Introduction: The coronavirus pandemic poses a massive challenge for the healthcare system and overburdens the Healthcare Workers (HCWs) in a developing country like India. The coronavirus may survive on various surfaces and/or aerosols for hours to days, making it a necessity to use Personal Protective Equipment (PPE) while treating infected patients. Wearing the PPE is often uncomfortable while working, more so in the summer season, when the temperatures in a tropical country like India are soaring. Aim: To identify, quantify and highlight the difficulties faced by the HCWs while wearing PPEs. Materials and Methods: This descriptive cross-sectional study was conducted in June 2020, by a team of researchers working in a government owned designated Coronavirus Disease- 2019 (COVID-19) hospital in metropolitan city, West India. The questionnaire was prepared for a multicentre survey for 230 HCWs who had used PPE kits during their COVID-19 duties. The online questionnaire responses were recorded in an Microsoft Excel sheet and the results were analysed using Statistical Package for the Social Sciences (SPSS) software version 19.0. Results: Total 230 responses were received out of which 74% were doctors, 21.7% nurses and 4.3% paramedical staff. The mean duration of work was 6.24 hours and per duty one, PPE was used by almost all of the respondents. The most common difficulty faced by the responders while on duty was excessive sweating (96%/n-221), itching of the nose (56%/n-129) and face (50.9%/n-117). While after the duty 61.7% of respondents reported being dehydrated and 68.2% complained of de novo headache. In a subset with a history of migraine, almost all reported worsening of migraine with increased frequency and severity of attacks. Many (40%) reported occasionally lowering the masks or face shield due to unbearable heat, risking self- contamination. Conclusion: The PPEs in current use and in the hot and humid conditions of summer months in tropical countries poses a unique challenge for the HCWs. Customisation of PPEs and working conditions is essential in the mitigation of the problems faced by the HCWs.

Endometriosis is a common and painful condition. We present a case of a 33-year-old woman who had delivered triplets after in vitro fertilisation (IVF) for male factor infertility. She did not have any clinical features suggestive of endometriosis before the IVF treatment. The patient presented 7 years after conception, with premensural and postmenstrual abdominal pain and intense pain on defecation. The patient was diagnosed to have endometriosis in the tract of transvaginal ovum pick up in the right pouch of Douglas and right distal uterosacral ligament. The patient underwent excision of a nodule of endometriosis. The patient is asymptomatic 1 month after surgery. Histopathology analysis revealed features suggestive of endometriosis. The needle ovum pick up tract must have implanted the endometriotic tissue near the pararectal tissue. This is an unreported and late complication of IVF treatment.

Teratomas of the ovary rarely present as inguinal hernias. Teratomas most commonly occur in the gonads or along with midline structures. Although the majority are asymptomatic, complications such as spontaneous rupture are known to occur. We present a previously unreported case of a ruptured ovarian teratoma presenting as an irreducible inguinal hernia. The patient underwent an open exploratory laparotomy with left oophorectomy, and the right inguinal hernia was repaired in the same setting with a separate inguinal incision.