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A few challenges such as dispensing of medicines for shorter duration, lack of awareness about the exact location of the clinics, and services available among target beneficiaries, and the incomplete records maintenance and reporting system at facilities were identified. Mohalla Clinics of Delhi ensured continuity of primary care and laboratory services during COVID-19 pandemic in 2020. In summary, Mohalla Clinics have made primary care accessible and affordable to under-served population (thus, addressed inequities) and brought attention of policy makers on strengthening and investing on health services. The external evaluations and assessments on the performance of these clinics, with robust methodology are needed. The services through these clinics should be expanded to deliver comprehensive package of primary healthcare with inclusion of preventive, promotive, community outreach, and other public health services.Mucocele of the appendix is a very rare disease entity that often discovered incidentally during surgery. It can result from both non-neoplastic and neoplastic lesions and histopathological examination is needed for confirmation. Failure to make an early preoperative diagnosis may results in its rapture and spillage of mucin contents into the peritoneal cavity leading to a disastrous complication of pseudomyxoma peritonei (PMP) that has a very bad prognosis. A clear pathological terminology and management strategies of appendiceal mucocele (AM) is lacking. This literature review aims to derive detailed information related to clinical significance of AM to avoid complication of PMP and plan appropriately during surgery according to the current evidence. The relevant articles from scientific databases such as Medline, PubMed, Google Scholar were searched and extracted using the keywords "mucocele appendix" "cystadenoma%". Data based on epidemiology, clinical manifestations, complications, pathology, diagnostic work up and management were analyzed and summarized. A meticulous surgical excision is the mainstay of treatment and open surgical approach is still preferred over laparoscopy. Preoperative diagnosis of AM is very imperative as it may harbour neoplasm and can be made utilising the imaging tools like computed tomography and ultrasonography. Primary care physicians can have a crucial role in making early detection and timely referral for appropriate management in order to avoid complications. After appendectomy, 5-year survival rate for the simple AM is 91%-100% but it reduces to 25% for the malignant AM.COVID-19 has affected those disciplines where close contact is required and where there is no need for urgent care such as the field of dermatology. Due to the contagious nature of the virus, front line health care workers such as family health care physicians and primary health care doctors are using personal protective measures (PPE), which might result in skin disorders. In addition, social distancing has also resulted in the compromise of teaching and learning mainly bedside teaching in the dermatology wards. Moreover, there is also uncertainty about the guidelines different to be followed by primary health care and family physicians while assessing patients of dermatology. We aim to provide an overview of how COVID-19 has affected the primary health care workers and physicians. We have highlighted the challenges faced by the family health care physicians from the perspective of dermatology along with recommendations and future directions for family health care physicians. Results reveal that wearing PPE measures might be challenging for primary health care workers and family physicians as it can cause facial inflammatory papules, acne rosacea, seborrheic dermatitis, and facial itching. They cannot escape encounter with the patients, and they need to be careful by undertaking some precautionary measures while taking care of the patients in general with a specific focus on COVID-19. COVID-19 has also affected all teaching and learning in the field of dermatology. However, academic institutions can use digital tools such as zoom or skype to continue learning dermatology during the crisis of COVID-19.With the frequently changing guidelines on Pregnancy care, management of obstetric patients remains a major challenge during COVID-19 Pandemic. The department of Obstetrics and Gynecology had a huge responsibility to provide respectable maternity care to all women irrespective of their virologic status and at the same time protect the frontline warriors dealing with patient care during the COVID-19 pandemic. ML198 ic50 We would like to share our perspective regarding the challenges faced and the solutions sought for, in both patient care and teaching and research.COVID-19 pandemic has involved nations and incapacitated the health systems globally. The pandemic preparedness has been tested with immense losses. Universal health coverage is needed more than ever to recuperate from the effects of the current pandemic. Post pandemic, many lessons need to be learnt especially for developing economies like India where public healthcare system is grossly inadequate to take care of health needs of citizens. World Health Organization's framework of six health system building blocks was utilized to study the lessons learnt and actionable points in the post pandemic period. Participation in Global Health Security Alliance has to be stepped up with involvement in Joint external evaluation and development of epidemiological core capacities. National Health Security Action Plan needs to drafted and available for health emergences. Ayushman Bharat scheme should incorporate elements to address surge capacity at the time of health emergencies and measures to deliver care at the time of pandemic. Technology through telemedicine, m-health, and digital platforms or apps should contribute to trainings, supervision, and facilitation of healthcare delivery at remote locations. Open data sharing policies should be developed for the practice of evidence-based public health. Public healthcare system and health manpower trained in epidemiology should be given a boost to have system readiness to respond in case of future pandemics.
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