Telemedicine during COVID-19: India embracing the change

Telemedicine has been around for decades but it has taken foreground in health services recently. When COVID-19 cases started to be reported in the country it brought with itself panic and chaos. At all India level, the adult literacy rate is 77.7%, this could also be linked to unawareness related to the disease in rural areas. The sudden countrywide lockdown imposed was of no help and further worsened the situation for economically weaker section of the society. During the struggle of our nation to overcome the COVID-19 Telemedicine has indeed played a vital role. People in fear of contacting the disease and due to nationwide lockdown were unable to reach their health care provider. People with pre-existing conditions that needs regular monitoring, pregnancy related queries, queries on new symptoms, psychological counselling and many more could not wait for the COVID-19 to be over before they get any help on the issues.­­ Telemedicine shall continue developing and be used in a multitude of settings by more health-care doctors and patients, and these standards of practice will be a crucial driver within this evolution.

Epidemiological study of fatal road traffic accident cases

The present study is an epidemiological study of fatal Road Traffic (RTA) cases brought and admitted in our tertiary health care centre from Nov 2017 to December 2019. There were 148 fatal RTA cases involving 112 males and 36 female. In the present study males cases outnumbered the female with an approximate male female ratio of 3.1:1. Many cases of fatal head injuries were due to four & two wheelers. Most commonly seen external injuries were abrasions. Lower limbs showed fractured in 31 cases, 20.95%, and upper limbs showed fractured in 22 cases, 14.89%. So, far case fatality is concerned involvement of head plays the most important role.

Autopsy dissection techniques and investigations in deaths due to COVID-19 triggered fungal infections - A diagnostic review

The COVID-19 pandemic, which originated from Wuhan, China, has rapidly spread worldwide, including India. As India grappled with the second wave, COVID-triggered fungal infection has suddenly risen tremendously, raising a sense of panic in the country. The fungal infection in COVID-19 includes Mucormycosis and Aspergillosis, as common fungal infections primarily affecting rhino-orbital structures. Many research papers have published postmortem findings in autopsies conducted on COVID-19 decedents, thereby helping to understand this contagious disease's pathogenesis. But, with the arrival of COVID-triggered fungal infection, which is a crucial invasive disease responsible for fatality, very few research papers have commented on the postmortem findings of invasive fungal infections affecting the rhino-orbital and craniocerebral structures in COVID-19 deaths. Therefore, the role of invasive fungal infection due to COVID-19 illness must be established in the causation of deaths in COVID-19 patients. This review research deals with autopsy dissection techniques and possible postmortem findings of invasive fungal infections involving the nasal and paranasal sinuses and orbital structures in COVID-19 deaths. The findings of fungal infection affecting nasal and paranasal systems may not differ in live patients and in a deceased; however, it is essential that correct interpretation of the postmortem findings aided by pre-or post-autopsy investigations is necessary to establish the role of covid triggered fungal infection in such deaths.

Homicide and corpse dismemberment: A study of one case

Homicide may be an isolated impulsive act arising from a situation or based on a previous conception, which is premeditation. Despite its nature or motivations, homicide remains a wrongful criminal act at all times and in all places. Several studies conducted in Western countries on this topic have highlighted the overriding concern of the criminal, which includes concealing the criminal offence in most cases.In Africa, apart from cases of infanticide, the discovery of the body of a homicide victim in a public place is a relatively common phenomenon, particularly if it involves mutilation.The body was examined; it was a young adult African female whose corpse was wrapped in a plastic bag. The autopsy established that the section or cutting planes were preferably lodged in the large joints.Death was caused by mechanical asphyxia. The focus of this case lies in the atypical nature of this type of postmortem manipulation in the West African context.The unusual nature of this type of homicide illustrates and underscores some reality in our development context.

Effect of maternal high body mass index on outcome of pregnancy in women with recurrent miscarriages

The epidemic of obesity is spreading worldwide and subsequently, rate of obesity during pregnancy has also increased. Maternal overweight and obesity are widely associated with adverse pregnancy outcomes. Recurrent miscarriage is an important reproductive health issue, because it affects many couples. So the present study is planned to study the relationship between maternal obesity and pregnancy outcome in women with recurrent miscarriages. Observational Cross sectional study was conducted in a tertiary care hospital. 111 Postnatal women between 18 to 44 years of age with history of two or more miscarriages less than 20 weeks of gestation in previous pregnancy were included in the study. First trimester weight at the first visit (registration) was recorded, BMI was calculated & women were divided into obese and non obese groups. The outcome of present pregnancy was noted as Mode of delivery, Gestational diabetes mellitus, Pregnancy induced hypertension, Preterm delivery etc. Statistical tests were used to quantify the risk. Gestational diabetes (OR= 13.6) and pregnancy induced hypertension (OR=4.2) were significantly associated with obesity in women with recurrent miscarriages. [At 95% CI] The incidence of LSCS and preterm delivery was more in overweight and obese mothers, though not statistically significant. Maternal obesity significantly contributes to poor prognosis for the mother and the baby during delivery. Hence the women of this group should be regarded as ‘high risk’ and counselling and the risk assessment should be done during ANC visits.

Death following accidental compression of neck by safety harness: A case of fall from height

Work related fall from height many a times causes fatal injuries and death amongst working in various construction sites. It leads to different types of fatal bodily injuries including spinal injuries causing economic burden to the family. Although, they have been provided with protective gears and proper training for its use; it has been observed that workers are not using these in a proper ways. They eventually met with accidents which can easily be prevented. Accidental compression of neck by safety harness following fall from height has rarely been described leading to death of the individual. A case was brought for autopsy following accidental compression of neck structure causing fracture of cervical spine and transaction of spinal cord. In this paper, the case has been described with its autopsy findings.

Awareness, attitude and practice of COVID-19 and its vaccination in J&K, India

COVID-19 Pandemic has severely affected the health care delivery system, economic and social progress since its inception. Although COVID-19 vaccines have given, a new hope but Vaccine hesitancy has been recognized as a serious public health problem that needs extensive research among different population groups. This study was aimed to assess awareness, attitude and practice towards COVID-19 vaccination and its association with Sociodemographicvariables among social media users in Jammu and Kashmir, India.The Department of Community Medicine, Government Medical College, Anantnag conducted this cross-sectional study in June 2021, among social media users, 18 and above years of age, using online questionnaire through Google Forms. The questionnaire comprised of four segments, sociodemographic details, awareness, attitude, and practice regarding COVID-19 vaccination, ten questions from each segment.In this study, although the calculated sample size was 423, a total of 425 respondents were included. The mean scores of awareness, regarding COVID-19 disease and its vaccination, was 3.68 ± 0.44, with overall awareness was 73.6%, positive attitude 3.53 ± 0.41, with an overall positive attitude of 70.6%, and good practice towards adopting COVID-19 appropriate behaviour and vaccination was 3.43 + 0.71 with an overall good practice of 68.6% respectively. Participants with higher awareness regarding COVID-19 disease and its vaccination were 9.1 times (95% C.I = 5.16-14.32) more likely to have a positive attitude towards using COVID-19 appropriate behaviour and its vaccination and 7.8 times (95% C.I = 4.62-13.83) adopting good practice than with the low level of awareness.In Jammu and Kashmir, social media users are having good awareness toward COVID-19 disease and its vaccination. Awareness generation seems to be a good tool for bringing behavioural changes and this platform should be used to disseminate information regarding COVID-19 appropriate behaviour and its vaccination.

A suicidal heavy metal poisoning mimicking corrosive acid poisoning: A rare case report

Ingestion of corrosive substances may cause severe to serious injuries of the upper aero-digestive tractand the poisoning can even result in death. Acute corrosive intoxications pose a major problem in clinical toxicology since the most commonly affected population are the young with psychic disorders, suicidal intent and alcohol addiction. In our case report, a 19-year-old male, 2year engineering student committed suicide by consuming a heavy metal salt available in his chemistry lab after leaving a suicidal note. He got treated in a private hospital for 2 days and later he succumbed due to poisoning. Though the findings of this heavy metal poisoning mimicks corrosive acid poisoning, it has to be viewed through the eye of forensic toxicology for a clear view in clinching the diagnosis in the earlier phase of treatment.

Association between Tobacco and Tuberculosis: A short narrative review

Tobacco use increases the risk of contracting tuberculosis (TB), and blights the response to treatment of the disease. Although Links between Tobacco and TB have long been suspected, still many Indian patients continue to use tobacco. Our goal is to couple reviews of older and new research to provide definitive evidence of this dangerous connection so as to put an end to the TB epidemic.: Search of studies with English language abstract published between 2000 to June 2020 was undertaken in Google Scholar and PubMed. Search included the use of keywords “tobacco” with “tuberculosis,” “cessation,” or ‘’Tuberculosis Control Programme’’. Reference lists of the articles were examined for other relevant titles that included effective estimates of tobacco exposure in relation to tuberculosis outcomes.: Available evidence shows a strong association between tobacco and tuberculosis. People who use tobacco unknowingly put themselves at high risk of getting this disease. Reduction in the prevalence of tobacco use is urgent to bring about collateral benefits in the control of the TB problem.It is high time that TB control programs must begin to address tobacco control. Within the healthcare system opportunities must be created to provide encouragement for the TB patients so that it is easier for them to overcome this addiction.There urgent need for research in the field of tobacco and tuberculosis so as to reduce the burden of tuberculosis in India.

An outbreak investigation of dengue in medical students and health care workers in a tertiary care hospital, Pune

Dengue is fast emerging mosquito borne viral disease. There was sudden outbreak of dengue cases among Medical students and Health Care Workers in tertiary care hospital from September to November 2019. Therefore, outbreak investigation carried out and corrective actions taken to halt the outbreak. Study Objectives are to investigate outbreak of dengue cases in medical students and Health Care Workers and to take corrective actions to halt the outbreak.The outbreak investigations of Dengue cases was done as 28 cases were admitted which includes medical students and Health Care Workers in tertiary care hospital from September to November 2019. A thorough search for breeding sites of Aedes mosquito was done in premises of hospital, college and residential area. 5 teams were made consisting of Sanitary Inspector, interns, resident doctors and lecturer. House to house surveys were done for container index in Resident quarters and employees quarters. Health education on prevention of dengue was given to Medical students and Health Care Workers including interns, resident doctors, undergraduate students. Antilarval measures like abating, fogging and spraying of oildone.The mean age was 27.2 years, ranged for 14-68 years. Males 15(53.5%) and Females 13(46.4%). Out of 28,12(42.8%) Undergraduate students, 9(32.1%) Resident doctors and 7(25%) employees. 22(78.5%) NS-1positivecases and 16(57.1%) IgM dengue positive cases. The most common symptom found in this was fever (100%). Thrombocytopenia was most common abnormal laboratory finding which was present in 22(79%) patients out of 28 patients. Out of 22 patients having thrombocytopenia, platelet transfusion was done to 4 patients. Mean duration of stay in the hospital was 4 days.With the corrective measures taken, no new case of dengue was notified in November 2019 among Medical Students and Health Care Workers.