Natl Med J India
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Observational Study
Study of pre-hospital care, patterns of injury and outcomes of suburban railway accident victims in Mumbai, India.
. India has one of the largest railway networks, with a high incidence of railway-related accidents and fatality rate of 150/million passengers per year. We evaluated the pre-hospitalization period, pattern of injury and outcome of train accident victims in a metropolitan city. ⋯ . We found a high incidence of people in their productive age group losing their lives to railway accidents, which can be prevented with the help of a robust transport system and training the first responder emergency medical care providers.
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Case Reports
Mitral valve repair in an octogenarian with symptomatic severe mitral regurgitation: First use of MitraClip in India.
Percutaneous mitral valve repair is an accepted treatment of choice in Europe and North America for severe primary or secondary mitral regurgitation, in highly symptomatic patients for whom surgical repair is prohibitively high risk. We describe the first use of the MitraClip in India in a frail elderly female with symptomatic heart failure from severe primary mitral regurgitation who was considered high risk for surgical repair. She had substantial improvement in her symptoms as well as quality of life following the procedure.
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Elite controllers (ECs) constitute a rare subset of HIV-infected individuals who possess the remarkable ability to suppress viral replication (defined as an undetectable viral load or viral load <50 copies/ml for >12 months) in the absence of antiretroviral therapy (ART). Studies show that immunological parameters and indicators of long-term complications demonstrate the benefits of initiation of ART even in patients with undetectable viral loads or normal CD4 levels. ⋯ Multiple tests on viral load were undetectable. The patient was initiated on ART in view of falling CD4 counts, to ameliorate the high CD8 levels and to prevent future cardiovascular events.