Synopsis Our retrospective review revealed that antenatal infection with the Omicron variant is associated with minimal symptoms in vaccinated patients, minimal medical intervention, and good obstetric outcomes.

No abstract

Background Actinomycosis is a rare infectious disease caused by Actinobacteria. It has a wide spectrum of presenting symptoms depending on anatomical location and can occasionally mimic pelvic malignancy and cause diagnostic difficulty. Case A female in her seventies presented with altered bowel habit, anorexia and abdominal discomfort with a history of diverticulosis. CT-AP revealed a sigmoid lesion causing large bowel obstruction. She underwent a laparoscopic defunctioning sigmoid loop colostomy and limited sigmoidoscopy. Subsequent endoscopy showed no dysplastic change but obvious stricturing. A diagnosis of locally perforated diverticular disease was made. Subsequent imaging showed rapid progression with hydroureter and hydronephrosis, now suggesting locally perforated sigmoid tumour or gynaecological malignancy. Tumour markers were normal. She underwent surgical exploration and resection. Specimen evaluation revealed Actinomyces likely originating from diverticular disease. Treatment involved long-term antibiotics for 12 months. Conclusion Pelvic Actinomyces is a difficult diagnosis to make on clinical and radiological findings. It should be considered in differential diagnoses of progressive pelvic lesions.

Background & Objective. Polycystic ovarian syndrome (PCOS) is the most common reproductive endocrinopathy in women of reproductive age with many associated metabolic symptoms, in particular hyperinsulinemia, insulin resistance, and a high lifetime risk of type 2 diabetes mellitus. e e ects of time-restricted eating on metabolic pro les have been investigated in many endocrinopathies, but there is minimal data for PCOS. Here we explore the potential role of time-restricted eating in the nonpharmacological management of PCOS. Designs & Methods. Medline, CINAHL, EMBASE, Web of Science, and Cochrane Library were searched for controlled trials of e ects of time-restricted eating regimens on insulin levels in patients with PCOS. A further narrative discussion on the time-restricted eating in PCOS was conducted. Results. 2662 papers were identi ed with 37 selected for full-text review and one paper meeting criteria for inclusion. Ramadan fasting was the only time-restricted eating regimen trialled in this population with no strong evidence of a signi cant e ect on insulin levels. Conclusion. As the systematic review retrieved only one study investigating time-restricted eating to reduce insulin in patients with PCOS, there is no evidence to suggest that this intervention is e ective. From the narrative review, based on studies in other patient groups, time-restricted eating could improve insulin resistance in those with PCOS; however, well-designed studies are required before this intervention can be recommended.