A descriptive audit of healthcare workers exposed to COVID-19 at a tertiary care center in India.

OBJECTIVE: To provide a descriptive audit of healthcare workers (HCWs) exposed to COVID-19, and their contacts, to understand the dynamics of transmission among HCWs. METHODS: Retrospective analysis of contact tracing data of infected HCWs was done from March 1, 2020 to July 31, 2020 at a tertiary care center in New Delhi, India. Contacts were categorized according to the nature of contact and followed for 14 days. RESULTS: Qualitative RT-PCR testing was performed on 106 HCWs (from a total of 257) owing to exposure or development of symptoms. Positive results were found in 16 HCWs (6.2%) who were exposed to 120 other HCWs, generating 197 exposure incidents. Of these, 30 (15.2%) exposure incidents were high risk with multiple exposures in 48 (40.0%) HCWs. Exposure to infected HCWs was noted in 3 (18.8%) of 16 positive cases. Of the 197 exposure incidents, 54 (27.4%) were deemed avoidable exposures. Infection prevention and control policies were periodically reviewed, and the department implemented mitigating steps to minimize the risk to healthcare providers. CONCLUSION: Instituting appropriate infection prevention and control policies and use of adequate precautions by HCWs is vital to minimize high-risk exposure to COVID-19.

Glycaemic profile in the second and third trimesters of normal pregnancy compared to non-pregnant adult females.

AIM: To assess the glycaemic profile and glycaemic variation in the second and third trimesters of normal pregnancies. METHODOLOGY: Healthy pregnant women aged 19-35 years between 24 and 36 weeks of gestation were recruited for ambulatory glucose profile monitoring. A total of 18 women in the second trimester, 15 women in the third trimester and 9 healthy non-pregnant women were recruited providing, respectively, 205 days (19,680 data points), 147 days (14,112 data points) and 100 days (9,600 data points) for analysis. RESULTS: Mean blood glucose level was 20.2% lower in the second trimester and 10.6% lower in the third trimester than non-pregnant women (p < 0.001). In pregnancy, it took 15 to 20 minutes more to reach peak postprandial blood glucose levels compared to non-pregnant women (p = 0.003). Glycaemic variability was more in the third trimester (p < 0.001). CONCLUSION: There is tight blood sugar control along with lower mean blood glucose in healthy pregnant women compared to non-pregnant women. Despite this tight glycaemic control, glycaemic variability is higher during pregnancy.

Adolescent sexual behaviour and its determinants: A hospital-based study.

AIM: To know the prevalence of sexual activity, their sexual behaviour and attitude towards sex among unmarried adolescent females. MATERIALS AND METHODS: It was a hospital-based prospective observational study. The study duration was 1 year. The study participants were unmarried girls between the age group of 10-19 years who gave written informed consent. In the case of a minor, consent was obtained from parents also. Pre-designed, pre-structured and pre-tested questionnaire was used to evaluate the sexual behaviour. RESULTS: Out of the 320 adolescents presented to the OPD, only 165 consented to participate in the study. Prevalence of sexual activity was 16.9% (28/165) in the study. Eight (8/165) adolescent girls have not attained menarche and all were not having any knowledge of sex. Three girls were the victims of sexual exploitation. Around 64% of these girls were sexually active with their classmates. All the sexually active females were having intercourse through the vaginal route, however non-vaginal route was also practiced by 6 girls. Home (11, 39%) was the preferred place followed by the hotel (10, 35.7%) for sexual activity. CONCLUSION: Prevalence of sexual activity is low among Indians as compared to the western world but it may be a tip of iceberg as it is a hospital-based study. This is the first study that assessed the route of intercourse, frequency of sexual activity, and place preferred by these adolescents to evaluate the sexual health behaviour.

Study on Prevalence and Severity of Urogenital Complaints in Postmenopausal Women at a Tertiary Care Hospital.

OBJECTIVE: The objective of this study was (1) to find the prevalence of urogenital (UG) complaints after menopause, (2) to evaluate the various risk factors for UG problems in postmenopausal women, and (3) to assess the severity of the symptoms depending on the duration of menopause. MATERIALS AND METHODS: This study is a prospective study conducted at the Specialty Outpatient Department in Safdarjung Hospital over a period of 1 year. Two hundred postmenopausal women during this period were screened for UG complaints by eliciting detailed history in a pro forma and were divided into two groups based on the duration of menopause. Women with preexisting complaints before menopause and those with some medical disorders such as diabetes, stroke, or neurological problems were excluded from the study. Data were analyzed by standard statistical analytical tests. RESULTS: The prevalence of UG symptoms in our study was 67%. Group A constitutes 127 (63.5%) participants in which menopause attained was of 1-5-year duration. Group B comprises the women with >5-year duration of menopause and it includes 73 (36.5%) patients. Among the genital complaints, vaginal dryness was the most common complaint in both the groups (Group A: 62% and Group B: 48%) followed by vaginal discharge or infection (Group A: 28% and Group B: 25%). Around 19 (15%) in Group A and 10 (13.6%) in Group B were having burning micturition (dysuria), the most common complaint encountered. The UG complaints were not statistically significantly different in both the groups. The severity of the symptoms was significantly different in two groups with more severe complaints in Group A as compared to Group B. CONCLUSION: UG complaints associated with estrogen loss can occur episodically throughout a women's life, but it is most common and chronic in the duration in postmenopausal women.

Primary amenorrhoea and clitoromegaly in a nulliparous woman: successful medical and surgical management.

Clitoromegaly is an important sign of virilisation and poses difficulty in sex determination, when present since birth. The diagnosis and treatment in an adult is a major challenge to the treating gynaecologist. The primary reason for its development is androgen excess due to congenital adrenal hyperplasia, polycystic ovarian syndrome, ovarian virilising tumours, neurofibromas, adrenal neoplasm and prolonged intake of anabolic steroids. A case of young nulliparous married woman who presented with primary amenorrhoea and clitoromegaly and was managed successfully has been reported.

Ruptured choledochal cyst during early pregnancy with successful fetomaternal outcome.

Choledochal cyst is a rare congenital malformation which is usually found in young children and adolescents but can rarely present in the adult age group. It can present with several complications like cholangitis, pancreatitis, biliary cirrhosis, portal hypertension, liver abscess, malignancy and rarely spontaneous rupture (in 2% of cases) causing biliary peritonitis. A case of spontaneous rupture of choledochal cyst during second trimester of pregnancy is reported where the patient was managed by minimal surgery, peritoneal washout, placement of T-tube and planned for definitive treatment in the postpartum period. The pregnancy continued till 35 weeks with favourable fetomaternal outcome.

Cornual ectopic pregnancy: laparoscopic management step by step.

Cornual (interstitial) ectopic pregnancy is an uncommon type of ectopic pregnancy which is located in the interstitial part of the fallopian tube. It accounts for 2%-4% of all ectopic pregnancies. Cornual pregnancies often pose a diagnostic and therapeutic challenge with a significant high morbidity and mortality as a result of massive intraperitoneal bleeding. A case of unruptured cornual ectopic pregnancy in a patient with abnormal uterine bleeding is reported which was successfully managed laparoscopically.