Safety and complications of labour epidural analgesia in obese parturients: worrying is not worth the weight!

The physiological transformations accompanying pregnancy, compounded by the implications of obesity, pose intricate challenges for anaesthesiologists attending to obese parturients. Obesity makes it harder to successfully provide epidural analgesia to a parturient. This narrative review explains the most recent data on the safety and complications of providing labour epidural analgesia in obese expectant mothers. We have emphasised the evidence-based approaches that are the most effective for obese pregnant mothers receiving labour epidural analgesia.

"The show must go on": Aftermath of Covid-19 on anesthesiology residency programs.

COVID-19 has caused tectonic changes in the personal and professional lives of anesthesiologists and, among several aspects, anesthesiology residency and sub-specialty training has also undergone an unforeseen overhaul. We read the articles published on the impact of COVID-19 on training of anesthesiologists and set out to extract and narrate all the significant observations. At the outset, we begin by explaining how this pandemic posed a threat to the safety of the residents and mitigating measures like PPE and barriers that have now become 'the new normal'. Sub-specialties like critical care, cardiac anesthesia, pain and palliative care have also faced difficulty in imparting training due to an initial dearth in elective surgery case load but have adapted innovative measures to overcome that. Initially, conducting thesis and research became difficult due to problems in achieving the desires sample size needed to get significant results, but this pandemic has emerged as a dynamic laboratory where topics like 'psychological impact of COVID-19' and 'development of artificial intelligence models in COVID -19 ICUs' came into the fore. Pattern of examination has also become virtual and webinars showed how knowledge, with the right medium, has the potential of global outreach. As the pandemic took a toll on the mental health of the residents, attention was paid to this previously neglected aspect and ensuring their emotional well-being became a priority to avoid the issue of burn-out. We comment on how what initially was considered a scary problem, actually paved way for growth. It brought attention to safety, innovation, new tools for training, finding solutions within constraints, continuing developing our residents into future leaders who were also trained for mitigating disasters. Changes like online education, research on socio-economic impact, priority to mental health and artificial intelligence are here to stay and by imbibing it, we ensure that 'the show must go on'.

Ganglionic Cyst of Periosteal Origin Mimicking as Pes Anserine Bursitis - A Rare Entity and Literature Review.

Introduction: Periosteal ganglion is a form of cystic swelling commonly seen around long bones of lower extremities. Case Report: A 55-year-old male presented to outdoor clinic with gradually increasing swelling around anteromedial aspect of the right knee joint with intermittent pain on prolonged standing and walking for 8 months. Magnetic resonance imaging was suggestive of ganglionic cyst which was confirmed later by histopathological examination. Conclusion: Ganglionic cyst of periosteal origin is a rare entity. Complete excision is the recommended treatment option; if not performed appropriately chances of recurrence are high.

An unusual presentation of mycetoma around knee joint as a subcutaneous mass - A case report.

Introduction: Mycetoma is a form of chronic granulomatous disease which involves subcutaneous tissues and causes bone destruction in advanced stages. The characteristic features are sinus formation, granules formation, and mass in subcutaneous region. Case Report: A 19-year-old male presented to our out-patient clinic with complaint of a painless swelling around the medial aspect of the right knee joint for 8 months with no sinus or discharge of granules. Pes anserinus bursitis was thought of as differential diagnosis for the present condition. "Staging-classification of mycetoma" is commonly used for classifying mycetoma and as per classification, the present case had Stage-A. Conclusion: Single-stage local excision was performed and supplemented with anti-fungal agent for 6 months, which showed good outcome at the final follow-up of 13 months.