Aim Studies on the changes in the presentation and management of acute myocardial infarction (AMI) during the COVID-19 pandemic from low- and middle-income countries are limited. We sought to determine the changes in the number of admissions, management practices, and outcomes of AMI during the pandemic period in India. Methods & Results In this two-timepoint cross-sectional study involving 187 hospitals across India, patients admitted with AMI between 15th March to 15th June in 2020 were compared with those admitted during the corresponding period of 2019. We included 41,832 consecutive adults with AMI. Admissions during the pandemic period (n = 16414) decreased by 35·4% as compared to the corresponding period in 2019 (n = 25418). We observed significant heterogeneity in this decline across India. The weekly average decrease in AMI admissions in 2020 correlated negatively with the number of COVID cases (r = −0·48; r 2 = 0·2), but strongly correlated with the stringency of lockdown index (r = 0·95; r 2 = 0·90). On a multi-level logistic regression, admissions were lower in 2020 with older age categories, tier 1 cities, and centers with high patient volume. Adjusted utilization rate of coronary angiography, and percutaneous coronary intervention decreased by 11·3%, and 5·9% respectively. Conclusions The magnitude of reduction in AMI admissions across India was not uniform. The nature, time course, and the patient demographics were different compared to reports from other countries, suggesting a significant impact due to the lockdown. These findings have important implications in managing AMI during the pandemic.

Introduction: Demographic and clinical profile of traumatic brain injury (TBI) of a particular place is very crucial for strengthening the guidelines. The details of same are scant from a tertiary institute, Nellore district. The present study aims to explore the demographic, injury and clinical aspects of cerebro-cranial injury patients from an institute setup. Methods: The study consists of two years retrospective data and one year prospective data. The study was approved by institute ethical committee. The patient data was entered on pre designed proforma that includes the desired variables. The data analysis was done using StatsDirect software. Both prospective and retrospective data was merged for analysis. Percentages for categorical data and mean values for continuous data were calculated. Results: There were total of 336 patients. Patients in age group of 21 to 50 years constituted 67% and males were four times higher than females. Nearly one fourth of patients were influenced by alcohol. Three fourth of accidents were due to road traffic accidents (RTAs) followed by falls (17%) and assault (6%). About one tenth of patients were pedestrians. One fourth of patients had associated injuries other than head and brain. On CT findings majority of patients had cerebral contusion (46%) followed by skull fracture (40%), SDH (28%) and EDH (23%). Twenty two patients died in the study period. Conclusion: Knowledge of injury and its later consequences to public is very important. Strict rules to consider safety precautions and compulsory family insurances should be encouraged. Rules to prevent paediatric drive.

This multi-center registry study on "real world, all comers" has, thus, showed that EXCEL™ stent which is PLA-coated biodegradable Rapamycin-Eluting Stent exhibited high efficacy and safety profile in treatment of patients undergoing PCI as evidenced by significantly lower rates of MACE and no case of stent thrombosis. There was no event even after DAPT was discontinued after 6 months.

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