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Paradoxical reaction to midazolam in preterm neonates: A case series
We report two newborns in our Neonatal Unit, who developed myoclonic seizure after the administration of midazolam. Both of these neonates were preterm, require multiple invasive and noninvasive investigations also leads to parent and clinician stress. (Source: Indian Journal of Critical Care Medicine)
Source: Indian Journal of Critical Care Medicine - April 18, 2018 Category: Intensive Care Authors: Mahendra Kumar Gupta Jayashree A Mondkar Deepraj Hegde Source Type: research

Cerebrospinal fluid lactate as a prognostic indicator in postneurosurgical bacterial meningitis and use of intrathecal colistin
Pradeepkumar Hiremath, Pradeep Rangappa, Ipe Jacob, Karthik RaoIndian Journal of Critical Care Medicine 2018 22(4):297-299Postneurosurgical bacterial meningitis (PNBM) is an emergency and requires early diagnosis and treatment with appropriate antibiotics. The cornerstone of diagnosis is microbiological analysis of the cerebrospinal fluid (CSF) cytochemical characteristics such as leucocyte count, CSF glucose, and protein concentration and CSF: Serum glucose ratio. However, this is often misleading in PNBM. The role of CSF lactate assay for diagnosis and prognosis has been debated. This case report looks into the serial me...
Source: Indian Journal of Critical Care Medicine - April 18, 2018 Category: Intensive Care Authors: Pradeepkumar Hiremath Pradeep Rangappa Ipe Jacob Karthik Rao Source Type: research

Epidemiological analysis of extended-spectrum beta-lactamase-producing bacterial infections in adult live donor liver transplant patients
Conclusions: Infections with ESBL-producing organism in liver transplant recipients has a high mortality and very limited therapeutic options. (Source: Indian Journal of Critical Care Medicine)
Source: Indian Journal of Critical Care Medicine - April 18, 2018 Category: Intensive Care Authors: Ajeet Singh Deepak Govil Usha Krishan Baveja Anand Gupta Neha Tandon Shrikanth Srinivasan Sachin Gupta Sweta J Patel Sanjiv Saigal Arvinder Singh Soin Source Type: research

Pressure ulcer and nutrition
Seied Hadi Saghaleini, Kasra Dehghan, Kamran Shadvar, Sarvin Sanaie, Ata Mahmoodpoor, Zohreh OstadiIndian Journal of Critical Care Medicine 2018 22(4):283-289Pressure ulcers can diminish global life quality, contribute to rapid mortality in some patients and pose a significant cost to health-care organizations. Accordingly, their prevention and management are highly important. Nutritional deprivation and insufficient dietary intake are the key risk factors for the development of pressure ulcers and impaired wound healing. Unplanned weight loss is a major risk factor for malnutrition and pressure ulcer development. Suboptim...
Source: Indian Journal of Critical Care Medicine - April 18, 2018 Category: Intensive Care Authors: Seied Hadi Saghaleini Kasra Dehghan Kamran Shadvar Sarvin Sanaie Ata Mahmoodpoor Zohreh Ostadi Source Type: research

Expert consensus document on management of ST-Elevation myocardial infarction: Adaptation of 2012 ESC guidelines
Tiny Nair, Rajesh Agrawal, Sandeep Bansal, Anjanlal Dutta, Raja Ray, Saumitra RayIndian Journal of Critical Care Medicine 2018 22(4):274-282In 2012, the European Society of Cardiology (ESC) guidelines provided recommendations on the management of ST-elevation myocardial infarction (STEMI). The recommendation from these guidelines is restricted to the European subcontinent. To adapt the updated recommendations for Indian subset of STEMI patients, a panel of experts in the management of STEMI provided their expert opinions. This document provides expert consensus on adapting 2012 ESC STEMI guidelines recommendations in India...
Source: Indian Journal of Critical Care Medicine - April 18, 2018 Category: Intensive Care Authors: Tiny Nair Rajesh Agrawal Sandeep Bansal Anjanlal Dutta Raja Ray Saumitra Ray Source Type: research

Practice guidelines for nutrition in critically Ill patients: A relook for indian scenario
Conclusion: This paper summarizes the optimum nutrition practices for critically ill patients. The possible solutions to overcome the challenges in this field are presented as practice guidelines at the end of each section. These guidelines are expected to provide guidance in critical care settings regarding appropriate critical-care nutrition practices and to set up Intensive Care Unit nutrition protocols. (Source: Indian Journal of Critical Care Medicine)
Source: Indian Journal of Critical Care Medicine - April 18, 2018 Category: Intensive Care Authors: Yatin Mehta JD Sunavala Kapil Zirpe Niraj Tyagi Sunil Garg Saswati Sinha Bhuvaneshwari Shankar Sanghamitra Chakravarti MN Sivakumar Sambit Sahu Pradeep Rangappa Tanmay Banerjee Anshu Joshi Ganesh Kadhe Source Type: research

Definition of terms used in limitation of treatment and providing palliative care at the end of life: The Indian council of medical research commission report
Naveen Salins, Roop Gursahani, Roli Mathur, Shivakumar Iyer, Stanley Macaden, Nagesh Simha, Raj Kumar Mani, MR RajagopalIndian Journal of Critical Care Medicine 2018 22(4):249-262Background: Indian hospitals, in general, lack policies on the limitation of inappropriate life-sustaining interventions at the end of life. To facilitate discussion, preparation of guidelines and framing of laws, terminologies relating to the treatment limitation, and providing palliative care at the end-of-life care (EOLC) need to be defined and brought up to date. Methodology: This consensus document on terminologies and definitions of terminol...
Source: Indian Journal of Critical Care Medicine - April 18, 2018 Category: Intensive Care Authors: Naveen Salins Roop Gursahani Roli Mathur Shivakumar Iyer Stanley Macaden Nagesh Simha Raj Kumar Mani MR Rajagopal Source Type: research

Impact of & #8220;Stroke Code & #8221;-Rapid response team: An attempt to improve intravenous thrombolysis rate and to shorten Door-to-Needle time in acute ischemic stroke
Conclusion: Implementation of SC helped us to increase thrombolysis rate in AIS and decrease DTN time. (Source: Indian Journal of Critical Care Medicine)
Source: Indian Journal of Critical Care Medicine - April 18, 2018 Category: Intensive Care Authors: Sushma K Gurav Kapil G Zirpe RS Wadia Avinash Naniwadekar Prajakta U Pote Amit Tungenwar Abhijeet M Deshmukh Srikanta Mohopatra Balakrishna Nimavat Prasad Surywanshi Source Type: research

Thromboelastographic analysis of hemostatic abnormalities in dengue patients admitted in a multidisciplinary intensive care unit: A cross-sectional study
Conclusion: Factor deficiency pattern was the major abnormality noted in dengue patients followed by platelet dysfunction and primary fibrinolysis. Platelet count did not show significant association with platelet function. aPTT did not show significant association with factor deficiency and low fibrinogen patterns. Factor deficiency pattern and low fibrinogen pattern did not show significant association with hepatitis. (Source: Indian Journal of Critical Care Medicine)
Source: Indian Journal of Critical Care Medicine - April 18, 2018 Category: Intensive Care Authors: VK Sureshkumar Deepak Vijayan Shamim Kunhu Zuhail Mohamed Sujith Thomas Muraleedharan Raman Source Type: research

Predictors of mortality in acute kidney injury patients admitted to medicine intensive care unit in a Rural Tertiary Care Hospital
Conclusion: The overall in-hospital mortality in patients of AKI admitted to medicine-ICU was 28.4%. Sepsis was the most common cause of AKI (24.5%). The presence of metabolic acidosis, hypotension, GCS and APACHE 2 score, advanced AKI stage, higher serum creatinine, and blood urea levels on diagnosis of AKI and the peak rise in their level within 48 h of diagnosis of AKI, use of mechanical ventilator, leukocytosis, and hyperkalemia were associated with in-hospital mortality in AKI patients. (Source: Indian Journal of Critical Care Medicine)
Source: Indian Journal of Critical Care Medicine - April 18, 2018 Category: Intensive Care Authors: Amrish Saxena Shrikant V Meshram Source Type: research

Antibiotic prescription, organisms and its resistance pattern in patients admitted to respiratory ICU with respiratory infection in Mysuru
Conclusion: Piperacillin-tazobactam was the most common antibiotic prescribed to patients with respiratory infection admitted to ICU. More than half of patients (60%) had resistance to the empirical antibiotic used in our ICU, highlighting the need for antibiogram for each ICU. Thirty six percent of patient had prior antibiotic use and had mainly gram negative organisms with high resistance to commonly used antibiotics. (Source: Indian Journal of Critical Care Medicine)
Source: Indian Journal of Critical Care Medicine - April 18, 2018 Category: Intensive Care Authors: M Mahendra BS Jayaraj KS Lokesh SK Chaya Vivek Vardhan Veerapaneni Sneha Limaye Raja Dhar Rajesh Swarnakar Shrikant Ambalkar PA Mahesh Source Type: research

Knowledge and attitude of ER and intensive care unit physicians toward Do-Not-Resuscitate in a Tertiary Care Center in Saudi Arabia: A survey study
Conclusions: There is a lack of knowledge about DNR policy which makes the optimization of DNR process difficult. Most physicians wish DNR for themselves and their patients at the end of life, but only a few of them have advance directives. The most important barriers for initializing and discussing DNR were lack of patient understanding, level of education, and the culture of patients. Most of the Muslim physicians believe that DNR is not against Islamic rules. We suggest that the DNR concept should be a part of any training program. (Source: Indian Journal of Critical Care Medicine)
Source: Indian Journal of Critical Care Medicine - April 18, 2018 Category: Intensive Care Authors: Alaa Gouda Norah Alrasheed Alaa Ali Ahmad Allaf Najd Almudaiheem Youssuf Ali Ahmad Alghabban Sami Alsalolami Source Type: research

The impact of dopamine on insulin secretion in healthy controls
Conclusion: In this study, dopamine infusion did not adversely impact insulin secretion. (Source: Indian Journal of Critical Care Medicine)
Source: Indian Journal of Critical Care Medicine - April 18, 2018 Category: Intensive Care Authors: Lisa J Underland Erika R Mark Ranjitha Katikaneni Rubina Heptulla Source Type: research

Quiz Section
Yash JaveriIndian Journal of Critical Care Medicine 2018 22(3):204-204 (Source: Indian Journal of Critical Care Medicine)
Source: Indian Journal of Critical Care Medicine - March 16, 2018 Category: Intensive Care Authors: Yash Javeri Source Type: research

Quiz Answers
Yash JaveriIndian Journal of Critical Care Medicine 2018 22(3):202-203 (Source: Indian Journal of Critical Care Medicine)
Source: Indian Journal of Critical Care Medicine - March 16, 2018 Category: Intensive Care Authors: Yash Javeri Source Type: research