Comparison of presentations to the emergency department during the COVID-19 pandemic (COPED-C).

BACKGROUND: Concerns have been raised that patients requiring emergency care may not have accessed healthcare services during coronavirus disease 2019 (COVID-19) lockdown. METHODS: This case control study aimed to understand changes in characteristics and diagnosis of patients attending a large UK Emergency Department (ED) during the first wave of the COVID-19 pandemic (March-May 2020) compared with equivalent weeks in 2019. RESULTS: We found a 50.7% drop in first attendances to the ED in 2020. Likelihood of attendance and admission decreased for paediatric patients and increased for patients ≥ 46 years, and for men. Likelihood of admission increased for all Black ethnic groups and for patients from the most deprived index of multiple deprivation quintiles. This shift to an older, male, more deprived patient population with greater representation of ethnic minority groups was amplified in the 'Infections' diagnostic category. CONCLUSIONS: COVID-19 has dramatically impacted ED usage. Our analysis contributes to local resource planning and understanding of changes in healthcare-seeking behaviour during the pandemic. Future research to identify positive behaviour changes could help sustain a reduction in non-urgent visits in the longer term.

Unspoken victims: A national study of male rape incidents and police investigations in South Africa.

BACKGROUND: The burden of sexual violence has been well described in children of both sexes and in women, but there is minimal literature on adult male rape victims. Studies of adult male rape victims have mainly been conducted among incarcerated males or military personnel, and in high-income countries. OBJECTIVES: To describe the epidemiology, occurrence and reporting of rape cases involving male victims, both child (<18 years old) and adult, in South Africa (SA). METHODS: The study consisted of a nationally representative sample of case dockets maintained by the SA Police Service of rape incidents reported in 2012. A retrospective review of the dockets provided sociodemographic information on the victim and suspect, the circumstances of the rape and the medicolegal services provided to the victim. Data on male victims were analysed using Stata 13 to test for significant differences between child and adult male victims. RESULTS: The study comprised 209 male victims, including 120 (57.4%) children and 89 (42.6%) adults. The findings showed that there were significant differences in the occurrence and reporting of rape of male victims by age. Adult males experienced more violent rapes, perpetrators were more likely to be armed and often humiliated the victim, and rapes were more likely to occur in institutional settings. Adult males reported incidents of rape earlier and therefore had visible non-genital injuries during the medical examination. In contrast, more child rapes involved known perpetrators, occurred in a home and perpetrators were more likely to act kindly to the victim after the incident. This parallels the patterns in rape circumstances seen in female adult and child victims. CONCLUSIONS: While there is political commitment to understanding sexual violence against women as a societal problem, work on such violence against men lags behind and is little understood. Rape of males needs to be acknowledged, and their vulnerabilities to sexual abuse and rape need to be addressed. Prevention efforts to end violence against women and girls, especially in relation to children, can be used to address violence against men and boys.

Quantitative immunological status of males of unexplained infertility in eastern U.P.

126 males of unexplained infertility and 75 fertile males were studied during a period of more than 2 years. Statistically significant increase in the levels of serum IgM was observed in cases of males of unexplained infertility. Level and percentage of cases showing semen IgM was more in study group (134.61 +/- 25.5 mg %, 41.26%) than control (24%, 99.3 +/- 8.3%). Semen IgA was found only in study group in 30.15% cases. Though definite correlation between serum and semen immunoglobulin was not observed, semen immunoglobulin was found to be 1-2 fold lower than serum. Results of the present study indicate towards a possible immunological role in cases of unexplained infertility in males.

Recanalisation of vas.

PIP: Observations made on a series of 42 cases of vas recanalization following vasectomy are reported. The study was performed in India. Observed indications for the reanastomosis include death of son (50%), death of daughter (4.8%), death of all issue (19%), remarriage (11.9%), ill effects of vasectomy (9.5%), and unmarried men who underwent the operation for the monetary incentive and claim misrepresentation of facts. Age of patients varied from 20-45 years. 38% of the cases were aged 25-30 years. 42.8% had an interval of 2-5 years between vasectomy and request for reversal, by far the greatest percentage. 40 of the 42 cases had bilateral vasectomy. In all cases, end-to-end vasovasotomy was performed. A stainless steel splint was used in 39 cases, and suture material was all that was necessary in 3 cases. 3 complications were noted postoperatively: 1 case of hematoma, 1 of splint descending into the scortum, and l wound infection. The following success rates are given by interval from vasectomy to reanastomsis: 100% (up to 6 months); 100% (6 months-1 year); 75% (1-2 years); 81.2% (2-5 years); and 62.5% (5-10 years).^ieng