IMPACTS OF COVID-19 ON THE INFORMAL SECTOR OF INDIA

The Indian economy is comprised of both the formal or organized sector and the informal or unorganized sector. Both these sectors were severely harmed during the Covid-19 pandemic. The government of India announced an abrupt and sudden lockdown without any prior steps of combating the drawbacks of such an abrupt action. This left the informal sector completely stranded amidst the pandemic. Taking this into consideration, the paper tries to discuss the impacts of the lockdown on the informal sector. While stressing on the adversaries faced by the labourers, the paper addresses the negative impacts of the lockdown on the female workers in the informal sector. Followed by this contextual discussion, the paper attempts to discuss the steps and schemes promulgated by the government for combating this crisis and its limitations. Finally, the paper concludes with an attempt on briefly analyzing the contingencies and suggesting ways forward to meet the exigencies.

Bacteriological and Antimicrobial Susceptibility Profile of Orthopaedic Surgical Site Infections

Background: Orthopedic implant site infection is major component of surgical site infection associated with high morbidity and mortality. Implants are foreign to the body so that orthopedic surgery is at risk of microbiological contamination .The changes in pathogenic flora has lead to emergence of antibiotic resistance creating problems in the management of orthopedic diseases. The aim of this study was to determine the type of bacterial pathogens isolated from surgical site infection (SSI) in Guru Nanak Dev Hospital attached to Govt. Medical College, Amritsar and their antibiotic sensitivity profile. Methods: During this period of study from August 2018 to July 2019, 509 pus samples were sent to microbiology department suspected as surgical site infection, from orthopaedic department of Government Medical College, Amritsar. Standard microbiological techniques were used to identify the organisms and determine the antibiotic susceptibility pattern as per CLSI guidelines. Results: In the study, out of 397 (77.6%) positive cultures, 109 (27.45%) Gram positive organisms were isolated among whom Staphylococcus aureus 92 (23.17%) was most common and 288 (72.54%) Gram negative organisms were isolated among whom Klebsiella species 90 (22.67 %) was most common isolate. Conclusion: S. aureus is the most common organism responsible for SSIs. Antibiotic preference should be made according to local sensitivity pattern of the hospital.

Obstetrics ICU admissions: learning objectives

Background: The management of critical illness in pregnancy requires intensive monitoring of obstetric patients in the intensive care unit. Systematic way of surveillance will allow the measurement of outcomes of interest and associated risk factors. Intensive care unit is highly specified and sophisticated area of hospital which is specifically designed, staffed, furnished and equipped, dedicated to the management of critically sick patients, injuries or complications. The aim of this study was to know the frequency of ICU admission in obstetrical patients, to analyse the medical or surgical comorbidity related to obstetrical problems, to segregate the cause of morbidity and to identify the risk reducing strategies.Methods: This observational study was conducted in 40 ICU patients in present institute from 1st December 2016 to 28th February 2019. The present study was divided into two groups in group I, intervention was done first followed by ICU intervention and in group II, ICU stabilization was done first followed by obstetrical intervention. The parameters noted were age, parity, gestation age, diagnosis on admission, associated medical and surgical comorbidity, reason for ICU admission, any surgical procedure performed, details of treatment given in ICU like ventilator support, blood transfusion, dialysis or ionotropic support. Patients outcome, review of mortality and area of improvement were also noted.Results: There were 17.5% mortalities observed in present study. The most common ICU intervention was blood transfusion (81.19%) followed by mechanical ventilation (37.8%). Commonest cause of mortality was multiorgan dysfunction (28.5%) followed by hypertensive disorder of pregnancy (14.3%), peripartum cardiomyopathy (14.3%), acute fatty liver of pregnancy (14.3%), septic shock (14.3%) and acute febrile illness (14.3%). Most of the patients were unbooked (74.3%), 47.2% cases did not receive antenatal care.Conclusions: There is need for antenatal registration of all pregnant women and institutional deliveries should be the aim. There should be antenatal detection and management of medical and surgical comorbidities. There is need for training in emergency obstetrics so that complication can be recognized and managed at an optimum time.