Hospital admissions pattern helps to understand the acceptability and utilization of health care services and also indicates the disease burden prevailing in the serving community. This study is an attempt to determine the current pattern of admissions and their clinical outcomes at a tertiary care hospital in Assam. A retrospective record-based study was conducted in Jorhat Medical College and Hospital from 2011 to 2014. A total of 9, 10,157 patients have attended the Out Patient Department (OPD) and 1,28,824 patients were admitted to the In Patients Department (IPD). The daily average of patients attended the OPD ranges between 688-848 and about 77 to 98 patients were admitted to the IPD. In OPD, majority of the patients attended medicine department (19.5%) followed by Emergency (15.4%) and Orthopedics (10.2%) department. Similar pattern was observed in the IPD with Medicine having the highest case load (30.5%) followed by Obstetrics and Gynaecology (25.6%) and Surgery (16.7%). The rural urban patient ratio was calculated as 60:40. The Bed Occupancy Rate (BOR) of the hospital was found 87.8%. Approximately 3% patients died in hospital, 80% improved and 12% were referred to other institution. We could not evaluate the status of 5% patients who were Discharged Against Medical Advice (DAMA). Our study indicates that the services provided by this teaching hospital are acceptable to the community and showing an increasing trend of patient flow with efficient bed occupancy rate. Majority of the admitted patients were discharged from the hospital on improvement. For a newly established government hospital it may be labelled as time-honoured advancement.

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PurposeJapanese encephalitis (JE) has emerged as a major public health concern in North East India due to its complex eco-epidemiological risk factors. The objective of this study was to understand the various risk factors associated with JE infection in the endemic study location.Methods A hospital-based case-control study was conducted at Jorhat Medical College and Hospital from August 2017 to September 2018. The study participants included 49 confirmed JE cases with two control arms, one consisting of non-JE acute encephalitis syndrome (AES) patients (n = 91) and the other of non-JE non-AES patients (n = 140), admitted at the same time in the pediatric and medicine wards. A predesigned, pretested, structured questionnaire was used for data collection. ResultsUnivariate analysis revealed the following to be risk factors: age at onset, sex, religion, immunization status, proximity to pigs, proximity to paddy fields (<100 m), use of a mosquito net, impregnated mosquito net, mosquito repellent, and outdoor activities. Multiple logistic regression analysis identified age at onset (adjusted odds ratio [AOR], 20.900; 95% confidence interval [CI], 2.210–31.815) and proximity to pigs (AOR, 4.190; 95% CI, 1.592–11.040) as risk factors for the first control arm and proximity to paddy fields (<100 m) (AOR, 8.470; 95% CI, 2.0251–35.438) was the only risk factor found for second control arm, whereas impregnated mosquito nets (AOR, 0.082; 95% CI, 0.009–0.725) and mosquito repellent (AOR, 0.173; 95% CI, 0.052–0.575) were found to be associated with the second control arm.ConclusionAge at onset, proximity to pigs, proximity to paddy fields (<100 m), impregnated mosquito nets, and mosquito repellent were the most significant risk factors for JE in the NE region to warrant public health actions.

Acute Encephalitis Syndrome (AES) is a major public health problem and Japanese Encephalitis (JE) is one of the most important causes of AES. Therefore, it is crucial to know the etiology of AES for patient management and decision making. The present study aimed to assess the morbidity and mortality prole of AES/JE patients admitted in tertiary care setting. An observational prospective cross-sectional study was conducted among 140 hospitalized AES patients admitted in Pediatric and Medicine ward of Jorhat Medical College and Hospital (JMCH), Jorhat over a period from August, 2017 to July 2018. Blood serum and cerebrospinal uids (CSF) were tested for presence of JE specic IgM antibody by Mac ELISA during acute illness of AES. The data were compiled and analyzed using the IBM SPSS, V23.0. Of the total 140 AES cases, majority (60%) were below 15 years age (p-value 0.180). Signicantly higher proportion of AES cases were from rural areas (94.3%) (p-value <0.0001). The male and female ratio was 1.3:1. The most common presenting symptoms in AES patients were fever (100%), change in mental status (100%), seizure (56.4%) and headache (42.9%). Signs of meningeal irritation were present in 69.3% of cases. Around 22.9% AES patients had GCS ≤ 8. A total 49 (35%) cases were found to be laboratory conrmed JE following detection of JE specic IgM antibody. Among the JE patients, only 4.1% were immunized with SA 14-14-2 vaccine and 14% died before discharge. The complete recoveries were observed in 78% of cases. JE is one of the major causes of AES which is highly prevalent in this part of India. The signicant ndings in the present study calls for policy decision to combat JE.

Background: AES is responsible for causing high social and economic burden to the affected families. The study was conducted to know the household characteristics, cost of illness and coping strategy adopted by the family members of AES children admitted to a tertiary care facility in Assam, India. Methods: It was a sequential exploratory mixed method study, with a cross-sectional survey among AES children and their guardians, followed by In Depth interview. Results: Out of 51 cases 55% were male. The median age was 11 years. 53% of the families belonged to lower socioeconomic class. 96% of families reported to reside in rural areas. Commonly reported household assets were mobile phone 94%, bicycle 86%, television 31% and motorcycle 29%. Three major themes were emerged to contribute towards economic burden. The first major theme is “Direct cost” due to patient transportation cost (mean Rs 1161.00) and hospital costs: mostly due to medicinal cost (mean Rs1955.00), investigational cost (mean Rs 2920.00) and food cost (mean Rs 8375.00). The second theme “Indirect cost” is due to work days loss: 100% care providers had missed work days during hospital stay of their children and 84% had missed work days during post hospital care. The third theme is “Inherent cost spotted through coping mechanisms” which mostly 94% included borrowing money from the market and 31.4% selling household assets. Conclusion: Cost of illness is a huge burden to the AES afflicted families which demands reforms in health care financing and reimbursement in current context.