Background: Interventions which were made to promote a better self-management have produced improvements in the glycaemic control in patients with Diabetes mellitus. An improved glycaemic control is known to prevent the long term complications.Method: This study was conducted at the Dr. Pinnamaneni Siddhartha Institute of Medical Sciences and Research Foundation, which is a rural tertiary health care centre. 546 patients were included in our study and they were assessed for the glycaemic control (HbA1c), diabetes distress (DDs), and self care activities.Results: Of the total 546 patients, 49% had a poor glycaemic control, as was indicated by HbA1c levels of >7%. The factors which are significantly associated with a poor glycaemic control are age (p=0.03 ), sex (p= 0.0415), literacy (p=0.0422), duration of the disease (p=0.0006), diabetic distress (p=0.0001) and self care activities like diet ( p=0.0001), medication (p=0.0001) and exercise (p=0.0001), whereas there was no significant effect of the BM I (p=0.094) on the glycaemic control. Conclusion:This study revealed the factors that could predict the glycaemic control in the diabetic patients who attended our tertiary care teaching hospital. The barriers that prevent these patients from meeting their goals must be explored, to improve their health outcomes.

Background There was evidence that antibiotic usage increased in hospitalized COVID-19 patients during the early days of the pandemic. Objective We assessed the impact of stewardship interventions on antibiotic usage in these patients. Methods We designed a quasi-experimental study using an interrupted time series. Patients were stratified according to the severity category of the illness – mild and moderate-to-severe (O2 saturation ≥94% and <93% respectively). Baseline antibiotic usage data was collected in the pre-intervention phase. Intervention was given in the form of focus group discussion (FGD) and followed up with feedback-audit during the post-intervention phase. Primary outcome was the change in days of therapy (DOT) per 1000 patient-days. Results 361 adult patients were recruited in both phases during July to December, 2020. In the post-intervention phase, DOT per 1000 patient-days reduced from 589 to 523 (P=0.013) and from 843 to 585 (P <0.0001) in mild and moderate-to-severe categories, respectively. De-escalations at 48 hours increased significantly from 21% to 41% (P=0.0079) and from 31% to 62% (P=0.0006), respectively. No difference in mortality was observed. Conclusion We found high usage of empirical antibiotics in adult patients hospitalized with COVID-19. FGD and feedback audits can successfully reduce antibiotic overuse in these patients.