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Indian Journal of Critical Care Medicine

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https://www.readbyqxmd.com/read/30294141/organ-donation-rate-in-brain-dead-patients-in-a-tertiary-referral-center
#1
Shivakumar Mutnal, Pradeep Rangappa, Ipe Jacob, Karthik Rao
No abstract text is available yet for this article.
September 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/30294140/echographic-comparison-of-optic-nerve-sheath-diameter-between-both-eyes
#2
Maddalena De Bernardo, Ilaria De Pascale
No abstract text is available yet for this article.
September 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/30294139/speech-and-swallowing-function-outcome-following-early-tracheostomy-in-patients-who-underwent-neurosurgical-intervention
#3
Pralay Shankar Ghosh, Sukanya Naskar, Afzal Azim
No abstract text is available yet for this article.
September 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/30294138/verapamil-as-an-adjuvant-treatment-for-drug-resistant-epilepsy
#4
S Lakshmikanthcharan, Mohamed Hisham, S K Chaitanya Juluri, Sivakumar Mundilipayalam Nandakumar
Almost one-third of the people suffering from epilepsy continue to have seizures in spite of using appropriate antiepileptics. Pharmacoresistance is defined as the failure to achieve seizure control with two or more anticonvulsant medications at appropriate daily dosage. Here, we discuss one such gentleman whose seizures had been intractable despite multiple antiepileptic drugs in maximum tolerable doses. Verapamil, a calcium channel blocker, was used for its P-glycoprotein inhibition properties to overcome the pharmacoresistance in this patient with satisfactory seizure control...
September 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/30294137/a-rare-case-of-localized-tetanus
#5
Deepak S Sharma, Mit B Shah
Tetanus is a severe and potentially fatal infection caused by the bacterium Clostridium tetani . Presentations of tetanus include generalized tetanus, neonatal tetanus, cephalic tetanus, and localized tetanus, the latter two being much rarer. We present case of a 55-year-old male farmer, presented with an injury to the left toe. A surgical wound exploration and washout with administration of human tetanus immunoglobulin and tetanus toxoid were given as treatment with antibiotic support. This case report points out the importance of the early recognition of a rare form of this fatal infectious disease, which may present with prodromal symptoms before the generalized form shows its clinical effects...
September 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/30294136/severe-hypokalemia-mimicking-brain-death
#6
Asif Ali Hitawala, Piyush Garg, Abhay Jain, Ashish Nahar
We discuss a case of a 20-year-old female who presented with history of fever, vomiting, and decreased oral intake for 10 days followed by one episode of generalized tonic-clonic seizure and altered sensorium for 5-6 h. On arrival in the emergency room, she had Glasgow Coma Scale 3 (E1V1M1), both pupils fixed and dilated, low blood pressure, low oxygen saturation, and few gasping breaths. She appeared to be brain dead and was assumed to have a very poor prognosis. Investigations revealed severe hypokalemia...
September 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/30294135/hepatitis-a-virus-induced-severe-hemolysis-complicated-by-severe-glucose-6-phosphate-dehydrogenase-deficiency
#7
Dhruva Sharma, Omender Singh, Deven Juneja, Amit Goel, Suneel Kumar Garg, Shashank Shekhar
Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an x-linked recessive genetic disorder with mutation in the G6PD gene. Defect in the enzyme G6PD causes red blood cells (RBCs) to breakdown prematurely causing hemolytic anemia. Hemolytic anemia is also a known hematological complication associated with viral hepatitis. In such patients, hemolysis may be more severe if there is any secondary injury to RBC in the form of membrane defect, oxidative stress, or enzyme deficiency like in G6PD deficiency. Here, we present a case of an adult, not previously diagnosed with G6PD deficiency, who presented with viral hepatitis, severe hemolysis, and multiorgan failure...
September 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/30294134/hypernatremia-due-to-urea-induced-osmotic-diuresis-physiology-at-the-bedside
#8
Sonali Vadi, Kenneth Yim
Hypernatremia secondary to urea-induced solute diuresis is due to the renal excretion of electrolyte-free water. This concept is explained here step-wise physiologically with the help of a clinical vignette.
September 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/30294133/diagnostic-and-prognostic-role-of-neutrophil-to-lymphocyte-ratio-in-early-and-late-phase-of-sepsis
#9
Rajnish Kaushik, Monika Gupta, Madhu Sharma, Debraj Jash, Neetu Jain, Nitin Sinha, Aditya Chaudhry, Dhruva Chaudhry
Objective: Early diagnosis of sepsis is necessary to decrease morbidity and mortality. This study aims to evaluate neutrophil-to-lymphocyte ratio (NLR) as diagnostic and prognostic of early and late phase of sepsis. Methods: It was a prospective, observational study, conducted in Intensive Care and High Dependency Unit (Daycare) of the Department of Pulmonary and Critical Care Medicine (tertiary care center), Rohtak, from January 2017 to December 2017. A total of 56 cases of newly diagnosed cases of sepsis were included in the study and 20 healthy adults were taken as controls...
September 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/30294132/survey-on-perceived-impact-of-religion-culture-and-social-network-information-on-surrogate-decision-making-in-a-south-asian-developed-country
#10
Shahla Siddiqui, Sukhanya Sureish, Audris Chia
Introduction: Relatives often have to assume responsibility for making end of life choices as surrogate decision-makers for patients with diminished or are lacking capacity. Our aim was to study the influence of religion, culture and social network information on surrogate decision making. Methods: This study was an exploratory, prospective, survey. Questions addressed the role of surrogates in decision making and the importance and influence of religion, culture and social media on such decisions...
September 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/30294131/evaluating-extravascular-lung-water-in-sepsis-three-lung-ultrasound-techniques-compared-against-transpulmonary-thermodilution
#11
Pattarin Pirompanich, Dimitrios Karakitsos, Abdulrahman Alharthy, Lawrence Marshall Gillman, Michael Blaivas, Brian M Buchanan, Peter G Brindley, Anan Wattanathum
Background: Excessive extravascular lung water (EVLW) is associated with increased morbidity and mortality. We compared three lung-ultrasound (L-US) techniques against the reference-standard transpulmonary thermodilution (TPTD) technique to access EVLW. Materials and Methods: This was a prospective, single-blind, cross-sectional study. Forty-four septic patients were enrolled. EVLW index was measured by the TPTD method, and an index of ≥10 mL/kg was considered diagnostic of pulmonary edema...
September 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/30294130/sonographic-measurement-of-optic-nerve-sheath-diameter-how-steep-is-the-learning-curve-for-a-novice-operator
#12
Gentle Sunder Shrestha, Binayak Upadhyay, Aanchal Shahi, K C Jaya Ram, Pankaj Joshi, Bishesh Sharma Poudyal
Background: Transbulbar sonography for measuring optic nerve sheath diameter (ONSD) is noninvasive bedside technique for detection of raised intracranial pressure. This study aims to evaluate the number of sonographic evaluations required for a novice operator to learn proper measurement of ONSD after a formal training and supervised scanning session. Methods: Three novice operators and one expert operator measured ONSD of 27 healthy volunteers using linear array transducer HFL38x (frequency range of 6-13 MHz) (MicroMaxx®; SonoSite, USA)...
September 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/30294129/targeted-volume-noninvasive-ventilation-reduces-extubation-failure-in-postextubated-medical-intensive-care-unit-patients-a-randomized-controlled-trial
#13
Vorawut Thanthitaweewat, Dittapol Muntham, Naricha Chirakalwasan
Purpose: Till date, the benefit of using noninvasive ventilation (NIV) routinely after extubation to prevent reintubation has been conflicting. We aim to demonstrate the effect of targeted-volume NIV for the prevention of reintubation and extubation failure after planned extubation in medical intensive care unit (ICU) patients. Study Design: This was a prospective, randomized controlled study. Materials and Methods: Patients on invasive mechanical ventilation for more than 48 hrs for acute respiratory failure, who were ready for extubation, were randomized into targeted-volume NIV (intervention group) or oxygen mask (controlled group) immediately after extubation and continuously for 24 hrs...
September 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/30294128/non-neurological-complications-after-traumatic-brain-injury-a-prospective-observational-study
#14
Keshav Goyal, Amarjyoti Hazarika, Ankur Khandelwal, Navdeep Sokhal, Ashish Bindra, Niraj Kumar, Shweta Kedia, Girija P Rath
Introduction and Aims: Recognizing and treating nonneurological complications occurring in traumatic brain injury (TBI) patients during intensive care unit (ICU) stay are challenging. The aim is to estimate various nonneurological complications in TBI patients. The secondary aim is to see the effect of these complications on ICU stay, disability, and mortality. Materials and Methods: This was a prospective observational study at the neuro-ICU of a Level-I trauma center...
September 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/30294127/the-importance-of-serial-time-point-quantitative-assessment-of-cardiac-troponin-i-in-the-diagnosis-of-acute-myocardial-damage
#15
Arindam Bose, Vidyut Jain, Girish Kawthekar, Chandrabala Chhabra, Nanda Hemvani, Dhananjay S Chitnis
Objective: The present study was aimed to establish a threshold value for cardiac troponin I (cTnI) for nonacute coronary syndrome (ACS) participants from the local population and also to determine the importance of serial time point estimation of cTnI in acute myocardial infarction (AMI), non-ST-elevated MI (NSTEMI), and unstable angina cases. Methods: The present study included 194 cases, admitted in ICCU with the complaint of anginal pain; 31 were diagnosed with AMI with typical electrocardiography (ECG) changes; whereas, 48 cases were diagnosed with NSTEMI...
September 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/30186019/unusual-cause-of-hypotension-in-a-polytrauma-victim-a-case-of-fahr-s-syndrome
#16
Ajay Yadav, Richa Aggarwal, Riddhi Kundu, Kapil Dev Soni
No abstract text is available yet for this article.
August 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/30186018/pseudo-bulbar-palsy-a-rare-cause-of-extubation-failure
#17
Ritu Singh, Monalisa Nayak, Sunil Kumar Jena, Afzal Azim
No abstract text is available yet for this article.
August 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/30186017/uncommon-cause-of-acute-liver-failure-with-encephalopathy
#18
Subodh Kumar Mahto, Ankita Sheoran, Atul Goel, Nagina Agarwal
No abstract text is available yet for this article.
August 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/30186016/severe-adult-onset-still-s-disease-mimicking-systemic-infection
#19
Rajani Gubbala, Ganshyam Jagathkar, Nagalakshmikanth Reddy Mayaluri, K P Raghavendra
Adult-onset Still's disease (AOSD) is an uncommon entity that can mimic infection. Patients present with fever for more than 1-week, joint pain, and rash. We report a case of 22-year-old male who presented with fever, sore throat, and abdominal pain. During hospitalization, he had multiple episodes of tachycardia and tachypnea requiring mechanical ventilation. The patient had elevated white blood cell count, procalcitonin, and troponin. He was extensively investigated and diagnosed as AOSD. He responded to steroids and was discharged on day 20...
August 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/30186015/acute-suppurative-thyroiditis-with-thyroid-abscess-by-klebsiella-pneumoniae-an-unusual-presentation
#20
Prashant Nasa, K G Mathew, Rakesh Sanker, Sandeep Chaudhary, Vikas Singhal
Acute suppurative thyroiditis with thyroid abscess is very uncommon cause of thyroiditis. Thyroid infection in a diabetic patient is commonly labeled to the relative immunosuppressive state of diabetes mellitus. We present a case of a diabetic patient showing clinical symptoms of acute thyroiditis with progressing dysphagia, who was diagnosed as thyroid abscess as a result of Klebsiella pneumoniae . The infection in the absence of other significant history was initially considered de novo ; however, on extensive evaluation was associated with other distant primary source of the same microbe...
August 2018: Indian Journal of Critical Care Medicine
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