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Pituitary insufficiency is an uncommon disorder. The most common cause is compression due to a pituitary mass. Other causes include inflammatory damage and vascular injury like postpartum pituitary apoplexy. Postpartum pituitary apoplexy, also known as Sheehan's syndrome, leads to hormonal deficiencies and causes postpartum amenorrhea, lactational failure, chronic hyponatremia, hypoglycemia, and loss of secondary sexual characters. Here we are discussing the clinical course of 15 female patients of panhypopituitarism. Most of them had a history of postpartum hemorrhage. Knowledge about this entity is essential as it is a treatable condition and ignorance could prove to be fatal.
Bhushan D, Agarwal M, Shukla RK. Hypopituitarism A Rare but Often Neglected Condition. Indian J Crit Care Med 2020;24(5)350-352.
Bhushan D, Agarwal M, Shukla RK. Hypopituitarism A Rare but Often Neglected Condition. Indian J Crit Care Med 2020;24(5)350-352.
To assess the accuracy of the passive leg raising (PLR) test to anticipate fluid responsiveness in critically ill children under age of 5 years.
A prospective observational study was conducted, in a university hospital pediatric intensive care unit from June 1, 2017, to January 30, 2018. Hemodynamic parameters including stroke volume using bedside transthoracic echocardiography were assessed at baseline I (45° semi-recumbent position), after PLR, at baseline II, and following fluid challenge. Changes in the stroke volume (delta SV) and in the cardiac index (CI) were recorded after PLR and fluid challenge.
Delta SV of 10% after PLR was an excellent discriminator of the fluid responsiveness with an area under ROC (AUC) of 0.81 (95% CI 0.68-0.9) with a sensitivity of 65.38% and a specificity of 100%. The change in CI of 8.7% after PLR was a significant discriminator of fluid responsiveness with an AUC of 0.7 (95% CI 0.56-0.81) with 57.78% sensitivity and 91.67% specificity.
Passive leg raising can identify nonresponders among seriously ill children under the age of 5 years but it cannot identify all responders with certainty.
Passive leg raising is reliable test in under 5 year-old-children if performed appropriately using bedside echocardiography for the measurement of its transient effect.
El-Nawawy AA, Farghaly PM, Hassouna HM, Accuracy of Passive Leg Raising Test in Prediction of Fluid Responsiveness in Children. Int J Clin Pediatr Dent 2020;24(5)344-349.
El-Nawawy AA, Farghaly PM, Hassouna HM, Accuracy of Passive Leg Raising Test in Prediction of Fluid Responsiveness in Children. Int J Clin Pediatr Dent 2020;24(5)344-349.
In children, pulmonary and cardiac diseases are closely associated, and their integrated evaluation is important. Flexible fiber-optic bronchoscopy (FFB) can be used for both diagnostic and therapeutic purposes in pediatric cardiac intensive care units (PCICU). The objective of this study was to evaluate the utility of FFB in children with congenital heart disease (CHD).
A retrospective, descriptive study was conducted at a tertiary care center in pediatric patients who underwent FFB in PCICU over a period of 6 years (2012-2017).
Total 71 bronchoscopies were done in 58 patients with CHD with median age and weight of 2.5 months and 3.4 kg, respectively. Total of 20 different cardiac lesions were present among patients who underwent FFB. While 38 (53.5%) and 30 (42.3%) procedures were performed in pre-op and postoperative patients, respectively, 3 intraoperative bronchoscopies were also performed. The main indications for FFB were persistent atelectasis (42/71), prolonged oxygen requirement (13/71), stridoshi R, Agarwal N. Flexible Fiber-optic Bronchoscopy-directed Interventions in Children with Congenital Heart Diseases. Indian J Crit Care Med 2020;24(5)340-343.
Hands are the most common medium for initiation and spread of infection in clinics. Hand hygiene is the simplest and most economic method for reducing the healthcare-associated infections (HCAIs).
The aim of the present study was to compare the efficacy of hand sanitizer, liquid soap, and their combination for reducing the microbial colonies on hands.
The study was a single-blinded randomized controlled trial executed in a dental college on 90 participants, which were randomly assigned into three intervention groups of 30 each. The participants were instructed to contaminate their hands followed by a hand hygiene protocol for the liquid hand-wash group, the alcohol-based hand sanitizer (ABHS) group, and the combination group according to WHO guidelines. The swabs were collected pre- and post-intervention and mean colony-forming units were determined for each group.
Median percentage reduction was highest for the combination group (100%), followed by the ABHS group (94.29%) and lowest for the liquid soap (92.31%). This difference in the amount of colony-forming units (CFU) among all the groups was nonsignificant (
= 0.114).
The results of the study show that there was no significant difference in hand disinfection potential among hand sanitizer, liquid soap, or their combination. All the three interventions were equally effective with the reduction of total bacterial contamination from participants' hands.
Khairnar MR, Anitha G, Dalvi TM, Kalghatgi S, Datar UV, Wadgave U,
Comparative Efficacy of Hand Disinfection Potential of Hand Sanitizer and Liquid Soap among Dental Students A Randomized Controlled Trial. Indian J Crit Care Med 2020;24(5)336-339.
Khairnar MR, Anitha G, Dalvi TM, Kalghatgi S, Datar UV, Wadgave U, et al. Comparative Efficacy of Hand Disinfection Potential of Hand Sanitizer and Liquid Soap among Dental Students A Randomized Controlled Trial. Indian J Crit Care Med 2020;24(5)336-339.
Knowledge about basic life support (BLS) is mandatory for healthcare professionals. This study aims to evaluate the knowledge among medical students who have completed their MBBS course and have enrolled for internship.
A questionnaire pertaining to BLS before and after the BLS workshop (pretest and posttest 1) was distributed among the 50 participants consented for the study. The questionnaire was again given to the same participants at the end of their 1 year of internship (posttest 2) and were analyzed.
Among the participants, 96% of students had attended nonstructured BLS classes in the past but the knowledge and skill in BLS and ability to recognize arrest were very low. Knowledge about the essential components of effective cardiopulmonary resuscitation (CPR) was poor among students, which improved to near 100% in posttest 1. this website Awareness about cervical spine stabilization, log rolling, and management of choking was poor among the students, which improved after the class. Although attrition had occurred, the knowledge in posttest 2 was significantly better than pretest (
value < 0.
