat endoscopy planned in two weeks. Conclusion: Spontaneous esophageal hematoma, although rare in incidence, should be identified as a differential diagnosis in a patient on anticoagulation presenting with chest pain. Literature shows a higher incidence of this complication in women. Timely diagnosis and management along with discontinuing anticoagulation can significantly lower morbidity and mortality and overall has favorable prognosis.