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Publisher: Medknow Publishers   (Total: 356 journals)

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Showing 1 - 200 of 356 Journals sorted alphabetically
Advanced Arab Academy of Audio-Vestibulogy J.     Open Access  
Advances in Human Biology     Open Access  
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: 2)
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: 10, 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  
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: 3, 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: 8, 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  [356 journals]
  • Use of nutrition risk in critically ill (NUTRIC) score to assess
           nutritional risk in mechanically ventilated patients: A prospective
           observational study

    • Authors: MS Kalaiselvan, MK Renuka, AS Arunkumar
      Pages: 253 - 256
      Abstract: MS Kalaiselvan, MK Renuka, AS Arunkumar
      Indian Journal of Critical Care Medicine 2017 21(5):253-256
      Context: Nutritional risk assessment must be done on all critically ill patients. Malnutrition in intensive care unit (ICU) patients is associated with adverse clinical outcomes. Traditional scoring systems cannot be used for screening in mechanically ventilated (MV) patients because these patients are unable to provide information on their history of food intake and weight loss. The Nutrition Risk in Critically ill (NUTRIC) score is the appropriate nutritional assessment tool in MV patients. Aims: This prospective observational study was conducted to identify the nutritional risk in MV patients using modified NUTRIC (mNUTRIC) score (with the exception of interleukin-6). Patients and Methods: All adult patients admitted to the ICU and required MV for more than 48 h were included in the study. Data were collected on variables required to calculate mNUTRIC score. Patients with mNUTRIC score ≥5 are considered at nutritional risk. Outcome data were collected on ICU length of stay, ventilator-free days, and mortality. Results: A total of 678 MV patients fit into the inclusion criteria. Majority of the patients were male (67%). Mean age of the patients was 55 years. About 288 (42.5%) patients were at high nutritional risk (mNUTRIC score ≥5). Patients with high mNUTRIC score ≥5 had longer mean ICU average length of stay of 9.0 (±4.2) versus 7.8 (±5.8) mean (± standard deviation) days (P < 0.01) and higher mortality 41.4% versus 26.1% (P < 0.0) compared to patients with low NUTRIC score (≤4). High mNUTRIC score (≥5) predicted mortality with area under the curve of 0.582 (95% confidence interval 0.535-0.628). Conclusions: Nearly 42.5% of MV patients admitted to ICU were at nutritional risk, and high mNUTRIC score was associated with increased ICU length of stay and higher mortality.
      Citation: Indian Journal of Critical Care Medicine 2017 21(5):253-256
      PubDate: Tue,16 May 2017
      DOI: 10.4103/ijccm.IJCCM_24_17
      Issue No: Vol. 21, No. 5 (2017)
       
  • Reliability of ultrasonography in confirming endotracheal tube placement
           in an emergency setting

    • Authors: Vimal Koshy Thomas, Cherish Paul, Punchalil Chathappan Rajeev, Babu Urumese Palatty
      Pages: 257 - 261
      Abstract: Vimal Koshy Thomas, Cherish Paul, Punchalil Chathappan Rajeev, Babu Urumese Palatty
      Indian Journal of Critical Care Medicine 2017 21(5):257-261
      Background and Objectives: Over the past few years, ultrasonography is increasingly being used to confirm the correct placement of endotracheal tube (ETT). In our study, we aimed to compare it with the traditional clinical methods and the gold standard quantitative waveform capnography. Two primary outcomes were measured in our study. First was the sensitivity and specificity of ultrasonography against the other two methods to confirm endotracheal intubation. The second primary outcome assessed was the time taken for each method to confirm tube placement in an emergency setting. Methods: This is a single-centered, prospective cohort study conducted in an emergency department of a tertiary care hospital. We included 100 patients with indication of emergency intubation by convenient sampling. The intubation was performed as per standard hospital protocol. As part of the study protocol, ultrasonography was used to identify ETT placement simultaneously with the intubation procedure along with quantitative waveform capnography (end-tidal carbon dioxide) and clinical methods. Confirmation of tube placement and time taken for the same were noted by three separate health-care staffs. Results and Discussion: Out of the 100 intubation attempts, five (5%) had esophageal intubations. The sensitivity and specificity of diagnosis using ultrasonography were 97.89% and 100%, respectively. This was statistically comparable with the other two modalities. The time taken to confirm tube placement with ultrasonography was 8.27 ± 1.54 s compared to waveform capnography and clinical methods which were 18.06 ± 2.58 and 20.72 ± 3.21 s, respectively. The time taken by ultrasonography was significantly less. Conclusions: Ultrasonography confirmed tube placement with comparable sensitivity and specificity to quantitative waveform capnography and clinical methods. But then, it yielded results considerably faster than the other two modalities.
      Citation: Indian Journal of Critical Care Medicine 2017 21(5):257-261
      PubDate: Tue,16 May 2017
      DOI: 10.4103/ijccm.IJCCM_417_16
      Issue No: Vol. 21, No. 5 (2017)
       
  • A pilot randomized controlled trial of comparison between extended daily
           hemodialysis and continuous veno-venous hemodialysis in patients of acute
           kidney injury with septic shock

    • Authors: Shakti Bedanta Mishra, Afzal Azim, Narayan Prasad, Ratendra Kumar Singh, Banani Poddar, Mohan Gurjar, Arvind Kumar Baronia
      Pages: 262 - 267
      Abstract: Shakti Bedanta Mishra, Afzal Azim, Narayan Prasad, Ratendra Kumar Singh, Banani Poddar, Mohan Gurjar, Arvind Kumar Baronia
      Indian Journal of Critical Care Medicine 2017 21(5):262-267
      Aim of Study: Acute kidney injury (AKI) is common in patients of septic shock. There is sparse data comparing sustained low-efficiency dialysis (SLED) and continuous renal replacement therapy (CRRT) in patients with septic shock. Materials and Methods: This is a prospective randomized study in a 12-bedded medical intensive care unit. After clearance from institute's ethics committee and obtaining informed consent from the relatives, sixty adult patients with septic shock who were to undergo dialysis for AKI were included in the study. They were randomly assigned to SLED or CRRT group. Hemodynamic instability was defined as in terms of vasopressor dependency (VD). The worst value of VD during the dialysis session was taken into consideration. The primary objective was look at hemodynamic changes and secondarily into the efficacy. Results: The demographic data were comparable between the sixty patients randomized to thirty in each group. Delta VD and delta vasopressor index (DVI) were similar in SLED group compared to the CRRT group. CRRT group had better efficacy in terms of both equivalent renal urea clearance though fluid balance was not significantly better in CRRT group. Conclusion: SLED is a viable modality of renal replacement therapy in patients with septic shock as the hemodynamic effects are similar to CRRT.
      Citation: Indian Journal of Critical Care Medicine 2017 21(5):262-267
      PubDate: Tue,16 May 2017
      DOI: 10.4103/ijccm.IJCCM_85_17
      Issue No: Vol. 21, No. 5 (2017)
       
  • Thromboelastography for evaluation of coagulopathy in nonbleeding patients
           with sepsis at intensive care unit admission

    • Authors: Syed Nabeel Muzaffar, Arvind Kumar Baronia, Afzal Azim, Anupam Verma, Mohan Gurjar, Banani Poddar, Ratender Kumar Singh
      Pages: 268 - 273
      Abstract: Syed Nabeel Muzaffar, Arvind Kumar Baronia, Afzal Azim, Anupam Verma, Mohan Gurjar, Banani Poddar, Ratender Kumar Singh
      Indian Journal of Critical Care Medicine 2017 21(5):268-273
      Background: Thromboelastography (TEG) is a global test of coagulation which analyzes the whole coagulation process. TEG is popular in trauma, liver transplant, and cardiac surgeries, but studies in sepsis are limited. We have assessed the utility of TEG for evaluating coagulopathy in nonbleeding patients with sepsis. Materials and Methods: A prospective, observational study was done in 12-bedded Intensive Care Unit (ICU) of a tertiary care hospital in North India, during May 2014-November 2014. After ethical clearance, all patients at ICU admission with sepsis were included in the study. Exclusion criteria were age
      Citation: Indian Journal of Critical Care Medicine 2017 21(5):268-273
      PubDate: Tue,16 May 2017
      DOI: 10.4103/ijccm.IJCCM_72_17
      Issue No: Vol. 21, No. 5 (2017)
       
  • The benefit of benzodiazepine reduction: Improving sedation in surgical
           intensive care

    • Authors: Ralph Schneider, Andreas Puetz, Timon Vassiliou, Thomas Wiesmann, Ulrike Lewan, Hinnerk Wulf, Detlef K Bartsch, Caroline Rolfes
      Pages: 274 - 280
      Abstract: Ralph Schneider, Andreas Puetz, Timon Vassiliou, Thomas Wiesmann, Ulrike Lewan, Hinnerk Wulf, Detlef K Bartsch, Caroline Rolfes
      Indian Journal of Critical Care Medicine 2017 21(5):274-280
      Aims: Sedation, as it is often required in critical care, is associated with immobilization, prolonged ventilation, and increased morbidity. Most sedation protocols are based on benzodiazepines. The presented study analyzes the benefit of benzodiazepine-free sedation. Methods: In 2008, 134 patients were treated according to a protocol using benzodiazepine and propofol (Group 1). In 2009, we introduced a new sedation strategy based on sufentanil, nonsteroidal anti-inflammatory drugs, neuroleptics, and antidepressants, which was applied in 140 consecutive patients (Group 2). Depth of sedation, duration of mechanical ventilation, duration of Intensive Care Unit, and hospital stay were analyzed. Results: Group 1 had both a longer duration of deep sedation (18.7 ± 2.5 days vs. 12.6 ± 1.85 days, P = 0.031) and a longer duration of controlled ventilation (311, 35 ± 32.69 vs. 143, 96 ± 20.76 h, P < 0.0001) than Group 2. Ventilator days were more frequent in Group 1 (653, 66 ± 98.37 h vs. 478, 89 ± 68.92 h, P = 0.128). Conclusions: The benzodiazepine-free sedation protocol has been shown to significantly reduce depth of sedation and controlled ventilation. Additional evidence is needed to ascertain reduction of ventilator days which would not only be of benefit for the patient but also for the hospital Management.
      Citation: Indian Journal of Critical Care Medicine 2017 21(5):274-280
      PubDate: Tue,16 May 2017
      DOI: 10.4103/ijccm.IJCCM_67_17
      Issue No: Vol. 21, No. 5 (2017)
       
  • Hospital-acquired infection: Prevalence and outcome in infants undergoing
           open heart surgery in the present era

    • Authors: Manoj Kumar Sahu, Bharat Siddharth, Velayudham Devagouru, Sachin Talwar, Sarvesh Pal Singh, Shiv Chaudhary, Balram Airan
      Pages: 281 - 286
      Abstract: Manoj Kumar Sahu, Bharat Siddharth, Velayudham Devagouru, Sachin Talwar, Sarvesh Pal Singh, Shiv Chaudhary, Balram Airan
      Indian Journal of Critical Care Medicine 2017 21(5):281-286
      Background: The aim of this study is to evaluate the causal relation between hospital-acquired infection (HAI) and clinical outcomes following cardiac surgery in neonates and infants and to identify the risk factors for the development of HAI in this subset of patients. Materials and Methods: After Ethics committee approval, one hundred consecutive infants undergoing open heart surgery (OHS) between June 2015 and June 2016 were included in this prospective observational study. Data were prospectively collected. The incidence and distribution of HAI, the microorganisms, their antibiotic resistance and patients' outcome were determined. The Centers for Disease Control and Prevention criteria were used for defining HAIs. Univariate and multivariate risk factor analysis was done using Stata 14. Results: Sixteen infants developed microbiologically documented HAI after cardiac surgery. Neonatal age group was found to be most susceptible. Lower respiratory tract infections accounted for majority of the infections (47.4%) followed by bloodstream infection (31.6%), urinary tract infection (10.5%), and surgical site infection (10.5%). Klebsiella (36.8%) and Acinetobacter (26.3%) were the most frequently isolated pathogens. HAI was associated with prolonged ventilation duration (P = 0.005), Intensive Care Unit stay (P = 0.0004), and hospital stay (P = 0.002). Multivariate risk factor analysis revealed that preoperative hospital stay (odds ratio [OR] 1.22, 95% confidence interval (CI) 1.6-1.39, P = 0.004), and prolonged cardiopulmonary bypass (CPB) (OR 1.03, 95% CI 1.01-1.05, P = 0.001) were associated with the development of HAI. Conclusion: HAI still remains a dreaded complication in infants after OHS and contributing to morbidity and mortality. Strategies such as decreasing preoperative hospital stay, CPB time, and early extubation should be encouraged to prevent HAI.
      Citation: Indian Journal of Critical Care Medicine 2017 21(5):281-286
      PubDate: Tue,16 May 2017
      DOI: 10.4103/ijccm.IJCCM_62_17
      Issue No: Vol. 21, No. 5 (2017)
       
  • The effect of high-dose parenteral sodium selenite in critically ill
           patients following sepsis: A clinical and mechanistic study

    • Authors: Legese Chelkeba, Arezoo Ahmadi, Mohammad Abdollahi, Atabak Najafi, Mohammad Hosein Ghadimi, Reza Mosaed, Mojtaba Mojtahedzadeh
      Pages: 287 - 293
      Abstract: Legese Chelkeba, Arezoo Ahmadi, Mohammad Abdollahi, Atabak Najafi, Mohammad Hosein Ghadimi, Reza Mosaed, Mojtaba Mojtahedzadeh
      Indian Journal of Critical Care Medicine 2017 21(5):287-293
      Introduction: Severe sepsis and septic shock is characterized by inflammation and oxidative stress. Selenium levels have been reported to be low due to loss or increased requirements during severe sepsis and septic shock. We investigated the effect of high-dose parenteral selenium administration in septic patients. Methods: A prospective, randomized control clinical trial was performed in septic patients. After randomization, patients in selenium group received high-dose parenteral sodium selenite (2 mg intravenous [IV] bolus followed by 1.5 mg IV continuous infusion daily for 14 days) plus standard therapy and the control group received standard therapy. The primary endpoint was mortality at 28 days. Changes in the mean levels of high mobility group box-1 (HMGB-1) protein and superoxide dismutase (SOD), duration of vasopressor therapy, incidence of acute renal failure, and 60 days' mortality were secondary endpoints. Results: Fifty-four patients were randomized into selenium group (n = 29) and control group (n = 25). There was no significant difference in 28-day mortality. No significant difference between the two groups with respect to the average levels of HMGB-1 protein and SOD at any point in time over the course of 14 days had observed. Conclusion: In early administration within the first 6 h of sepsis diagnosis, our study demonstrated that high-dose parenteral selenium administration had no significant effect either on 28-day mortality or the mean levels of HMGB-1 and SOD (Trial Registration: IRCT201212082887N4 at WHO Clinical Trial Registry, August 29, 2014).
      Citation: Indian Journal of Critical Care Medicine 2017 21(5):287-293
      PubDate: Tue,16 May 2017
      DOI: 10.4103/ijccm.IJCCM_343_16
      Issue No: Vol. 21, No. 5 (2017)
       
  • Critically ill obstetric patients in a general critical care unit: A 5
           years' retrospective study in a public teaching hospital of Eastern
           India

    • Authors: Sugata Dasgupta, Tulika Jha, Priyojit Bagchi, Shipti Sradha Singh, Ramprasad Gorai, Sourav Das Choudhury
      Pages: 294 - 302
      Abstract: Sugata Dasgupta, Tulika Jha, Priyojit Bagchi, Shipti Sradha Singh, Ramprasad Gorai, Sourav Das Choudhury
      Indian Journal of Critical Care Medicine 2017 21(5):294-302
      Background: Critical care services are essential for the subset of obstetric patients suffering from severe maternal morbidity. Studies on obstetric critical care are important for benchmarking the issues which need to be addressed while managing critically ill obstetric patients. Although there are several published studies on obstetric critical care from India and abroad, studies from Eastern India are limited. The present study was conducted to fill in this lacuna and to audit the obstetric critical care admissions over a 5 years' period. Settings and Design: Retrospective cohort study conducted in the general critical care unit (CCU) of a government teaching hospital. Materials and Methods: The records of all obstetric patients managed in the CCU over a span of 5 years (January 2011-December 2015) were analyzed. Results: During the study, 205 obstetric patients were admitted with a CCU admission rate of 2.1 per 1000 deliveries. Obstetric hemorrhage (34.64%) was the most common primary diagnosis among them followed by pregnancy-induced hypertension (26.83%). Severe hemorrhage leading to organ failure (40.48%) was the main direct indication of admission. Invasive ventilation was needed in 75.61% patients, and overall obstetric mortality rate was 33.66%. The median duration (in days) of invasive ventilation was 2 (interquartile range [IQR] 1-7), and the median length of CCU stay (in days) was 5 (IQR 3-9). Conclusions: Adequate number of critical care beds, a dedicated obstetric high dependency unit, and effective coordination between critical care and maternity services may prove helpful in high volume obstetric centers.
      Citation: Indian Journal of Critical Care Medicine 2017 21(5):294-302
      PubDate: Tue,16 May 2017
      DOI: 10.4103/ijccm.IJCCM_445_16
      Issue No: Vol. 21, No. 5 (2017)
       
  • Management of potential organ donor: Indian Society of Critical Care
           Medicine: Position statement

    • Authors: Rahul Anil Pandit, Kapil G Zirpe, Sushma Kirtikumar Gurav, Atul P Kulkarni, Sunil Karnath, Deepak Govil, Babu Abhram, Yatin Mehta, Abinav Gupta, Ashit Hegde, Vijaya Patil, Pradip Bhatacharya, Subhal Dixit, Srinivas Samavedan, Subhash Todi
      Pages: 303 - 316
      Abstract: Rahul Anil Pandit, Kapil G Zirpe, Sushma Kirtikumar Gurav, Atul P Kulkarni, Sunil Karnath, Deepak Govil, Babu Abhram, Yatin Mehta, Abinav Gupta, Ashit Hegde, Vijaya Patil, Pradip Bhatacharya, Subhal Dixit, Srinivas Samavedan, Subhash Todi
      Indian Journal of Critical Care Medicine 2017 21(5):303-316

      Citation: Indian Journal of Critical Care Medicine 2017 21(5):303-316
      PubDate: Tue,16 May 2017
      DOI: 10.4103/ijccm.IJCCM_160_17
      Issue No: Vol. 21, No. 5 (2017)
       
  • A study of 24 patients with colistin-resistant Gram-negative isolates in a
           tertiary care hospital in South India

    • Authors: Rajalakshmi Arjun, Ram Gopalakrishnan, P Senthur Nambi, D Suresh Kumar, R Madhumitha, V Ramasubramanian
      Pages: 317 - 321
      Abstract: Rajalakshmi Arjun, Ram Gopalakrishnan, P Senthur Nambi, D Suresh Kumar, R Madhumitha, V Ramasubramanian
      Indian Journal of Critical Care Medicine 2017 21(5):317-321
      Background: As the use of colistin to treat carbapenem-resistant Gram-negative infections increases, colistin resistance is being increasingly reported in Indian hospitals. Materials and Methods: Retrospective chart review of clinical data from patients with colistin-resistant isolates (minimum inhibitory concentration >2 mcg/ml). Clinical profile, outcome, and antibiotics that were used for treatment were analyzed. Results: Twenty-four colistin-resistant isolates were reported over 18 months (January 2014-June 2015). A history of previous hospitalization within 3 months was present in all the patients. An invasive device was used in 22 (91.67%) patients. Urine was the most common source of the isolate, followed by blood and respiratory samples. Klebsiella pneumoniae constituted 87.5% of all isolates. Sixteen (66.6%) were considered to have true infection, whereas eight (33.3%) were considered to represent colonization. Susceptibility of these isolates to other drugs tested was tigecycline in 75%, chloramphenicol 62.5%, amikacin 29.17%, co-trimoxazole 12.5%, and fosfomycin (sensitive in all 4 isolates tested). Antibiotics that were used for treatment were combinations among the following antimicrobials-tigecycline, chloramphenicol, fosfomycin, amikacin, ciprofloxacin, co-trimoxazole, and sulbactam. Among eight patients who were considered to have colonization, there were no deaths. Bacteremic patients had a significantly higher risk of death compared to all nonbacteremic patients (P = 0.014). Conclusions: Colistin resistance among Gram-negative bacteria, especially K. pneumoniae, is emerging in Indian hospitals. At least one-third of isolates represented colonization only rather than true infection and did not require treatment. Among patients with true infection, only 25% had a satisfactory outcome and survived to discharge. Fosfomycin, tigecycline, and chloramphenicol may be options for combination therapy.
      Citation: Indian Journal of Critical Care Medicine 2017 21(5):317-321
      PubDate: Tue,16 May 2017
      DOI: 10.4103/ijccm.IJCCM_454_16
      Issue No: Vol. 21, No. 5 (2017)
       
  • Titration of ideal positive end-expiratory pressure in acute respiratory
           distress syndrome: Comparison between lower inflection point and
           esophageal pressure method using volumetric capnography

    • Authors: Nandakishore Baikunje, Inderpaul Singh Sehgal, Sahajal Dhooria, Kuruswamy Thurai Prasad, Ritesh Agarwal
      Pages: 322 - 325
      Abstract: Nandakishore Baikunje, Inderpaul Singh Sehgal, Sahajal Dhooria, Kuruswamy Thurai Prasad, Ritesh Agarwal
      Indian Journal of Critical Care Medicine 2017 21(5):322-325
      The tenets of mechanical ventilation in acute respiratory distress syndrome (ARDS) include the utilization of low tidal volume and optimal application of positive end-expiratory pressure (PEEP). Optimal PEEP in ARDS is characterized by reduction in alveolar dead space along with improvement in the lung compliance and resultant betterment in oxygenation. There are various methods of setting PEEP in ARDS. Herein, we report a patient of ARDS, wherein we employed measurement of dead space using volumetric capnography to compare two different PEEP strategies, namely, the lower inflection point and transpulmonary pressure monitoring.
      Citation: Indian Journal of Critical Care Medicine 2017 21(5):322-325
      PubDate: Tue,16 May 2017
      DOI: 10.4103/ijccm.IJCCM_11_17
      Issue No: Vol. 21, No. 5 (2017)
       
  • Severe pediatric acute respiratory distress syndrome due to scrub typhus:
           Successful ventilation with airway pressure release ventilation mode after
           becoming refractory to protective ventilation

    • Authors: Sudha Chandelia, Sarika Jain
      Pages: 326 - 328
      Abstract: Sudha Chandelia, Sarika Jain
      Indian Journal of Critical Care Medicine 2017 21(5):326-328
      Scrub typhus can affect lungs from mild illness like pneumonitis to a severe illness like acute respiratory distress syndrome (ARDS). Such patients may be very challenging to treat when their hypoxemia becomes severe and refractory to treatment. Main treatment is supportive in terms of mechanical ventilation. In adult ARDS, low tidal volume (TV) ventilation has been recommended, but there is no consensus on most effective ventilation mode in children. We present a case of a 12-year-old girl who developed severe ARDS (PO 2 /FiO 2 ratio - 58), refractory to low TV ventilation. There was a rapid improvement in oxygenation on the application of airway pressure release ventilation (APRV) mode within ΍ h. She was successfully ventilated and weaned off the ventilator over 5 days. This case highlights the utility of APRV mode of ventilation as a rescue therapy for severe refractory ARDS in children.
      Citation: Indian Journal of Critical Care Medicine 2017 21(5):326-328
      PubDate: Tue,16 May 2017
      DOI: 10.4103/ijccm.IJCCM_38_17
      Issue No: Vol. 21, No. 5 (2017)
       
  • Neurogenic pulmonary edema in traumatic brain injury

    • Authors: Ramanan Rajagopal, Swaminathan Ganesh, Muralidharan Vetrivel
      Pages: 329 - 331
      Abstract: Ramanan Rajagopal, Swaminathan Ganesh, Muralidharan Vetrivel
      Indian Journal of Critical Care Medicine 2017 21(5):329-331
      A 29-year-old male admitted with severe traumatic brain injury following a road traffic accident was sedated and ventilated uneventfully for 72 h. On the fourth posttrauma day, after stopping sedation to assess readiness for extubation, he developed sudden onset desaturation; arterial blood gas showed severe diffusion defect with very low PaO 2 /FiO 2 ratio following an episode of generalized tonic-clonic seizure. The differential diagnoses and further management are discussed.
      Citation: Indian Journal of Critical Care Medicine 2017 21(5):329-331
      PubDate: Tue,16 May 2017
      DOI: 10.4103/ijccm.IJCCM_431_16
      Issue No: Vol. 21, No. 5 (2017)
       
  • Intentional self-harm human poisoning with agricultural micronutrient
           foliar spray: From rural India of Southern Karnataka

    • Authors: Srujitha Marupuru, Girish Thunga, Muralidhar Varma, Sudha Vidyasagar, Pranav Chandak, Sai Mounika Cherukuri
      Pages: 332 - 333
      Abstract: Srujitha Marupuru, Girish Thunga, Muralidhar Varma, Sudha Vidyasagar, Pranav Chandak, Sai Mounika Cherukuri
      Indian Journal of Critical Care Medicine 2017 21(5):332-333

      Citation: Indian Journal of Critical Care Medicine 2017 21(5):332-333
      PubDate: Tue,16 May 2017
      DOI: 10.4103/ijccm.IJCCM_345_16
      Issue No: Vol. 21, No. 5 (2017)
       
  • Overestimation of cardiac output by bent pulmonary artery catheter

    • Authors: Monish S Raut, Sibashankar Kar, Arun Maheshwari, Moloy Rajkhowa, Sumir Dubey, Ganesh Shivnani, Himanshu Arora
      Pages: 333 - 334
      Abstract: Monish S Raut, Sibashankar Kar, Arun Maheshwari, Moloy Rajkhowa, Sumir Dubey, Ganesh Shivnani, Himanshu Arora
      Indian Journal of Critical Care Medicine 2017 21(5):333-334

      Citation: Indian Journal of Critical Care Medicine 2017 21(5):333-334
      PubDate: Tue,16 May 2017
      DOI: 10.4103/ijccm.IJCCM_59_17
      Issue No: Vol. 21, No. 5 (2017)
       
  • Trouble shooting a small sized IJV

    • Authors: Vikas Saini, Dinesh Kumar Sardana, Tanvir Samra, Sameer Sethi
      Pages: 335 - 336
      Abstract: Vikas Saini, Dinesh Kumar Sardana, Tanvir Samra, Sameer Sethi
      Indian Journal of Critical Care Medicine 2017 21(5):335-336

      Citation: Indian Journal of Critical Care Medicine 2017 21(5):335-336
      PubDate: Tue,16 May 2017
      DOI: 10.4103/ijccm.IJCCM_398_16
      Issue No: Vol. 21, No. 5 (2017)
       
  • Erratum: Changes in B-type natriuretic peptide and related hemodynamic
           parameters following a fluid challenge in critically ill patients with
           severe sepsis or septic shock

    • Pages: 337 - 337
      Abstract:
      Indian Journal of Critical Care Medicine 2017 21(5):337-337

      Citation: Indian Journal of Critical Care Medicine 2017 21(5):337-337
      PubDate: Tue,16 May 2017
      DOI: 10.4103/0972-5229.206320
      Issue No: Vol. 21, No. 5 (2017)
       
 
 
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