Journal of the Indian Medical Association
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Delirium (acute confusional state) is one of the most common mental disorders encountered in patients with medical illness, particularly among those who are older. It is associated with many complex underlying medical conditions and can be hard to recognise. Systematic studies and clinical trials are difficult to perform in patients with cognitive impairment; recommendations for evaluating and treating delirium are based primarily upon clinical observation and expert opinion. Our knowledge of the clinical epidemiology of delirium has substantially increased in the last decade, providing a basic framework for understanding and managing the disorder.
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Randomized Controlled Trial Comparative Study
Comparison of neonatal outcome in women with severe pre-eclampsia undergoing caesarean section under spinal or general anaesthesia.
Ideal method of anaesthesia during caesarean section in women with severe pre-eclampsia is difficult to decide. The aim and objective of the study were to compare neonatal outcome in women with severe pre-eclampsia, undergoing caesarean section in intrapartum period, either under general or spinal anaesthesia. Women with severe pre-eclampsia, undergoing caesarean section in intrapartum period, were included in the study. ⋯ Subgroup analysis in the population with pre-operative scalp blood pH < 7.2, neonatal umbilical artery base deficit was significantly higher in general anaesthesia group. Five minutes APGAR score was comparable but resuscitation at birth was more common in the general anaesthesia group. Correlation coefficient between maternal base deficit and foetal base deficit in this subgroup was 0.42 (p = 0.05) and -0.57 (p < 0.05) respectively for general and spinal anaesthesia.