“MASK-NE”-Mask associated Acne, is a common form of acne during COVID-19 pandemic. It is type of acne mechanica seen when external factor occludes the skin, leads to irritation, inflammation and starts/aggravates all grades of acne.We conducted a cross-sectional study among 773 participants, using a Self-administered, aim oriented, questionnaire which includes demographic data, acne related history, type and duration of wearing mask & other mask related skin problems in COVID-19 pandemic during 15 October to 15December,2020.: Among 773 participants, age ranged 18-45 years with mean 30.69 (SD: 61.30) and M:F was 1:1.78. After starting of Pandemic, occurrence of new development of mask associated Acne/ Maskne was higher among Health Care Workers (HCW) (34.98%) as compared to non- Health Care Workers (non-HCWs) (17.36%). Moreover, more number of HCWs had aggravation of their pre-existing acne and/or development of new of acne during pandemic (81.2%) than non-HCWs (61%). Wearing N95 type of mask showed the highest aggravation (82%) of Maskne as compare to wearing Surgical mask (75.5%) and wearing cloth (cotton) mask (65.6%).Wearing a face mask for 4 to 8 hours/day and >8 hours/day showed increase in the aggravation of Maskne as compared to wearing a facemask <4 hrs/day.Though wearing face masks can be the best strategy against COVID-19 infection, HAZARD OF THIS SAFETY is not negligible especially in front-line workers-doctors, nurses, pharmacist, policemen, hospital staff who are at higher risk due to several factors including type of mask use, duration of mask use etc.

BackgroundHigh mortality has been described in coronavirus disease 2019 (COVID-19) with cytokine release syndrome (CRS). Tocilizumab (TCZ), an interleukin-6 (IL-6) receptor antagonist may be associated with improved outcomes in such patients; however, the subgroups of patients who benefit the most need to be identified.ObjectiveTo analyze the efficacy and optimal timing of administration of TCZ in moderate to severe COVID-19 with features of CRS, where the response to steroids was poor.MethodsThis is a retrospective study of 125 patients admitted between May 5 to July 31, 2020, in a tertiary care hospital in western India, with moderate to severe COVID-19 who were treated with TCZ along with steroids. The primary outcomes were the need for mechanical ventilation (MV) or death, and secondary outcomes were a decrease in oxygen requirement and inflammatory markers; the incidence of secondary infections, and renal or hepatic dysfunction. Kaplan Meier survival analysis and log rank test were used for evaluating primary outcomes. Secondary outcomes were analyzed using the Wilcoxon Signed-Rank test.ResultsAmong 1081 patients admitted during the study period, 125 were administered TCZ (median age, 56 [95% CI 54 - 60] years; 100 [80%] male). The commonest symptoms were fever (96%), cough (64%), and dyspnea (48.8%). 78.4% patients had comorbidities (hypertension 51.2%, diabetes 43.2%, obesity 25.6% and chronic cardiac disease 13.6%). Of 117 patients who were treated with TCZ before requiring MV, 18.8% progressed to MV. Overall, 25% of the patients needed MV support. 65.3% of patients were discharged by day 14 after TCZ administration. Mortality was nil, 16.2%, 50%, and 62.5% in patients who received TCZ on room air, low flow oxygen, high flow nasal cannula (HFNC) and bilevel positive airway pressure (BiPAP), and MV respectively; overall 24.8% of patients died. Survival analysis showed no difference in outcome with respect to age and gender, while progression to MV showed a statistically significant reduction for the event death (90.9% of patients who progressed to MV died as compared to 6.3% who did not; log rank test with p < 0.0001). No adverse events were noticed.ConclusionMortality was least in patients of COVID-19 with CRS who received TCZ while on low flow oxygen. When administered in the early hypoxemic phase, TCZ is associated with reduced mortality and decreased need for mechanical ventilation.

COVID 19 pandemic is a global health emergency which every country is grappling with since beginning of this year.  Countries have their own strategies to cope with the cases and there have been no universal guidelines or recommendations for same. We commend the Hon. Prime Minister for taking pre-emptive timely measures to contain the pandemic at very beginning of infection in India as sustaining containment measures. Even the World Health Organisation (WHO) has acknowledged India’s efforts. According to experts for effective herd immunity about 60% of population needs to be infected, after which the infection will slow down and cases will continue to occur at low levels. For that we need good data coming from the system and government shall ensure that good data is provided for monitoring and surveillance. If all the susceptible population is exposed (without any restrictions) then we have an exponential rise in cases and our health system will be overwhelmed probably resulting in large number of deaths.  Great Britain went ahead with strategy of developing herd immunity in its population and safeguarding the elderly but after projections from Imperial College COVID 19 team, reversed their strategy to social distancing and saving lives as their health system will be overwhelmed.  COVID 19 is a mild disease for people in the younger age group while in people above the age of 60 years, the mortality is high. So staggered exposure of younger population to infection while safeguarding the elderly population at home will prevent the surge of cases and facilitate gradual development of immunity in population. Government should also focus on developing a robust health care system for screening and management of cases coupled with gradual relaxation of restriction so that health system is not overwhelmed with management of COVID 19.

No abstract

Background: Maternal determinants influence the outcome of pregnancy and child’s health in early years.  Rashtriya Bal Swasthya Karyakram (RBSK) deals with the 4 D (birth defects, chronic diseases, deficiency disorders and developmental delays) among children (from birth till 18th years). Objectives were to determine and document the association between maternal determinants especially antenatal care (ANC) and 4 Ds and suggest preventive measures. Methods: Out of 302 children with 4 D’s registered during April 2018-March 2020, 102 children were selected using probability proportionate to sample size (PPS) sampling for each category of 4D. Information of socio demographic details and maternal determinants was gathered on a semi structured questionnaire by interviewing mothers/caretaker. Results: Relevant information could be gathered from 96 mothers. Mean maternal age was 26.4±4.1 years. Congenital defects were significantly associated with higher maternal age (p<0.0001). Out of 102 cases under study, minimum recommended 4 ANC visits were not taken by 17 (17.7%) mothers. Also, 13 (13.5%) did not take IFA supplementation. Poor health status during pregnancy, was significantly associated for deficiency disorders of child in later life (p<0.04). Conclusions: Maternal age at pregnancy, health status of mother, ANC care (number of ANC visits, IFA supplementation), health seeking behaviour, birth weight and birth order of child were major determinants of 4Ds.