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Background & objectives: Data from the National Clinical Registry for COVID-19 (NCRC) were analyzed with an aim to describe the clinical characteristics, course and outcomes of patients hospitalized with COVID-19 in the third wave of the pandemic and compare them with patients admitted earlier. Methods: The NCRC, launched in September 2020, is a multicentre observational initiative, which provided the platform for the current investigation. Demographic, clinical, treatment and outcome data of hospitalized COVID-19 patients were captured in an electronic data portal from 38 hospitals across India. Patients enrolled during December 16, 2021 to January 17, 2022 were considered representative of the third wave of COVID-19 and compared with those registered during November 15 to December 15, 2021, representative of the tail end of the second wave. Results: Between November 15, 2021 and January 17, 2022, 3230 patients were recruited in NCRC. Patients admitted in the third wave were significantly younger than those admitted earlier (46.7±20.5 vs. 54.6±18 yr). The patients admitted in the third wave had a lower requirement of drugs including steroids, interleukin (IL)-6 inhibitors and remdesivir as well as lower oxygen supplementation and mechanical ventilation. They had improved hospital outcomes with significantly lower in-hospital mortality (11.2 vs. 15.1%). The outcomes were better among the fully vaccinated when compared to the unvaccinated or partially vaccinated.Interpretation & conclusions: The pattern of illness and outcomes were observed to be different in the third wave compared to the last wave. Hospitalized patients were younger with fewer comorbidities, decreased symptoms and improved outcomes, with fully vaccinated patients faring better than the unvaccinated and partially vaccinated ones.
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Background: Kolkata, one of the major metropolitan cities of India, is also the capital of the state West Bengal, contributes largest number of malaria cases reported from West Bengal. The present study was undertaken to assess the anti-malarial prescribing pattern in a tertiary care teaching hospital in Kolkata.Methods: This was an observational, prospective, cross-sectional study for a period of one year (from March 2017 to February 2018) in which prescriptions of diagnosed pediatric and adult malaria patients were scanned and reviewed for anti-malarial use pattern. Core drug use indicators were also analyzed to assess the rational prescribing pattern.Results: During one-year study period, 122 adult and 24 child malaria patient encounters were screened. Among adult patients, 48(39.3%) patients had P. falciparum and 74(60.7%) patients had P. vivax malaria; in children, 9(37.5%) patients had P. falciparum and 15(62.5%) patients had P. vivax malaria. All adult and pediatric P. vivax malaria patients were treated with chloroquine. Artemisinin derivatives were prescribed to 91.67% of adult and 88.88% of pediatric falciparum malaria patients, 77.09% of adults and 66.67% of children received ACT. Artemether- lumefantrine was the most commonly prescribed ACT (33.34% in adults and 55.56% in children). Prescriptions were usually in generic name and from National EDL. Percentage of encounters with antibiotics was high in both age group but percentage of encounters with injections was low in adults and children. Conclusion: Chloroquine was used rationally for treatment of P. vivax malaria patients. Artemether-lumefantrine was the most common ACT used for treatment of P.falciparum malaria cases though the National guideline for treatment of malaria does not recommend Artemether-lumefantrine for this state and region for treatment of falciprum cases.
RÉSUMÉ
Background : The propaganda for the use of condoms remains one of the mainstay for prevention of human immunodeficiency virus (HIV) transmission. In spite of the proven efficacy of condom, some moral, social and psychological obstacles are still prevalent, hindering the use of condoms. Aims : The study tried to construct a short condom-attitude scale for use among the migrant workers, a major bridge population in India. Settings and Design : The study was conducted among the male migrant workers who were 18-49 years old, sexually active and had heard about condoms and were engaged in nonformal jobs. We recruited 234 and 280 candidates for Phase 1 and Phase 2 respectively. Materials and Methods : Ten items from the original 40-item Brown's ATC (attitude towards condom) scale were selected in Phase 1. After analysis of Phase 1 results, using principal component analysis six items were found appropriate for measuring attitude towards condom use. These six items were then administered in another group in Phase 2. Utilizing Pearson's correlations, scale items were examined in terms of their mean response scores and the correlation matrix between items. Cornbach's alpha and construct validity were also assessed for the entire sample. Results : Study subjects were categorized as condom users and nonusers. The scale structure was explored by analyzing response scores with respect to the items, using principal component analysis followed by varimax rotation analysis. Principal component analysis revealed that the first factor accounted for 71% of the variance, with eigenvalue greater than one. Eigenvalues of the second factor was less than one. Application of screen test suggests only one factor was dominant. Mean score of six items among condom users was 20.45 and that among nonusers was 16.67, which was statistically significant ( P Conclusion : This tailor-made attitude-toward-condom-use scale, targeted for most vulnerable people in India, can be included in any rapid survey for assessing the existing beliefs and attitudes toward condoms and also for evaluating efficacy of an intervention program.