Natl Med J India
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Comparative Study
Predictors of mortality in a medical intensive care unit.
Scoring systems to predict mortality in intensive care units have been developed in western populations. There is a need to identify and validate prognostic variables in the Indian context. We compared two scoring systems to predict the discharge outcome in patients admitted to a medical intensive care unit. ⋯ The modified OSF score was superior to the modified APACHE II score in predicting mortality in patients admitted to the medical intensive care unit.
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Preoperative over-ordering of blood is very common and leads to holding up of the blood bank reserve, ageing of the blood unit and wastage of blood bank resources. We evaluated the preoperative blood-ordering and transfusion practices for common elective general surgical procedures at a major Indian hospital. The principal aim of this study was to identify the surgical procedures where type and screen can be introduced and to formulate a maximum surgical blood-order schedule for those procedures where a complete cross-match appears mandatory. ⋯ This study shows that blood was over-ordered in 10 out of the 21 procedures studied. Implementation of the recommended maximum surgical blood-order schedule and introduction of type and screen for eligible surgical procedures is a safe, effective and economic solution to preoperative over-ordering of blood.
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Brain death is the irreversible cessation of all brain functions. Brainstem death is the 'physiological core' of brain death. The Indian Parliament has given legal recognition to brain death though it applies only in the context of performance of organ transplantation. ⋯ These should always be frank and sympathetic. It has been suggested that those whose interests lie in transplantation must bear the responsibility of educating the general public. This will help intensivists who expose themselves knowingly to the unpleasant aspects of organ donation.
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Emergency medicine has been recognized as a specialty in western countries. However, in India, most hospitals and medical colleges have no provision for teaching this specialty. This study was done to assess the feasibility of incorporating emergency medicine in the undergraduate medical curriculum. ⋯ As a specialty that emphasizes basic clinical skills, emergency medicine should be incorporated in the undergraduate medical curriculum.