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Key Clinical Message: Oral mucosal leishmaniasis is a rare finding posing challenges in the diagnosis and treatment in a nonendemic setting. This disease is present in dental clinics as nonhealing chronic growth. Timely diagnosis and appropriate treatment are crucial to prevent further complications and death. [ABSTRACT FROM AUTHOR]

Background and Aims: The shortage of beds at the maternity ward is ever increasing with an increasing trend in total birth and cesarean section deliveries thereby increasing the daily number of obstetric patients awaiting admission. This quality improvement (QI) project was conducted to mitigate the problem of bed shortage by implementing modified enhanced recovery after surgery in low‐risk cesarean section mothers. We aimed to increase the process measure of second day postoperative discharge in low‐risk cesarean section mothers admitted in the maternity ward from 0% to 25% over 2 months period. Simultaneously, the outcome measure of daily number of obstetric patients awaiting admission was assessed. Methods: The study was conducted at the maternity ward, Jigme Dorji Wangchuck National Referral Hospital, Thimphu Bhutan. Fishbone analysis was used to analyze problems leading to delayed discharge. Interventions were discussed, implemented, and reviewed using Plan, Do, Study, and Act (PDSA) cycle over 8 week period from June 1 to July 31, 2021. Data were collected using the EXCEL sheet and analyzed using STATA 13. Process and outcome measures during the pre and postintervention period were analyzed. Descriptive statistics were used to express the results. Wilcoxon Signed‐Rank test was used to determine the statistical significance at p < 0.05. Results: The postintervention second day postoperative discharge increased to a median value of 65.5% (interquartile range [IQR]: 45–80) compared to the preintervention value of zero. The number of daily waiting obstetric patients decreased from the preintervention median value of 6.0 (IQR: 0–7) to the postintervention median value of 1.0 (IQR: 0–2) which was statistically significant at p = 0.0001. Conclusion: QI initiative can address bed shortages by increasing the early postoperative discharge, thereby reducing the number of obstetric patients awaiting admissions. The outcome of this QI initiative can be used to provide evidence to modify the existing Standard Operating Procedures in our setup. [ABSTRACT FROM AUTHOR]

A case of intimate partner violence (IPV) with vaginal insertion of an irritant foreign body, chili pod of Capsicum annum, in a 36‐year‐old woman. She presented with severe burning sensation in the lower abdomen and vulva. This highlights the unique role of gynecologists in the recognition and treatment of IPV. [ABSTRACT FROM AUTHOR]

As clinicians, we need to be vigilant about these rare and atypical presentations given the endemic nature of scrub typhus in southern belt of the country. Timely diagnosis and appropriate treatment is the key aspect to prevent further complications. [ABSTRACT FROM AUTHOR]

Subarachnoid hemorrhage (SAH) can be an initial presentation of cerebral venous thrombosis. Eclampsia and postpartum onset of SAH should prompt physicians to identify possible causes and institute prompt management to avert irreversible cerebrovascular sequelae. [ABSTRACT FROM AUTHOR]