Natl Med J India
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Pain perception is highly subjective, and effective pain management can be challenging in the elderly. We aimed to identify a set of practical measures that could be used to assess pain in elderly patients with or without cognitive impairment, as the first step towards effectively managing their pain. ⋯ We identified a number of reliable and valid methods for pain assessment in the elderly. Elderly patients can receive treatment in a variety of settings, and frequently it is administered by a caregiver or family member, rather than a medical employee. The development of a pain assessment tool that is not subject to variations arising from differences in settings or caregivers is needed to assess pain accurately in elderly patients, and provide timely treatment. Natl Med J India 2017;30:203-7.
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Admission of a patient to an intensive care unit (ICU) can result in tremendous stress to family caregivers not only because of the need to provide physical and emotional support to the sick relative, but also due to the burden of decision-making on behalf of the critically ill person. We enquired about family caregivers' perspectives on intensive care, the challenges they faced with decision-making and their perceptions on the nature of their interactions with healthcare providers. ⋯ Our study highlights the problems faced by family caregivers and of the need to improve their satisfaction through clear and simple communication strategies.
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Construct validity and predictive utility of internal assessment in undergraduate medical education.
Internal assessment is a partial requirement of all medical college examinations in India. It can help teachers provide remedial action and guide learning. But its utility and acceptability is doubted because, with no external control, internal assessment is considered prone to misuse. It is therefore not used as a tool for learning. There is no study on the validity of internal assessment from India. ⋯ Internal assessment marks correlate well with marks in university examinations. This provides evidence for construct validity and predictive utility of internal assessment. Internal assessment can predict performance at summative examinations and allow remedial action.
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Scrub typhus, a potentially fatal rickettsial infection, is common in India. It usually presents with acute febrile illness along with multi-organ involvement caused by Orientia tsutsugamushi. As there was an outbreak of scrub typhus in the Hadoti region of Rajasthan and there is a paucity of data from this region, we studied this entity to describe the diverse epidemiological, clinico-radiological, laboratory parameters and outcome profile of patients with scrub typhus in a tertiary care hospital. ⋯ Scrub typhus has emerged as an important cause of febrile illness in the Hadoti region and can present with varying clinical manifestations with or without eschar. A high index of suspicion, early diagnosis and prompt intervention may help in reducing the mortality.