July-September 2018 Volume 16 | Issue 3
Page Nos. 83-120
Online since Friday, November 9, 2018
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ARTICLES - ORIGINAL ARTICLES
Emergency department visits of staff and students of a large medical college and hospital in South India
p. 83
D Ahikam, SS Karun, Kundavaram Paul Prabhakar Abhilash, Reginald George AlexDOI :10.4103/cmi.cmi_9_18 Background: The emergency department (ED) is always kept busy by patients requiring urgent health care. A part of the patients is the staff and students of the very institute running the ED. Sick staff and students are a liability as they contribute to economic loss and loss of person-hours of the institute. Materials and Methods: The retrospective cross-sectional study done in Christian Medical College, Vellore, included all staff and students who presented to the ED during the period of January 2014–December 2014. Results: During the study period, a total of 54,562 patients presented to the ED with various complaints. A total of 956 staff and students comprised 2.8% (1528/54,562) of all the emergency visits. There were 1350 staff visits and 178 student visits during the 1-year study period. More than half (57.5%) had general medical complaints and only required pharmacological therapy. A quarter of the staff and students (25.5%) presented to the ED with trauma with more than half of those being road traffic accidents. Univariate analysis for risk factors for trauma among staff had been carried out and the results were summarized. Class 3 and 4 employees had a higher incidence of trauma (21.6% vs. 12.6%, P < 0.001; odds ratio [OR] = 1.91 [95% confidence interval (CI): 1.43–2.55]) as also males (25.8% vs. 11.8%; P < 0.001; OR = 2.6 [95% CI: 1.94–3.48]). Conclusions: A significant number of staff and students present to the ED with trauma with males and class 3 and 4 employees having a higher risk. In addition, acute febrile illness present in specific seasonal patterns through the year and are the most common presentations to the ED.
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Neonatal outcome in women receiving vaginal progesterone for prevention of preterm birth
p. 87
Pratibha Singh, Yashika Rathore, Ratna Thakur, Kuldeep SinghDOI :10.4103/cmi.cmi_26_18 Background: Preterm birth (PTB) may be caused by several etiological factors and there is some evidence that administration of progesterone has an effect in the prevention of preterm birth, however its role is not well defined. Study Design: This study was planned to know the effect of vaginal progesterone on women with a history of PTB on pregnancy and neonatal outcome. A total of 64 women with a singleton pregnancy (between 14-28 weeks gestation), with at least one previous preterm delivery were prospectively studied and received vaginal micronized progesterone 100 mg twice daily starting at 14–28 weeks [recruitment period] and continued till 34 weeks of pregnancy. Results: In the study, 1.66% women delivered before 34 weeks, 14 (23.33%) women delivered between 34 and 36 + 6 weeks period of gestation. Overall 15/60 (25%) patients delivered before 37 weeks and 45/60 (75%) delivered after 37 weeks. Mean gestation of delivery was 37.31 ± 1.58 (Range: 33–39 weeks). Conclusions: This study provides some evidence that vaginal administration of progesterone in high-risk women for PTB starting in the second trimester and continued till 34 weeks can lower the PTB and improve the neonatal prognosis, without causing any adverse effect to the neonate.
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ARTICLES - REVIEW ARTICLE
Corrosive injuries of the upper gastrointestinal tract: A review of management practices
p. 92
Sasank Kalipatnapu, Jonathan Sadhu Reddipogu, Sam Varghese George, Vijay Abraham, Inian SamarasamDOI :10.4103/cmi.cmi_34_18 Corrosive injuries to the upper gastrointestinal tract can occur by either acid or alkali ingestion. They can lead to significant morbidity and mortality, thus necessitating a rapid assessment and appropriate management. This article aims to provide an overview of corrosive injuries and to provide a management plan for corrosive injuries.
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ARTICLES - CASE REPORT
Precipitation of Sheehan's syndrome following severe dengue infection
p. 96
Ajay Kumar Mishra, DM MaheshDOI :10.4103/cmi.cmi_24_18 Sheehan's syndrome as described by Sheehan refers to necrosis of pituitary gland due to severe postpartum hemorrhage. Although its incidence is decreasing in developed countries, it still continues to be one of the most common causes of hypopituitarism in the underdeveloped and developing countries. The clinical presentation can be variable, and emphasis must be on adequate obstetric history to avoid undue delay in diagnosis. We report a 42-year-old female with the unmasking of Sheehan's syndrome who had lactation failure and amenorrhea for 9 years, developing panhypopituitarism following an episode of severe dengue infection.
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EVIDENCE BASED MEDICINE – SUMMARY OF STUDY
Aspirin may be related to an increased death rate, especially from cancer-related deaths
p. 99
Ann Helen PrasadDOI :10.4103/cmi.cmi_39_18
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Is transcatheter mitral-valve repair a safe and effective treatment option for secondary mitral regurgitation?
p. 101
Ann Helen PrasadDOI :10.4103/cmi.cmi_40_18
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CME IN IMAGES
Trigeminal Neuralgia Secondary to Basilar Artery Dolichoectasia
p. 103
Jamir Pitton Rissardo, Ana Letícia Fornari CapraraDOI :10.4103/cmi.cmi_16_18
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PRACTICE STORY
Fatehpur – transformation through community health work
p. 105
Sunitha VargheseDOI :10.4103/cmi.cmi_29_18
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HISTORY OF MEDICINE
Paracetamol, digoxin, cisplatin
p. 110
DOI :10.4103/0973-4651.245046
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REGULARS
Drug dialogues – Medication news and new medications
p. 112
DOI :10.4103/0973-4651.245045
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Medical news - from around the world
p. 116
DOI :10.4103/0973-4651.245058
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DEVOTIONAL
Submitting to god’s purpose?
p. 120
DOI :10.4103/0973-4651.245044
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