Natl Med J India
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Background Integrating psychiatric care into the general practice of primary care doctors (PCDs) is necessary to overcome the shortage of human resources to cater to the burgeoning public mental health needs of India. The traditional psychiatry curriculum is often top-down and specialist-based that contributes little in terms of skill quotient. We designed an innovative, digitally driven, distance education-based, part-time, modular-based Primary Care Psychiatry Programme (PCPP, skill-based). ⋯ Conclusion This PCPP curriculum contains pragmatic modules with higher TQ. This curriculum is dynamic as the learning is bi-directional. This can be used by policy-makers, innovators and academia for integration with national health programmes such as those for non-communicable diseases and reproductive and child health.
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Case Reports
Pneumopericardium, pneumomediastinum and surgical emphysema in spontaneous pneumothorax.
Spontaneous pneumothorax leading to pneumomediastinum, pneumopericardium and surgical emphysema is a benign condition. Progression to the development of epidural pneumatosis is rare. We report a 19-year-old man who presented with dyspnoea and swelling of the chest wall following a bout of cough. ⋯ Close cardio-pulmonary monitoring is mandatory for complications and accompanying conditions. Most patients with uncomplicated spontaneous pneumomediastinum respond well to oxygen and conservative management. In this case, the patient's symptoms and severe tachypnoea prompted the insertion of an intercostal drainage tube.
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Case Reports Observational Study
Preoperative cardiology referral practices at a tertiary care centre: A retrospective observational study.
Background Preoperative consultations and testing add to healthcare costs. Unnecessary consultations lead to further testing and delay in surgery. Guidelines help us in clinical practice but are seldom followed. ⋯ Conclusion The majority of consultations were by surgeons and were not indicated according to the guidelines and did not have any impact on patient outcome. A large proportion of these patients had low cardiac risk index. As anaesthesiologists, we are best equipped to quantify risk and optimize a patient and should be the leaders of the perioperative period.
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The General Hospital (GH) of Madras (presently Chennai) grew out of a hospital intended for the personnel attached to the Madras army-a Military Hospital (MH)-established within the Fort St George in 1664. Although the GH grew out of this MH, its relocation at its present Périamét (then known as Narimédu, Hog's Hill) site in 1772, bearing the name 'General Hospital' marks its 250th anniversary in 2022. From being MH that serviced the 'white' residents of Madras, it opened to locals in 1899. ⋯ Surgeon Samuel Browne's erroneous dispensation of a medication resulted in the death of James Wheeler, a prominent English-East India Company (EEIC) civil servant in Madras. Following an order to execute an investigation by the Governor, Fort St George, an autopsy of the body of Wheeler was carried out by Surgeon Edward Bulkley. Further to referring to such landmark historical details of early time segments of the MH and GH, we briefly refer to the remarkable medical work of Charles Donovan, William Niblock and Mysore Ramaswami Guruswami Mudaliar, who worked at the GH in the early decades of the 20th century.
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Mesothelioma is a tumour arising from the mesothelial cells lining the pleura, pericardium, peritoneum, or the tunica vaginalis of testes. Primary pericardial mesothelioma is a rare tumour that can have varied manifestations and survival in patients with malignant pericardial tumours is generally dismal. ⋯ The prognosis is generally poor with the treatment options available. We present a middle-aged man with large pericardial effusion secondary to primary pericardial mesothelioma with no previous exposure to asbestos.