Natl Med J India
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Doctors are duty bound to assist the delivery of justice by providing expert opinion/evidence in a court of law. However, the time spent in doing so comes at the cost of patient care. The healthcare sector and the judiciary are seized of the matter, and the use of technology as an avenue to ease the process is desirable. ⋯ The Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, has institutionalized the mechanism of tele-evidence with the concurrence of the High Court of Punjab and Haryana. This was made possible after many permutations and combinations were tried, because the existing information technology infrastructure of the stakeholders was not compatible. The desired solution was achieved, and other institutions working to establish similar facilities can learn from the experience of PGIMER to achieve faster results.
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Historical Article
A pioneer of maternal health: Jerusha Jhirad, 1890-1983.
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Administration of intravenous fluids is the most common therapy given to patients admitted to a hospital. Evidence suggests that the use of normal saline (NS) in large quantities is not without adverse effects. Balanced salt solutions (BSS) contain bicarbonate or one of its precursors that act as a buffer, and the electrolyte composition resembles that of plasma. ⋯ In surgical patients, studies found only transient hyperchloraemia and increase in the base deficit in patients receiving NS. Systematic reviews and meta-analyses did not find any significant differences in adverse outcomes such as the need for renal replacement therapy or mortality with the use of saline; however, blood chloride levels were consistently higher with saline compared to BSS. There is a need for larger trials with better methodology to determine if the physiological benefits of BSS translate into better clinical outcomes.