Emergency Medical Treatment Research Articles

An Update on Recent Advances for the Treatment of Cerebral Malaria.

Among all the parasitic diseases in humans, malaria is the most significant and malicious one. The widespread species are Plasmodium falciparum and Plasmodium vivax, but the infection caused by the former is the deadliest. According to the November 2018 report of the World Health Organization (WHO), a total of 219 million cases of malaria were reported globally in 2017, which led to an estimated 435,000 deaths. Mortality due to malaria is estimated at 1.5 - 2.7 million deaths each year. Among all the complications associated with Plasmodium falciparum infection, cerebral malaria (CM) is the most fretful, accounting for almost 13% of all malaria-related deaths. CM is a medical emergency that requires immediate clinical testing and treatment. A compromised microcirculation, with sequestration of parasitized erythrocytes, is central in the disease pathology. No effective therapeutic agents are available yet for the treatment of CM, and therefore, potential interventions are needed to be developed urgently. The currently available anti-malarial drugs lack lipophilicity and are thus not able to reach the brain tissues. Therefore, safe, cost-effective agents with improved lipophilicity possessing the potential to target brain tissues are needed to be searched in order to fight CM worldwide. The aim of present review is to systematically revise the published research work available concerning the development and evaluation of some potential drug targets in the management of CM.

Cardiac Arrhythmia Prediction and Prevention of Heart failure using PCG(PhonoCardioGram) and CNN

Abstract: Arrhythmias are abnormal cardiac rhythms. According to WHO, in today's world 31% of deaths occur due to Cardiac Arrhythmia. Life-threatening arrhythmias including Ventricular Tachycardia (VT) and Ventricular Fibrillation are frequent causes of cardiac arrest (VF). The sinus node controls the heart's rhythm by triggering an electrical signal that goes through the heart, causing the heart to beat and circulate blood around throughout. The heart does not pump efficiently if there is too much electrical activity in the top or bottom chambers. Shortness of breath, fainting, an abrupt loss of heart function, and unconsciousness are the most common signs of Arrhythmia, which can result in death within minutes unless the victim receives emergency medical treatment to restart the heart. The purpose of this research is to use the CNN and VGG16 models in conjunction with data augmentation and picture pixel creation to diagnose cardiac arrhythmias using PCG signals. For greater efficiency, phonocardiography (PCG) is also investigated. The majority of arrhythmia detection and classification methods rely solely on surface ECG analysis. So, to improve the efficiency of heart diagnostics, an algorithm is devised that relates to wavelet analysis at several resolutions combining temporal and wavelet properties of Electrocardiogram and Phonocardiogram, as well as ElectrocardiogramPhonocardiogram interactions. We want to be able to classify phonocardiograms (PCGs) or heartbeat recordings. as "normal" or "abnormal" in order to identify individuals who will require further diagnosis. The main concept is to transform each cardiac sound recording (wav file) into a spectrogram image and train a CNN model on that picture. We will then be able to categorize a fresh PCG recording as normal or abnormal.

Fuzzy based approach for smart health monitoring systems using IoT devices

IoT systems base devices are considered an excellent research domain owning to its expertise and applications in wide range of areas. IoT in health care domain is gaining attention due to its better access to the doctor and paramedical staff as well as sensor based studies which results in less man to man interacting and less fault in the data. The health care provider can easily access the vitals and various other medical parameters by even staying miles away from the patient. However, large amount of data transfer over various communication mediums results in more data traffic. This data transfer will require more power which will be utilized to transfer the data. To reduce this data traffic issues, an efficient method is used in this work in which only the data that is predominantly important to be send to the health care provider is send via the communication medium. Rule based fuzzy logic tool is used in this work for an elder patient having cardiac issues. Blood sugar (After eating), Blood pressues (systolic), Blood pressure (Diastolic) and cholesterol level are taken as the parameter that are examined for the patient and the medical treatment required is calculated. The rules are set on the basis of real time data and human knowledge. The results from the fuzzy logic interference shows that the health care provider will be alarmed using communication medium only when active or emergency medical treatment of the patient is required. A comparative study between the power utilized in normal data driven method and fuzzy method shows that the fuzzy method utilize 8 times less power than the normal method. The simulated and MAMDANI model calculated values shows less than 1% error which shows the accuracy of the work in health care domain.

Adverse experiences resulting in emergency medical treatment seeking following the use of lysergic acid diethylamide (LSD).

Background:Recreational lysergic acid diethylamide (LSD) use is growing in popularity amid increasing research interest on psychedelics and their possible therapeutic potential yet; the potent psychotropic effects of LSD may result in adverse reactions and behaviour.Aims:This study aimed to investigate the 12-month incidence and nature of LSD-related adverse experiences resulting in emergency medical treatment (EMT) seeking in an international sample of people reporting LSD use.Methods:We use data from the 2017 Global Drug Survey – a large anonymous online survey on patterns of drug use conducted between November 2016 and January 2017.Results:Out of 10,293 past-year LSD users, 102 (1.0%) reported seeking EMT, with a per-event risk estimate of 0.2%. Younger age, comorbid mental health conditions and higher frequency of use were associated with increased risk of EMT seeking. The most common symptoms were psychological, including anxiety, panic and confusion, with the most common explanatory factors cited by respondents being poor ‘setting’ and ‘mindset’. Most responders reported feeling back to normal within 24 h, but 11 participants experienced persistent issues after 4 weeks.Conclusion:The results suggest that LSD is a relatively safe drug in recreational settings. Adverse reactions are typically short-lived, self-limiting and psychological in nature. Sub-optimal set and setting were commonly reported as suspected contributory factors. Within clinical settings, patient screening, preparatory sessions and supervision should reduce these acute risks considerably.

A Rare Case of Mastoiditis in an Adult Patient

Mastoiditis is more commonly seen and easily recognized in children. However, adults are more likely to present with complications requiring emergency medical treatment. One of the challenges in the management of mastoiditis is recognizing symptoms and beginning treatment with antibiotics early to prevent progression of disease and potential surgical management. This case report details an unusual case of a 41-year-old woman whose indolent symptoms went unrecognized for three weeks before presenting to the emergency department with unilateral ear pain and hearing loss. Imaging revealed coalescing mastoiditis with erosion of the medial cortex into the jugular foramen and enhancement suggestive of meningitis. This report can assist practitioners in recognizing and managing mastoiditis and its associated complications in the emergency setting.

피마자 중독사에서 혈액 중 Ricinine의 정량 분석

The castor bean plant (Ricinus comminis), is the only known source of the toxin ricin. Ricinine is an alkaloid present in the castor bean plant that can be used as a biomarker for ricin poisoning. There are only a few reports on the quantitative determination of ricinine in human’s biological samples including intoxication cases. In the present study, we developed a liquid chromatography-tandem mass spectrometry (LC-MS/MS) method with simple protein precipitation for sample extraction. Using this method, we performed a quantitative determination of ricinine in postmortem blood of a woman who was dead in her house after taking several castor beans. The validation parameters including linearity, accuracy, precision, matrix effect, and recovery were satisfactory. The concentration of ricinine in the victim’s blood was 35.3 ng/mL. This method can be usefully used for the determination of ricin poisoning in forensic field and emergency medical treatment system.

Action request episodes in trauma team interactions in Japan and the UK - A multimodal analysis of joint actions in medical simulation

Grounding is a fundamental human practice for cooperation and collaboration in a joint activity, when more than two people interact. Emergency care is one such interactive situation, and whether a trauma team can efficiently establish and increment their common ground at an appropriate timing during the complex and fluid activity of emergency medical treatment is key to maximise collective competence to best perform as a trauma team. This article investigates recurrent patterns in the grounding process between the trauma team leader and the members, comparing the practices between Japan and the UK, using an eye-tracking device. The embodied practice of grounding was multimodally described, applying both quantitative multimodal corpus analytic and qualitative interactional linguistic approaches. The analysis has shown that five grounding episodes reoccurred, most of which were more ego-centric and one of them ba-centric interactions, drawing on intersubjectivity and the theory of ba in Western and Eastern philosophy respectively.

Ability of the Australian general public to identify common emergency medical situations: Results of an online survey of a nationally representative sample

ObjectiveTo investigate the Australian general public’s ability to identify common medical emergencies as requiring an emergency response. MethodsAn online survey asked participants to identify likely medical treatment pathways they would take for 17 hypothetical medical scenarios (eight emergency and nine non-emergency). The number and type of emergency scenarios participants correctly suggested warranted an emergency medical response was examined. Participants included Australian residents (aged>18 years; n = 5264) who had never worked as an Australian registered medical doctor, nurse or paramedic. ResultsMost emergencies were predominately correctly classified as requiring emergency responses (e.g. Severe chest pain, 95% correct). However, non-emergency medical responses were often chosen for some emergency scenarios, such as a child suffering from a scalp haematoma (67%), potential meningococcal disease (57%), a box jellyfish sting (40%), a paracetamol overdose (37%), and mild chest pain (26%). Participants identifying as Aboriginal or Torres Strait Islander suggested a non-emergency response to emergency scenarios 29% more often compared with non-indigenous participants. ConclusionsEducational interventions targeting specific medical symptoms may work to alleviate delayed emergency medical intervention. This research highlights a particular need for improving symptom identification and healthcare system confidence amongst Aboriginal and Torres Strait Islander populations.

Mitral valve repair in papillary muscle rupture.

Papillary muscle rupture (PMR) is a significant mechanical complication following myocardial infarction (MI), a condition associated with a high mortality. It results in severe mitral valve regurgitation (MR), often accompanied by cardiogenic shock and pulmonary edema, requiring both emergent medical treatment and surgical intervention. Surgical treatment includes either chordal sparing mitral valve replacement or mitral valve repair, which is associated with a high mortality. Mitral valve repair is believed to be superior to mitral valve replacement with respect to improving left ventricular function, albeit with risk of repair failure and resulting in increased cross clamp times. Concomitant coronary revascularization may improve both short- and long-term outcomes after surgery. With advances in medical innovations in the field of transcatheter devices, these devices may serve as a bridge to recovery or treatment in the setting of acute MR due to PMR. However, long-term data will be required to establish the non-inferiority of one treatment modality over the other. Management of these patients should be guided by a dedicated mitral heart team.

Medical liability and criminal law in emergency medicine

Medical liability is booming. Malpractice can entail both civil and criminal consequences. Besides financial and custodial penalties, at worst the license to practice medicine can be withdrawn. Physicians owe their patients atreatment according to current standards. Furthermore, physicians are obliged to fulfill their duty of care. Nevertheless, the patient's right of self-determination must not be violated. Especially in emergency situations, physicians have to focus on taking protective measures in order to avert further dangers to the health of patients. This article analyses common pitfalls in emergency medical treatment with respect to the legal aspects.

A Study on the Role of Intelligent Medical Simulation Systems in Teaching First Aid Competence in Anesthesiology.

Anesthesiology is a subject with strong practicality and application. Undergraduate anesthesiology teaching needs to strike a balance between theoretical knowledge, clinical skill training, and clinical thinking development. Clinical probation and practice are an important part of undergraduate anesthesia teaching. Traditional clinical teaching uses real patients for demonstration and training, but as patients become more self-protective and less cooperative, there are not enough patients for clinical skill training. Simulation is to teach medical scenes in real life under the control of standardized technical guidelines and parameters. Since then, with the rapid development of computer technology, simulation technology and simulation teaching have been greatly developed and are more and more used in clinical teaching, skill evaluation, and scientific research. This study explores the effective methods of clinical teaching in anesthesiology by comparing the effectiveness of traditional teaching methods and simulation teaching methods in undergraduate clinical teaching. It is difficult to combine theory and practice in first aid, which does not allow them to directly receive and deal with emergency medical treatment and resuscitation. In China's current medical environment and patients' high demand for medical services, it is imperative to vigorously carry out simulated medical education. In the eastern part of Inner Mongolia, according to the advantages of teaching hospitals, our hospital took the lead in carrying out the simulation education project, which is still in the exploratory stage and not systematic enough. This study will help us to better carry out simulation teaching and improve the clinical skills of medical students in the future. Methods. The student group and class took the advanced simulator training as the experimental group, applied the advanced integrated simulator and other systems of the Norwegian company, referred to the international guidelines for cardiopulmonary resuscitation and cardiovascular first aid in 2005, and practiced in the emergency department during the clinical internship and “emergency clinical simulation training” course. The course includes basic life support, advanced life support, and comprehensive training of CPR (cardiopulmonary resuscitation) and endotracheal intubation. Results. The passing rate of simulated first aid practice was 94.4%; 100% of the students think it is necessary to set up the course, 91% of the students think it is practical, 91% of the students think the course content is reasonable and perfect, and 77%–100% of the students think the course has improved their first aid operation ability, comprehensive application of knowledge, and clinical thinking ability. Conclusion. Carrying out the course of “clinical simulated first aid training” through the advanced simulator system can effectively improve the interns' clinical first aid operation ability, teamwork ability, and self-confidence, improve the students' clinical thinking and judgment ability, and improve the service level to patients.

Risk Factor–Guided Early Discharge and Potential Resource Allocation Benefits in Patients with Traumatic Subarachnoid Hemorrhage

We sought to develop screening criteria predicting the lack of poor neurologic outcomes in patients presenting with traumatic subarachnoid hemorrhage (tSAH) and to evaluate their potential to improve resource allocation in these cases. We retrospectively reviewed patients presenting with tSAH to the emergency department (ED) of a tertiary-care institution from 2016 to 2018. We defined good neurologic outcomes as patients with stable/improving neurologic status, who did not require neurosurgical intervention, had no expanding bleed, and needed no hospital readmission. Univariate and multivariate models were generated to predict risk factors inversely associated with good neurologic outcome. A total of 167 patients presented with tSAH from 2016 to 2018. The presence of depressed skull fracture, concomitant spinal fracture, low Glasgow Coma Scale (GCS) score, cranial nerve palsies, disorientation, concomitant hemorrhages, midline shift, increased international normalized ratio (INR), and emergent medical intervention were inversely correlated with likelihood of good neurologic outcome on univariate analysis. Multivariate regression showed that midline shift (odds ratio [OR], 0.22; 95% confidence interval [CI], 0.05-0.89; P= 0.04), GCS score <13 (OR, 0.22; 95% CI, 0.05-0.99; P= 0.05), increased INR (OR, 0.18; 95% CI, 0.03-0.85; P= 0.04), and emergent medical intervention (OR, 0.18; 95% CI, 0.04-0.63; P= 0.01) were independently associated with lower likelihood of good neurologic outcome. Forty-six patients without any factors had good outcomes but were held in the ED or admitted to the hospital. These patients (if instead discharged directly) meant a potential cost savings of $179,172. In our study, we found multiple risk factors inversely associated with good neurologic outcome, namely low GCS score, midline shift, emergent medical intervention, and INR ≥1.4. Our findings may aid clinicians in determining which tSAH patients are candidates for safe early discharge.

Adverse experiences resulting in emergency medical treatment seeking following the use of magic mushrooms.

Background:Psilocybin-containing mushrooms are used for recreational, spiritual, self-development and therapeutic purposes. However, physiologically relatively nontoxic, adverse reactions are occasionally reported.Aims:This study investigated the 12-month prevalence and nature of magic mushroom-related adverse reactions resulting in emergency medical treatment seeking in a global sample of people reporting magic mushroom use.Methods:We use data from the 2017 Global Drug Survey – a large anonymous online survey on patterns of drug use conducted between November 2016 and January 2017.Results:Out of 9233 past year magic mushroom users, 19 (0.2%) reported having sought emergency medical treatment, with a per-event risk estimate of 0.06%. Young age was the only predictor associated with higher risk of emergency medical presentations. The most common symptoms were psychological, namely anxiety/panic and paranoia/suspiciousness. Poor ‘mindset’, poor ‘setting’ and mixing substances were most reported reasons for incidents. All but one respondent returned back to normality within 24 h.Conclusions:The results confirm psilocybin mushrooms are a relatively safe drug, with serious incidents rare and short lasting. Providing harm-reduction information likely plays a key role in preventing adverse effects. More research is needed to examine the detailed circumstances and predictors of adverse reactions including rarer physiological reactions.

First Reported Cases of COVID-19-Associated Mucormycosis in Tunisia

COVID-19 infection is associated with several complications such as mucormycosis. We report, to the best of our knowledge, the first published cases of mucormycosis associated with severe COVID-19 infection in Tunisia. The first case was a diabetic, 68-year-old man, who presented a rhino-orbito-cerebral mucromycosis. The second case was a 37-year-old woman with a chronic renal failure hemodialysis stage and liver disease and who presented a rhino-sinuso-orbital mucormycosis. The diagnosis of mucormycosis was retained in both cases seven days after COVID-19 infection. Antifungal treatment was prescriped. Surgical treatment was not possible. Both cases died. We should think about mucormycosis in patients with COVID-19 infection and emergency medical and surgical treatment must be started to reduce mortality.

Change Of Heart: Interesting Case Of An Impella 5.5 Device Precipitating Electrical Storm And Right Ventricular Failure Treated With A Heart Transplant

<h3>Introduction</h3> Electrical storm (ES) due to ventricular arrhythmias is a life-threatening condition requiring emergent medical and mechanical intervention. <h3>Case</h3> A 60-year-old man with a history of nonischemic cardiomyopathy and ventricular tachycardia (VT) on sotalol and remote implantable-cardioverter implantation (ICD), already listed for transplant was admitted for shortness of breath at rest and worsening lower extremity edema. Physical examination; jugular venous pressure (JVP) of 12cm H₂O, S3 gallop, bibasilar rales on chest auscultation, and bilateral lower extremity edema with warm extremities. A right heart catheterization revealed a cardiac index of 1.6 with elevated filling pressures and blood pressure of 80s/50s mmHg. EKG showed chronic left bundle branch block with 1^st degree AV block. TTE reported severe MR and LVEF of 15 %. Sotalol was discontinued and IV diuretics with vasopressor support were attempted, but recalcitrant cardiogenic shock (approximately18 hours later) required escalation to mechanical support via Impella 5.5. Subsequently, i.e., 36 hours after Impella placement, the patient had multiple episodes of incessant VT requiring more than 20 ICD shocks complicated by cardiovascular collapse <b>(Figure 1)</b>. The patient was emergently intubated, deeply sedated, and initiated on Amiodarone and Lidocaine infusions (after bolus). Bedside TTE revealed evidence of RV failure with uncertainty regarding the distal tip of the Impella. He underwent emergent veno-arterial extracorporeal membrane oxygenation support (ECMO); transplant listing was upgraded to UNOS status I and he received a heart transplant within 24 hours. Post-operatively patient had no recurrence of VT and he was transferred to a skilled nursing facility 45 days later. <h3>Discussion</h3> Our case met the criteria for a ventricular or electrical storm as defined by 3 or more sustained episodes of VT/VF or appropriate ICD shocks within 24 hours. The etiology was deemed to be the nidus of severe structural heart disease <b>(Figure 2)</b> exacerbated by discontinuation of anti-arrhythmic and possible provocation of the myocardium by Impella. Appropriate interventions including combination IV antiarrhythmic agents, deep sedation, and ECMO were temporary measures deemed insufficient to curb the ES; therefore, transplant was the only best option. <h3>Conclusion</h3> ES may require emergent medical and drastic surgical interventions including ECMO. This case represents a unique clinical situation where the patient was essentially (and ultimately) "treated" with a donor heart transplant.

Who Let All These People In?

Children’s hospitals are wonderful places full of dedicated pediatricians, nurses, respiratory therapists, pharmacists, paramedics, and others focused on optimizing the outcomes for pediatric patients. Over the years, more “free-standing” children’s hospitals have been built that are isolated from adult medicine counterparts to support the specialized staff and programs required for cutting edge clinical care while providing a developmentally appropriate environment for children and families at their most vulnerable time.1 Free-standing children’s hospitals are designed to take care of kids, from the emergency department, to radiology, to the wards, outpatient clinics, and ICUs. The staff are trained experts in caring for kids enabling them to excel at their mission while also creating a unique vulnerability, which includes dealing with the occasional medical emergency of all the adult pediatric providers, support staff, and a majority of the parents, grandparents, and other family members who visit children’s hospitals. The dedicated, highly-trained code response team is usually the one called because of the Emergency Medical Treatment and Labor Act in the United States.2 The response necessary for adult emergencies will be very different than that necessary for a typical hospitalized child, in which thoughts of “could this be a STEMI?” or “what is their Cincinnati Stroke score?” are exceedingly rare.3In this month’s issue, Hoffman et al4 also rightly identify that beyond being a hospital, most children’s hospitals are actually large medical centers with a far larger outpatient population than inpatient. The authors note that their highly qualified emergency response team for managing acutely deteriorating hospitalized children is frequently called on to manage both outpatient children and visiting adults, neither of which match the typical population for which the team was likely designed. Simply calling 9-1-1 is not a good option, partly because of the aforementioned Emergency Medical Treatment and Labor Act rules, but also because many municipalities struggle to fully staff their emergency medical services, and pulling a response to the hospital may delay responses to locations that do not have trained medical personnel handily available (personal communication, local emergency medical services director). Fortunately, actual need for a full resuscitative effort including chest compressions and defibrillation for these nonhospitalized individuals is rare. The authors report only a single event requiring defibrillation; importantly, the shock was delivered before arrival of the code team thanks to the availability of a public access automated external defibrillator.There are two big take home points from this article: first is that there are more nonhospitalized individuals than patients in a children’s hospital; therefore, planning for adult and outpatient responses are important. The second is that because the events are both common and rarely severe, a different level of response may be optimal to decrease the drain on resources in the intensive care units or within the emergency departments. As always, the responding team should be prepared and comfortable with all potential emergencies, including adult emergencies. More notably, the most significant adult event described in the paper was managed by bystanders by using a public access automated external defibrillator before the team’s arrival. No matter the emergency response chosen by a children’s hospital, encouraging all employees to learn basic life support, including cardiopulmonary resuscitation and automated external defibrillator use, can be lifesaving. As we build more free-standing children’s hospital to continue to support pediatric patients and their families, we must continue to care for not just the hospitalized children but also the outpatients and the families and staff that exist within this environment. Hoffman et al4 help us to understand the type of team we might need and the best way to help others.

Analysis of the Effect of Emergency Medical Treatment for Senile Severe Heart Failure

Analysis of the Effect of Emergency Medical Treatment for Senile Severe Heart Failure

Clinical Analysis of Emergency Medical Treatment of Acute Pancreatitis

Clinical Analysis of Emergency Medical Treatment of Acute Pancreatitis

Abstract TMP29: Emergency Department Variability In Use Of Advanced Neuroimaging By Insurance Status

Introduction: Prior data indicate inpatient disparities exist among patients with stroke associated with insurance status for degree of neurologic impairment, hospital length of stay and mortality. Patients presenting to the Emergency Department (ED) with acute neurologic symptoms often require evaluation for acute ischemic stroke and, in 2015, guidelines recommended CTA when LVO is considered. CTP was added in 2018 for select patients. In the ED, the Emergency Medical Treatment and Labor Act (EMTALA) requires anyone presenting to be stabilized and treated, regardless of insurance status and should limit variability in advanced neuroimaging use based on insurance status. We examined ED stroke assessment disparities by evaluating national variability in the use of advanced stroke imaging by primary payer (Private Insurance, Medicare, Medicaid, Self-Pay). Methods: Retrospective cohort study using adult encounters admitted to the same hospital in the 2018 National Emergency Department Sample (NEDS), an AHRQ dataset containing a weighted 20% sample of US ED encounters. CTA (head/neck) and CTP imaging use was determined from Common Procedural Terminology (CPT) codes and adjusted by age. Rate per 100,000 ED visits were compared across primary payers using ANOVA with Tukey adjustment. Results: Age-adjusted CTP rates varied by payer but did not research statistical significance. Rates of CTA acquisition were significantly different across payer groups (p&lt;0.001). See Table. Conclusion: Variability in age-adjusted rates of advanced neuroimaging use in the ED was identified. The variability for CTP, a unique ED imaging modality for stroke, was not significant, however interpretation is limited by confidence interval size. Variability in CTA was significant between groups and will undergo further analysis to evaluate for confounding by other patient or hospital factors.

Impact of COVID-19 related lockdown on hospital admissions, hospital burden and deaths due to non- COVID illnesses in a tertiary care centre in Southern Sri Lanka

Background: Sri Lanka imposed an aggressive curfew to prevent the spread of COVID-19, which led to major changes in population behaviour. It was presumed that these measures could affect the morbidity patterns and management of other medical conditions. We aimed to study the impact of the pandemic on hospital admissions, morbidity patterns and mortality from non-COVID illnesses during the period of lockdown.Methods: A retrospective study was conducted to gather data related to all non- COVID medical admissions from four medical wards and emergency treatment unit (ETU) of the Teaching Hospital Karapitiya for a six-week period during the lockdown. Data on the total number of admissions, reasons for admission, diagnoses, duration of hospital stay and outcome including deaths were obtained. Corresponding data from the same period of the previous year (pre COVID period) were compared.Results: The total number of admissions during the pre- COVID period was 2939 and that reduced to 1491 during the lockdown period. There was a significant reduction of admissions due to infectious illnesses including respiratory tract infections (p &lt;0.001), dengue (p= 0.01) and leptospirosis (p=0.02) during the lockdown period. There was a significant increase in requested admissions (p=0.002) including admissions for procedures, investigations, referrals and transfers. The mortality during the two periods did not change significantly (pre-covid period 5.1 %, lockdown period 4.2%, p=0.16).Conclusions: The results of the study showed that social distancing and travel restriction had a significant impact on health seeking behaviour, disease patterns and outcome. Reduction in hospital admissions and changes in disease patterns, especially reduction in respiratory tract infections could be a positive effect of preventive measures: physical distancing, wearing masks and travel restriction. Total lockdown of the country had no significant effect on total deaths as well as deaths related to NCDs.