Analysis of Maternal and Infant Death Reporting System (MIDRS) in a North Indian State during 2013-2018.

Background: Haryana launched the Maternal and Infant Death Reporting System (MIDRS) in 2013 to report deaths and their causes. We evaluated the system in terms of its data quality, accuracy, and timing of reporting. Methods: Secondary data analysis of data about the maternal, infant, and child deaths from the state level MIDRS portal from 2013 to 2018. The portal combines infant and maternal deaths and stillbirths reported through passive and active surveillance. We used the descriptive measure of statistics (proportion) to describe the characteristics and causes of neonatal, post-neonatal, and maternal deaths. Results: Of 1,18, 028 neonatal deaths, 39% (46,140) neonates died at a government facility. Gender was not recorded in 7,093 (6.0%) deaths. "Others" was a predominant category (14,664, 53%) of death. Of 2,842 maternal deaths, the cause of death was unknown in 465 (16.4%) deaths and mentioned as "others" in 1,618 (56.9%) instances. Nearly 60% of maternal deaths occurred at a health facility. Stillbirth was published as a cause of death in 228 (7.8%) child deaths (1-5 years). Missing data were observed in critical variables such as the timing of maternal mortality (50, 1.8%) and sex of child (4884, 4.3%). Conclusion: Delay in reporting, inconsistencies in data, and missing information were some challenges. Ascertainment of the exact cause of death needs to be improved through better training.

Impact of Underlying Comorbidities on Mortality in SARS-COV-2 Infected Cancer Patients: A Systematic Review and Meta-Analysis.

BACKGROUND: The evidence has shown that SARS CoV-2 infected patients with comorbidities are more likely to have severe disease sequel and mortality. In SARS-CoV-2 infected cancer patients risks associated with other underlying comorbidities might vary from those in non-cancer SARS CoV-2 infected patients. The relative impact of different underlying health conditions among patients with cancer and SARS CoV-2 infection remains yet to be explored. This systematic review aims to explore the prevalence of comorbidities among cancer patients with SARS CoV-2 infection and their impact on mortality. METHODS: Online databases PubMed, Embase, Scopus and Web of science were searched for articles published between 9th July 2019 to July 8th 2020.Studies of cancer patients (>18 years) with diagnosis of SARS CoV-2 infection, published in English were included. A random-effects modelling for the meta-analyses was applied to assess the pooled prevalence and odds ratio for mortality due to comorbidities in SARS CoV-2 infected cancer patients. RESULTS: Total 31studies with 4086 SARS-CoV-2 infectedcancer patientsmet the inclusion criteria. Most prevalent co-morbidities in cancer patients with SARS CoV-2 infection were hypertension [42.3% (95%CI:37.5- 47.0)], diabetes [17.8% (95% CI: 15.3-20.4)] and cardiovascular diseases [16.7% (95%CI:12.9-20.4)].The risk of mortality (pOR) was significantly higher in individuals with hypertension[1.6(95%CI 1.24-2.00)], cardiovascular diseases [2.2 (95%CI 1.49- 3.27)], chronic obstructive pulmonary diseases [1.4(95% CI 1.05-2.00)] and diabetes [1.35(95%CI 1.06-1.73)]. CONCLUSION: Our results indicates that the mortality in SARS-CoV-2 infected cancer patients is affected by preexisting non-cancer comorbidities. By identifying the comorbidities predictive for mortality, clinicians can better stratify the risk of cancer patients presenting with SARS-COV-2, on their initial contact with health services.
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Impact of educational intervention on knowledge, attitude and awareness of good clinical practice among health care providers.

BACKGROUND: Clinical trials play an important role in the generation of evidence-based data in health care practices. To ensure the credibility of data and the safety and well-being of the patients Good clinical practice (GCP) guidelines play an important role. At present, we have little knowledge about awareness of GCP guidelines among health care providers in India. AIM: To assess the level of awareness, and perception of the health care providers toward GCP and subsequent change in these after a dayer training session on GCP guidelines. SETTINGS AND DESIGN: A cross-sectional descriptive questionnaire-based study was conducted amongst health care providers, that is, doctors, dentists, nurses of a Tertiary Health Care and Teaching Institute. MATERIALS AND METHODS: Participants were given descriptive questionnaire; they completed the questionnaire before and after undergoing a day training program in GCP guidelines. STATISTICAL ANALYSIS USED: The impact of the effectiveness of educational intervention among healthcare professionals was evaluated by two-tailed Z-test. RESULTS: Out of 120 participants, 80 were medical doctors, 20 dental doctors, and 20 nurses. A dayse training program on GCP guidelines was found to increase positive attitudes toward various aspects of clinical trials. CONCLUSION: A day's training program on GCP guidelines may help to increase the knowledge as well as awareness about principles and techniques of clinical research, which will increase the credibility of clinical research in the country.