Natl Med J India
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Review Meta Analysis
Non-operative treatment for low back pain: A review of evidence and recommendations.
Background Low back pain (LBP) is a healthcare problem with high global prevalence, with non-operative management being the first line of treatment in the majority of patients. This literature review summarizes the current evidence for various modalities of non-operative treatment for LBP. Methods We did a literature search to elicit high-quality evidence for non-operative treatment modalities for LBP, including Cochrane Database reviews and systematic reviews or meta-analysis of randomized controlled trials. ⋯ Conclusion The current evidence for non-operative treatment modalities for LBP is insufficient to draw conclusions or make recommendations to clinicians. High-quality trials are required before widespread use of any treatment modality. Considering that non-operative treatment is usually the first line of therapy for most patients with LBP, it deserves to be the focus of future research in spinal disorders.
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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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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.