Background: Telemedicine facilitates patient care in various fields including antenatal care. Its application and usefulness need objectification and can be a guide to using this service in the care of pregnant women. Material and Methods: This was a prospective observational study conducted from May 2020 to December 2020. Following the telemedicine practice guideline of the country, 3,360 teleconsultations were sought by 862 antenatal patients. The duration of each call, an indication of referral and pregnancy risk stratification were noted. Further management was classified into three categories depending upon the need for an immediate hospital visit, no hospital visit or scheduled visit after at least 48 h after the first contact. Results: The antenatal cases were referred for either maternal, foetal or both indications in 24.7, 54.8 and 20.5% of the cases, respectively. Women were classified as low risk (61.6%), high risk (35.7%) and severe risk (2.7%). In 1.4% of the patients, history and review of the records could not be done through telemedicine. The average time spent was 16.6 min for the first contact and 3.1 min for subsequent contacts. Further management was done with immediate visits in 385 (45.3%), scheduled hospital visits in 292 (34.3%) women and no tertiary care hospital visit in 173 (20.4%). Discussion: Women (20.4%) not called to the maternal-foetal medicine department of the institute were managed along with the treating obstetrician and no difference in pregnancy outcome was noted. Conclusion: Antenatal care can be provided following triage over teleconsultation and 1.4% of the women may not be able to use telehealth.

Objective To study the evolving pathophysiology and symptomatology of invasive fungal rhinosinusitis affecting the skull base. Design Retrospective clinical study Setting Single-Centre Materials and Methods: All cases of invasive fungal rhinosinusitis with clinico-radiological and/or operative evidence of anterior and central skull base, orbit, and orbital apex involvement with or without intracranial disease were included in the study. We assessed the risk factors such as COVID 19 infection, diabetes mellitus and radiological features and management strategy Results: There were 79 patients, of which 65.8% had skull base ROCM, and 34.2% had invasive aspergillosis. The mean duration of onset of the disease was 36.75±20.97 days in ROCM with the majority of patients (66%) presenting after 30 days of symptoms. In the Invasive aspergillosis group, the median presentation duration after symptom onset was 21 weeks. In 40.8% of patients, tissue diagnosis was unavailable, and galactomannan assay and clinico-radiological assessment were used for diagnosis. The most common area of the skull base was the pterygopalatine fossa (88.5%). The most common Neural structure involved was the pterygopalatine ganglion. Conclusion: With the increasing incidence of invasive fungal infections worldwide, particularly after the Covid- 19 pandemic, it is crucial to understand the evolving nature of this disease. ROCM, documented in the literature to cause fulminant disease, became a chronic illness, possibly due to the improvement of the patient's immunity during the disease course.