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A facility-based cross sectional study was carried out among 188 doctors working at the Kasturba Medical College in Mangalore, India, to assess the perception and practice of evidence based medicine (EBM) among medical professionals. Data was collected using a pre-tested questionnaire and results obtained were expressed in percentages. Results: The mean age of participants was 35 ± 8.33 years. A higher proportion of participants (n=182, 96.8%) referred to textbooks for information for clinical decision making. A majority of the participants (n=180, 95.8%) opined that evidence based medicine should be included in a medical curriculum. More than half of the participants (n=98, 52.1%) used PubMed. A majority (n=150, 79.8%) of the participants had a good level of self-rated confidence in evaluating research, while 55.3% (n=104) of the participants had a good level of self-rated confidence in their ability to conduct clinical appraisals. Lack of time and insufficient EBM skills were the major perceived barriers to practicing evidence based medicine. Conclusion: Positive attitudes and higher awareness regarding EBM among doctors in the present study compared to other reported literature is an encouraging finding. Medical regulators must utilize the best available evidence and experience in formulating policy on medical education and health care.

Background/Aims: Neutrophil-to-lymphocyte ratio (NLR) is a proven marker in coronavirus disease 2019 (COVID-19) severity and mortality. However, the utility of a sequential NLR 2 (on day 5) in comparison to baseline NLR in predicting clinical outcomes and severity remains largely unexplored. Methods: This was a hospital-based retrospective observational study. Results: Higher mortality (19.9% vs. 48%) and a more severe disease (14.8% vs. 21%) were observed with elevated NLR 1 and NLR 2, respectively. NLR 2 at a cutoff of 9.88 was a better predictor of mortality, when compared to NLR 1 at 5.67, and NLR 2 has a strong correlation with mortality rates in COVID-19. Conclusion: Our study demonstrated that NLR 1 and NLR 2 were more reliable predictors of mortality than disease severity; in comparison, NLR 2 is a more accurate predictor of mortality than NLR 1. The study unravels the potential role of a sequential NLR 2, to have a better correlation in predicting the clinical severity and outcomes. The potential role of NLR 2 in assessing the interim progression of the disease and thereby initiating specific interventions at critical junctures to influence the outcome is unveiled and merits exploration in detail by larger studies.