The National medical journal of India最新文献_第7页

Efficacy and safety of management of placenta accreta spectrum by transverse uterine fundal incision in a single tertiary care centre: A retrospective study. 在一家三级医疗中心采用子宫底横切法处理胎盘早剥谱的有效性和安全性：回顾性研究。

The National medical journal of India Pub Date : 2024-01-01 DOI: 10.25259/NMJI_331_21

Kallol Kumar Roy, Rinchen Zangmo, Anamika Das, Gayatri Suresh, Rakhi Rai, Bhavana Girish, Archana Kumari, Vanamail P, Juhi Bharti, Seema Singhal, Jyoti Meena

{"title":"Efficacy and safety of management of placenta accreta spectrum by transverse uterine fundal incision in a single tertiary care centre: A retrospective study.","authors":"Kallol Kumar Roy, Rinchen Zangmo, Anamika Das, Gayatri Suresh, Rakhi Rai, Bhavana Girish, Archana Kumari, Vanamail P, Juhi Bharti, Seema Singhal, Jyoti Meena","doi":"10.25259/NMJI_331_21","DOIUrl":"https://doi.org/10.25259/NMJI_331_21","url":null,"abstract":"Background We assessed the efficacy and safety of management of morbidly adherent placenta by the transfundal uterine incision approach. As a secondary outcome measure, we compared ultrasound and magnetic resonance imaging (MRI) for the diagnosis of adherent placenta. Methods We retrospectively analysed the records of 5 years of women with adherent placenta. Twenty-five women with an antenatal diagnosis of placenta increta and percreta operated by transfundal uterine incision were included. Blood loss, transfusion requirements, operative injuries, and maternal and neonatal intensive care unit (ICU) stay were compared among three different types of adherent placenta. Surgical and other outcome measures were also analysed. Results On antenatal screening with ultrasound, an accurate diagnosis could be achieved in all cases of increta and two-thirds of percreta. Antenatal diagnosis by MRI detected 93.3% of increta and all percreta cases. The mean (SD) gestation at delivery was 34 (4.9) weeks in accreta, 34.9 (2.7) weeks in increta and 31 (4.8) weeks in percreta patients. The mean blood loss encountered intraoperatively was 1012.5 (193.1) ml, 1566.67 (566.52) ml and 1591.67 (629.61) ml in accreta, increta and percreta patients, respectively. Inadvertent bladder injury occurred in 3 women who had placenta percreta invading the bladder. There was no long-term morbidity and no mortality. Conclusion Transfundal incision for delivery of baby is associated with the advantage of avoiding the placenta thereby minimizing blood loss.","PeriodicalId":519891,"journal":{"name":"The National medical journal of India","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141891521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Macrolipasemia variant of macroenzymes: An endocrine laboma. 大酶变异型巨脂蛋白血症：内分泌唇瘤

The National medical journal of India Pub Date : 2024-01-01 DOI: 10.25259/NMJI_161_21

Lokesh Kumar Sharma, Rashmi Rashi Datta, Anshita Aggarwal, Neera Sharma, Deep Dutta

{"title":"Macrolipasemia variant of macroenzymes: An endocrine laboma.","authors":"Lokesh Kumar Sharma, Rashmi Rashi Datta, Anshita Aggarwal, Neera Sharma, Deep Dutta","doi":"10.25259/NMJI_161_21","DOIUrl":"https://doi.org/10.25259/NMJI_161_21","url":null,"abstract":"Macroenzymes, formed by polymerization of physiological enzymes with immunoglobulins, have slower renal clearance rates due to their higher molecular mass. They are usually incidentally detected, have no pathophysiological importance, and can potentially lead to over-treatment and iatrogenic morbidity. We present, possibly for the first time, a macro-lipasemia variant of macroenzyme, detected in a 14-year-old girl with type-1 diabetes admitted with severe hyperglycaemia and pain abdomen. Raised lipase levels (414 U/L), initially raised the suspicion of underlying pancreatitis, which was ruled out by the clinical symptoms and normal ultrasound and CT imaging of the pancreas. Upper gastrointestinal endoscopy revealed pangastritis, which could explain the mild upper abdominal pain in the child. She improved with proton pump inhibitor therapy and was discharged after 5 days of hospital admission after good glycaemic control using multiple subcutaneous injections of insulin. Post-polyethylene glycol (PEG) precipitation, the recovery of lipase activity in PEG treated serum sample was 30.6% (127 U/L), which confirmed the presence of macrolipase. An increased clinical suspicion and performing a cheap reliable test (PEG precipitation), whenever there is clinical biochemical discordance can help us in diagnosing more patients with macroenzymes and macrolipasemia.","PeriodicalId":519891,"journal":{"name":"The National medical journal of India","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141891527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pseudo-subarachnoid haemorrhage: An unusual presentation of hyperviscosity syndrome. 假性蛛网膜下腔出血：高粘度综合征的一种不寻常表现。

The National medical journal of India Pub Date : 2024-01-01 DOI: 10.25259/NMJI_336_20

Anil Thomas, Hyma Jose, Lydia Jacob, Jency Maria Koshy, Greeshma Merin Sebastian

引用次数: 0

The undergraduate virtual grand teaching ward round: Perceptions from the subcontinent. 本科生虚拟教学大查房：来自次大陆的看法。

The National medical journal of India Pub Date : 2024-01-01 DOI: 10.25259/NMJI_429_2022

Thushan Gooneratne, Mandika Wijeyaratne

{"title":"The undergraduate virtual grand teaching ward round: Perceptions from the subcontinent.","authors":"Thushan Gooneratne, Mandika Wijeyaratne","doi":"10.25259/NMJI_429_2022","DOIUrl":"https://doi.org/10.25259/NMJI_429_2022","url":null,"abstract":"Background Grand ward rounds are an integral component of undergraduate medical education. Covid-19 prevented the conduct of conventional grand ward rounds (CWRs) prompting a 'virtual' grand ward round (VWR). With restrictions lifted should future grand ward rounds remain virtual? Undergraduate perceptions on the two formats were sought to explore the feasibility of the VWR as a teaching ward round for medical students. Methods Our study was done during April 2021 to April 2022. The weekly grand ward round was converted to a VWR during April-November 2021. Following lifting of restrictions, it was reverted to a CWR. All patients provided informed consent. A Zoom-based, secure, online platform was created with the use of smartphones to share audiovisuals and patient discussions. An online anonymised feedback survey was conducted for undergraduates during both VWR and CWR phases. Results The response rate was 71% (182/258). VWR was considered more advantageous than the CWR in terms of time efficiency (p=0.03), space restrictions (p=0.01), improved audibility (p=0.02) and better opportunity to engage in discussions (p=0.1). Most students (80%) felt that the VWR provides a more 'ideal' grand ward. Overall preference was towards VWR across safety (92%), efficacy (72%), communication (85%), information availability (84%) and training opportunity (73%). Again 80% of students preferred future ward rounds to be virtual. Conclusions VWR is an innovative approach. While not a substitute for bedside teaching it appears safer, efficient, thought/discussion-provoking and more satisfactory. Successful elements of the VWR can be adopted in future, to develop a more ideal undergraduate grand ward round.","PeriodicalId":519891,"journal":{"name":"The National medical journal of India","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141891533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Time to Treat the Climate and Nature Crisis as one Indivisible Global Health Emergency. 是时候将气候和自然危机作为一个不可分割的全球健康紧急事件来对待了。

The National medical journal of India Pub Date : 2024-01-01 DOI: 10.25259/NMJI_1043_2023

Kamran Abbasi, Parveen Ali, Virginia Barbour, Thomas Benfield, Kirsten Bibbins-Domingo, Stephen Hancocks, Richard Horton, Laurie Laybourn-Langton, Robert Mash, Peush Sahni, Wadeia Mohammad Sharief, Paul Yonga, Chris Zielinski

引用次数: 0

Perceptions of mothers with gestational diabetes and their healthcare workers on postpartum physical activity to attenuate progression of gestational diabetes to diabetes mellitus: A qualitative study. 妊娠糖尿病母亲及其医护人员对产后体育锻炼以减少妊娠糖尿病发展为糖尿病的看法：定性研究。

The National medical journal of India Pub Date : 2024-01-01 DOI: 10.25259/NMJI_412_21

Thamudi Sundarapperuma, Champa Wijesinghe, Priyadarshika Hettiarachchi, Sudharshani Wasalathanthri

{"title":"Perceptions of mothers with gestational diabetes and their healthcare workers on postpartum physical activity to attenuate progression of gestational diabetes to diabetes mellitus: A qualitative study.","authors":"Thamudi Sundarapperuma, Champa Wijesinghe, Priyadarshika Hettiarachchi, Sudharshani Wasalathanthri","doi":"10.25259/NMJI_412_21","DOIUrl":"https://doi.org/10.25259/NMJI_412_21","url":null,"abstract":"Background Mothers with a history of gestational diabetes mellitus (GDM) have a high risk of progressing to type 2 diabetes mellitus (T2DM) in the future. This progression can be attenuated by appropriate lifestyle interventions. We aimed to understand the perceptions of mothers with GDM and their healthcare workers regarding postpartum physical activity with a view to design a lifestyle intervention programme. Methods We did this qualitative study in three selected districts of Sri Lanka. We also conducted six focus group discussions with 30 antenatal mothers with a history of GDM in a previous pregnancy, and six in-depth interviews with 3 postnatal nurses and 3 field midwives caring for postpartum mothers to explore their perceptions on postpartum physical exercises. Framework analysis was used to analyse the data. The transcripts were analysed using a Microsoft matrix and themes were generated. Results Eight themes related to physical exercises emerged from both groups of participants. Two themes, 'Myths regarding postpartum physical activity' and 'Lack of awareness of the importance of postpartum physical activity' emerged from both groups of participants. Three themes, 'Time pressure', 'Stigma' and 'Child demands' emerged only from mothers while three themes, 'Traditional and cultural beliefs', 'Lack of influence from healthcare workers' and 'Lack of motivation' emerged solely from healthcare workers. Conclusions The findings, especially the facilitators and barriers deserve the attention of health policy-makers when designing appropriate interventions to enhance postpartum physical exercises to attenuate the development of T2DM in women with GDM.","PeriodicalId":519891,"journal":{"name":"The National medical journal of India","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141891529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Letter from Mumbai. 来自孟买的信

The National medical journal of India Pub Date : 2024-01-01 DOI: 10.25259/NMJI_556_2024

Sunil K Pandya

引用次数: 0

Epidemiology and clinical spectrum of melioidosis: Analysis of cases from a tertiary care centre in southern Tamil Nadu. 梅里埃病的流行病学和临床表现：泰米尔纳德邦南部一家三级医疗中心的病例分析。

The National medical journal of India Pub Date : 2024-01-01 DOI: 10.25259/NMJI_402_2022

Vithiya Ganesan, Raja Sundaramurthy

{"title":"Epidemiology and clinical spectrum of melioidosis: Analysis of cases from a tertiary care centre in southern Tamil Nadu.","authors":"Vithiya Ganesan, Raja Sundaramurthy","doi":"10.25259/NMJI_402_2022","DOIUrl":"https://doi.org/10.25259/NMJI_402_2022","url":null,"abstract":"Background We studied the clinical features and treatment outcome of patients with melioidosis in our hospital. Methods We did this retrospective observational chart review over a period of 7 years between December 2014 and February 2022. Results There were 59 cases and 23 deaths attributable to melioidosis over the study period. The age range was 5 to 74 years and 48 (81.3%) were men. The comorbid conditions included diabetes mellitus (68%), alcoholism (11.8%), pulmonary tuberculosis (6.7%) and chronic kidney disease (5%). Over three-fourths of patients (78%) presented during the rainy season (June to December) and were acute presentations (44 [75%]). The most common sites were liver and spleen, followed by the musculoskeletal system, skin, soft tissues, lungs and brain. Of the 21 (36%) patients with septic shock, 16 (76%) died. On the contrary, of 38 (64%) patients without septic shock, only 11% died. Of the 27 (47%) admitted to ICU, 11 (41%) died. In ICU, 18 (67%) were ventilated. Of the 23 (39%) deaths overall, median time from admission to death was 4 days. There were no relapses in the 42% patients followed up for 2-6 months. Conclusions The epidemiology of melioidosis is similar to other endemic areas with preponderance of men. There was a temporal association with the monsoon season and a higher number of acute cases. The differences included a higher proportion of deep visceral abscesses and musculo-skeletal involvement compared to lung involvement.","PeriodicalId":519891,"journal":{"name":"The National medical journal of India","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141891522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Legal mechanisms and procedures in alleged medical negligence: A review of Indian laws and judgments. 涉嫌医疗过失的法律机制和程序：印度法律和判决回顾。

The National medical journal of India Pub Date : 2024-01-01 DOI: 10.25259/NMJI_955_2021

Rohit Goel, Maheshnath Amarnath, Ranjit Immanuel James, Arthy Amarnath

引用次数: 0

Do-it-yourself chandelier illumination. 自己动手制作吊灯照明。

The National medical journal of India Pub Date : 2023-11-01 DOI: 10.25259/NMJI_1030_2022

Pradeep Venkatesh, Amber Amar Bhayana, Shorya Vardhan Azad

引用次数: 0