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Background: Leptospirosis is a zoonotic infection with high mortality rates. The incidence of leptospirosis is more during floods. The aim of the study was to find the difference in clinical profile of leptospirosis during post flood and non-post flood periods.Methods: This was a cross sectional observational study comparing the clinical profile of leptospirosis patients admitted in Government Medical College Ernakulam, Kerala during the post flood period of 2018 with that of non-post flood period. The data with respect to clinical features and investigations were retrieved from the hospital records.Results: Out of the 42 patients studied 15 were from the post flood period and the rest 27 patients were from the non-post flood period. The mean age in the post flood group was 40 years and that in the non-post flood group 43 years. Myalgia, icterus and calf tenderness was significantly higher in the post flood group. The mean platelet count was significantly lower in the non-post flood period (p value=0.011). Mean serum urea and total bilirubin were significantly higher in the post flood group compared to non-post flood group (p value=0.001). Cardiac complications were seen only among the post flood group.Conclusions: The clinical profile and complications were different in leptospirosis patients during post flood and non-post flood periods. These findings help the treating physicians to formulate different approaches in treating patients during the post flood and non-post flood period.

There is an increasing need for improving faculty development for ensuring quality in medical education in India with a fast growing number of medical colleges. There are very few studies which highlight the selfperception of the faculty regarding the impact of such training in medical education technology on their own teaching practice. Although the impact can be evaluated by various means, a self-evaluation of one's own perception of the impact is an emerging concept. Objective: To study the impact of training in medical education technology on one's own teaching practice as perceived by the teaching faculty themselves.

BACKGROUND Dengue fever is expanding in newer areas globally, with greater morbidity and mortality. We wanted to determine the proportion of bleeding manifestations among the confirmed dengue fever patients and evaluate the clinical outcomes in those with bleeding manifestations. METHODS 230 Dengue confirmed patients admitted in Government Medical College, Ernakulam from January 2018 to December 2018 were enrolled for the study. Data was recorded and entered in Microsoft Excel, and analysed using SPSS. RESULTS In the current study out of 230 subjects, bleeding manifestations were more common in 21 - 30 & 41 - 50 age groups. Out of 230 subjects, 102 had bleeding manifestations (44.3 %) like petechiae (34 %), purpura (24 %), echymosis (19.1 %), gum bleeding (17.8 %), menorrhagia (10.9 %), melena (10.4 %), conjunctival haemorrhage (9.1 %), haematuria (4.8 %), epistaxis (3.5 %), haemoptysis (2.2 %) and hematemesis (0.9 %). 86 subjects (37.4 %) received platelet transfusion on an average of 4 units. Age group, fever, previous history of dengue, IgG positivity, NS1 positivity were significantly (P < 0.0001) associated with bleeding. Most of the bleeding manifestations were significant in patients who had lower platelet counts on the first day of admission when it was less than ten thousand. CONCLUSIONS 44.3 % had bleeding manifestations with significant association between age, fever and IgG positivity. A low platelet count on admission especially less than 10,000 was significantly associated with these bleeding manifestations. These significant observations are important for both the primary care and tertiary care physicians in meticulous management and referral of dengue patients. KEY WORDS Dengue Fever, Bleeding Manifestations, Ns1 Antigen, Platelet Count.

Introduction: The risk of coronary artery disease (CAD) is higher in diabetic patients. In Indians, CAD occurs one decade earlier than the west. HbA1C is an easy marker of long term glucose regulation as it provides a good reflection of plasma glucose concentrations over 8 -12 weeks .Abnormal glucose metabolism is associated with increased mortality and complications following ACS. This study was conducted in ICU of Govt. Medical College, Ernakulam among patients admitted following ACS using HbA1C in blood and observing the complications for first week. Materials and Methods: 188 patients admitted with Acute Coronary Syndrome in Government Medical college, Ernakulam between January 2016 and December 2016, were evaluated clinically and with the investigatory facilities available at this institution. Their HbA1C levels were measured at the laboratory of Government Medical college Ernakulam. The clinical features and investigation results were noted. HbA1C levels in UNSTABLE ANGINA, NSTEMI, STEMI, and in complications like arrhythmias, cardiac failure, cardiogenic shock also were studied and the data analysed.