Natl Med J India
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Medical malpractice suits are quite common in developed countries leading to an increase in malpractice insurance. Recent trends indicate that India is at the cusp of a medical malpractice crisis. There has been a rise in medical negligence cases filed against doctors, though often the allegations are frivolous. ⋯ Doctors thus not only need to remain updated on medical knowledge and skills but also obtain knowledge of legal paradigms. We aim to raise awareness among doctors about handling negligence cases in various forums and share insights through relevant literature, court judgments and government orders. We also map the process of handling complaints, procedures followed in various courts and the different levels of remedies available for doctors.
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Case Reports Comparative Study
Health impact of screen addiction: A cross-sectional comparative study.
Background Prevalence-based, non-comparative studies have been done to assess psychological and physical consequences of social media and gaming addiction. However, similar studies are lacking for binge-watching, especially in India. We compared the physical and psychological health impact between screen addicted and healthy screen users, by minimizing bias due to confounding factors. ⋯ Results The mean (SD) age of the participants was 19.3 (3.2) years, one-third were women; 68% were from medical colleges and 16% each from engineering colleges and high schools. The prevalence and scores of depression, anxiety and stress; poor sleep quality; and dry eye disease; and prevalence of loneliness, aggression and musculoskeletal pain in the wrist, thumb, neck and back were significantly higher in the screen addicted group (p<0.05). Conclusions There was a significant difference in the prevalence and levels of physical and psychological health impact between screen addicted and healthy screen users.
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Macroenzymes, formed by polymerization of physiological enzymes with immunoglobulins, have slower renal clearance rates due to their higher molecular mass. They are usually incidentally detected, have no pathophysiological importance, and can potentially lead to over-treatment and iatrogenic morbidity. We present, possibly for the first time, a macro-lipasemia variant of macroenzyme, detected in a 14-year-old girl with type-1 diabetes admitted with severe hyperglycaemia and pain abdomen. ⋯ She improved with proton pump inhibitor therapy and was discharged after 5 days of hospital admission after good glycaemic control using multiple subcutaneous injections of insulin. Post-polyethylene glycol (PEG) precipitation, the recovery of lipase activity in PEG treated serum sample was 30.6% (127 U/L), which confirmed the presence of macrolipase. An increased clinical suspicion and performing a cheap reliable test (PEG precipitation), whenever there is clinical biochemical discordance can help us in diagnosing more patients with macroenzymes and macrolipasemia.
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Hyperviscosity syndrome can present with haematological, neurological or cardiovascular manifestations. The common differential diagnoses for severe headache and altered sensorium in a patient with Eisenmenger syndrome include brain abscess, meningitis, cortical venous thrombosis and subarachnoid haemorrhage (SAH). We report a patient with Eisenmenger syndrome with hyperviscosity, presenting as pseudo-SAH, which was successfully treated with phlebotomy.
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Case Reports Observational Study
Epidemiology and clinical spectrum of melioidosis: Analysis of cases from a tertiary care centre in southern Tamil Nadu.
Background We studied the clinical features and treatment outcome of patients with melioidosis in our hospital. Methods We did this retrospective observational chart review over a period of 7 years between December 2014 and February 2022. Results There were 59 cases and 23 deaths attributable to melioidosis over the study period. ⋯ Conclusions The epidemiology of melioidosis is similar to other endemic areas with preponderance of men. There was a temporal association with the monsoon season and a higher number of acute cases. The differences included a higher proportion of deep visceral abscesses and musculo-skeletal involvement compared to lung involvement.