The entire world has been in the grip of COVID-19 for more than a year and is susceptible to have further pandemics in future. Although elective surgical procedures should be postponed in infected patients, they may require emergency surgeries. At the beginning of the COVID-19 pandemic, most operating room (OR) setups were not as per the requirements. Hence, several modifications and innovations were made to handle the situation. The existing ORs were converted temporarily into COVID ORs using these modifications. However, now it is well understood that the world is quite susceptible to these types of infectious diseases, and special ORs will be required for surgical management of infected patients. Therefore, it becomes extremely important to prepare dedicated ORs for emergency surgeries in patients with airborne infectious diseases, which can be readily used to manage infected or suspected patients in the event of any future pandemic. We aim to review the current relatively scarce literature and answer some questions about the readiness and methods required for conducting safe surgery during the COVID-19 pandemic, as well as any other such pandemic in future. The preparations are needed in the field of infrastructure, staff requirements and management, equipment and other supplies, and formulation of guidelines for clinical management. The ultimate aim is to prevent spread of infection from the patient to the staff members, OR environment, and other patients without compromising the care of the infected patient. This review highlights these issues and also discusses specific concerns in some special patient populations.

Background: The influenza pandemics have caused serious morbidity and mortality around the world. Only a few studies have described the clinical profile of both influenza A and B infections among children and its seasonal variations. Aims: To study the clinical profile of children with influenza (A and B) admitted to a tertiary care hospital in India over a period of 17 months. Methods: A retrospective case file review was done for all influenza-positive cases (by real time-polymerase chain reaction) admitted in the ward and pediatric intensive care unit of a tertiary care hospital from January 2018 to May 2019. Results: A total of 164 admitted children were screened for influenza, of which 41 children (25%) were positive. Seasonal variation showed highest peak in the month of October with 17 positive cases (41%). Influenza B was observed during the first half of the year 2018 followed by an increase in influenza A infection in the last 6 months. The common presenting symptoms were cough (16, 39%) and respiratory distress (21, 51%). Out of 41, 18 children (44%) required respiratory support, but only 2 (5%) required mechanical ventilation. Hyponatremia was present at admission in 13 (61%) of 21 (51%) tested samples. The median length of hospital stay in the admission hyponatremia group was 7 days (interquartile range [IQR] 4, 15) as compared to the overall median length of stay of 4 days (IQR 3, 7). Conclusions: Our study showed a predominance of influenza B in the first half of the year and influenza A infection during the second half. A similar pattern was also seen in the first half of the subsequent year. Further studies are required to understand the impact of hyponatremia in these patients.

Background: The Adolescents for Health Action model: Kishori Panchayat (KP) is a novel community participation approach for mobilizing and empowering adolescent girls. The model is expected to improve life skills of adolescent girls not only through occasional life skills sessions but also by providing them a platform for interaction with peer-groups, villagers and health-care providers, sharing experiences, community level health, and social activities. Objective: We aimed to assess whether life skills of KP girls are better in comparison to non-KP girls aged 12–18 years. Methodology: A cross-sectional study was carried out among 100 KP and non-KP girls, respectively, of aged 12–18 years, selected using random lottery method over 1-year period under Anji and Waifad Primary health center areas (10 villages from each) of rural Wardha, Maharashtra. Validated self-administered scales for communication skill, critical thinking, decision-making, problem-solving, and self-esteem were used. Written consent from participants and permission from institutional ethics committee were taken. Results: The mean life skill scores were better among KP girls compared to non-KP with a significant difference (P < 0.001) in both groups regarding communication skill, critical thinking skill, decision-making, problem-solving, self-esteem, and total life skill scores. Conclusion: Community-based adolescents for health action model for the rural adolescent girls can empower and enhances their life skills with minimum resource and intensive effort.

Background: Pancreatitis is common in South India, with a 20-fold higher incidence than the West. Objectives: This study was carried out to assess the nutritional knowledge and dietary pattern of patients with pancreatitis in South India. Materials and Methods: A validated food frequency questionnaire was used to assess the dietary pattern. An authorial questionnaire (98 questions) was used to assess nutritional knowledge, attitude, and adherence to advice. The data were entered in Microsoft Excel and analyzed in SPSS version 20. Results: A total of 86 patients with pancreatitis (acute: 50, chronic: 36) were included. Of them, 13%, 45%, and 42% of the patients had <25%, 25%–50%, and >50% scores, respectively, in nutritional knowledge assessment. Fifty-nine patients perceived their nutritional knowledge to be average (46%) or above average (22%). Restricted food items were avoided by majority, such as fried snacks (34%), raw chilly (67%), garlic (88%), and coffee (48%). Intake of recommended food items like cooked vegetables (94%) was practiced, but frequencies of consuming low-fat milk (0%), egg (8%), etc., were not adequate. Seventy-three percent of the patients knew high-fat/oil consumption was detrimental. Doctor was the source of dietary advice in 92% of patients. Only 32% were satisfied with the dietary advice received. There were no significant correlations between nutritional knowledge, adherence, and factors such as age, gender, education, type of pancreatitis, and disease duration. Conclusion: The dietary pattern, nutritional knowledge, and adherence to recommendations in patients with pancreatitis are insufficient, irrespective of demographic/clinicopathological factors.

Background: For any blood transfusion services, knowing the prevalence and distribution of blood groups in their corresponding geographical area is essential. Hence, this study was done to know the prevalence and distribution of the ABO blood group and the antibody titer levels of blood donors at a premier tertiary care center in Southern India. Methodology: This was a cross-sectional study conducted over 22 months from September 2015 to June 2017 in the Department of Transfusion Medicine, JIPMER, Puducherry, among blood donors in a single tertiary care teaching hospital blood center. The ABO blood group and Rhesus factors (Rh) were determined by the antigen-antibody agglutination test by the test tube method. Titration of anti-A and anti-B antibodies was also done for selected “O” group donors by the doubling dilution technique in the tube method. Results: It was found that the most common blood group in our blood donor population was the “O” blood group with 11,904 (38.43%) followed by “B” 10,643 (34.37%), “A” 6,201 (20.02%), and “AB” 2,219 (7.17%). We had 4 Bombay blood group donors during the study period (0.01%). A titer of 1:32 was the most frequently encountered for IgM anti-A and anti-B antibodies; in Group “O” donors and IgG antibodies, it was 1:8. Conclusion: The prevalence of ABO in and around Puducherry is comparable to those published from other regions in Southern India, with the “O” group being the most common. The distribution of antibody titers for anti-A and anti-B is similar to other studies in India.

Sepsis is one of the most common clinical diagnosis made in neonatal intensive care units. However, there are not so uncommon situations when the laboratory results do not support bacterial infections. Viral infections are under-recognized and often missed in sick neonates. We describe a case series of neonatal nonpolio enteroviral sepsis confirmed by the polymerase chain reaction. Although the first patient expired, early recognition of etiology in the index case helped control an outbreak.

Hypoparathyroidism is a disorder rarely observed during pregnancy. It poses a major challenge in managing a patient appropriately to prevent maternal and fetal complications. We report a case of a 21-year-old gravid woman, a diagnosed case of hypoparathyroidism. She was successfully treated with calcium and calcitriol before pregnancy. Dosage was adjusted according to serum calcium values, and she delivered a healthy baby with normal serum calcium level.