Change in Disease Dynamics and Health Care Utilisation in Children during COVID 19 in a Tertiary Care Hospital of Eastern India

This retrospective, observational study was conducted by collecting data from medical records during COVID 19 pandemic from March 2020 till August 2020. This was compared with the data of 2019 during similar months. The impact of COVID 19 on use of preventive and curative paediatric health care service units like outpatient department, casualty, intensive care and immunization clinic were assessed. Data from 2019 to 2020 were compared using standard parametric and nonparametric tests. There was a significant decline in routine OPD (68%) attendance during the COVID 19 period as compared to pre-COVID period. Paediatric ward admissions and PICU admissions were decreased by 55% and 42% respectively. We also observed a significant 43% decline in the number of children attending immunization clinic in the year 2020. The fear of COVID 19 pandemic and the measures taken to control the pandemic has affected the health seeking behaviour of patients. This evaluation of trends in healthcare use may help in planning the delivery of healthcare service delivery in future.

Circadian variation in onset of myocardial infarction : Comparison between diabetics (Niddm) and non-diabetics.

Aims and Objectives : A number of retrospective and prospective studies have demonstrated a peak in the onset of MI in the morning hours and a trough at night. This has led to investigations of the factors which can affect or modify the circadian pattern of onset of MI. The current study was undertaken with an objective of assessing whether the presence of diabetes can or cannot affect the circadian pattern of onset of myocardial infarction in an Indian population. Material & methods : 50 non diabetic subjects and 50 diabetic subjects were randomly selected from among patients admitted to cardiac ICCU of LTMMC and GH Sion, Mumbai. For all patients the time of onset of MI was noted and the results were tabulated. Results : 44% of non-diabetic subjects experienced onset of myocardial infarction in the period between midnight to 6:00 a.m. as compared to 32% in case of diabetics but an application of Chi Square Test, did not come out to be significant. But on comparing diabetics with >5 years and <5 years history, a significant loss of circadian rhythm was observed in case of diabetics of >5 years duration, indicating that autonomic neuropathy may play a role in the loss of circadian rhythm. Conclusion: It has important implications for the treatment of myocardial infarction in case of diabetics. This study can be followed up with additional studies to verify other factors which can affect circadian pattern of onset of myocardial infarction. Loss of biorhythms can result in increased incidence of thrombotic events throughout the day leading to increased cardiovascular mortality and morbidity.

Borderline tuberculoid leprosy--an unusual presentation: a case report.

A twenty-six year old lady presented herself with multiple erythmatous, scaly, well-defined, hypo-esthetic plaques over bilateral soles, face and left leg. Histopathology revealed features consistent with borderline tuberculoid leprosy.

Role of the male partner in the lower genitourinary tract infection of female.

We studied the relationships of selected microbes and the role of consorts in the causation of vaginal discharge which may be due to cervicitis or vaginitis. A total of 93 consecutive patients in the reproductive age group with symptoms of vaginal discharge along with their sexual partners were studied. Samples were collected from the cervix and posterior fornix of the female patients and from the urethra and sub-prepucial area of the male partner for culture of Neisseria gonorrhoeae, Gardnerella vaginalis, Mycoplasma hominis, ureaplasma, candida, aerobic and anaerobic organisms. Apart from cultures, KOH and Gram stain of the discharge were made. Predominant pathogen isolated was Ureaplasma urealyticum from 40 (43.01%) females and 23 (24.7%) males. The next common pathogenic organisms isolated were candida species from 11 (11.8%) females and 5 (5.4%) males and Chlamydia trachomatis in 3 (3.2%) females and 1 (1.1%) male. Various organisms were more frequently isolated from the 29 of 43 (67.4%) couples who had had sexual intercourse 7 days prior to the recruitment as compared to 14 of 43 (32.6%) who had had coitus more than 7 days prior to their recruitment. This may be due to the spontaneous disappearance or decrease in the number of organisms to the level that they could be detected by culture. In our study, 6 (6.5%) of male partners carrying pathogenic organisms were asymptomatic, indicating that their screening and treatment is vital.