Natl Med J India
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Randomized Controlled Trial
Primer of Epidemiology IV. Study designs II: Interventional or experimental designs.
In this article, we describe experimental study designs and focus on randomized controlled trials. Experimental studies are intervention studies in which the investigator tests a new treatment on a selected group of patients. ⋯ Experimental studies are similar to cohort studies except that the exposure is a deliberate change (intervention) made by the researcher in one group of participants and it overcomes confounding because the treatment is assigned randomly. Further, we discuss various types of randomization (random sequence allocation) and importance of allocation concealment and blinding for proper assessment of outcomes in randomized trials.
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Observational Study
Use of platelet components: An observational audit at a tertiary care centre.
Background Platelets should be transfused appropriately, based on the cause of thrombocytopenia. The practice and policies of transfusion vary among institutions and even among clinical practitioners, leading to inappropriate use of platelets, which might increase the risk of transfusion-related complications to recipients, and lead to a shortage of platelets. An audit of platelet components helps to determine the effectiveness and appropriateness of their use and in improving transfusion practices. ⋯ Indications for appropriate transfusion classified as pre-procedure, prophylactic and therapeutic transfusions were 11.3% (293), 66.1% (1450) and 13% (412), respectively. Medicine and medical oncology were the specialties with the highest level of appropriateness. Conclusion An audit of transfusion practices benefits transfusion services and clinicians in terms of judicious use of platelet components and better inventory management.
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Diabetic myonecrosis or muscle infarction (DMI), a clinicoradiological entity is an underdiagnosed complication of diabetes mellitus. It refers to spontaneous aseptic necrosis of skeletal muscles commonly of the lower limb without evidence of any large vessel disease. It presents as painful swollen limb without any external insult in patients with long-standing diabetes mellitus with other microvascular complications especially nephropathy. We present four instances of DMI in our patients who had end-stage renal disease with a varied course.