Natl Med J India
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Background Hyperglycaemia and hypoglycaemia in hospitalized patients are associated with poor clinical outcomes. We assessed whether administration of an online educational course for medicine residents improves the glycaemic management of hospitalized patients with diabetes. Methods We conducted this quasi-experimental, pre-post study from January 2019 to April 2019. ⋯ The total hypoglycaemic event rate reduced significantly by 45.8% and this was accompanied by a trend towards improved glycaemic control. At the time of discharge, the patient awareness on insulin injection technique, hypoglycaemic symptoms and its home remedies were significantly increased. Conclusion The administration of an online course increases the knowledge level of residents, improves patient safety and may improve glycaemic control in hospitalized patients with diabetes.
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Case Reports
Isolated pulmonary valve endocarditis with pulmonary annular abscess in a patient of Noonan syndrome.
Right-sided endocarditis is a rare entity, with various series reporting an incidence of 5%-10%. Pulmonary valve (PV) is not only the least commonly involved valve in infective endocarditis (IE), with an incidence of 1.5%-2%, but 'isolated' pulmonic valve endocarditis (PVE) without tricuspid valve involvement is even rarer with limited published data. ⋯ Initially, he was managed conservatively, but due to persistent fever, pulmonary regurgitation and evidence of pulmonary annular abscess extending into the right ventricular outflow tract, he required surgical intervention. Considering the low incidence of isolated PVE, it poses a challenge for physicians in prompt diagnosis and timely management of the infection.