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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: 2)
African J. for Infertility and Assisted Conception     Open Access  
African J. of Business Ethics     Open Access   (Followers: 6)
African J. of Medical and Health Sciences     Open Access   (Followers: 2)
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: 5)
Anesthesia : Essays and Researches     Open Access   (Followers: 9)
Annals of African Medicine     Open Access   (Followers: 1, SJR: 0.331, h-index: 15)
Annals of Bioanthropology     Open Access   (Followers: 4)
Annals of Cardiac Anaesthesia     Open Access   (Followers: 14, 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: 5, SJR: 0.388, h-index: 19)
Annals of Tropical Medicine and Public Health     Open Access   (Followers: 12, 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: 10)
Archives of Medicine and Health Sciences     Open Access   (Followers: 3)
Archives of Pharmacy Practice     Open Access   (Followers: 6)
Asia Pacific J. of Clinical Trials : Nervous System Diseases     Open Access  
Asia-Pacific J. of Oncology Nursing     Open Access   (Followers: 4)
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  
Bulletin of Faculty of Physical Therapy     Open Access   (Followers: 1)
Cancer Translational Medicine     Open Access   (Followers: 2)
CHRISMED J. of Health and Research     Open Access  
Clinical Dermatology Review     Open Access   (Followers: 2)
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   (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: 11)
Dentistry and Medical Research     Open Access  
Digital Medicine     Open Access  
Drug Development and Therapeutics     Open Access  
Education for Health     Open Access   (Followers: 6, 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   (Followers: 1)
Egyptian J. of Internal Medicine     Open Access   (Followers: 1)
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   (Followers: 2)
Egyptian J. of Psychiatry     Open Access   (Followers: 2)
Egyptian J. of Surgery     Open Access   (Followers: 1)
Egyptian Orthopaedic J.     Open Access   (Followers: 1)
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   (Followers: 2)
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: 3)
European J. of Psychology and Educational Studies     Open Access   (Followers: 11)
Fertility Science and Research     Open Access  
Formosan J. of Surgery     Open Access   (SJR: 0.107, h-index: 5)
Genome Integrity     Open Access   (Followers: 3, 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: 7, SJR: 0.302, h-index: 13)
Indian J. of Burns     Open Access   (Followers: 1)
Indian J. of Cancer     Open Access   (Followers: 1, 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: 4, 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: 2, 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: 3, SJR: 0.203, h-index: 13)
Indian J. of Ophthalmology     Open Access   (Followers: 5, 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: 8, 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: 2, 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   (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: 4)
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: 3, SJR: 0.229, h-index: 13)
Intl. J. of Health & Allied Sciences     Open Access   (Followers: 3)
Intl. J. of Health System and Disaster Management     Open Access   (Followers: 3)
Intl. J. of Heart Rhythm     Open Access  
Intl. J. of Medicine and Public Health     Open Access   (Followers: 6)
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: 2)
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: 5, 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: 13)
Intl. J. of Yoga : Philosophy, Psychology and Parapsychology     Open Access   (Followers: 5)
Iranian J. of Nursing and Midwifery Research     Open Access   (Followers: 3)
Iraqi J. of Hematology     Open Access  
J. of Academy of Medical Sciences     Open Access  
J. of Advanced Pharmaceutical Technology & Research     Open Access   (Followers: 3, SJR: 0.427, h-index: 15)
J. of Anaesthesiology Clinical Pharmacology     Open Access   (Followers: 7, SJR: 0.416, h-index: 14)
J. of Applied Hematology     Open Access   (Followers: 1)
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: 5, 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   (Followers: 1, 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: 2)
J. of Clinical Ophthalmology and Research     Open Access   (Followers: 3)
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: 2)
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: 2)
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: 2)
J. of Family Medicine and Primary Care     Open Access   (Followers: 11)

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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]
  • The advance directives and foregoing of life support: Where do we stand
           now?

    • Authors: Raj Kumar Mani, Sri Nagesh Simha, Roop Gursahani
      Pages: 135 - 137
      Abstract: Raj Kumar Mani, Sri Nagesh Simha, Roop Gursahani
      Indian Journal of Critical Care Medicine 2018 22(3):135-137

      Citation: Indian Journal of Critical Care Medicine 2018 22(3):135-137
      PubDate: Fri,16 Mar 2018
      DOI: 10.4103/ijccm.IJCCM_116_18
      Issue No: Vol. 22, No. 3 (2018)
       
  • Factors affecting the effective management of acute stroke: A prospective
           observational study

    • Authors: CV Nagendra, T S Srinath Kumar, Vikram Bohra, Viju Wilben, Vivek Karan, Vikram Huded
      Pages: 138 - 143
      Abstract: CV Nagendra, T S Srinath Kumar, Vikram Bohra, Viju Wilben, Vivek Karan, Vikram Huded
      Indian Journal of Critical Care Medicine 2018 22(3):138-143
      Background : Stroke, characterized by sudden loss of cerebral function, is among one of the leading cause of death and disability world over. The newer treatment modalities have changed the landscape of stroke treatment but are very much time bound. Aim: To characterize pre-hospital and in-hospital factors affecting acute stroke management thus defining lacunae in stroke management. Subjects and Methods: A prospective observational study, conducted at the emergency department of a tertiary care center in southern India from August 2015 to July 2016. All stroke patients presenting within first 24 hours of onset were included. A pre -defined Knowledge-Attitude-Practice (KAP) questionnaire was used. Results: Total of 133 patients were eligible out of which 28 were excluded for various reasons. Majority were >60 years age and male (61%). About 60% arrived within window. Distance from the hospital was one of the major factors for arrival within the window period. When compared by KAP questionnaire, bystanders of those arriving within window period had better awareness of stroke symptoms. Conclusions: Improving awareness of stroke symptoms and increasing availability of EMS is likely increase chances of stroke patients receiving appropriate acute management.
      Citation: Indian Journal of Critical Care Medicine 2018 22(3):138-143
      PubDate: Fri,16 Mar 2018
      DOI: 10.4103/ijccm.IJCCM_232_17
      Issue No: Vol. 22, No. 3 (2018)
       
  • Delirium in the Intensive Care Unit: Incidence, risk factors, and impact
           on outcome

    • Authors: Nejla Tilouche, Mohamed Fekih Hassen, Habiba Ben Sik Ali, Oussamma Jaoued, Rim Gharbi, S Souheil El Atrous
      Pages: 144 - 149
      Abstract: Nejla Tilouche, Mohamed Fekih Hassen, Habiba Ben Sik Ali, Oussamma Jaoued, Rim Gharbi, S Souheil El Atrous
      Indian Journal of Critical Care Medicine 2018 22(3):144-149
      Background: The incidence and risk factors for delirium vary among studies. Objective: We aimed to determine the incidence, risk factors, and impact on outcome of delirium in a medical Intensive Care Unit (ICU) in Tunisia using a prospective observational study. Patients: All consecutive patients admitted to the ICU between May 2012 and April 2013 were included if they were aged more than 18 years and had an ICU stay of more than 24 h. Patients who had a cardiac arrest or have a history of dementia or psychosis were excluded. Patients eligible for the study were evaluated by the medical staff to detect delirium using the CAM-ICU. Results: A total of 206 patients were included, 167 did not present delirium and 39 (19%) were analyzed for delirium. Delirious patients had a significantly longer duration of mechanical ventilation (10 days[6–20] vs. 2 days[0–7]) respectively and length of stay in ICU (21.5 days [10.5–32.5] vs. 8 days [5–13]), with no impact on mortality. Delirium was associated with high incidence of unintentional removal of catheters (39% vs. 9%; P < 0.0001), endotracheal tubes (18% vs. 1%; P < 0.0001), and urinary catheters (28% vs. 2%, P < 0.0001). In multivariable risk regression analysis, age (odds ratio [OR] = 4.1, 95% confidence interval [CI]: 1.39–12.21; P = 0.01), hypertension (OR = 3.3, 95% CI: 1.31–8.13; P = 0.011), COPD (OR = 3.5, 95% CI: 1.47–8.59; P = 0.005), steroids (OR = 2.8, 95% CI: 1.05–7.28; P = 0.038), and sedation (OR = 5.4, 95% CI: 2.08–13.9; P < 0.0001) were independent risk factors for delirium. We did not find a relationship between delirium and mortality. Conclusion: Delirium is frequent in the ICU and is associated with poor outcome. Several risk factors for delirium are linked to intensive care environment.
      Citation: Indian Journal of Critical Care Medicine 2018 22(3):144-149
      PubDate: Fri,16 Mar 2018
      DOI: 10.4103/ijccm.IJCCM_244_17
      Issue No: Vol. 22, No. 3 (2018)
       
  • Comparison of Optic Nerve Sheath Diameter between both eyes: A bedside
           ultrasonography approach

    • Authors: Uday Yanamandra, Amul Gupta, Srinivasa A Bhattachar, Sushma Yanamandra, Subrat K Das, Sagarika Patyal, Rajan Grewal, Velu Nair
      Pages: 150 - 153
      Abstract: Uday Yanamandra, Amul Gupta, Srinivasa A Bhattachar, Sushma Yanamandra, Subrat K Das, Sagarika Patyal, Rajan Grewal, Velu Nair
      Indian Journal of Critical Care Medicine 2018 22(3):150-153
      Context: Optic nerve sheath diameter (ONSD) has long been accepted as a reliable proxy of intracranial pressure especially in critical care and bedside settings. The present consensus is to measure ONSD in both eyes and take average value, which is cumbersome and a potential cause of discomfort to the patient. Aim: We aim to compare the values of ONSD of the right and left eye in a random sample as measured by bedside ocular ultrasonography (USG) in Indian adults. Settings and Design: This was a prospective study conducted from September 2012 to March 2013 in the Department of Internal Medicine of a tertiary care hospital situated at moderate high altitude (11,500 ft) in India. Materials and Methods: Patients admitted with high altitude pulmonary edema (HAPE) were recruited by convenience sampling. The ONSD of both eyes were measured 3 mm behind the globe using a 7.5 MHz linear probe on the closed eyelids of supine subjects. Statistical Analysis: Analysis was done using SPSS 17.0. Results: A total of 47 patients of HAPE were recruited to the study with daily ONSD recording of both eyes during the admission period. The mean ONSD of the left eye was 4.60 (standard deviation [SD] = 0.71) whereas the mean ONSD of right eye 4.59 (SD = 0.72). The ONSD of the right eye and left eye was strongly correlated (correlation coefficient = 0.98 with P < 0.0001). The mean difference in the ONSD of both eyes (right–left) was −0.0044 (SD = 0.11) which was not statistically significant (P = 0.533). Conclusion: Our results suggest that the difference in ONSD of both eyes is not statistically significant in disease or health. This study also suggests that the ONSD of either eye can be predicted by the other eye recordings. Based on these findings, it can be suggested that during ocular USG for routine bedside/research purposes it is sufficient to measure ONSD of any of the one eye to save time and avoid discomfort to the patient.
      Citation: Indian Journal of Critical Care Medicine 2018 22(3):150-153
      PubDate: Fri,16 Mar 2018
      DOI: 10.4103/ijccm.IJCCM_498_17
      Issue No: Vol. 22, No. 3 (2018)
       
  • Targeted interventions in critically ill children with severe dengue

    • Authors: Suchitra Ranjit, Gokul Ramanathan, Balasubramaniam Ramakrishnan, Niranjan Kissoon
      Pages: 154 - 161
      Abstract: Suchitra Ranjit, Gokul Ramanathan, Balasubramaniam Ramakrishnan, Niranjan Kissoon
      Indian Journal of Critical Care Medicine 2018 22(3):154-161
      Background: The World Health Organization guidelines provide suggestions on early recognition and treatment of severe dengue (SD); however, mortality in this group can be high and is related both to disease severity and the treatment complications. Subjects and Methods: In this prospective observational study, we report our results where standard therapy (ST) was enhanced by Intensive Care Unit (ICU) supportive measures that have proven beneficial in other conditions that share similar pathophysiology of capillary leak and fluid overload. These include early albumin for crystalloid-refractory shock, proactive monitoring for symptomatic abdominal compartment syndrome (ACS), application of a high-risk intubation management protocol, and other therapies. We compared outcomes in a matched retrospective cohort who received ST. Results: We found improved outcomes using these interventions in patients with the most devastating forms of dengue (ST+ group). We could demonstrate decreased positive fluid balance on days 1–3 and less symptomatic ACS that necessitated invasive percutaneous drainage (7.7% in ST+ group vs. 30% in ST group, P = 0.025). Other benefits in ST+ group included lower intubation and positive pressure ventilation requirements (18.4% in ST+ vs. 53.3% in ST, P = 0.003), lower incidence of major hemorrhage and acute kidney injury, and reduced pediatric ICU stays and mortality (2.6% in ST+ group vs. 26% in ST group, P = 0.004). Conclusion: Children with SD with refractory shock are at extremely high mortality risk. We describe the proactive application of several targeted ICU supportive interventions in addition to ST and could show that these interventions resulted in decreased resuscitation morbidity and improved outcomes in SD.
      Citation: Indian Journal of Critical Care Medicine 2018 22(3):154-161
      PubDate: Fri,16 Mar 2018
      DOI: 10.4103/ijccm.IJCCM_413_17
      Issue No: Vol. 22, No. 3 (2018)
       
  • Severe varicella pneumonia in adults: Seven years' single-center
           experience from India

    • Authors: Akashdeep Singh, Siddharth Parkash, Sunil K Gupta, RK Soni
      Pages: 162 - 167
      Abstract: Akashdeep Singh, Siddharth Parkash, Sunil K Gupta, RK Soni
      Indian Journal of Critical Care Medicine 2018 22(3):162-167
      Context: Varicella pneumonia is a rare but a serious complication of chickenpox in adults. There is paucity of data on varicella pneumonia from India. Aims: The aim of this study is to describe the clinical manifestations, hospital course, treatment, and outcome of adult patients with severe varicella pneumonia. Settings and Design: This was a retrospective, observational study of patients with severe varicella pneumonia attending a tertiary care teaching hospital. Subjects and Methods: The cases of varicella were identified by a computerized search of the medical record for the period between January 2010 and December 2016. During this period, 137 patients got admitted with varicella of which 22 had severe varicella pneumonia. Statistical Analysis: Mean and standard deviation were computed. Fisher's Z-test of proportions and analysis of variance were applied. Results: There were 17 (77.3%) men and 5 (22.7%) women. The mean age of the patients was 33.4 ± 10.8 years. History of contact with an infected person followed by high-grade fever and typical rash was present in all patients. Forty-five percent (10/22) of patients were immunosuppressed. All the patients received intravenous acyclovir. Forty-five percent (10/22) of patients received invasive mechanical ventilation. The various factors associated with the need for mechanical ventilation were partial pressure of oxygen:fraction of inspired oxygen ratio <150, quick sequential (sepsis-related) organ failure assessment (qSOFA) >2, and early bacterial coinfection. The mean Intensive Care Unit and hospital stay were 7 days (range; 1–16) and 9 days (range; 4–21), respectively. The overall mortality was 22.7% and reached 50% in those requiring invasive ventilation. The mortality was higher among patients with qSOFA >3, mean arterial blood pressure <60 mmHg, and severe acute respiratory distress syndrome at presentation. Conclusions: Patients with severe varicella pneumonia are at an increased risk of respiratory failure and death.
      Citation: Indian Journal of Critical Care Medicine 2018 22(3):162-167
      PubDate: Fri,16 Mar 2018
      DOI: 10.4103/ijccm.IJCCM_495_17
      Issue No: Vol. 22, No. 3 (2018)
       
  • Methylene blue for vasoplegic syndrome postcardiac surgery

    • Authors: Aly Makram Habib, Ahmed Galal Elsherbeny, Rayd Abdelaziz Almehizia
      Pages: 168 - 173
      Abstract: Aly Makram Habib, Ahmed Galal Elsherbeny, Rayd Abdelaziz Almehizia
      Indian Journal of Critical Care Medicine 2018 22(3):168-173
      Objectives: cardiopulmonary bypass (CPB) can be complicated by vasoplegia that is refractory to vasopressors. Methylene blue (MB) represents an alternative in such cases. Patients and Methods: Retrospective observational historical control-matched study. From 2010 to 2015, all patients who received MB for vasoplegia post-CPB were included in this study. Historical controls from the period of 2004 to 2009 were matched. End-points were the time till improvement of vasoplegia (Ti), 30-day mortality, cardiac surgical Intensive Care Unit (CSICU) morbidity, and length of stay (LOS). Results: Twenty-eight patients were matched in both groups. There were no statistically significant differences between the two groups in demographic, laboratory data on admission, or hemodynamic profile before use of MB. Ti and time to complete discontinuation of vasopressors were statistically significant less in MB group (8.2 ± 2.6 vs. 29.7 ± 6.4, P = 0.00 and 22.6 ± 5.2 vs. 55.3 ± 9.4, P = 0.00) respectively. Mortality at day 30 was significantly higher in controls compared to MB (1 patient [3.6%] vs. 6 patients [21.4%], long rank P = 0.04). CSICU, hospital LOS, and incidence of renal failure was significantly higher in control group (12.4 ± 3.7 vs. 7 ± 1.4, P = 0.03), (19.5 ± 2.4 vs. 10.9 ± 3.2, P = 0.05) and (9 patients [32.1%] vs. 2 patients [7.1%], P = 0.04), respectively. Duration of mechanical ventilation was less in MB patients; however, did not reach statistical significance. Conclusions: the use of MB for vasoplegia postcardiac surgery was associated with rapid recovery of hemodynamics, shorter need for vasopressors, less ICU mortality, less incidence of renal failure, and shorter LOS.
      Citation: Indian Journal of Critical Care Medicine 2018 22(3):168-173
      PubDate: Fri,16 Mar 2018
      DOI: 10.4103/ijccm.IJCCM_494_17
      Issue No: Vol. 22, No. 3 (2018)
       
  • Comparison of glycemic control between continuous regular insulin infusion
           and single-dose subcutaneous insulin glargine injection in medical
           critically ill patients

    • Authors: Rungsun Bhurayanontachai, Tharittamon Rattanaprapat, Chanon Kongkamol
      Pages: 174 - 179
      Abstract: Rungsun Bhurayanontachai, Tharittamon Rattanaprapat, Chanon Kongkamol
      Indian Journal of Critical Care Medicine 2018 22(3):174-179
      Background and Aims: This study aimed to compare glycemic control between continuous intravenous regular insulin infusion and single-dose subcutaneous insulin glargine injection in medical critically ill patients. Subjects and Methods: A prospective noninferiority study was conducted in medical critically ill patients who developed hyperglycemia and required regular insulin infusion by the Intensive Care Unit glycemic control protocol. The eligible patients were switched from the daily regular insulin requirement to single-dose subcutaneous insulin glargine injection by a 100% conversion dose. Arterial blood glucose was checked every 2 h for 24 h. Success cases were blood glucose levels of 80–200 mg/dL during the study period. The mean time-averaged area under the curves (AUCs) of blood glucose levels between the two types of insulin were compared by t-test. Results: Of 20 cases, 14 cases (70%) were successful. The mean time-averaged AUCs of blood glucose levels between the two types of insulin were not significantly different (155.91 ± 27.54 mg/dL vs. 151.70 ± 17.07 mg/dL, P = 0.56) and less than the predefined noninferior margin. No severe hypoglycemic cases were detected during the study period. Conclusions: Single-dose subcutaneous insulin glargine injection was feasibly applied for glycemic control in medical critically ill patients. The glycemic control in the critically ill patients by a single dose of subcutaneous insulin glargine was comparable to standard intravenous regular insulin infusion. A conversion dose of 100% of the daily requirement of regular insulin is suggested.
      Citation: Indian Journal of Critical Care Medicine 2018 22(3):174-179
      PubDate: Fri,16 Mar 2018
      DOI: 10.4103/ijccm.IJCCM_273_17
      Issue No: Vol. 22, No. 3 (2018)
       
  • Smoke inhalation injury: Etiopathogenesis, diagnosis, and management

    • Authors: Kapil Gupta, Mayank Mehrotra, Parul Kumar, Anoop Raj Gogia, Arun Prasad, Joseph Arnold Fisher
      Pages: 180 - 188
      Abstract: Kapil Gupta, Mayank Mehrotra, Parul Kumar, Anoop Raj Gogia, Arun Prasad, Joseph Arnold Fisher
      Indian Journal of Critical Care Medicine 2018 22(3):180-188
      Smoke inhalation injury is a major determinant of morbidity and mortality in fire victims. It is a complex multifaceted injury affecting initially the airway; however, in short time, it can become a complex life-threatening systemic disease affecting every organ in the body. In this review, we provide a summary of the underlying pathophysiology of organ dysfunction and provide an up-to-date survey of the various critical care modalities that have been found beneficial in caring for these patients. Major pathophysiological change is development of edema in the respiratory tract. The tracheobronchial tree is injured by steam and toxic chemicals, leading to bronchoconstriction. Lung parenchyma is damaged by the release of proteolytic elastases, leading to release of inflammatory mediators, increase in transvascular flux of fluids, and development of pulmonary edema and atelectasis. Decreased levels of surfactant and immunomodulators such as interleukins and tumor-necrosis-factor-α accentuate the injury. A primary survey is conducted at the site of fire, to ensure adequate airway, breathing, and circulation. A good intravenous access is obtained for the administration of resuscitation fluids. Early intubation, preferably with fiberoptic bronchoscope, is prudent before development of airway edema. Bronchial hygiene is maintained, which involves therapeutic coughing, chest physiotherapy, deep breathing exercises, and early ambulation. Pharmacological agents such as beta-2 agonists, racemic epinephrine, N-acetyl cysteine, and aerosolized heparin are used for improving oxygenation of lungs. Newer agents being tested are perfluorohexane, porcine pulmonary surfactant, and ClearMate. Early diagnosis and treatment of smoke inhalation injury are the keys for better outcome.
      Citation: Indian Journal of Critical Care Medicine 2018 22(3):180-188
      PubDate: Fri,16 Mar 2018
      DOI: 10.4103/ijccm.IJCCM_460_17
      Issue No: Vol. 22, No. 3 (2018)
       
  • Failure of postexposure prophylaxis in a patient given rabies vaccine
           intramuscularly in the gluteus muscle, Himachal Pradesh, India

    • Authors: Omesh Kumar Bharti, Vivek Sharma
      Pages: 189 - 190
      Abstract: Omesh Kumar Bharti, Vivek Sharma
      Indian Journal of Critical Care Medicine 2018 22(3):189-190
      A 48–year-old male was bitten by a dog on the forehead and on the RIGHT side of left eyebrow on November 26, 2017, at 2 pm. The patient was immediately rushed to a nearby private hospital where an MBBS doctor gave him immediate wound wash with soap and water and prescribed five doses of rabies vaccine intramuscularly (IM). Since the patient weight was 60 kg, he was also prescribed 2400 IU of equine rabies immunoglobulin (ERIG), but as eRIG was not available, it was not administered. All the four doses of rabies vaccine were given IM in gluteus muscle. On December 17, 2017, the patient was brought to the Government Regional Hospital Hamirpur with the symptoms of difficulty in swallowing water (Hydrophobia) for 2 days. He was given injection diazepam and referred to Rajinder Prasad Government Medical College Tanda, Kangra, Himachal Pradesh, India, where he died of suspected rabies on December 19, 2017. The explicit consent to publish this report and picture was taken from the relatives of the patient, so that others have a lesson from this case report.
      Citation: Indian Journal of Critical Care Medicine 2018 22(3):189-190
      PubDate: Fri,16 Mar 2018
      DOI: 10.4103/ijccm.IJCCM_521_17
      Issue No: Vol. 22, No. 3 (2018)
       
  • Lung collapse secondary to massive pericardial effusion in adults: Two
           case reports

    • Authors: Yogesh Manhas, Antara Gokhale
      Pages: 191 - 194
      Abstract: Yogesh Manhas, Antara Gokhale
      Indian Journal of Critical Care Medicine 2018 22(3):191-194
      We present two cases of respiratory insufficiency due to left lung collapse secondary to massive pericardial effusion. Both patients had pericardial effusion due to their underlying disease. Radioimaging showed compression of the left bronchus. Patients got symptomatic relief after pericardiocentesis. Follow-up imaging showed expansion of the lung.
      Citation: Indian Journal of Critical Care Medicine 2018 22(3):191-194
      PubDate: Fri,16 Mar 2018
      DOI: 10.4103/ijccm.IJCCM_391_17
      Issue No: Vol. 22, No. 3 (2018)
       
  • A clinical conundrum called amitraz poisoning - A case report

    • Authors: Sanjith Saseedharan, Edwin Joseph Pathrose, Bhumika Vedraj Madhav
      Pages: 195 - 196
      Abstract: Sanjith Saseedharan, Edwin Joseph Pathrose, Bhumika Vedraj Madhav
      Indian Journal of Critical Care Medicine 2018 22(3):195-196
      Amitraz is a nonsystemic insecticide and acaricide which is sometimes also used as scabicide. Due to its widespread use, amitraz poisoning has emerged during the past decade and a half although the literatures on human intoxication cases are scarce. Amitraz poisoning can present with numerous symptoms involving central nervous, cardiovascular, and respiratory systems. The mainstay of treatment is supportive and symptomatic. We present the case of a 60-year-old gentleman who was shifted from another hospital in unconscious state with an alleged history of consumption of an unknown substance which later was known to be amitraz.
      Citation: Indian Journal of Critical Care Medicine 2018 22(3):195-196
      PubDate: Fri,16 Mar 2018
      DOI: 10.4103/ijccm.IJCCM_241_17
      Issue No: Vol. 22, No. 3 (2018)
       
  • Preprocedural check of central venous catheter set

    • Authors: Komal Anil Gandhi, Tanvir Samra
      Pages: 197 - 198
      Abstract: Komal Anil Gandhi, Tanvir Samra
      Indian Journal of Critical Care Medicine 2018 22(3):197-198

      Citation: Indian Journal of Critical Care Medicine 2018 22(3):197-198
      PubDate: Fri,16 Mar 2018
      DOI: 10.4103/ijccm.IJCCM_360_17
      Issue No: Vol. 22, No. 3 (2018)
       
  • Risk factors and outcome of acute kidney injury after congenital heart
           surgery

    • Authors: Nagarajan Muthialu
      Pages: 198 - 199
      Abstract: Nagarajan Muthialu
      Indian Journal of Critical Care Medicine 2018 22(3):198-199

      Citation: Indian Journal of Critical Care Medicine 2018 22(3):198-199
      PubDate: Fri,16 Mar 2018
      DOI: 10.4103/ijccm.IJCCM_508_17
      Issue No: Vol. 22, No. 3 (2018)
       
  • Rabies treatment: Are we anywhere close to cure?

    • Authors: Subramanian Senthilkumaran, Namasivayam Balamurugan, Nanjundan Karthikeyan, Ponniah Thirumalaikolundusubramanian
      Pages: 199 - 200
      Abstract: Subramanian Senthilkumaran, Namasivayam Balamurugan, Nanjundan Karthikeyan, Ponniah Thirumalaikolundusubramanian
      Indian Journal of Critical Care Medicine 2018 22(3):199-200

      Citation: Indian Journal of Critical Care Medicine 2018 22(3):199-200
      PubDate: Fri,16 Mar 2018
      DOI: 10.4103/ijccm.IJCCM_8_18
      Issue No: Vol. 22, No. 3 (2018)
       
  • Symmetrical gangrene in both lower limbs in pneumococcal pneumonia

    • Authors: Subodh Kumar Mahto, Arjun Mallasandra Balakrishna, Nehal Aggarwal, Atul Goel
      Pages: 200 - 201
      Abstract: Subodh Kumar Mahto, Arjun Mallasandra Balakrishna, Nehal Aggarwal, Atul Goel
      Indian Journal of Critical Care Medicine 2018 22(3):200-201

      Citation: Indian Journal of Critical Care Medicine 2018 22(3):200-201
      PubDate: Fri,16 Mar 2018
      DOI: 10.4103/ijccm.IJCCM_530_17
      Issue No: Vol. 22, No. 3 (2018)
       
  • Quiz Answers

    • Authors: Yash Javeri
      Pages: 202 - 203
      Abstract: Yash Javeri
      Indian Journal of Critical Care Medicine 2018 22(3):202-203

      Citation: Indian Journal of Critical Care Medicine 2018 22(3):202-203
      PubDate: Fri,16 Mar 2018
      DOI: 10.4103/ijccm.IJCCM_76_18
      Issue No: Vol. 22, No. 3 (2018)
       
  • Quiz Section

    • Authors: Yash Javeri
      Pages: 204 - 204
      Abstract: Yash Javeri
      Indian Journal of Critical Care Medicine 2018 22(3):204-204

      Citation: Indian Journal of Critical Care Medicine 2018 22(3):204-204
      PubDate: Fri,16 Mar 2018
      DOI: 10.4103/ijccm.IJCCM_77_18
      Issue No: Vol. 22, No. 3 (2018)
       
 
 
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