Outcomes of Teleconsultation Services and Patient Satisfaction among Pregnant Women Delivering at a Tertiary Care Center in South India during Coronavirus Disease 2019 Pandemic

Coronavirus disease 2019 pandemic has disrupted the antenatal care in low? and middle?income countries such as India. Telemedicine was introduced for the first time in India for continuing antenatal care. Hence, a questionnaire?based descriptive cross?sectional study is done to assess the outcomes of teleconsultation services, factors influencing it, and patient’s perceived satisfaction. Three hundred and fifty?five women who delivered the following teleconsultation from July 2020 to October 2020 were included in the study. Thirty?two percent were high?risk pregnancies and 15% of the babies required neonatal intensive care unit admission. Ninety?eight percent could convey their health concerns, 18% had a referral to other departments, and 25% had visited casualty. Sixty?three percent procured medicine through e?prescription. Seventy?six percent were happy with teleconsultation overcrowded clinic, 82% were happy about saving travel expenditure, whereas overall satisfaction was 50%. Fourteen percent did not have access to smartphone and 9% did not receive the call at scheduled time. Telemedicine has a vital role in managing pregnancy concerns during this pandemic.

Management of internal hemorrhoids by Kshara karma: An educational case report.

A 66-year-old male patient came to the anorectal clinic, Outpatient department, AVT Institute for Advanced Research, Coimbatore, Tamil Nadu, with complaints of prolapsing pile mass during defecation and bleeding while passing stool. The case was diagnosed as “Raktarsha” - 11 & 7 ‘o’ clock position II degree internal hemorrhoids, deeply situated, projecting one and caused by pitta and rakta; with bleeding tendency. Kshara karma (application of caustic alkaline paste) intervention was done in this case to internal hemorrhoids under local anesthesia. The pile mass and per rectal bleeding resolved in 8 days and the patient was relieved from all symptoms within 21 days. No complications were reported after the procedure. The patient was followed up regularly from 2004 onward till date and proctoscopic examination did not reveal any evidence of recurrence of the hemorrhoids.