The World Health Organization Collaborating Center for Emergency and Trauma (WHO-CCET) in South East Asia, The World Academic Council of Emergency Medicine (WACEM), and The American College of Academic International Medicine (ACAIM) 2021 Framework for using Telemedicine Technology at Healthcare Institutions.

The coronavirus disease 2019 crisis has forced the world to integrate telemedicine into health delivery systems in an unprecedented way. To deliver essential care, lawmakers, physicians, patients, payers, and health systems have all adopted telemedicine and redesigned delivery processes with accelerated speed and coordination in a fragmented way without a long-term vision or uniformed standards. There is an opportunity to learn from the experiences gained by this pandemic to help shape a better health-care system that standardizes telemedicine to optimize the overall efficiency of remote health-care delivery.

Quadriparesis from a panspinal extradural abscess following pneumococcal meningitis.

A 63-year-old male presented with marked quadriparesis, three weeks after a pneumococcal meningitis. The MRI-scan was suggestive for extradural abscess in the craniocervical region extending into the lower thoracic spine. Cervical laminectomy was performed and a large abscess was drained.

Mitral valve repair in patients with low left ventricular ejection fractions: early and late results.

Study Objectives: This retrospective study was performed to examine the outcome of mitral valve repair (ie, mitral valvuloplasty [MVP]) in relation to preoperative low left ventricular ejection fraction (LVEF).

Design And Settings: From our series of 338 consecutive patients who underwent MVP between 1983 and 2001, we compared the course of 302 patients with preoperative LVEF of > 35% (group I) to that of 36 patients with LVEF of
Results: Preoperatively, group II patients were more likely to be associated with ischemic heart disease (IHD) [p < 0.

Hypomagnesaemia.

In the management of electrolyte abnormalities along with hypokalaemia and hypocalcaemia, etc, presence of hypomsgenesaemia should be thought of even when serum magnesium is within normal limit as magneium is a predominantly intracellulr ion. Two cases of hypomagnesaemia as one of the factors of electrolyte distrubances are communicated in this write-up.

Mobilization of the anterior mitral leaflet for excision of a left ventricular myxoma.

Left ventricular myxomas are extremely rare. We report use of a left atrial approach with mobilization of the anterior mitral valve leaflet to enhance exposure of the subvalvar region and facilitate excision of a left ventricular myxoma entangled within the chordal apparatus, lying between the anterolateral papillary muscle and the left ventricular wall. The detached mitral leaflet was reattached to the annulus with a continuous suture.