Journal of family medicine and primary care
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J Family Med Prim Care · Jan 2015
Prediction of ease of laryngoscopy and intubation-role of upper lip bite test, modified mallampati classification, and thyromental distance in various combination.
The incidence of difficult intubation in patients undergoing general anaesthesia is estimated to be approximately 1-18% whereas that of failure to intubate is 0.05-0.35%.1,2,3 Various methods have been used for prediction of difficult laryngoscopy. Although, upper lip bite has been shown to be a promising test in its introductory article, repeated validation in various populations is required for any test to be accepted as a routine test. We have compared upper lip bite test (ULBT), modified Mallampati test (MMC) and thyromental distance (TMD) individually and in various combinations to verify which of these predictor tests are significantly associated with difficult glottic exposure. ⋯ We conclude that all three screening tests for difficult intubation have only poor to moderate discriminative power when used alone. Combinations of individual tests add some incremental diagnostic value.
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J Family Med Prim Care · Oct 2014
Health and beyond… strategies for a better India: incorporating evidence to strengthen health policy.
India plans to roll-out universal health coverage in spite of having one of the lowest governments spending on health in the world. A scenario such as this means that health policy decisions particularly with respect to priority setting and resource allocation are often difficult and riddled with difficult choices. ⋯ Various opportunities which exist in order to incorporate evidence in order to inform health policy are discussed. The article highlights the need to develop a transparent, inclusive and independent mechanism to prospectively appraise all available evidence and help inform policy-making based on predetermined criteria and to as evaluate the impact of policy decisions thereby helping in knowledge creation, translation as well as its implementation.
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J Family Med Prim Care · Oct 2014
International classification of primary care: an Indian experience.
India is in the process of transition to universal health coverage for Indian citizens. The focus is to strengthen the primary and secondary level services. Coupled with this national scenario, the development of Family medicine as a distinct discipline is in a crucial stage. There is a nation-wide urge to build family medicine training units and service centers across the country to fulfill the unmet health needs of the population. ⋯ This study is the first to report on the RFE in India. This study demonstrated the breadth of clinical conditions seen by family physicians across all ages and in both genders. This study attempts to highlight the need for family physician based services as a training ground for trainees.
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J Family Med Prim Care · Oct 2014
Case ReportsIngested foreign bodies in children: a report of two cases.
Accidental foreign body ingestion and impaction of food bolus present as an emergency. Pediatric population is the most vulnerable. Since the act may go unnoticed, the child may present late. However, most foreign bodies pass spontaneously in the stools. ⋯ Decision regarding immediate intervention or conservative approach will require consideration of the level of lodgement & type of foreign body. Prevention is possible if parents/guardians exercise control on their wards & are aware of implications of such an event.