The Indian Practitioner

Reena J. Wani ¹

Affiliations
1 Dept. of Obstetrics & Gynaecology HBT Medical College & Dr R N Cooper Municipal Hospital, Juhu, Mumbai, IN

Abstract

No Abstract.

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Reena J. Wani ¹

Affiliations
1 HBT Medical College & Dr R N Cooper Municipal Hospital, Juhu, Mumbai, IN

Abstract

This is the opening stanza of a piece of timeless writing, a poem I first heard from my English teacher in school, and one which I have used as a motivational piece for my students and my own children. Desiderata is a Latin word for "things desired" and this poem gives us many important messages for what we may want in life in this fast-moving and materialistic world today.

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Reena J. Wani ¹, Sachin S. Paprikar ²

Affiliations
1 Professor Addl & Head of Unit, Obstetrics & Gynecology, HBT Medical College & Dr. R .N. Cooper Hospital, Mumbai, IN
2 S Registrar, Obstetrics & Gynecology, HBT Medical College & Dr. R .N. Cooper Hospital, Mumbai, IN

Abstract

The COVID-19 pandemic is the biggest threat in living memory to the human race. The Global havoc unleashed by the COVID-19 pandemic is unprecedented. As we complete more than 45 days since it was declared a pandemic, we review the available literature from across the world about everything related to COVID-19 and women’s health, from conception to delivery. We present guidelines for antenatal care, testing, and precautions for health care workers [HCW]. Special emphasis is given on intrapartum care for COVID positive and suspected cases. We also present an algorithm for HCW exposed to possible cases.

Keywords

COVID-19 and Pregnancy, Obstetric Positive Case, Screening Guidelines, PPE.

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Priya H. Manihar ¹, Varun J. Wani ¹, Reena J. Wani ²

Affiliations
1 Junior resident (JR2) in Community Medicine, TNMC & BYL Nair Hospital, Mumbai, IN
2 Professor (Addl) and Unit Head, Obstetrics & Gynecology, HBT Medical College & Dr RN Cooper Hospital, Mumbai, IN

Abstract

Fungi are one of the major Kingdoms on this planet which, like all other life forms, ‘adapt to survive’. The human-fungus interaction is vast, with mycology being a major subset of microbiology and infectious diseases. This article attempts to be a neutral perspective: it not only describes how we fight off fungal infections by preventive and curative methods, but also how the fungi fight for survival in the available habitat that is largely controlled by humans. Two diseases are focused on, ringworm and mucormycosis. While the former is a troublemaker since time immemorial, mucormycosis has recently taken the limelight as an opportunistic infection in COVID-19 patients. The direct increase in the population of immunocompromised individuals is this pandemic may be due to an intensive use of steroids for treatment. The article also emphasises the need for early detection by a comprehensive diagnostic intervention (histopathology, direct microscopic examination, culture, (1,3)-β-D-glucan, galactomannan, and PCR-based assays) to ensure effective treatments and also highlights the preventive measures which can be taken to save lives. It is prudent to know the risk factors, the types of invasive mycosis, the strengths and limitations of diagnostic methods, clinical settings, and the need for standard or individualized treatment for mucormycosis in COVID-19 patients

Keywords

Fungus, tinea, ringworm, mucormycetes, mucormycosis, black fungus

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Sanjay Panchal ¹, Reena J. Wani ², Kinjal Chauhan ³, Varun Wani ³, Priya Manihar ³

Affiliations
1 Dept of Community Medicine, TNMC & BYL Nair Ch Hospital, Mumbai, IN
2 HBT Medical College & Dr RN Cooper Municipal Hospital, Mumbai, IN
3 TNMC & BYL Nair Ch Hospital, Mumbai, IN

Abstract

Since the beginning of COVID-19 pandemic and Lockdown on March 2020 till date, measures like hand hygiene, social distancing and testing have worked only partially to contain the cases and deaths. Cooper Hospital, Mumbai, was one of the 10 nodal centres identified by Prime Minister’s Office in January 2021 to launch the Nationwide Vaccination drive, along with other public hospitals in Mumbai. We aim to highlight the challenges of vaccination setup and procedures in initial phases and discuss concerns/effect on our department workforce and workplan. We reviewed the patterns, procedures and problems faced by our vaccination centre from January 15th till March 15th (2 months). We also looked into setup at another centre in Mumbai. Over 37,000 vaccine doses have been administrated in our center alone by March end, and issues were analysed in detail with special reference to logistics & department work. Adverse Events Following Immunization (AEFI) were very few. We found that anxiety about side effects, concerns about choice of vaccine and long-term effects were the major impediments to vaccination. Although vaccination is not the final answer, it is an important tool to improve our response to the pandemic. Restructuring available infrastructure is essential in pandemic situations. Proper procedure, counselling and choice in the way forward in this crisis.

Keywords

COVID Vaccine, Covishield, Vaccination.

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Reena J. Wani ¹, Varun J. Wani ², Zachary DiBiase ³

Affiliations
1 HBT Medical College & Dr RN Cooper Hospital, Mumbai, IN
2 Community Medicine, TNMC & BYL Nair Hospital, Mumbai, IN
3 University of Notre Dame vGPE Program, IN

Abstract

Violence against women remains terribly pervasive and affects 1 in 3 (roughly 736 million) women across their lifetime. This violence can be from an intimate or non-intimate partner and have been fairly unchanged over that last decade since the onset of the COVID-19 pandemic, there has been emerging data from front line workers that violence of all forms against women and girls has intensified. Addressing this shadow pandemic is a health care crisis of global proportions, but of special significance in the patriarchal Indian scenario and needs to be prioritized amidst the COVID care issues. The first step forward is awareness, followed by access and availability of services. This cannot be achieved overnight but by a step-wise approach. There is an urgent need to adapt our approach, integrate these issues into our health care systems so that survivors can access appropriate medical and social services.

Keywords

Domestic Violence, Sexual Violence, COVID-19, Shadow Pandemic.

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Priya H. Manihar ¹, Varun J. Wani ¹, Reena J. Wani ²

Affiliations
1 Dept of Community Medicine, LTMMC and GH, Sion, Mumbai, IN
2 Dept of Obstetrics & Gynaecology, HBT Medical College & Dr RN Cooper Hospital, Mumbai, IN

Abstract

Breastfeeding is a natural act, but it is also a learned behaviour. This year’s theme for World Breastfeeding Week 2022 is ‘Step up for breastfeeding: Educate and support.’ Organizations like Mumbai Breastfeeding Promotion Committee (MBPC) Mumbai Obstetric & Gynecological Society (MOGS) and Federation of Obstetrics & Gynecologic Societies of India (FOGSI) have been holding activities, webinars and competitions to focus on this important topic. This has been a wonderful way to partner with neonatologists, pediatricians, community medicine and mother support groups. The aim of all these activities is to highlight the physiological importance of breastfeeding, promote exclusive breastfeeding, and make the general population aware about its multiple benefits. This article provides a few key points for practicing physicians to impart knowledge of the evidence-based advantages of breastfeeding to their patients, friends and relatives.

Keywords

Breastfeeding, Mother, Infant, Newborn, Lactation, MBPC, COVID, HIV.

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Reena J. Wani ¹, Mahin Bhatt ²

Affiliations
1 Professor and Head, Department of Obstetrics and Gynaecology, H. B. T. Medical College and Dr. R. N. Cooper Municipal General Hospital, Mumbai., IN
2 Research Associate, H. B. T. Medical College, and Dr. R. N. Cooper Municipal General Hospital, Mumbai., IN

Abstract

Sickle cell disease is caused by a mutation in the beta-globin gene, leading to the formation of abnormal haemoglobin and various complications. Managing this condition during pregnancy requires a collaborative approach, involving close follow-up, patient education, and active patient involvement. The process begins with pre-conception genetic counselling and assessing the patient’s baseline health. If the disease is uncontrolled or if the patient has kidney disease, hypertension, or frequent vaso-occlusive crises, pregnancy may need to be delayed or alternative reproductive options considered. The use of hydroxyurea during pregnancy is a subject of debate and is determined on a case-by-case basis. High-dose folic acid supplementation is recommended before and during pregnancy. Medications should be carefully reviewed, and any potentially harmful drugs to the fetus should be discontinued. Low-dose aspirin and adequate hydration are used to prevent hypertensive and vaso-occlusive crises, respectively. Severe anaemia may require a blood transfusion, but haemoglobin levels are maintained below 10g/dl to prevent increased blood viscosity. Vaginal delivery can be safely performed with appropriate measures such as hydration, warmth, and nasal oxygen. Cesarean sections are reserved for obstetric indications.

Keywords

Sickle Cell Disease, Pregnancy, Vaso-occlusive crises, Anemia, Hydroxyurea, Delivery.

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