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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  
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  
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: 5, 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: 2)
Archives of Pharmacy Practice     Open Access   (Followers: 4)
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: 1, 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   (Followers: 1)
Bulletin of Faculty of Physical Therapy     Open Access  
Cancer Translational Medicine     Open Access   (Followers: 1)
CHRISMED J. of Health and Research     Open Access  
Clinical Dermatology Review     Open Access  
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  
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  
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: 6)
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  
Heart India     Open Access  
Heart Views     Open Access  
Hepatitis B Annual     Open Access   (Followers: 3)
IJS Short Reports     Open Access  
Indian Anaesthetists Forum     Open Access  
Indian Dermatology Online J.     Open Access   (Followers: 2)
Indian J. of Allergy, Asthma and Immunology     Open Access   (Followers: 1)
Indian J. of Anaesthesia     Open Access   (Followers: 7, 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  
Indian J. of Community Medicine     Open Access   (Followers: 2, SJR: 0.618, h-index: 16)
Indian J. of Critical Care Medicine     Open Access   (Followers: 1, 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: 2, SJR: 0.563, h-index: 29)
Indian J. of Dermatopathology and Diagnostic Dermatology     Open Access  
Indian J. of Drugs in Dermatology     Open Access  
Indian J. of Endocrinology and Metabolism     Open Access   (Followers: 4)
Indian J. of Health Sciences     Open Access   (Followers: 1)
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: 1)
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  
Intl. J. of Educational and Psychological Researches     Open Access   (Followers: 2)
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: 1)
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: 6, 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  
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: 7, 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  
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]   [1 followers]  Follow
    
  This is an Open Access Journal Open Access journal
   ISSN (Print) 0972-5229
   Published by Medknow Publishers Homepage  [355 journals]
  • A retrospective study of physiological observation-reporting practices and
           the recognition, response, and outcomes following cardiopulmonary arrest
           in a low-to-middle-income country

    • Authors: Ambepitiyawaduge Pubudu De Silva, Jayasingha Arachchilage Sujeewa, Nirodha De Silva, Rathnayake Mudiyanselage Danapala Rathnayake, Lakmal Vithanage, Ponsuge Chathurani Sigera, Sithum Munasinghe, Abi Beane, Tim Stephens, Priyantha Lakmini Athapattu, Kosala Saroj Amarasiri Jayasinghe, Arjen M Dondorp, Rashan Haniffa
      Pages: 343 - 345
      Abstract: Ambepitiyawaduge Pubudu De Silva, Jayasingha Arachchilage Sujeewa, Nirodha De Silva, Rathnayake Mudiyanselage Danapala Rathnayake, Lakmal Vithanage, Ponsuge Chathurani Sigera, Sithum Munasinghe, Abi Beane, Tim Stephens, Priyantha Lakmini Athapattu, Kosala Saroj Amarasiri Jayasinghe, Arjen M Dondorp, Rashan Haniffa
      Indian Journal of Critical Care Medicine 2017 21(6):343-345
      Background and Aims: In Sri Lanka, as in most low-to-middle-income countries (LMICs), early warning systems (EWSs) are not in use. Understanding observation-reporting practices and response to deterioration is a necessary step in evaluating the feasibility of EWS implementation in a LMIC setting. This study describes the practices of observation reporting and the recognition and response to presumed cardiopulmonary arrest in a LMIC. Patients and Methods: This retrospective study was carried out at District General Hospital Monaragala, Sri Lanka. One hundred and fifty adult patients who had cardiac arrests and were reported to a nurse responder were included in the study. Results: Availability of six parameters (excluding mentation) was significantly higher at admission (P < 0.05) than at 24 and 48 h prior to cardiac arrest. Patients had a 49.3% immediate return of spontaneous circulation (ROSC) and 35.3% survival to hospital discharge. Nearly 48.6% of patients who had ROSC did not receive postarrest intensive care. Intubation was performed in 46 (62.2%) patients who went on to have ROSC compared with 28 (36.8%) with no ROSC (P < 0.05). Defibrillation, performed in eight (10.8%) patients who had ROSC and eight (10.5%) in whom did not, was statistically insignificant (P = 0.995). Conclusions: Observations commonly used to detect deterioration are poorly reported, and reporting practices would need to be improved prior to EWS implementation. These findings reinforce the need for training in acute care and resuscitation skills for health-care teams in LMIC settings as part of a program of improving recognition and response to acute deterioration.
      Citation: Indian Journal of Critical Care Medicine 2017 21(6):343-345
      PubDate: Thu,15 Jun 2017
      DOI: 10.4103/ijccm.IJCCM_136_17
      Issue No: Vol. 21, No. 6 (2017)
       
  • A study of continuous renal replacement therapy and acute peritoneal
           dialysis in hemodynamic unstable patients

    • Authors: Ajay Jaryal, Sanjay Vikrant
      Pages: 346 - 349
      Abstract: Ajay Jaryal, Sanjay Vikrant
      Indian Journal of Critical Care Medicine 2017 21(6):346-349
      Objective: The objective of the following study was to assess the outcome of continuous renal replacement therapy (CRRT) and acute peritoneal dialysis (PD) in dialysis-requiring renal failure in patients with hemodynamic instability. Materials and Methods: A retrospective analysis of all the patients who received CRRT and acute PD over a period of 1 year at our institute, a tertiary care center, was done for diagnosis, type of renal replacement therapy (RRT), and survival outcome. The indications for administering either of the therapy were usual indications of doing hemodialysis with the presence of hemodynamic instability (systolic blood pressure <90 mm of Hg even with inotropes). Results: Forty patients, 22 in CRRT and 18 in acute PD group were studied. All these patients required inotropes to maintain desired blood pressure. Twenty-five (62.5%) patients had acute kidney injury (AKI), and 15 (37.5%) had chronic kidney disease (CKD) superimposed over other primary diagnosis. A total of 8 (20%) patients (4 in CRRT, 4 in acute PD) survived at the time of discharge from hospital. The mean age of survivors was approximately a decade less than nonsurvivors (P = 0.15). Overall, there were no survivors in CKD group and all the patients who survived at the time of discharge from hospital had underlying AKI (P = 0.016). Conclusion: This study showing comparable survival outcome in acute PD and CRRT gives evidence that either of the modalities can be adopted in hemodynamically unstable patients requiring RRT depending on the resources available.
      Citation: Indian Journal of Critical Care Medicine 2017 21(6):346-349
      PubDate: Thu,15 Jun 2017
      DOI: 10.4103/ijccm.IJCCM_143_17
      Issue No: Vol. 21, No. 6 (2017)
       
  • Colistin nephrotoxicity in adults: Single centre large series from India

    • Authors: Abdul Ghafur, Swati Gohel, Vidyalakshmi Devarajan, T Raja, Jose Easow, MA Raja, Sankar Sreenivas, Balasubramaniam Ramakrishnan, T Ramakrishnan, SG Raman, Dedeepiya Devaprasad, Balaji Venkatachalam, Ramesh Nimmagadda
      Pages: 350 - 354
      Abstract: Abdul Ghafur, Swati Gohel, Vidyalakshmi Devarajan, T Raja, Jose Easow, MA Raja, Sankar Sreenivas, Balasubramaniam Ramakrishnan, T Ramakrishnan, SG Raman, Dedeepiya Devaprasad, Balaji Venkatachalam, Ramesh Nimmagadda
      Indian Journal of Critical Care Medicine 2017 21(6):350-354
      Context: Limited Indian data are available on the rate of colistin nephrotoxicity and other risk factors contributing to the development of this important side effect. Aim: This study aims to generate data on colistin nephrotoxicity from a large cohort of Indian patients. Design: Retrospective cohort study. Materials and Methods: Case record analysis of patients who received colistin, in an oncology center in India, between January 2011 and December 2015. Nephrotoxicity was assessed using risk, injury, failure, loss, and end-stage (RIFLE) criteria. Statistical Analysis: P < 0.05 was considered as statistically significant. Results: Out of the 229 patients, 13.1% (30/229) developed abnormal RIFLE. Abnormal RIFLE group (n = 30), in comparison to the normal renal function group (n = 199), had higher number of patients in intensive care unit (ICU) (96% vs. 79%, P = 0.02), higher Acute Physiology and Chronic Health Evaluation (APACHE II) score (23 vs. 19 P = 0.0001), Charlson score (5.9 vs. 4.3, P = 0.001), mechanical ventilation (90% vs. 67%, P = 0.016), 28 days mortality (63% vs. 25%, P = 0.0001), and abnormal baseline creatinine (36% vs. 8%, P = 0.001). Coadministration of vancomycin had higher rates of nephrotoxicity (P = 0.039). There was no significant difference in nephrotoxicity between 6 and 9 MU/day dosing pattern (8.8% vs. 13.8%, P = 0.058). Conclusion: Nephrotoxicity rate in our retrospective single center large series of patients receiving colistin was 13.1%. Patients with abnormal baseline creatinine, ICU stay, and higher disease severity are at higher risk of nephrotoxicity while on colistin. A daily dose of 9 million does not significantly increase nephrotoxicity compared to the 6 million. Concomitant administration of vancomycin with colistin increases the risk of nephrotoxicity.
      Citation: Indian Journal of Critical Care Medicine 2017 21(6):350-354
      PubDate: Thu,15 Jun 2017
      DOI: 10.4103/ijccm.IJCCM_140_17
      Issue No: Vol. 21, No. 6 (2017)
       
  • Continuous renal replacement therapy applications on extracorporeal
           membrane oxygenation circuit

    • Authors: Ayse Filiz Yetimakman, Murat Tanyildiz, Selman Kesici, Esra Kockuzu, Benan Bayrakci
      Pages: 355 - 358
      Abstract: Ayse Filiz Yetimakman, Murat Tanyildiz, Selman Kesici, Esra Kockuzu, Benan Bayrakci
      Indian Journal of Critical Care Medicine 2017 21(6):355-358
      Background and Aims: Continuous venovenous hemofiltration or hemodiafiltration is used frequently in pediatric patients, but experience of continuous renal replacement therapy (CRRT) application on extracorporeal membrane oxygenation (ECMO) circuit is still limited. Among several methods used for applying CRRT on ECMO patients, we aim to share our experience on inclusion of a CRRT device in the ECMO circuit which we believe is easier and safer to apply. Materials and Methods: The data were collected on demographics, outcomes, and details of the treatment of ECMO patients who had CRRT. During the study period of 3 years, venous cannula of ECMO circuit before pump was used for CRRT access for both the filter inlet and outlet of CRRT machine to minimize the thromboembolic complications. The common indication for CRRT was fluid overload. Results: CRRT was used in 3.68% of a total number of patients admitted and 43% of patients on ECMO. The patients have undergone renal replacement therapy for periods of time ranging between 24 h and 25 days (260 h mean). The survival rate of this group of patients with multiorgan failure was 33%. Renal recovery occurred in all of the survivors. Complications such as electrolyte imbalance, hypothermia, and bradykinin syndrome were easily managed. Conclusions: Adding a CRRT device on ECMO circuit is a safe and effective technique. The major advantages of this technique are easy to access, applying CRRT without extra anticoagulation process, preventing potential hemodynamic disturbances, and increased clearance of solutes and fluid overload using larger hemofilter.
      Citation: Indian Journal of Critical Care Medicine 2017 21(6):355-358
      PubDate: Thu,15 Jun 2017
      DOI: 10.4103/ijccm.IJCCM_128_17
      Issue No: Vol. 21, No. 6 (2017)
       
  • Quality of dying in the medical intensive care unit: Comparison between
           thai buddhists and thai muslims

    • Authors: Veerapong Vattanavanit, Supattra Uppanisakorn, Rungsun Bhurayanontachai, Bodin Khwannimit
      Pages: 359 - 363
      Abstract: Veerapong Vattanavanit, Supattra Uppanisakorn, Rungsun Bhurayanontachai, Bodin Khwannimit
      Indian Journal of Critical Care Medicine 2017 21(6):359-363
      Background and Aims: Religious belief is an important aspect that influences the life of a patient, especially in Asia. We aim to compare the quality of death in an Intensive Care Unit (ICU) between Buddhists and Muslims from the perspectives of the relatives of the patients and the nurses and physicians. Subjects and Methods: This was a cohort study of critically ill patients who died after admission to a medical ICU in Songklanagarind Hospital in Thailand between 2015 and 2016. We interviewed by telephone the relatives of patients. The nurses and physicians who cared for the patients responded to a self-questionnaire. Results: A total of 112 patients were enrolled in the study. The quality of death and dying-1 scores in Thai Buddhists and Muslim patients rated by the relatives (8 vs. 8, P = 0.55), nurses (8 vs. 8, P = 0.28), and physicians (7 vs. 7, P = 0.74) were not different. The ratings by the nurses correlated with the relatives (rs = 0.41, P < 0.001) but did not correlate with the physicians (rs = 0.15, P = 0.12). Compared with Buddhist patients, Muslim patients were more likely to have documentation in place at the time of the death of do not resuscitate (100% vs. 80.2%, P = 0.02) and withholding and withdrawing life support (100% vs. 80.2%, P = 0.02). Conclusion: There was no difference in the quality of dying and death between Thai Buddhists and Muslims. However, some elements of palliative care were not similar.
      Citation: Indian Journal of Critical Care Medicine 2017 21(6):359-363
      PubDate: Thu,15 Jun 2017
      DOI: 10.4103/ijccm.IJCCM_88_17
      Issue No: Vol. 21, No. 6 (2017)
       
  • Incidence proportion of acute cor pulmonale in patients with acute
           respiratory distress syndrome subjected to lung protective ventilation: A
           systematic review and meta-analysis

    • Authors: Saurabh Kumar Das, Nang Sujali Choupoo, Priyam Saikia, Amitabh Lahkar
      Pages: 364 - 375
      Abstract: Saurabh Kumar Das, Nang Sujali Choupoo, Priyam Saikia, Amitabh Lahkar
      Indian Journal of Critical Care Medicine 2017 21(6):364-375
      Introduction: Reported incidence of acute cor pulmonale (ACP) in patients with acute respiratory distress syndrome (ARDS) varies from 10% to 84%, despite being subjected to lung protective ventilation according to the current guidelines. The objective of this review is to find pooled cumulative incidence of ACP in patients with ARDS undergoing lung protective ventilation. Materials and Methods: We searched MEDLINE, EMBASE, Cochrane Library, KoreaMed, LILACS, and WHO Clinical Trial Registry. Cross-sectional or cohort studies were included if they reported or provided data that could be used to calculate the incidence proportion of ACP. Inverse variance heterogeneity (IVhet) and random effect model were used for the main outcome and measures. Results: We included 16 studies encompassing 1661 patients. The cumulative incidence of ACP using IVhet analysis was 23% (95% confidence interval [CI] = 18%–28%) over 3 days of lung protective ventilation. Random effect analysis of 7 studies (1250 patients) revealed pooled odd ratio of mortality of 1.16 (95% CI = 0.80-1.67, P = 0.44) due to ACP. Conclusion: Patients with ARDS have a 23% risk of developing ACP with lung protective ventilation. Findings of this review indicate the need of updating existing guidelines for ventilating ARDS patients to incorporate right ventricle protective strategy.PROSPERO registration number: CRD42017054688.
      Citation: Indian Journal of Critical Care Medicine 2017 21(6):364-375
      PubDate: Thu,15 Jun 2017
      DOI: 10.4103/ijccm.IJCCM_155_17
      Issue No: Vol. 21, No. 6 (2017)
       
  • Effect of calories delivered on clinical outcomes in critically ill
           patients: Systemic review and meta-analysis

    • Authors: Legese Chelkeba, Mojtaba Mojtahedzadeh, Zeleke Mekonnen
      Pages: 376 - 390
      Abstract: Legese Chelkeba, Mojtaba Mojtahedzadeh, Zeleke Mekonnen
      Indian Journal of Critical Care Medicine 2017 21(6):376-390
      Introduction: International guidelines are promoting early enteral nutrition (EN) as a means of feeding critically ill adult patients to improve clinical outcomes. The question of how much calorie intake is enough to improve the outcomes still remained inconclusive. Therefore, we carried out a meta-analysis to evaluate the effect of low calorie (LC) versus high calorie (HC) delivery on critically ill patients' outcomes. Methods: We included randomized clinical trials (RCTs) that compared LC EN with or without supplemental parenteral nutrition with HC delivery in this meta-analysis irrespective of the site of nutritional delivery in the gastrointestinal tract. We searched PubMed, EMBASE, and Cochrane central register of controlled trials electronic databases to identify RCTs that compared the effects of initially different calorie intake in critical illness. The primary outcome was overall mortality. Results: This meta-analysis included 17 RCTs with a total of 3,593 participants. The result of analysis showed that there was no significant difference between the LC group and HC group in overall mortality (risk ratio [RR], 0.98; 95% confidence interval [CI], 0.87–1.10; P = 0.74; I2 = 6%; P = 0.38), or new-onset pneumonia (RR, 0.92; 95% CI, 0.73–1.16, P = 0.46; I2 = 38%, P = 0. 11). Conclusion: The current meta-analysis showed that there was no significant difference in mortality of critically ill patients initially between the two groups.
      Citation: Indian Journal of Critical Care Medicine 2017 21(6):376-390
      PubDate: Thu,15 Jun 2017
      DOI: 10.4103/ijccm.IJCCM_453_16
      Issue No: Vol. 21, No. 6 (2017)
       
  • Fatal postoperative hemolysis due to severe falciparum malaria

    • Authors: Amol T Kothekar, Vijaya Patil, Nambiraj Konar, Jigeeshu Divatia
      Pages: 391 - 393
      Abstract: Amol T Kothekar, Vijaya Patil, Nambiraj Konar, Jigeeshu Divatia
      Indian Journal of Critical Care Medicine 2017 21(6):391-393
      A 60-year-old apparently healthy female patient underwent mastectomy for breast cancer. She had sinus tachycardia and no other abnormal finding in the preoperative period. However, the immediate postoperative course was stormy with the development of anemia, thrombocytopenia, hemolysis, and renal failure with severe metabolic acidosis. Peripheral blood smear revealed the presence of ring forms of Plasmodium falciparum. Multiorgan failure and death occurred within 36 h of surgery in spite of initiation of antimalarial agents. Diagnosis of malaria should be kept in mind in the event of development of sudden unexplained deterioration or multiorgan dysfunction associated with thrombocytopenia, hemolysis, and severe metabolic acidosis, even in previously asymptomatic patients, especially in residents or recent travelers of the malaria-endemic area.
      Citation: Indian Journal of Critical Care Medicine 2017 21(6):391-393
      PubDate: Thu,15 Jun 2017
      DOI: 10.4103/ijccm.IJCCM_338_16
      Issue No: Vol. 21, No. 6 (2017)
       
  • Rare presentation of congenital diaphragmatic hernia in a sexagenarian

    • Authors: C Danny Darlington, G Fatima Shirly Anitha
      Pages: 394 - 396
      Abstract: C Danny Darlington, G Fatima Shirly Anitha
      Indian Journal of Critical Care Medicine 2017 21(6):394-396
      Congenital diaphragmatic hernia (CDH) usually presents in the neonatal period, and about 10% of reported cases occur in adults. The most common type is Bochdalek's hernia, which occurs through a defect in the posterolateral portion of the diaphragm with an estimated prevalence of 1 in 2500 live births. CDH in adults presents with gastrointestinal or respiratory symptoms, which can be acute or intermittent. We report a case of CDH diagnosed in a 55-year-old man, who presented with acute onset of chest pain and dyspnea with insignificant past history. This patient was initially evaluated medically for myocardial infarction followed by intercostal chest drainage placement, before a definitive diagnosis of CDH was made. This case is reported for its rarity and to highlight the high index of suspicion needed to diagnose CDH in adulthood. This is specially important as CDH, masquerades as other acute conditions in older individuals thereby delaying the diagnosis.
      Citation: Indian Journal of Critical Care Medicine 2017 21(6):394-396
      PubDate: Thu,15 Jun 2017
      DOI: 10.4103/ijccm.IJCCM_83_17
      Issue No: Vol. 21, No. 6 (2017)
       
  • Melioidosis: An emerging infection with fatal outcomes

    • Authors: Isabella Princess, R Ebenezer, Nagarajan Ramakrishnan, Arun Kumar Daniel, S Nandini, MA Thirunarayan
      Pages: 397 - 400
      Abstract: Isabella Princess, R Ebenezer, Nagarajan Ramakrishnan, Arun Kumar Daniel, S Nandini, MA Thirunarayan
      Indian Journal of Critical Care Medicine 2017 21(6):397-400
      According to the Centers for Disease Control and Prevention, from being nonendemic for melioidosis, India has now become endemic for the disease since 2012. Until then, melioidosis cases were being reported sporadically from India. There have been isolated case reports from few states across the country for the past few years. Most of the times, Burkholderia pseudomallei may be misreported as Pseudomonas species, especially in resource-poor laboratories. Due to its varied clinical presentation, the specific clinical diagnosis can be difficult, thereby making laboratory diagnosis mandatory. This could make a huge impact on patient care as this organism has a different treatment protocol as well as virulence determinants which influence the course of management. Although known for its endemicity in Australia, Thailand, and other Southeast Asian countries, B. pseudomallei has emerged in new areas such as India, Southern China, Brazil, and Malawi. We present a rare case of melioidosis with rapid disease progression to fatal outcome from Chennai, South India.
      Citation: Indian Journal of Critical Care Medicine 2017 21(6):397-400
      PubDate: Thu,15 Jun 2017
      DOI: 10.4103/ijccm.IJCCM_122_17
      Issue No: Vol. 21, No. 6 (2017)
       
  • Metatarsal fracture leading to massive pulmonary embolism

    • Authors: Vikas Rajpurohit, Prateek Tejvir, Neelam Meena, Kailash Mittal
      Pages: 401 - 403
      Abstract: Vikas Rajpurohit, Prateek Tejvir, Neelam Meena, Kailash Mittal
      Indian Journal of Critical Care Medicine 2017 21(6):401-403
      Immobilization and bed rest after fracture and orthopedic surgery are routinely advised protocol. Period of bed rest usually depends on the type of injury and orthopedic procedure, ranging from few days to weeks. The trauma, surgery, and immobilization with other contributing factors can lead to deep vein thrombosis and pulmonary embolism (PE) in these patients. Although there is high incidence of PE in such patients, it is difficult to diagnose, primarily because of the variety of nonspecific signs and symptoms. Here, we discuss a case of a 30-year-old female, who had suffered a trivial roadside accident leading to metatarsal bone fracture and later on presented in emergency with seizures, pulmonary edema, and cardiac arrest, after immobilization of just 5 days which was diagnosed to be result of massive PE. Here, we will discuss the pathophysiology, risk factors, and management of massive PE.
      Citation: Indian Journal of Critical Care Medicine 2017 21(6):401-403
      PubDate: Thu,15 Jun 2017
      DOI: 10.4103/ijccm.IJCCM_125_17
      Issue No: Vol. 21, No. 6 (2017)
       
  • Blunt trauma neck with complete tracheal transection a diagnostic and
           therapeutic challenge to the trauma team

    • Authors: K. N. J Prakash Raju, D Anandhi, R Surendar, Ashwith Shetty, Vinay R Pandit
      Pages: 404 - 407
      Abstract: K. N. J Prakash Raju, D Anandhi, R Surendar, Ashwith Shetty, Vinay R Pandit
      Indian Journal of Critical Care Medicine 2017 21(6):404-407
      Survival following trachea-esophageal transection is uncommon. Establishing a secure airway has the highest priority in trauma management. Airway management is a unique and a defining element to the specialty of emergency medicine. There is no doubt regarding the significance of establishing a patent airway in the critically ill patient in the emergency department. Cannot intubate and cannot ventilate situation is a nightmare to all emergency physicians. The most important take-home message from this case report is that every Emergency physician should have the ability to predict “difficult airway” and recognize “failed airway” very early and be skilled in performing rescue techniques when routine oral-tracheal intubation fails. Any delay at any step in the “failed airway” management algorithm may not save the critically ill dying patient. Here, we report a case of blunt trauma following high-velocity road traffic accident, presenting in the peri-arrest state, in whom we noticed “failed airway” which turned out to be due to complete tracheal transection. In our patient, although we had secured the airway immediately, he had already sustained hypoxic brain damage. This scenario emphasizes the importance of prehospital care in developing countries.
      Citation: Indian Journal of Critical Care Medicine 2017 21(6):404-407
      PubDate: Thu,15 Jun 2017
      DOI: 10.4103/ijccm.IJCCM_103_17
      Issue No: Vol. 21, No. 6 (2017)
       
  • Invasive mediastinal Aspergillosis in immunocompetent male with invasion
           of left atrium and hilar structures

    • Authors: Munta Kartik, Arun Kanala, Sunilnadikuda, S Manimala Rao, P Swathi Prakasham
      Pages: 408 - 411
      Abstract: Munta Kartik, Arun Kanala, Sunilnadikuda , S Manimala Rao, P Swathi Prakasham
      Indian Journal of Critical Care Medicine 2017 21(6):408-411
      Aspergillus is described as mould characterised by septate hyphae about 2-4μ in diameter, it is ubiquitous in nature and spreads by inhalation of spores. It causes opportunistic infections in almost six forms namely Allergic bronchopulmonary aspergillosis, Aspergillus sinusitis, Cutaneous aspergillosis, Aspergilloma, Chronic pulmonary aspergillosis, Invasive aspergillosis. Invasive aspergillosis of mediastinum in an immunocompetent patient has rarely been reported. We present a case of a young male who had presented with chest pain, cough and breathleness was later diagnosed as fulminant mediastinal aspergillosis. Incisional biopsy with histology report and endotracheal cultures helped in diagnosing mediastinal aspergillosis. Despite initiation of the right antifungal therapy and best supportive measures, patient died of septic shock and multiorgan dysfunction. This case report highlights the need for higher suspicion in such cases of mediastinal masses and early tissue biopsy which can help in reducing mortality.
      Citation: Indian Journal of Critical Care Medicine 2017 21(6):408-411
      PubDate: Thu,15 Jun 2017
      DOI: 10.4103/ijccm.IJCCM_18_17
      Issue No: Vol. 21, No. 6 (2017)
       
  • Awareness of allergic angina syndrome

    • Authors: Monish S Raut, Sibashankar Kar, Arun Maheshwari
      Pages: 412 - 413
      Abstract: Monish S Raut, Sibashankar Kar, Arun Maheshwari
      Indian Journal of Critical Care Medicine 2017 21(6):412-413

      Citation: Indian Journal of Critical Care Medicine 2017 21(6):412-413
      PubDate: Thu,15 Jun 2017
      DOI: 10.4103/ijccm.IJCCM_58_17
      Issue No: Vol. 21, No. 6 (2017)
       
 
 
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