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Publisher: Medknow Publishers   (Total: 355 journals)

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Showing 1 - 200 of 355 Journals sorted alphabetically
Advanced Arab Academy of Audio-Vestibulogy J.     Open Access  
Advances in Human Biology     Open Access   (Followers: 1)
African J. for Infertility and Assisted Conception     Open Access  
African J. of Business Ethics     Open Access   (Followers: 7)
African J. of Medical and Health Sciences     Open Access   (Followers: 1)
African J. of Paediatric Surgery     Open Access   (Followers: 7, SJR: 0.269, h-index: 10)
African J. of Trauma     Open Access  
Ain-Shams J. of Anaesthesiology     Open Access   (Followers: 3)
Al-Azhar Assiut Medical J.     Open Access  
Al-Basar Intl. J. of Ophthalmology     Open Access   (Followers: 1)
Ancient Science of Life     Open Access   (Followers: 6)
Anesthesia : Essays and Researches     Open Access   (Followers: 7)
Annals of African Medicine     Open Access   (Followers: 1, SJR: 0.331, h-index: 15)
Annals of Bioanthropology     Open Access   (Followers: 3)
Annals of Cardiac Anaesthesia     Open Access   (Followers: 12, SJR: 0.408, h-index: 15)
Annals of Indian Academy of Neurology     Open Access   (Followers: 3, SJR: 0.308, h-index: 14)
Annals of Maxillofacial Surgery     Open Access   (Followers: 6)
Annals of Medical and Health Sciences Research     Open Access   (Followers: 7)
Annals of Nigerian Medicine     Open Access   (Followers: 1)
Annals of Pediatric Cardiology     Open Access   (Followers: 7, SJR: 0.441, h-index: 10)
Annals of Saudi Medicine     Open Access   (SJR: 0.24, h-index: 29)
Annals of Thoracic Medicine     Open Access   (Followers: 4, SJR: 0.388, h-index: 19)
Annals of Tropical Medicine and Public Health     Open Access   (Followers: 15, SJR: 0.148, h-index: 5)
APOS Trends in Orthodontics     Open Access   (Followers: 1)
Arab J. of Interventional Radiology     Open Access  
Archives of Intl. Surgery     Open Access   (Followers: 9)
Archives of Medicine and Health Sciences     Open Access   (Followers: 3)
Archives of Pharmacy Practice     Open Access   (Followers: 5)
Asia Pacific J. of Clinical Trials : Nervous System Diseases     Open Access  
Asia-Pacific J. of Oncology Nursing     Open Access   (Followers: 3)
Asian J. of Andrology     Open Access   (Followers: 1, SJR: 0.879, h-index: 49)
Asian J. of Neurosurgery     Open Access   (Followers: 2)
Asian J. of Oncology     Open Access   (Followers: 1)
Asian J. of Transfusion Science     Open Access   (Followers: 2, SJR: 0.362, h-index: 10)
Astrocyte     Open Access  
Avicenna J. of Medicine     Open Access   (Followers: 1)
AYU : An international quarterly journal of research in Ayurveda     Open Access   (Followers: 6)
Benha Medical J.     Open Access  
BLDE University J. of Health Sciences     Open Access  
Brain Circulation     Open Access  
Bulletin of Faculty of Physical Therapy     Open Access   (Followers: 1)
Cancer Translational Medicine     Open Access   (Followers: 1)
CHRISMED J. of Health and Research     Open Access  
Clinical Dermatology Review     Open Access   (Followers: 1)
Clinical Trials in Degenerative Diseases     Open Access  
Clinical Trials in Orthopedic Disorders     Open Access  
Community Acquired Infection     Open Access  
Conservation and Society     Open Access   (Followers: 11, SJR: 0.82, h-index: 12)
Contemporary Clinical Dentistry     Open Access   (Followers: 4)
Current Medical Issues     Open Access   (Followers: 1)
CytoJ.     Open Access   (Followers: 2, SJR: 0.339, h-index: 19)
Delta J. of Ophthalmology     Open Access  
Dental Hypotheses     Open Access   (Followers: 3, SJR: 0.131, h-index: 4)
Dental Research J.     Open Access   (Followers: 9)
Dentistry and Medical Research     Open Access  
Digital Medicine     Open Access  
Drug Development and Therapeutics     Open Access  
Education for Health     Open Access   (Followers: 4, SJR: 0.205, h-index: 22)
Egyptian J. of Bronchology     Open Access  
Egyptian J. of Cardiothoracic Anesthesia     Open Access  
Egyptian J. of Cataract and Refractive Surgery     Open Access   (Followers: 1)
Egyptian J. of Dermatology and Venerology     Open Access   (Followers: 1)
Egyptian J. of Haematology     Open Access  
Egyptian J. of Internal Medicine     Open Access  
Egyptian J. of Neurology, Psychiatry and Neurosurgery     Open Access   (Followers: 1, SJR: 0.121, h-index: 3)
Egyptian J. of Obesity, Diabetes and Endocrinology     Open Access  
Egyptian J. of Otolaryngology     Open Access  
Egyptian J. of Psychiatry     Open Access   (Followers: 2)
Egyptian J. of Surgery     Open Access   (Followers: 1)
Egyptian Orthopaedic J.     Open Access  
Egyptian Pharmaceutical J.     Open Access  
Egyptian Retina J.     Open Access  
Egyptian Rheumatology and Rehabilitation     Open Access  
Endodontology     Open Access  
Endoscopic Ultrasound     Open Access   (SJR: 0.473, h-index: 8)
Environmental Disease     Open Access  
European J. of Dentistry     Open Access   (Followers: 2, SJR: 0.496, h-index: 11)
European J. of General Dentistry     Open Access   (Followers: 1)
European J. of Prosthodontics     Open Access   (Followers: 2)
European J. of Psychology and Educational Studies     Open Access   (Followers: 7)
Fertility Science and Research     Open Access  
Formosan J. of Surgery     Open Access   (SJR: 0.107, h-index: 5)
Genome Integrity     Open Access   (Followers: 4, SJR: 1.227, h-index: 12)
Global J. of Transfusion Medicine     Open Access   (Followers: 1)
Heart India     Open Access   (Followers: 1)
Heart Views     Open Access   (Followers: 2)
Hepatitis B Annual     Open Access   (Followers: 3)
IJS Short Reports     Open Access  
Indian Anaesthetists Forum     Open Access  
Indian Dermatology Online J.     Open Access   (Followers: 3)
Indian J. of Allergy, Asthma and Immunology     Open Access   (Followers: 1)
Indian J. of Anaesthesia     Open Access   (Followers: 8, SJR: 0.302, h-index: 13)
Indian J. of Burns     Open Access   (Followers: 1)
Indian J. of Cancer     Open Access   (SJR: 0.318, h-index: 26)
Indian J. of Cerebral Palsy     Open Access   (Followers: 1)
Indian J. of Community Medicine     Open Access   (Followers: 2, SJR: 0.618, h-index: 16)
Indian J. of Critical Care Medicine     Open Access   (Followers: 2, SJR: 0.307, h-index: 16)
Indian J. of Dental Research     Open Access   (Followers: 4, SJR: 0.243, h-index: 24)
Indian J. of Dental Sciences     Open Access  
Indian J. of Dentistry     Open Access   (Followers: 1)
Indian J. of Dermatology     Open Access   (Followers: 2, SJR: 0.448, h-index: 16)
Indian J. of Dermatology, Venereology and Leprology     Open Access   (Followers: 3, SJR: 0.563, h-index: 29)
Indian J. of Dermatopathology and Diagnostic Dermatology     Open Access  
Indian J. of Drugs in Dermatology     Open Access   (Followers: 1)
Indian J. of Endocrinology and Metabolism     Open Access   (Followers: 4)
Indian J. of Health Sciences     Open Access   (Followers: 2)
Indian J. of Medical and Paediatric Oncology     Open Access   (SJR: 0.292, h-index: 9)
Indian J. of Medical Microbiology     Open Access   (Followers: 1, SJR: 0.53, h-index: 34)
Indian J. of Medical Research     Open Access   (Followers: 4, SJR: 0.716, h-index: 60)
Indian J. of Medical Sciences     Open Access   (Followers: 2, SJR: 0.207, h-index: 31)
Indian J. of Multidisciplinary Dentistry     Open Access   (Followers: 1)
Indian J. of Nephrology     Open Access   (Followers: 1, SJR: 0.233, h-index: 12)
Indian J. of Nuclear Medicine     Open Access   (Followers: 2, SJR: 0.213, h-index: 5)
Indian J. of Occupational and Environmental Medicine     Open Access   (Followers: 4, SJR: 0.203, h-index: 13)
Indian J. of Ophthalmology     Open Access   (Followers: 4, SJR: 0.536, h-index: 34)
Indian J. of Oral Health and Research     Open Access  
Indian J. of Oral Sciences     Open Access   (Followers: 1)
Indian J. of Orthopaedics     Open Access   (Followers: 9, SJR: 0.393, h-index: 15)
Indian J. of Otology     Open Access   (Followers: 1, SJR: 0.218, h-index: 5)
Indian J. of Paediatric Dermatology     Open Access   (Followers: 2)
Indian J. of Pain     Open Access   (Followers: 1)
Indian J. of Palliative Care     Open Access   (Followers: 5, SJR: 0.35, h-index: 12)
Indian J. of Pathology and Microbiology     Open Access   (Followers: 1, SJR: 0.285, h-index: 22)
Indian J. of Pharmacology     Open Access   (SJR: 0.347, h-index: 44)
Indian J. of Plastic Surgery     Open Access   (Followers: 12, SJR: 0.303, h-index: 13)
Indian J. of Psychiatry     Open Access   (Followers: 3, SJR: 0.496, h-index: 15)
Indian J. of Psychological Medicine     Open Access   (Followers: 1, SJR: 0.344, h-index: 9)
Indian J. of Public Health     Open Access   (Followers: 1, SJR: 0.444, h-index: 17)
Indian J. of Radiology and Imaging     Open Access   (Followers: 4, SJR: 0.253, h-index: 14)
Indian J. of Research in Homoeopathy     Open Access  
Indian J. of Rheumatology     Open Access   (SJR: 0.169, h-index: 7)
Indian J. of Sexually Transmitted Diseases and AIDS     Open Access   (Followers: 2, SJR: 0.313, h-index: 9)
Indian J. of Social Psychiatry     Open Access   (Followers: 2)
Indian J. of Urology     Open Access   (Followers: 3, SJR: 0.366, h-index: 16)
Indian J. of Vascular and Endovascular Surgery     Open Access   (Followers: 2)
Industrial Psychiatry J.     Open Access   (Followers: 2)
Intl. J. of Academic Medicine     Open Access  
Intl. J. of Advanced Medical and Health Research     Open Access  
Intl. J. of Applied and Basic Medical Research     Open Access  
Intl. J. of Clinical and Experimental Physiology     Open Access   (Followers: 1)
Intl. J. of Critical Illness and Injury Science     Open Access   (Followers: 1)
Intl. J. of Educational and Psychological Researches     Open Access   (Followers: 3)
Intl. J. of Environmental Health Engineering     Open Access   (Followers: 1)
Intl. J. of Forensic Odontology     Open Access   (Followers: 1)
Intl. J. of Green Pharmacy     Open Access   (Followers: 4, SJR: 0.229, h-index: 13)
Intl. J. of Health & Allied Sciences     Open Access   (Followers: 2)
Intl. J. of Health System and Disaster Management     Open Access   (Followers: 2)
Intl. J. of Heart Rhythm     Open Access  
Intl. J. of Medicine and Public Health     Open Access   (Followers: 7)
Intl. J. of Mycobacteriology     Open Access   (SJR: 0.239, h-index: 4)
Intl. J. of Noncommunicable Diseases     Open Access  
Intl. J. of Nutrition, Pharmacology, Neurological Diseases     Open Access   (Followers: 4)
Intl. J. of Oral Health Sciences     Open Access   (Followers: 1)
Intl. J. of Orthodontic Rehabilitation     Open Access  
Intl. J. of Pedodontic Rehabilitation     Open Access  
Intl. J. of Pharmaceutical Investigation     Open Access   (Followers: 1)
Intl. J. of Preventive Medicine     Open Access   (Followers: 1, SJR: 0.523, h-index: 15)
Intl. J. of Shoulder Surgery     Open Access   (Followers: 7, SJR: 0.611, h-index: 9)
Intl. J. of Trichology     Open Access   (SJR: 0.37, h-index: 10)
Intl. J. of Yoga     Open Access   (Followers: 15)
Intl. J. of Yoga : Philosophy, Psychology and Parapsychology     Open Access   (Followers: 6)
Iranian J. of Nursing and Midwifery Research     Open Access   (Followers: 2)
Iraqi J. of Hematology     Open Access  
J. of Academy of Medical Sciences     Open Access  
J. of Advanced Pharmaceutical Technology & Research     Open Access   (Followers: 4, SJR: 0.427, h-index: 15)
J. of Anaesthesiology Clinical Pharmacology     Open Access   (Followers: 8, SJR: 0.416, h-index: 14)
J. of Applied Hematology     Open Access  
J. of Association of Chest Physicians     Open Access   (Followers: 2)
J. of Basic and Clinical Reproductive Sciences     Open Access   (Followers: 1)
J. of Cancer Research and Therapeutics     Open Access   (Followers: 4, SJR: 0.359, h-index: 21)
J. of Carcinogenesis     Open Access   (Followers: 1, SJR: 1.152, h-index: 26)
J. of Cardiothoracic Trauma     Open Access  
J. of Cardiovascular Disease Research     Open Access   (Followers: 3, SJR: 0.351, h-index: 13)
J. of Cardiovascular Echography     Open Access   (SJR: 0.134, h-index: 2)
J. of Cleft Lip Palate and Craniofacial Anomalies     Open Access   (Followers: 2)
J. of Clinical and Preventive Cardiology     Open Access   (Followers: 1)
J. of Clinical Imaging Science     Open Access   (Followers: 1, SJR: 0.277, h-index: 8)
J. of Clinical Neonatology     Open Access   (Followers: 1)
J. of Clinical Ophthalmology and Research     Open Access   (Followers: 1)
J. of Clinical Sciences     Open Access  
J. of Conservative Dentistry     Open Access   (Followers: 4, SJR: 0.532, h-index: 10)
J. of Craniovertebral Junction and Spine     Open Access   (Followers: 4, SJR: 0.199, h-index: 9)
J. of Current Medical Research and Practice     Open Access  
J. of Current Research in Scientific Medicine     Open Access  
J. of Cutaneous and Aesthetic Surgery     Open Access   (Followers: 1)
J. of Cytology     Open Access   (Followers: 1, SJR: 0.274, h-index: 9)
J. of Dental and Allied Sciences     Open Access   (Followers: 1)
J. of Dental Implants     Open Access   (Followers: 7)
J. of Dental Lasers     Open Access   (Followers: 2)
J. of Dental Research and Review     Open Access   (Followers: 1)
J. of Digestive Endoscopy     Open Access   (Followers: 3)
J. of Dr. NTR University of Health Sciences     Open Access  
J. of Earth, Environment and Health Sciences     Open Access   (Followers: 1)
J. of Education and Ethics in Dentistry     Open Access   (Followers: 5)
J. of Education and Health Promotion     Open Access   (Followers: 5)
J. of Emergencies, Trauma and Shock     Open Access   (Followers: 9, SJR: 0.353, h-index: 14)
J. of Engineering and Technology     Open Access   (Followers: 6)
J. of Experimental and Clinical Anatomy     Open Access   (Followers: 2)
J. of Family and Community Medicine     Open Access   (Followers: 1)
J. of Family Medicine and Primary Care     Open Access   (Followers: 8)

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Journal Cover Indian Journal of Critical Care Medicine
  [SJR: 0.307]   [H-I: 16]   [2 followers]  Follow
    
  This is an Open Access Journal Open Access journal
   ISSN (Print) 0972-5229
   Published by Medknow Publishers Homepage  [355 journals]
  • A methodological study to develop a standard operational protocol for
           nurses on central line catheter care of patients in selected intensive
           care units

    • Authors: Rashmita Devi, Sandhya Ghai, Neena Vir Singh, GD Puri
      Pages: 483 - 487
      Abstract: Rashmita Devi, Sandhya Ghai, Neena Vir Singh, GD Puri
      Indian Journal of Critical Care Medicine 2017 21(8):483-487
      Aim: This study aims to develop a standard operational protocol (SOP) for central line catheter care for nurses. Materials and Methods: A preliminary draft of protocol based on extensive review of the literature was developed. The current practices of the nurses regarding central line catheter care were observed. Focus group discussions (FGD) were conducted with the nurses to identify the problems encountered by them during care of central line. Four rounds of Delphi were conducted to validate the protocol. The protocol was found to be feasible in terms of understanding, clarity and easy implementation after conducting a pilot study. An observation checklist was developed from the final draft of the protocol. The nurses were taught regarding the central line catheter care as per the protocol. 30 nurses were observed during central line catheter care by the researcher. After implementation of the protocol, feedback of the nurses was taken by conducting FGDs. Results: Content validity index of each item in the protocol was acceptable. The overall Cronbach's alpha value of the checklist was 0.75. It was concluded that the checklist is reliable and each item has a contribution in the checklist. Conclusion: This protocol addresses interventions to enable staff to provide proper care of the central line catheter to prevent CLABSI.
      Citation: Indian Journal of Critical Care Medicine 2017 21(8):483-487
      PubDate: Mon,14 Aug 2017
      DOI: 10.4103/ijccm.IJCCM_261_16
      Issue No: Vol. 21, No. 8 (2017)
       
  • Studying the power of the integrative weaning index in predicting the
           success rate of the spontaneous breathing trial in patients under
           mechanical ventilation

    • Authors: Sahar Ebrahimabadi, Ahmad Bagheri Moghadam, Mohammadali Vakili, Mahnaz Modanloo, Homeira Khoddam
      Pages: 488 - 493
      Abstract: Sahar Ebrahimabadi, Ahmad Bagheri Moghadam, Mohammadali Vakili, Mahnaz Modanloo, Homeira Khoddam
      Indian Journal of Critical Care Medicine 2017 21(8):488-493
      Background and Aims: The use of weaning predictive indicators can avoid early extubation and wrongful prolonged mechanical ventilation. This study aimed to determine the power of the integrative weaning index (IWI) in predicting the success rate of the spontaneous breathing trial (SBT) in patients under mechanical ventilation. Materials and Methods: In this prospective study, 105 patients undergoing mechanical ventilation for over 48 h were enrolled. Before weaning initiation, the IWI was calculated and based on the defined cutoff point (≥25), the success rate of the SBT was predicted. In case of weaning from the device, 2-h SBT was performed and the physiologic and respiratory indices were continuously studied while being intubated. If they were in the normal range besides the patient's tolerance, the test was considered as a success. The result was then compared with the IWI and further analyzed. Results: The SBT was successful in 90 (85.7%) and unsuccessful in 15 (14.3%) cases. The difference between the true patient outcome after SBT, and the IWI prediction was 0.143 according to the Kappa agreement coefficient (P < 0.001). Moreover, regarding the predictive power, IWI had high sensitivity (95.6%), specificity (40%), positive and negative predictive values (90.5% and 60), positive and negative likelihood ratios (1.59 and 0.11), and accuracy (86.7%). Conclusion: The IWI as a more objective indicator has acceptable accuracy and power for predicting the 2-h SBT result. Therefore, in addition to the reliable prediction of the final weaning outcome, it has favorable power to predict if the patient is ready to breathe spontaneously as the first step to weaning.
      Citation: Indian Journal of Critical Care Medicine 2017 21(8):488-493
      PubDate: Mon,14 Aug 2017
      DOI: 10.4103/ijccm.IJCCM_10_17
      Issue No: Vol. 21, No. 8 (2017)
       
  • How useful is extravascular lung water measurement in managing lung injury
           in intensive care unit?

    • Authors: Anirban Bhattacharjee, Debasis Pradhan, Prithwis Bhattacharyya, Samarjit Dey, Daniala Chhunthang, Akash Handique, Angkita Barman, Mohd Yunus
      Pages: 494 - 499
      Abstract: Anirban Bhattacharjee, Debasis Pradhan, Prithwis Bhattacharyya, Samarjit Dey, Daniala Chhunthang, Akash Handique, Angkita Barman, Mohd Yunus
      Indian Journal of Critical Care Medicine 2017 21(8):494-499
      Context: The primary goal of septic shock management is optimization of organ perfusion, often at the risk of overloading the interstitium and causing pulmonary edema. The conventionally used end points of resuscitation do not generally include volumetric parameters such as extravascular lung water index (EVLWI) and pulmonary vascular permeability index (PVPI). Aims: This study aimed to assess the prognostic value of EVLWI and PVPI by calculating their correlation with the severity of lung injury. Settings and Design: This prospective observational study included twenty mechanically ventilated critically ill patients with Acute Physiology and Chronic Health Evaluation score (APACHE II) >20. Subjects and Methods: EVLWI and PVPI were measured using transpulmonary thermodilution, and simultaneously, PaO2:FiO2 ratio, alveolar-arterial gradient of oxygen (AaDO2), and chest radiograph scores from two radiologists were obtained. Statistical Analysis: The correlation of EVLWI and PVPI with chest radiograph scores, PaO2:FiO2 ratio, and AaDO2 were calculated. The inter-observer agreement between the two radiologists was tested using kappa test. Results: EVLWI and PVPI correlated modestly with PaO2:FiO2 (r = −0.32, P = 0.0004; r = −0.39, P = 0.0001). There was a better correlation of EVLWI and PVPI with PaO2:FiO2 ratio (r = −0.71, P < 0.0001; r = −0.58, P = 0.0001) in the acute respiratory distress syndrome (ARDS) subgroup. The EVLWI values correlated significantly with corresponding chest radiograph scores (r = 0.71, P < 0.0001 for observer 1 and r = 0.68, P < 0.0001 for observer 2). Conclusions: EVLWI and PVPI may have a prognostic significance in the assessment of lung injury in septic shock patients with ARDS. Further research is required to reveal the usefulness of EVLWI as an end point of fluid resuscitation in the management of septic shock with ARDS.
      Citation: Indian Journal of Critical Care Medicine 2017 21(8):494-499
      PubDate: Mon,14 Aug 2017
      DOI: 10.4103/ijccm.IJCCM_40_17
      Issue No: Vol. 21, No. 8 (2017)
       
  • Effect of fat-based versus carbohydrate-based enteral feeding on glycemic
           control in critically ill patients: A randomized clinical trial

    • Authors: Mahdieh Nourmohammadi, Omid Moradi Moghadam, Mohammad Niakan Lahiji, Sevak Hatamian, Zahra Vahdat Shariatpanahi
      Pages: 500 - 505
      Abstract: Mahdieh Nourmohammadi, Omid Moradi Moghadam, Mohammad Niakan Lahiji, Sevak Hatamian, Zahra Vahdat Shariatpanahi
      Indian Journal of Critical Care Medicine 2017 21(8):500-505
      Background and Aims: The aim of this study was to evaluate the preventive effects of high-fat enteral feeding on glycemic control and clinical outcomes in critically ill patients: a randomized clinical trial. Materials and Methods: This study was done on 42 normoglycemic patients admitted to Intensive Care Unit (ICU). Patients were randomly classified into three groups of 14 each. Control group (A) received carbohydrate-based diet (protein: 20%, fat: 30%, and carbohydrate: 50%), study groups received two types of high-fat diet; Group B (protein: 20%, fat: 45% including half of olive oil and half sunflower oil, and carbohydrate: 35%); and Group C (protein: 20%, fat: 45% including sunflower oil, and carbohydrate: 35%) in the first 48 h of admission. Results: Basal characteristics of participants were the same. After the feeding trial, there was no difference between the groups in mean plasma and capillary glucose levels and insulin requirements. Serum high density lipoprotein (HDL)-cholesterol level was increased significantly in Group B on day 10 compared to admission level (40.75 ± 5.58 vs. 43.56 ± 2.25, P = 0.05). We did not find any difference in organ failure involvement and mortality rate between groups. The number of ICU free days was significantly more in Group B compared to the control group (P = 0.04). Conclusion: High-fat diets have no preventive effect on stress hyperglycemia. High monounsaturated fat diet may increase serum HDL-cholesterol level and decrease the length of stay in ICU.
      Citation: Indian Journal of Critical Care Medicine 2017 21(8):500-505
      PubDate: Mon,14 Aug 2017
      DOI: 10.4103/ijccm.IJCCM_118_17
      Issue No: Vol. 21, No. 8 (2017)
       
  • Association of massive transfusion for resuscitation in gastrointestinal
           bleeding with transfusion-related acute lung injury

    • Authors: James J Case, Nasreen Khan, Michael Delrahim, Jasmina Dizdarevic, Dane J Nichols, Martin A Schreiber, Thomas G Deloughery, Akram Khan
      Pages: 506 - 513
      Abstract: James J Case, Nasreen Khan, Michael Delrahim, Jasmina Dizdarevic, Dane J Nichols, Martin A Schreiber, Thomas G Deloughery, Akram Khan
      Indian Journal of Critical Care Medicine 2017 21(8):506-513
      Background and Aims: This study aimed to understand the use of massive transfusion (MT) for gastrointestinal bleeding (GIB). Patients and Methods: We performed a retrospective analysis of patients admitted to our medical Intensive Care Unit (ICU) with GIB for the type of bleeding, quantity of blood products transfused, and risk of transfusion-related acute lung injury (TRALI) and death. MT was defined as transfusion of 10 or more units of red blood cell (RBC) within a 24-h period in a 1-unit RBC: 1-unit fresh frozen plasma: and 1-unit platelet ratio. TRALI was defined as development of acute lung injury (ALI), within 6 h of transfusion, with new bilateral pulmonary infiltrates, absence of circulatory overload, or other explanation for ALI. Results: In a 43-month interval, 169 patients were admitted to the ICU with GIB and received blood products, of whom 13 received MT. Ten patients developed TRALI, of whom 7 (70%) had received MT. MT was associated with an increased risk of TRALI (odds ratio [OR]: 17.9, 95% confidence interval [CI]: 2.9–111.2, P = 0.002) after adjusting for age, sex, body mass index, baseline vitals, and laboratory data. Death was predicted by MT (OR: 5.6, 95% CI: 1.6–19.7, P = 0.007), TRALI (OR: 2.3, 95% CI: 1.1–4.6, P = 0.02), and Acute Physiologic Chronic Health Evaluation II score (OR: 1.17 per unit increase, 95% CI: 1.09–1.26, P < 0.001) after adjusting for age and sex. Conclusions: MT for GIB is associated with an increased risk of TRALI and death. Prospective studies assessing the use of MT in this population are needed to understand and improve outcomes.
      Citation: Indian Journal of Critical Care Medicine 2017 21(8):506-513
      PubDate: Mon,14 Aug 2017
      DOI: 10.4103/ijccm.IJCCM_380_16
      Issue No: Vol. 21, No. 8 (2017)
       
  • External validation of risk prediction scores for invasive candidiasis in
           a medical/surgical intensive care unit: An observational study

    • Authors: Armin Ahmed, Arvind Kumar Baronia, Afzal Azim, Rungmei S. K Marak, Reema Yadav, Preeti Sharma, Mohan Gurjar, Banani Poddar, Ratender Kumar Singh
      Pages: 514 - 520
      Abstract: Armin Ahmed, Arvind Kumar Baronia, Afzal Azim, Rungmei S. K Marak, Reema Yadav, Preeti Sharma, Mohan Gurjar, Banani Poddar, Ratender Kumar Singh
      Indian Journal of Critical Care Medicine 2017 21(8):514-520
      Background: The aim of this study was to conduct external validation of risk prediction scores for invasive candidiasis. Methods: We conducted a prospective observational study in a 12-bedded adult medical/surgical Intensive Care Unit (ICU) to evaluate Candida score >3, colonization index (CI) >0.5, corrected CI >0.4 (CCI), and Ostrosky's clinical prediction rule (CPR). Patients' characteristics and risk factors for invasive candidiasis were noted. Patients were divided into two groups; invasive candidiasis and no-invasive candidiasis. Results: Of 198 patients, 17 developed invasive candidiasis. Discriminatory power (area under receiver operator curve [AUROC]) for Candida score, CI, CCI, and CPR were 0.66, 0.67, 0.63, and 0.62, respectively. A large number of patients in the no-invasive candidiasis group (114 out of 181) were exposed to antifungal agents during their stay in ICU. Subgroup analysis was carried out after excluding such patients from no-invasive candidiasis group. AUROC of Candida score, CI, CCI, and CPR were 0.7, 0.7, 0.65, and 0.72, respectively, and positive predictive values (PPVs) were in the range of 25%–47%, along with negative predictive values (NPVs) in the range of 84%–96% in the subgroup analysis. Conclusion: Currently available risk prediction scores have good NPV but poor PPV. They are useful for selecting patients who are not likely to benefit from antifungal therapy.
      Citation: Indian Journal of Critical Care Medicine 2017 21(8):514-520
      PubDate: Mon,14 Aug 2017
      DOI: 10.4103/ijccm.IJCCM_33_17
      Issue No: Vol. 21, No. 8 (2017)
       
  • Mathematics of ventilator-induced lung injury

    • Authors: Ubaidur Rahaman
      Pages: 521 - 524
      Abstract: Ubaidur Rahaman
      Indian Journal of Critical Care Medicine 2017 21(8):521-524
      Ventilator-induced lung injury (VILI) results from mechanical disruption of blood-gas barrier and consequent edema and releases of inflammatory mediators. A transpulmonary pressure (PL) of 17 cmH2O increases baby lung volume to its anatomical limit, predisposing to VILI. Viscoelastic property of lung makes pulmonary mechanics time dependent so that stress (PL) increases with respiratory rate. Alveolar inhomogeneity in acute respiratory distress syndrome acts as a stress riser, multiplying global stress at regional level experienced by baby lung. Limitation of stress (PL) rather than strain (tidal volume [VT]) is the safe strategy of mechanical ventilation to prevent VILI. Driving pressure is the noninvasive surrogate of lung strain, but its relations to PL is dependent on the chest wall compliance. Determinants of lung stress (VT, driving pressure, positive end-expiratory pressure, and inspiratory flow) can be quantified in terms of mechanical power, and a safe threshold can be determined, which can be used in decision-making between safe mechanical ventilation and extracorporeal lung support.
      Citation: Indian Journal of Critical Care Medicine 2017 21(8):521-524
      PubDate: Mon,14 Aug 2017
      DOI: 10.4103/ijccm.IJCCM_411_16
      Issue No: Vol. 21, No. 8 (2017)
       
  • Fecal carriage of extended-spectrum beta-lactamase-producing
           enterobacteriaceae in intensive care unit patients

    • Authors: Shalini Shenoy Mulki, Kavya Ramamurthy, Sevitha Bhat
      Pages: 525 - 527
      Abstract: Shalini Shenoy Mulki, Kavya Ramamurthy, Sevitha Bhat
      Indian Journal of Critical Care Medicine 2017 21(8):525-527
      Background and Aims: Increasing and indiscriminate use of antibiotics has led the bacteria to develop resistance to most of the antibiotics. Beta-lactamase production is the mechanism of resistance to beta-lactams. Extended-spectrum beta-lactamases (ESBLs) have been found in the members of Enterobacteriaceae such as Escherichia coli and Klebsiella spp. which are the common health-care-associated pathogens. The aim was to study the rate of fecal carriage of ESBL-producing Enterobacteriaceae in patients admitted to the Intensive Care Unit (ICU) of tertiary care hospital and follow them subsequently for the development of infections. Materials and Methods: A hospital-based descriptive study was conducted in the department of microbiology of a tertiary care hospital for a period of 2 months from June 2016 to August 2016. Rectal swabs were collected from the patients admitted to the ICU after a period of 48 h. The swab was inoculated onto a special selective media (ChromID ESBL media). The results were noted according to the color of the colony produced. These patients are followed for the development of infection and the ESBL-producing organisms. Results: A total of 60 rectal swabs were cultured, 39 (65%) showed a positive result. Out of which, 22 (56%) were ESBL-producing E. coli and 17 (43%) Klebsiella spp. Twenty-three (38%) of the total patients screened were infected with ESBL-producing organisms. Conclusion: The study revealed high rates of carriage of ESBL producers in patients admitted to the ICU.
      Citation: Indian Journal of Critical Care Medicine 2017 21(8):525-527
      PubDate: Mon,14 Aug 2017
      DOI: 10.4103/ijccm.IJCCM_112_17
      Issue No: Vol. 21, No. 8 (2017)
       
  • Effectiveness of humidification with heat and moisture exchanger-booster
           in tracheostomized patients

    • Authors: Isabel Gonzalez, Pilar Jimenez, Jorge Valdivia, Antonio Esquinas
      Pages: 528 - 530
      Abstract: Isabel Gonzalez, Pilar Jimenez, Jorge Valdivia, Antonio Esquinas
      Indian Journal of Critical Care Medicine 2017 21(8):528-530
      Background: The two most commonly used types of humidifiers are heated humidifiers and heat and moisture exchange humidifiers. Heated humidifiers provide adequate temperature and humidity without affecting the respiratory pattern, but overdose can cause high temperatures and humidity resulting in condensation, which increases the risk of bacteria in the circuit. These devices are expensive. Heat and moisture exchanger filter is a new concept of humidification, increasing the moisture content in inspired gases. Aims: This study aims to determine the effectiveness of the heat and moisture exchanger (HME)-Booster system to humidify inspired air in patients under mechanical ventilation. Materials and Methods: We evaluated the humidification provided by 10 HME-Booster for tracheostomized patients under mechanical ventilation using Servo I respirators, belonging to the Maquet company and Evita 4. Results: There was an increase in the inspired air humidity after 1 h with the humidifier. Conclusion: The HME-Booster combines the advantages of heat and moisture exchange minimizing the negatives. It increases the amount of moisture in inspired gas in mechanically ventilated tracheostomized patients. It is easy and safe to use. The type of ventilator used has no influence on the result.
      Citation: Indian Journal of Critical Care Medicine 2017 21(8):528-530
      PubDate: Mon,14 Aug 2017
      DOI: 10.4103/ijccm.IJCCM_117_17
      Issue No: Vol. 21, No. 8 (2017)
       
  • Temporary left ventricular pacing: A desperate life-saving measure in
           emergency situation

    • Authors: Ajaz Ahamad Lone, Mohd Iqbal Dar, Fayaz Ahamad Rather, Mohd Sultan Alai, Imran Hafiz, Jahangir Rashid Beigh
      Pages: 531 - 533
      Abstract: Ajaz Ahamad Lone, Mohd Iqbal Dar, Fayaz Ahamad Rather, Mohd Sultan Alai, Imran Hafiz, Jahangir Rashid Beigh
      Indian Journal of Critical Care Medicine 2017 21(8):531-533
      Transcutaneous or transvenous pacing of the right ventricle is performed as a routine practice for patients received with symptomatic bradycardia or complete heart block with relative ease in cath lab. However, more and more patients are received with multiple comorbidities, critical condition, and difficult vascular access. In this article, we describe a patient with difficult venous access with tricuspid regurgitation and displaced the right ventricular pacemaker temporary lead undergoing coronary angiography who was managed with emergent nonconventional left ventricular pacing.
      Citation: Indian Journal of Critical Care Medicine 2017 21(8):531-533
      PubDate: Mon,14 Aug 2017
      DOI: 10.4103/ijccm.IJCCM_358_16
      Issue No: Vol. 21, No. 8 (2017)
       
  • Hemolytic-uremic syndrome complicating acute pancreatitis

    • Authors: Narinder Pal Singh, Neeru P Aggarwal, Hardik R Shah, Laxmi Kant Jha, Anish Kumar
      Pages: 534 - 536
      Abstract: Narinder Pal Singh, Neeru P Aggarwal, Hardik R Shah, Laxmi Kant Jha, Anish Kumar
      Indian Journal of Critical Care Medicine 2017 21(8):534-536
      Hemolytic-uremic syndrome (HUS) is characterized by acute kidney injury with hemolytic anemia and thrombocytopenia. It has diverse etiologies, clinical manifestations, and risk factors. Acute pancreatitis as a cause of HUS is rare in adults. We report a case of 32-year-old male who presented with ethanol-induced acute pancreatitis complicated with hemolytic-uremic syndrome managed with hemodialysis and plasmapheresis.
      Citation: Indian Journal of Critical Care Medicine 2017 21(8):534-536
      PubDate: Mon,14 Aug 2017
      DOI: 10.4103/ijccm.IJCCM_121_17
      Issue No: Vol. 21, No. 8 (2017)
       
  • Hemodialysis for lactic acidosis

    • Authors: N Karthiraj, Nagarajan Ramakrishnan, Ashwin K Mani
      Pages: 537 - 538
      Abstract: N Karthiraj, Nagarajan Ramakrishnan, Ashwin K Mani
      Indian Journal of Critical Care Medicine 2017 21(8):537-538
      Lactic acidosis (Type A) is common in critically ill patients and usually treated by correcting the underlying etiology. We present the case of a young female who presented with life-threatening lactic acidosis secondary to hematological malignancy. Timely initiation of hemodialysis was lifesaving. The case highlights the importance of considering Type B lactic acidosis (in this case secondary to a hematological malignancy) and also initiating renal replacement therapy when routine measures are ineffective.
      Citation: Indian Journal of Critical Care Medicine 2017 21(8):537-538
      PubDate: Mon,14 Aug 2017
      DOI: 10.4103/ijccm.IJCCM_167_17
      Issue No: Vol. 21, No. 8 (2017)
       
  • Thrombotic thrombocytopenic purpura or disseminated intravascular
           coagulation?

    • Authors: Ashok Kumar Pannu, Atul Saroch
      Pages: 539 - 539
      Abstract: Ashok Kumar Pannu, Atul Saroch
      Indian Journal of Critical Care Medicine 2017 21(8):539-539

      Citation: Indian Journal of Critical Care Medicine 2017 21(8):539-539
      PubDate: Mon,14 Aug 2017
      DOI: 10.4103/ijccm.IJCCM_174_17
      Issue No: Vol. 21, No. 8 (2017)
       
  • Does N-acetyl cysteine have protective effects in acute aluminum phosphide
           poisoning?

    • Authors: Samaneh Nakhaee, Omid Mehrpour, Mahdi Balali-Mood
      Pages: 539 - 540
      Abstract: Samaneh Nakhaee, Omid Mehrpour, Mahdi Balali-Mood
      Indian Journal of Critical Care Medicine 2017 21(8):539-540

      Citation: Indian Journal of Critical Care Medicine 2017 21(8):539-540
      PubDate: Mon,14 Aug 2017
      DOI: 10.4103/ijccm.IJCCM_223_17
      Issue No: Vol. 21, No. 8 (2017)
       
  • Dengue and thrombotic thrombocytopenic purpura

    • Authors: Viroj Wiwanitkit
      Pages: 540 - 541
      Abstract: Viroj Wiwanitkit
      Indian Journal of Critical Care Medicine 2017 21(8):540-541

      Citation: Indian Journal of Critical Care Medicine 2017 21(8):540-541
      PubDate: Mon,14 Aug 2017
      DOI: 10.4103/ijccm.IJCCM_217_17
      Issue No: Vol. 21, No. 8 (2017)
       
  • Vitamin D deficiency in critically ill

    • Authors: Suresh Kumar Angurana, Vishal Guglani
      Pages: 541 - 542
      Abstract: Suresh Kumar Angurana, Vishal Guglani
      Indian Journal of Critical Care Medicine 2017 21(8):541-542

      Citation: Indian Journal of Critical Care Medicine 2017 21(8):541-542
      PubDate: Mon,14 Aug 2017
      DOI: 10.4103/ijccm.IJCCM_224_17
      Issue No: Vol. 21, No. 8 (2017)
       
 
 
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