THE SYMPTOMS AND CO-MORBIDITIES OF COVID-19 PATIENTS AT HOME ISOLATION IN INDIA

Indian Government has issued the guidelines on home isolation for very mild/pre-symptomatic COVID-19 cases based on a proposal of the Directorate of Public Health and Preventive Medicine. This has originated when COVID-19 designated hospitals started to shift asymptomatic and stable patients to quarantine facilities to reserve beds for those in need of treatment. To determine the prevalence of symptoms and co-morbidities of COVID-19 positive patients at home isolation OPD. This cross-sectional study was conducted at a designated COVID-19 tertiary care hospital in Pune, India, which had included all COVID-19 positive patients enrolled for the home isolation care from the 15th July to 15th August 2020. There were total 639 adults out of which 362 were males and 277 females. The most common presenting symptom present in 49.4% cases was fever. Hypertension was the most prevalent comorbidity noticed in 10% of patients followed by Diabetes in 6.7%. The maximum time lag of positive COVID-19 test to registration for home isolation OPD of 8 days was observed in only 1 patient. The significant association was seen between symptom of fever with the adults (males) and in the age group of 31-50 years(p<0.05). Home isolation could be considered a classic model for COVID19 patients in resource constrained situation. Home isolation can substantially reduce health care expenses for the asymptomatic and mild symptomatic COVID-19 multitude

Multifocal cutaneous melanoacanthoma with ulceration: A case report with review of literature

We report a case of a 58-year-old female patient who presented with multiple, asymptomatic, slowly-growing, raised pigmented lesions all over her body for the past 10 years with ulceration in one of the lesions on the trunk for the past five months. Histopathology of the lesion revealed features consistent with melanoacanthoma. Here, we report the first case of cutaneous melanoacanthoma presenting with an ulcerated plaque and the third case of cutaneous melanoacanthoma with multiple lesions. To the best of our knowledge, ulceration has not yet been reported as a feature of cutaneous melanoacanthoma in the medical literature

Determinants and perception of postpartum intrauterine contraceptive device services in Maharashtra, India

Undesired and unintended pregnancies increase unwanted births or induced abortions, consequently increasing maternal morbidity and mortality. Postpartum insertion of the Intra Uterine Contraceptive Device (PPIUCD) is an effective method for population control. The authors conducted the study to assess the determinants of PPIUCD services by identifying beneficiaries and healthcare workers' perceptions. We conducted this study in Maharashtra State, India having five geographical divisions and 36 districts. The authors visited 10 Primary Health Centers and three Community Health Centers from five districts, randomly selecting one from each division. We interviewed 45 women who had undergone insertion one day to one year prior and 17 health care workers. About one-third of women received counseling during pregnancy. The medical officers obtained the consents mostly during delivery. They inserted about 85% of devices within one hour of delivery. About 38% of women had at least one complication. Lower abdominal pain (22.22%), irregular bleeding (20.00%), the expulsion of CuT (13.33%), pain during periods (13.33%) were common. The removal rate was 6.67%. The complication rates observed in the present study are comparable to the hospital studies. Thus, the study reassures that the services in small institutions are very safe, and governments can fearlessly implement the program.Keywords: ComplicationsCounselingExpulsionHealth center Quality Removal

Sexual Dimorphism of Dexamethasone as a Prophylactic Treatment in Pathologies Associated With Acute Hypobaric Hypoxia Exposure

Dexamethasone can be taken prophylactically to prevent hypobaric hypoxia-associated disorders of high-altitude. While dexamethasone-mediated protection against high-altitude disorders has been clinically evaluated, detailed sex-based mechanistic insights have not been explored. As part of our India-Leh-Dexamethasone-expedition-2020 (INDEX 2020) programme, we examined the phenotype of control (n = 14) and dexamethasone (n = 13) groups, which were airlifted from Delhi (∼225&nbsp;m elevation) to Leh, Ladakh (∼3,500&nbsp;m), India, for 3&nbsp;days. Dexamethasone 4&nbsp;mg twice daily significantly attenuated the rise in blood pressure, heart rate, pulmonary pressure, and drop in SaO2 resulting from high-altitude exposure compared to control-treated subjects. Of note, the effect of dexamethasone was substantially greater in women than in men, in whom the drug had relatively little effect. Thus, for the first time, this study shows a sex-biased regulation by dexamethasone of physiologic parameters resulting from the hypoxic environment of high-altitude, which impacts the development of high-altitude pulmonary hypertension and acute mountain sickness. Future studies of cellular contributions toward sex-specific regulation may provide further insights and preventive measures in managing sex-specific, high-altitude-related disorders