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IntroductionGut prolapse through vagina is rare complication with only few cases reported in the literature. This article highlights untrained professionals induced obstetrical trauma as a cause of vaginal evisceration leading to serious but preventable complications.Presentation of CaseCase 1: A 27 years old female, P2L0, had full term vaginal delivery of an IUD baby and presented 4 days later with small bowel evisceration through posterior vaginal wall. Case 2: A 24 years old female, P1A1 had underwent unsafe abortion and presented in shock, with small bowel evisceration through anterior uterine wall. Case 3: A 26 years female, P2A1, underwent evacuation for incomplete abortion and presented with omental prolapse through anterior uterine wall.DiscussionObstetrical trauma with associated evisceration of intraabdominal contents is a potentially serious complication that requires surgical intervention. General awareness may decrease these unsafe practices and thus would have impact in reducing maternal morbidity and mortality.

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Rothmund–Thomson syndrome (RTS) is a rare autosomal recessive disorder caused by mutations in RECQL4 and has characteristic clinical features. We report two unrelated phenotypically diverse patients (cases 1 and 2) with RTS having novel variants in RECQL4 gene. Case-1 was evaluated for poor growth and recurrent fractures and skin lesions. Case-2 presented at 4 months with failure to thrive and radial ray defect and developed poikilodermatous skin lesions after infancy. Both cases were confirmed to have homozygous pathogenic variants in RECQL4. Both patients have normal intellect and are on supportive therapy. The presence of characteristic poikiloderma lesions with specific distribution and skeletal anomalies in a patient with proportionate short stature is a clue toward the diagnosis of RTS.

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COVID-19 has affected millions worldwide. To combat the infectious pandemic in resource limited settings, healthcare workers and techies have come up with multiple innovations. Nations with scarcity of resources have resorted to innovative strategies involving optimal utilization and repurposing of available commodities to overcome the demand–supply mismatch. Emergency rooms overburdened with diseased population are resorting to local innovative ideas to overcome obstacles in COVID-19 patient care. Point of care testing strategies in emergency rooms, sampling booths to reduce Personal Protective Equipment (PPE) use, disinfection strategies such as tunnel disinfection and local production of sanitizers, face masks/shields, aerosol containment chambers, novel triage protocols, telehealth care strategies reaching out to remote population and utilizing point for care ultrasound for resuscitation are few of the novel innovations which have benefitted medical fraternity and patient care in testing times. Medical innovations have emerged as the positive outcome of otherwise devastating COVID-19 pandemic. These practice changing innovations could also prove beneficial in future infectious pandemics.