This study aimed to analyse the number of myocardial infarction (MI) admissions during the COVID-19 lockdown periods of 2020 and 2021 (March 15th to June 15th) and compare them with corresponding pre-pandemic period in 2019. The study also evaluated changes in critical treatment intervals: onset to door (O2D), door to balloon (D2B) and door to needle (D2N) and assessed 30-day clinical outcomes. This study examined MI care trends in India during the COVID-19 lockdown period, irrespective of patients’ COVID-19 infection status.

Multicentre retrospective cohort study

Twenty-three public and private hospitals across multiple Indian states, all with 24/7 interventional cardiology facilities.

All adults (>18 years) admitted with acute myocardial infarction between March 15 and June 15 in 2019 (pre-pandemic), 2020 (first lockdown) and 2021 (second lockdown). A total of 3614 cases were analysed after excluding duplicates and incomplete data.

Number of MI admissions, median O2D, D2B and D2N times.

30-day outcomes including death, reinfarction and revascularisation.

MI admissions dropped from 4470 in year 2019 to 2131 (2020) and 1483 (2021). The median O2D increased from 200 min (IQR 115–428) pre-COVID-19 to 390 min (IQR 165–796) in 2020 and 304 min (IQR 135–780) in 2021. The median D2B time reduced from 225 min (IQR 120–420) in 2019 to 100 min (IQR 53–510) in 2020 and 130 min (IQR 60–704) in 2021. Similarly, D2N time decreased from 240 min (IQR 120–840) to 35 min (IQR 25–69) and 45 min (IQR 24–75), respectively. The 30-day outcome of death, reinfarction and revascularisation was 4.25% in 2020 and 5.1% in 2021, comparable to 5.8% reported in the Acute Coronary Syndrome Quality Improvement in Kerala study.

Despite the expansion of catheterisation facilities across India, the country continues to fall short of achieving international benchmarks for optimal MI care.

Poor quality handover instructions prepared by hospital staff have been identified as a key threat to safe discharges. To optimise patient safety, it is important to identify and understand the influences on how discharge documentation is prepared by hospital staff. The aim of this study was to systematically identify and explore important barriers and enablers to the preparation of high-quality discharge documentation by healthcare professionals (HCPs) for primary care teams at patient discharge.

HCPs from different staff groups (doctors, nurses, pharmacists, occupational and physiotherapists) participated in online interviews.

Semistructured interviews informed by the theoretical domains framework (TDF), to identify key influences on the preparation of discharge documentation. Anonymised transcripts were analysed thematically using a combined inductive-deductive approach. Themes were framed as influences on the preparation of discharge documentation. The likely importance of influences was decided through iterative team discussions structured on predetermined criteria. Criteria included whether the influence was an existing enabler, whether beliefs about the influences were expressed voluntarily and how often they were mentioned.

12 HCPs were interviewed (5 junior doctors, 1 advanced nurse practitioner, 2 nurses, 1 occupational therapist, 1 physiotherapist and 2 pharmacists). Of 44 influences identified, 10 were deemed most important in the preparation of discharge documentation, spread across five TDF domains: knowledge (eg, lack of awareness of guidelines), skills (experience of hospital staff), social and professional role and identity (effective team communication), environmental context and resources (eg, software limitations) and social influences (eg, lack of feedback).

This study identified 10 important influences on how discharge documentation is prepared by hospital staff. These influences are potential targets for subsequent interventions to improve the quality of discharge documentation and patient safety during discharge.

Suicide rates in India are among the highest in the world, with the most recent suicide death rate estimates ranging between 18 and 21 deaths per 100 000 population (compared with the global average of 11/100 000). Responsible media reporting of suicide is one of the few evidence-based population-level suicide prevention interventions. Reports of recent suicides are a routine daily feature in major newspapers in India, and the reporting style carries many concerning features. In 2019, the Press Council of India adopted the WHO media guidelines, yet there has been no investigation as to whether this guidance is being followed. The aim of this paper was to systematically investigate whether the quality of print media reports of suicides has changed since the adoption of media guidelines for suicide reporting in India.

We used content analysis to assess the quality of suicide reporting against WHO guidelines in nine of the most highly read daily newspapers in the southern state of Tamil Nadu between June and December 2016 and June and December 2023. Our analyses of changes in reporting were based on a sample of 1681 print newspaper articles from 2016 and 512 print newspaper articles from 2023. Two-tailed t-tests and proportion tests on aggregate means and frequencies assessed whether the reporting characteristics had changed between 2016 and 2023.

There were small yet statistically discernible reductions in the proportion of articles containing various potentially harmful reporting characteristics, such as articles placed on the front page (4.9–1.8%, p=0.002) and articles mentioning the suicide method (92.7–86.5%, p

We observed substantial improvements in the reporting quality of some English-language newspapers, with minimal improvements in the quality of reporting in Tamil-language newspapers. The media guidelines in India are supporting the early phases of a culture shift on media reporting of suicide, yet they are just the start of the conversation. Strategies are required to engage and support vernacular language newspapers in India on their reporting of suicide, with media sector leadership as a core component.