The ongoing COVID-19 pandemic is raising great concern all over the world. The recent introduction of vaccines has offered reason for optimism, however, new issues have arisen, such as vaccine reluctance. The safety of vaccines for pregnant women is one of the most serious of these concerns. The purpose of this review article is to provide updated international vaccine recommendations, results of ongoing studies and clinical trials, and the role of gynecologists in counseling the women to understand the risks versus benefits as well as form an informed decision towards vaccine acceptance for COVID-19. Although COVID-19 infection increases the risk of severe morbidity and mortality in pregnant women, pregnant women were not included in the initial vaccine trials. As a result, safety information is scarce. Nations have differing recommendations, though many have recently approved the COVID-19 immunization in pregnancy following a risk-benefit analysis. The Joint Committee on Vaccination and Immunization (JCVI) of the United Kingdom recently approved an mRNA vaccination for pregnant women. Vaccination is recommended by the CDC, ACOG, ARFM, and WHO. India recently took a stand, with the ICMR and the Ministry of Health and Family Welfare recommending vaccination during pregnancy and lactation.

Background: New emerging coronavirus strains are responsible for the rampant spread of COVID-19. This pandemic is not only associated with detrimental health but also with low socio-economic and adverse psychological consequences among healthcare workers, especially those working in emergency departments.Methods: Cross-sectional survey with purposive sampling was conducted. In this report, 96 obstetrics and gynaecology residents from India took part. The participants filled out a 61 item questionnaire to determine the psychological effect of COVID-19 on obstetrics and gynaecology residents in an online survey.Results: 22.9% of residents were tested RT-PCR positive to SARS-CoV2. 52.1% were reported they received an adequate quantity of personal protective equipment (PPE). 71.9% and 68.8% of residents have claimed that the number of elective cases/procedures and average OPD footfall per month respectively have decreased during this pandemic. 72.9% of residents have reported a reduction in teaching and academic activities. Of all the participants 66.7% had stress, 68.7% had anxiety while 61.5% had symptoms of depression. According to the Kessler distress scale, 37.5% of residents are likely to have a serious mental disorder. 42.7% of respondents were reported to suffer from moderate to severe clinical insomnia. The FCV-19 scale mean score was 18.79±6.782 suggesting a mild to moderate level of fear of the ongoing pandemic. Anxiety, depression, fear, psychological distress and insomnia were all strongly correlated to stress (p<0.001).Conclusions: The study highlights the urgency in dealing with the psychological wellbeing of healthcare professionals, especially in overburdened emergency services departments like obstetrics and gynaecology in such an overwhelming pandemic scenario.

<p class="abstract">COVID-19 patients are particularly susceptible to secondary infections, both bacterial and fungal, most likely due to immunological dysregulation. Secondary systemic mucormycosis was identified to be the significant cause of this epidemic among fungal infections. Post-COVID-19 complications are being reported all around the world, creating major pressure on healthcare services and the lives of the patients. PRISMA guidelines were used to conduct a literature review for articles published on COVID-19 associated Mucormycosis (CAM) between January 1, 2020, to May 18, 2021. The inclusion criteria were based on peer-reviewed studies in English covering cases with COVID-associated mucormycosis (CAM). Articles describing fungal coinfections that were not mucormycosis cases, non-COVID-19 cases, and studies with a lack of clarity were excluded from the review. The review includes 31 articles comprising of 21 Case Reports and 10 Case Series. Out of 104 cases, 76% were from India, 77.9% were males. Predisposing variables such as diabetes (71.15%), hypertension (37.5%), and ketoacidosis (10.6%) were found to be substantial contributors to the aggressive growth of opportunistic fungal infections such as mucormycosis. Rhino-orbital mucormycosis (n=47), followed by Rhino-orbital-cerebral mucormycosis (n=32), and Pulmonary mucormycosis (n=10) were commonly reported in the case studies and literature reviews which presented either following COVID-19 infection or a few weeks after active COVID-19 infection. Significant mortality (36.9%) was reported among patients. As per our observations, CAM could be a serious consequence of severe COVID-19, especially in people with uncontrolled diabetes.</p><p class="abstract"> </p>

The aim of this review is to conduct an analysis of existing literature on outcomes of application of various methods of joint decompression in management of septic arthritis of the hip in children. A search of literature in PubMed, Embase, and Google Scholar was conducted for identification of studies reporting on the outcomes of intervention for septic arthritis of the hip in children. Of the 17 articles selected, four were comparative studies; two of these were randomized controlled trials while the rest were single arm studies. Statistical difference was observed between the proportion of excellent clinical and radiological outcomes in arthrotomy (90%, 95% confidence interval [CI] 81-98%; 89%, 95% CI 80-98%), arthroscopy (95%, 95% CI 91-100%; 95%, 95% CI 90-99%), and arthrocentesis (98%, 95% CI 97-100%; 99%, 95% CI 97-100%), respectively. The highest overall rate of additional unplanned procedures was observed in the arthrocentesis group (24/207, 11.6%). Patients who underwent arthrocentesis had a statistically greater chance of excellent clinical and radiological outcomes, although the highest level of need for additional unplanned surgical intervention was observed in the arthrocentesis group, followed by the arthroscopy group and the arthrotomy group. Future conduct of a prospective multicentric study focusing on the developed and developing world, along with acquisition of data. such as delay of treatment and severity of disease will enable assessment of the efficacy of one technique over the other by surgeons worldwide.

A quality indicator is a tool that enables the user to quantify the quality of a selected aspect of care by comparing it with a set benchmark. The objective of this study was to review quality indicators for COVID-19 molecular testing at S.S. Institute of Medical Sciences and Research Centre and to compare with the predefined quality indicators in order to improve the performance of the molecular laboratory and to initiate the corrective and preventive measures. Over the period of one year we assessed different quality indicators collected from the molecular laboratory of a tertiary care hospital in Central Karnataka which has processed 36000 throat swabs for the diagnosis of COVID-19. Twelve quality indicators under pre-analytical, analytical and post analytical stage were assessed for the quality by referring it with the select criteria. Missing test request form / specimen (1.36/1000) was the most common inconsistency observed during the assessment of pre-analytical indicators followed by specimen inadequacy (0.194/1000), duplicate specimen referral forms (SRF) generated in ICMR portal (0.277/1000) and color change in the viral transport medium. In analytical phase, non-conformity with QC was seen in 2.83/1000 samples. In post analytical phase, excessive turnaround time was seen in 0.75/1000 samples followed by revised reports due to transcription error (0.38/1000) and duplicate reports (0.13/1000). The results of assessment of quality indicators in the molecular laboratory explicitly supports that laboratory could keep the incidence of errors to the minimum level by following proper corrective and preventive measures. Thus, catering quality laboratory services during devastated COVID pandemic year.