The outbreak Coronavirus disease 2019 (COVID-19) is a respiratory tract infection caused by a highly contagious and lethal beta coronavirus SARS-CoV-2, which has spread fast to encroach the entire globe and hence declare pandemic. Pregnancy alters body physiology and immune systems, can have worse effects of some respiratory infections and due to limited research and published data we still are in dilemma of appropriate management guidelines This article covers the updated guidelines for infection prevention and control (IPC), screening, sampling, antenatal visit schedules, risk scoring, triaging, supportive care, delivery, postpartum care and care of the newborn. This article aims to provide up-to-date information as per recent guidelines of various association which would serve as guidance in managing pregnant women and newborn with suspected or confirmed COVID-19. All the published papers till date, NCPRE, WHO Interim guidelines, RCOG, FOGS GCPRI, Medical Council of India , ICMR, MOFHW, CDC , ACOG guidelines are referred to compile this article to reach to a conclusion of evidence based management of pregnant ladies during COVID-19 pandemic. This article covers the not only infection prevention and control (IPC) guidelines, but also screening and sampling guidelines, antenatal visit schedules, risk scoring, triaging but also in-patient supportive care, delivery, postpartum care and care of the newborn. Data are very limited and hence very difficult to accurately define clinical management strategies and needs to be constantly updated.

Background: The aim of this study was to evaluate the adequacy of Flamm and Geiger scoring system in prediction of successful vaginal birth after caesarean section.Methods: A prospective observational study was carried out on 75 pregnant women with previous one caesarean section in department of obstetrics and Gynecology, St Stephen’s hospital, New Delhi over a period of one year.Results: In the present study, out of 75 patients, 40% patients had successful VBAC and 60% patients had emergency LSCS. Among successful VBAC 70% patients had spontaneous vaginal delivery, while 23.3% patients had vacuum assisted and 6.7% had forceps assisted vaginal delivery. Most of the patients with total Flamm and Geiger score < 3 at the time of admission had emergency caesarean section while most of the patients with score >4 had successful VBAC. There were 53.3%, 75%, 85.7% and 100% probabilities of Successful VBAC with total score 4,5,6 and >8 respectively.  Mean score for successful VBAC was 5±1.66and for emergency caesarean was 2.97±0.83.Conclusions: As total Flamm and Geiger score increases, a chance of successful VBAC increases. Application of Flamm and Geiger scoring gives fare judgment of successful vaginal birth in TOLAC and reduces the rate of failed trial leading to emergency caesarean section, thus improving outcome in a trial of labor.

Background: Research examining the role of vitamin D deficiency and the development of menstrual disorders in women is of widespread interest. Studies have been published showing that supplementation with high-dose vitamin D can lead to the restoration of the menstrual cycle. We lack adequate information regarding the effect of vitamin D levels on the physiology of menstruation and further on fertility in women of reproductive age due to the contradictory results reported by studies. Objective: To study the association of 25-hydroxy vitamin D with menstrual cycle characteristics including long and short cycle length and cycle irregularity. Materials and Methods: In this cross-sectional study, serum vitamin D levels of 166 women attending an outpatient department with menstrual irregularities after excluding all obvious causes of menstrual disorders (n = 83) between April-June 2019 were measured and were compared with women of similar profiles with complaints other than menstrual irregularities (n = 83). Results: A decreased level of vitamin D was associated with a 13.3 times odds of an irregular cycle (OR (95% CI): 13.30 (5.79-30.60), p < 0.001). 25-hydroxy vitamin D was not associated with age or body mass index. We found a significant difference (p < 0.001) in mean vitamin D levels among the females with irregular cycles vs. regular cycles. Conclusion: Vitamin D plays a role in the physiology of reproduction specific to the menstrual cycle and ovulation. Long-term prospective studies assessing the exact cutoff value and the exact dose of supplementation required are needed. Key words: Menstrual disturbances, Ovulation, Reproductive period, Vitamin D deficiency, Dietary supplements, Polycystic ovarian syndrome.

Objective: The aim of the present study was to isolate the endophytic fungi from medicinal plant Rauvolfia serpentina (L.) Benth. ex Kurz. (Family Apocynaceae) and observed their antibacterial activity against bacteria as well as the molecular characterization of most potent fungal strain. Methods: Collection and isolation of endophytic fungi from different parts (root, shoot, leaves) of Rauvolfia serpentina plant. Screening of endophytic fungi for antibacterial activity was scrutinised against six bacteria viz. Bacillus subtilis, Enterococcus sp., Klebsiella pneumoniae, Escherichia coli, Salmonella typhimurium and Streptococcus pyogenes by using Agar well diffusion method. For molecular sequencing of potent fungi, the DNA was extracted, quantified and amplified by using two oligonucleotide primers ITS4 and ITS6 in PCR.Results: A total seven endophytic fungi Aspergillus niger, Penicillium citrinum, Cladosporium sp., Curvularia lunata, Aspergillus sp., Alternaria sp. and Aspergillus fumigatus were isolated from different parts of Rauvolfia serpentina and fungal strain Penicillium citrinum was shown the maximum zone of inhibition against Bacillus subtilis (23.0±0.12 mm), Escherichia coli (19.9±0.16 mm), Streptococcus pyrogens (19.2±0.59 mm), Enterococcus sp., (17.2±0.08 mm), Klebsiella pneumoniae (18.9±0.16 mm) and Salmonella typhimurium (15.1±0.16 mm). The molecular sequencing of the potent fungi was done by primers (ITS4 and ITS6) which showed strong specificity with fungal DNA and the percentages of identical matches of ITS4 and ITS6 DNA sequences in the GeneBank database (NCBI) were determined to 98 %.Conclusion: In the present study, the endophytic fungal strain Penicillium citrinumshowed the potential source of antibacterial bioactive compounds and molecular sequencing of this fungus helps in future to determine the various metabolic pathways that are responsible for the production of such type of novel compounds.

BACKGROUND: The lack of fundamental knowledge and awareness about the biological process of reproduction is low worldwide but has reportedly higher incidence rates in under-developed countries. Infertility can have a tremendous effect on a woman's psychological and social well-being, pushing her toward mental stress, anxiety, depression self-blame, self-isolation, feeling of worthlessness, and lack of interest in life. The present study was conducted to determine the level of knowledge and awareness regarding factors affecting fertility and also to ascertain the emotional status of females visiting the Obstetrics and Gynecology out-patient department for fertility assistance. MATERIALS AND METHODS: A cross-sectional study was performed by using a questionnaire which had two parts; the first part had questions about awareness and knowledge of the subject of infertility, and the second part had 12 questions that assessed the psychological and emotional status of the participants, and it also explored prevailing myths about infertility based on a validated questionnaire. RESULTS: There was a significant difference in mean knowledge score; those who were more educated had better knowledge of various aspects of infertility. The overall adequacy for knowledge and awareness revealed that only 62 (47.7%) of the participants had adequate knowledge (score >6) regarding female infertility. The mean score for knowledge among all the respondents was 6.61 ± 1.48. The overall emotional and psychological score suggested that 30 (23%) of the respondents were disturbed because of stress because of infertility. CONCLUSION: Infertility can have a serious impact on the psychological well-being of females, and social pressure and stigma associated with childlessness can further worsen the physical and emotional well-being of couples, which needs to be addressed before starting treatment of infertility for a better response to treatment. The limited knowledge and prevailing mis-conceptions regarding infertility need to be sincerely dealt with to complement the medical treatment of infertility.