The Indian Journal of Critical Care Medicine, volume 27, issue 2, published articles spanning pages 135 to 138 in 2023.
Anton MC, Shanthi B, and Vasudevan E's study focused on determining prognostic cutoff values of the D-dimer coagulation factor for ICU admission in COVID-19 patients. The Indian Journal of Critical Care Medicine's 2023, volume 27, issue 2, contained pages 135 to 138.
The Curing Coma Campaign (CCC), a 2019 initiative spearheaded by the Neurocritical Care Society (NCS), sought to aggregate coma scientists, neurointensivists, and neurorehabilitationists from varying disciplines for a unified approach to coma research.
This campaign's objective is to transcend the constraints of current coma definitions, pinpointing methods to enhance prognostication, identify suitable test therapies, and influence outcomes. At this time, the comprehensive approach adopted by the CCC seems both ambitious and challenging in its entirety.
It is plausible that only the North American, European, and a few select advanced countries within the Western world would concur with this claim. Still, the complete concept of CCC could potentially face obstacles in lower-middle-income countries. A meaningful result for India, as anticipated in the CCC, necessitates addressing several hurdles that stand in the way.
This article delves into several potential hurdles India confronts.
Kapoor I, Mahajan C, Zirpe KG, Samavedam S, Sahoo TK, and Sapra H.
The Indian Subcontinent's anxieties center on the Curing Coma Campaign. Within the Indian Journal of Critical Care Medicine, volume 27, number 2, published in 2023, the content encompassed pages 89 through 92.
Amongst the contributors to the study were I. Kapoor, C. Mahajan, K.G. Zirpe, S. Samavedam, T.K. Sahoo, H. Sapra, and colleagues. In the Indian Subcontinent, the Curing Coma Campaign presents some concerns. Volume 27, issue 2 of the Indian Journal of Critical Care Medicine (2023) showcases articles on pages 89 through 92.
Nivolumab's application in melanoma treatment is experiencing a rising trend. Nevertheless, the application of this substance is linked to the possibility of serious adverse effects, impacting every bodily system. Nivolumab therapy in a patient is documented as the cause of severe diaphragm malfunction. With the escalating use of nivolumab, these types of complications are likely to become more prevalent, and every clinician should be aware of its potential manifestation when a patient undergoing nivolumab treatment experiences dyspnea. A readily available diagnostic tool for diaphragm dysfunction is ultrasound.
JJ Schouwenburg, a relevant figure. A Case Report: Nivolumab and Its Impact on Diaphragm Function. Article 147-148 of the 2023, volume 27, issue 2 of the Indian Journal of Critical Care Medicine.
Schouwenburg, identified as JJ. A Patient Case Illustrating Nivolumab-Associated Diaphragm Dysfunction. The Indian Journal of Critical Care Medicine, issue 2, volume 27 of the 2023 publication, discusses critical care medicine on pages 147-148.
Exploring the influence of ultrasound-guided fluid resuscitation protocols in conjunction with clinical assessment on the prevention of fluid overload on day three in children with septic shock.
The prospective, parallel-limb, open-label, randomized controlled superiority trial was executed in the PICU of a government-funded tertiary care hospital located in eastern India. Vesanoid The process of enrolling patients extended from June 2021 until March 2022. Children, diagnosed with or suspected of having septic shock, aged between one month and twelve years (fifty-six in total), were randomized into groups receiving either ultrasound-guided or clinically-guided fluid boluses (in an 11:1 ratio), and were subsequently observed for various outcomes. The primary outcome was the incidence of fluid overload experienced by patients on the third day following admission. The treatment group, following clinical and ultrasound guidance, received fluid boluses. The control group received the same fluid boluses, but without ultrasound guidance, up to a maximum of 60 mL/kg.
By day three of the hospital stay, the ultrasound group showed a significantly lower frequency of fluid overload (25%) than the control group (62%).
For day 3, the median (IQR) cumulative fluid balance percentages differed significantly; 65 (33-103) compared to 113 (54-175).
Generate a JSON array consisting of ten distinct sentences, each rewritten with a different grammatical structure from the initial one. The ultrasound-guided fluid bolus administration was demonstrably less, averaging 40 mL/kg (30-50) compared to 50 mL/kg (40-80), as observed by the ultrasound.
A meticulous and detailed approach to sentence composition is evident in each carefully considered phrase. The study revealed a notable difference in resuscitation time between the ultrasound group (134 ± 56 hours) and the control group (205 ± 8 hours).
= 0002).
In children with septic shock, ultrasound-guided fluid boluses were demonstrably more effective in preventing fluid overload and its associated complications compared to the clinically guided approach. Pediatric septic shock resuscitation in the PICU might benefit from ultrasound, given these contributing factors.
Sarkar M, Kaiser RS, Raut SK, Mahapatra MK, Uz Zaman MA, and Roy O.
A clinical trial comparing the efficacy of sonographically guided versus conventionally guided fluid therapy for children suffering from septic shock. The Indian Journal of Critical Care Medicine, specifically volume 27, issue 2 of 2023, contains articles found on pages 139-146.
Kaiser RS, Sarkar M, Raut SK, Mahapatra MK, Uz Zaman MA, Roy O, et al. A research study analyzing the differences between ultrasound-guided and clinically-based fluid management in pediatric septic shock. Vesanoid Indian Journal of Critical Care Medicine, 2023, volume 27, number 2, pages 139 to 146.
The use of recombinant tissue plasminogen activator (rtPA) has brought about a significant improvement in the management of acute ischemic stroke. For achieving superior outcomes in thrombolysed patients, effective management of door-to-imaging and door-to-needle times is indispensable. Through an observational study, we analyzed the time from door to imaging (DIT) and door-to-non-imaging treatment (DTN) for all thrombolysed patients.
At a tertiary care teaching hospital, a cross-sectional observational study followed 252 acute ischemic stroke patients over 18 months; 52 of these patients underwent rtPA thrombolysis. Observations regarding the time difference between neuroimaging arrival and thrombolysis initiation were made.
Of the thrombolysed patients, a mere 10 underwent neuroimaging (non-contrast computed tomography (NCCT) head with MRI brain screen) within the initial 30 minutes of their hospital arrival; 38 patients were imaged within the 30-60 minute window; and a further 2 each were scanned within the 61-90 and 91-120 minute intervals. Thirty to sixty minutes was the DTN time for three patients, whereas thirty-one patients were thrombolysed within the timeframe of 61 to 90 minutes, while seven patients required 91 to 120 minutes, and five patients each completed the process within 121 to 150 minutes and 151 to 180 minutes respectively. One patient's DTN took anywhere from 181 minutes to 210 minutes to complete.
Among patients in the study, neuroimaging was conducted within 60 minutes of their hospital arrival, and thrombolysis typically ensued within 60 to 90 minutes. Vesanoid While the timeframes fell short of the optimal intervals, the stroke management protocols in Indian tertiary care facilities require further refinement.
Shah A and Diwan A's 'Stroke Thrombolysis: Beating the Clock' provides a detailed study of the crucial aspect of timing in stroke thrombolysis. Indian Journal of Critical Care Medicine, 2023, volume 27, number 2, pages 107 through 110.
Stroke thrombolysis, a race against the clock, is examined by Shah A. and Diwan A. Indian Journal of Critical Care Medicine, 2023, volume 27, number 2, pages 107 to 110.
Our tertiary care hospital facilitated hands-on training in oxygen therapy and ventilatory management for COVID-19 patients, specifically designed for health care workers (HCWs). Our study examined the practical application of oxygen therapy training for COVID-19 patients and its subsequent impact on the knowledge and retention of that knowledge by healthcare workers, six weeks after the training event.
The study's commencement was contingent upon prior Institutional Ethics Committee approval. A questionnaire, structured with 15 multiple-choice questions, was administered to the individual healthcare worker. The HCWs participated in a structured 1-hour training session on Oxygen therapy in COVID-19, whereupon they received the same questionnaire, but with the questions presented in a different sequence. A reformatted questionnaire, distributed as a Google Form, was sent to the participants exactly six weeks after the initial survey.
Both pre-training and post-training tests produced a total of 256 responses collectively. Pre-training test scores, having a median of 8 and an interquartile range of 7 to 10, showed a significant improvement upon post-training, with a median score of 12 and an interquartile range between 10 and 13. The median retention score, positioned centrally within the data, was 11; this encompassed a range of 9 to 12. A statistically substantial difference emerged between the pre-test scores and the higher retention scores.
In a significant proportion – 89% – of healthcare workers, a notable advancement in knowledge was witnessed. The success of the training program is evident in the 76% of healthcare workers who managed to retain the learned knowledge. After six weeks of training, there was a notable upgrade in the comprehension of foundational knowledge. Following six weeks of primary training, we propose supplemental reinforcement training to improve retention.
Singh A., Salhotra R., Bajaj M., Saxena A.K., Sharma S.K., and Singh D.
A Longitudinal Examination of Knowledge Retention and Clinical Effectiveness of Oxygen Therapy Training in COVID-19 Management for Healthcare Personnel.