Background: Multimorbidity has substantial impact on the health of the individual in terms of safety, quality of life and functional ability, but little is known about it from rural areas in developing countries. Hence the present study attempted to determine the prevalence and gender difference in multimorbidity from a rural area. Methods: A register based cross sectional study was done by retrieving data from the family health register of the rural health centre. Data on age, gender and all the morbidities, were collected. The most prevalent morbidities were presented as frequency and percentages, prevalence of multimorbidity were presented as dyads and triads. Multiple Logistic regression was done to find the age adjusted risk of gender on multimorbidity. Results: The prevalence of multimorbidity was 16.2% (13.05-19.35).The most prevalent morbidities were hypertension, diabetes, dyslipidaemia, visual impairment and thyroid in both males and females and most common dyad was hypertension and diabetes. Conclusion: In the context of lack of studies from this area, the findings of the study may help the health care providers to plan interventions. Further research has to be done to identify the risk factors of multimorbidity.

Background Comorbidities have major implications for the care of people with dementia. Aim To investigate the patterns of comorbidities in dementia in the last five years of life and how these patterns differed between three cohorts. Methods The study included people who died at age 70 and above in 2001 (n = 13,717), 2007 (n = 34,750) and 2013 (n = 38,087) in Finland. ICD-10 morbidity data for a five-year period prior to death were extracted from national registers. Principal component analysis was employed to identify patterns for several morbidities. The associations of principal component scores with dementia were analysed using binary logistic regression. Linear regression was used to examine changes in the number of morbidities in patterns over time. Results The morbidity patterns identified in the last years of life were (1) cardiometabolic disorders, (2) neurological, (3) cerebrovascular diseases and (4) musculoskeletal, thyroid and psychiatric disorders. Among the patterns, neurological and musculoskeletal, thyroid and psychiatric disorders were associated with dementia. The number of diagnoses in the cerebrovascular pattern increased and those in the musculoskeletal, thyroid and psychiatric pattern decreased over time. Discussion Comorbidity patterns identified in this nationwide register study are largely in line with previous evidence. Time difference in these patterns provide crucial information for service planning. Conclusions Comorbidities in dementia in the last years of life occur in patterns and change over time. More systematic monitoring and updated clinical guidelines are needed for the care of comorbidities with dementia.

Background There is limited data on frontline health-care workers and risk of COVID-19 from the developing nations. It is imperative to identify those at higher risk to prevent further transmission. We assessed the relationship between exposure risk and COVID-19 among front-line health-care workers who were primary contacts of a COVID-19 patient. Methods A retrospective cohort study was conducted among front-line health-care workers in a tertiary care hospital who were exposed to a COVID-19 patient. Information on demographic factors, medical history, exposure related factors and subsequently COVID-19 lab reports were collected. An exposure risk assessment designed collating various exposure related factors categorized the participants into those with high and low risk. We used logistic regression to estimate the odds ratio of our primary outcome, a positive COVID-19 test when the independent variables were exposure risk, age, gender and occupation. Results Among1858 frontline workers who were primary contacts of a COVID-19 patient at the hospital, 106 (5.7%) incident reports of a positive COVID-19 test were recorded. None of the exposure related factors had any significant association with a positive COVID-19 test. However, high exposure risk category was significantly associated with COVID-19 positive test at the end of quarantine. Conclusion COVID-19 was more frequent among front-line health-care workers who belonged to high exposure category. Education at different levels of service delivery at hospitals is required for best practice in order to prevent COVID-19 among health care providers. There is need to develop additional strategies to ensure that the information is translated in to practice.