Logistics and administration-related stressors among young physicians working in the emergency medicine (EM) department and their perceived job satisfaction in EM department across hospitals of India: a nationwide multicentric digital survey.

Objective: Emergency medicine (EM) is a growing specialty in India with the board approving training programme commencing only since 2009. This study aimed to identify the challenges faced by EM department personnel in the country and to obtain valuable insight into the concerns and problems experienced by them.

Methods: This study was a cross-sectional digital survey conducted among EM department personnel in teaching institutions across India.

Clinical potential of sensory neurites in the heart and their role in decision-making.

The process of decision-making is quite complex involving different aspects of logic, emotion, and intuition. The process of decision-making can be summarized as choosing the best alternative among a given plethora of options in order to achieve the desired outcome. This requires establishing numerous neural networks between various factors associated with the decision and creation of possible combinations and speculating their possible outcomes.

Unveiling Sex Differences in Tricuspid Valve Disease: A Systematic Review and Meta-Analysis of Surgical Management.

Tricuspid regurgitation (TR) is a heart condition where blood flows backward through the tricuspid valve. Tricuspid valve disease constitutes a major valvular heart condition that is receiving heightened attention due to tailored treatment options and sex-specific differences in treatment outcomes. The study aims to investigate whether biological sex has a significant influence on the development, progression, and treatment outcomes of tricuspid valve disease in adults.

SPINE20 recommendations 2023: One Earth, one family, one future WITHOUT spine DISABILITY.

Introduction: The purpose is to report on the fourth set of recommendations developed by SPINE20 to advocate for evidence-based spine care globally under the theme of "One Earth, One Family, One Future WITHOUT Spine DISABILITY".

Research Question: Not applicable.

Material And Methods: Recommendations were developed and refined through two modified Delphi processes with international, multi-professional panels.

Insight Into Neonatal Sepsis: An Overview.

There are approximately 1.3 million cases of neonatal sepsis reported worldwide with deaths occurring more commonly in preterm and low-weight newborns. Neonatal sepsis is the third major cause of neonatal deaths resulting in 203,000 deaths per year.

DASH Diet: A Review of Its Scientifically Proven Hypertension Reduction and Health Benefits.

The Dietary Approach to Stop Hypertension (DASH) constitutes a nonpharmacological dietary strategy tailored with the primary objective of mitigating hypertension and averting its potential complications. Numerous clinical studies, such as the PREMIER trial, DASH sodium study, and OmniHeart trial, as well as other studies, substantiate the DASH diet's ability to manage hypertension. Beyond its profound impact on hypertension reduction, the DASH diet has exhibited notable efficacy in addressing an array of conditions such as heart failure, lipid homeostasis, dyslipidemia, and uric acid dysregulation.

Tiny Toes to Tau Tangles: Down's Syndrome and Its Association With Alzheimer's Disease.

Down's syndrome (DS) is a common genetic condition caused by the trisomy of chromosome 21, which leads to the development of many multisystemic complications, early-onset Alzheimer's disease (AD) being one of its most common complications. In this article, we have performed an intensive literature review that established a strong relationship between AD and DS. These two conditions are clubbed pathologically, clinically, and diagnostically to understand the association between AD and DS.

Celiac Disease and the Autoimmune Web of Endocrinopathies.

Gluten-sensitive enteropathy or Celiac disease (CD) is a disease that has become very prevalent in most parts of the globe especially in the western world. Resulting from a chaotic interplay between the backgrounds of autoimmunity and genetics, this disorder targets primarily the gastrointestinal tract with ominous extraintestinal counterparts that have a very discrete presentation. Among those counterparts, the one that has been reviewed in this article is the involvement of the endocrine system as concurrence of hormonal disorders with CD possesses numerous challenges that lead to a refractory treatment and a dull prognosis.

Efficacy and safety of oral tranexamic acid as an adjuvant in Indian patients with melasma: a prospective, interventional, single-centre, triple-blind, randomized, placebo-control, parallel group study.

Background: Melasma is a chronic recalcitrant pigmentary disorder whose treatment frustrates physician and patient alike. Tranexamic acid, a plasmin inhibitor, has demonstrated hypopigmenting properties.

Aim: To compare safety and efficacy of combination of oral tranexamic acid (TXA) and topical fluocinolone-based combination cream (FbTC) with that of topical FbTC alone in melasma.

Pinch of salt: A modified technique to treat umbilical granuloma.

Background: Umbilical granuloma is an overgrowth of granulation tissue following the separation of umbilical cord. Treatment options for this common entity are limited and have side effects such as chemical burns. In this study, we present a novel modification of the salt application method to treat infants with umbilical granuloma.

Yoga in Children with Epilepsy: A Randomized Controlled Trial.

Context: Majority of epilepsy begins in childhood. Twenty to thirty percent of patients may not respond to antiepileptic drugs. Yoga as a complementary therapy has been found to be beneficial in adults, but has not yet been studied in children with epilepsy.

A pilot study comparing two sites for incision during pacemaker implantation and their influence on the scar.

Objective: There are two most common incisions that are used during most pacemaker implantation procedures, with the first type of incision being inferior and parallel to the clavicle (Group C) and the second type of incision along the deltopectoral groove (Group D). We evaluated the scars resulting from the two types of incision to objectively evaluate the degree of superiority in cosmetic outcomes, between these two types of incisions.

Methods: Seventy-six patients who underwent left pre-pectoral pacemaker insertion were evaluated, close to 6 months after the date of the pacemaker implantation, using a simple scoring system based on atrophy, contour and colour of the scar.

Routine health check-ups: A boon or a burden?

Healthcare provider institutions in India now offer structured health check-up 'packages' for routine screening of common diseases. While some tests included within their ambit are in keeping with international and Indian recommendations, some are entirely unwarranted. Unnecessary and inappropriate screening tests may cause more harm than benefit.

Giant molluscum contagiosum with granulomatous inflammation and panniculitis: An unusual clinical and histopathological pattern in an HIV seropositive child.

Molluscum contagiosum is known to occur in the advanced stages of immunodeficiency in HIV infected patients and may present as atypical variants including giant molluscum. Here we describe the rare occurrence of giant molluscum contagiosum in an HIV seropositive child, which warranted surgical excision followed by skin grafting due to its unusually large size. We also highlight in this case report, a rare granulomatous inflammatory reaction pattern to molluscum with panniculitis.

Acute Pulmonary Oedema: A Post-Operative Complication Due to Neostigmine and Post Obstructive Pulmonary Oedema in a Case of Tonsillectomy.

Acute pulmonary oedema has been described in relation to perioperative period. The aetiology may be multifactorial and its management poses a challenge to the anaesthesiologist. Its occurrence in a normal healthy person with no other medical history makes the diagnosis difficult.

Congenital Chikungunya--A Cause of Neonatal Hyperpigmentation.

A 12-day-old neonate presented with ill-defined dark pigmentation over the centrofacial area with flagellate pigmentation on the trunk and patchy pigmentation on the extremities. The mother had a history of fever starting a week before delivery and continuing for 3 days in the postpartum period. Together these led to consideration of a possible diagnosis of congenital chikungunya, which was confirmed according to the immunoglobulin M antibodies to chikungunya in the mother and child.

Long term refractive and structural outcome following laser treatment for zone 1 aggressive posterior retinopathy of prematurity.

Aim: To report the long term refractive, visual and structural outcome post-laser for zone 1 aggressive posterior retinopathy of prematurity (AP-ROP).

Materials And Methods: A retrospective analysis was performed of refractive status of premature infants with zone 1 AP-ROP who underwent laser photocoagulation from 2002 to 2007 and followed up till 2013. Once the disease regressed, children were followed up six monthly with detailed examination regarding fixation pattern, ocular motility, nystagmus, detailed anterior segment and posterior segment examination, and refractive status including best corrected visual acuity.

Streptococcus pneumoniae bacteraemia leading to the diagnosis of multiple myeloma.

Multiple myeloma (MM) is a malignant plasma cell disorder characterised by the neoplastic proliferation of a single clone of plasma cells producing a monoclonal immunoglobulin. Anaemia, bone pain from lytic lesions, hypercalcaemia and renal failure are the most common presentations at diagnosis; however, the presence of infection at the time of diagnosis is rarely reported. The author reports an elderly male presenting with isolated fever and initial blood cultures positive for Streptococcus pneumoniae.

Perforating disorders of the skin.

Background: Perforating disorders of the skin, is an often overlooked entity characterized by transepidermal elimination of material from the upper dermis and are classified histopathologically according to the type of epidermal disruption and the nature of the eliminated material. They include Kyrle's disease, perforating folliculitis, reactive perforating collagenosis, and elastosis perforans serpiginosa.

Aim: The aim of this study was to delineate the clinical and histopathological features of perforating disorders of the skin.

Iron deficiency anemia in pregnancy: intravenous versus oral route.

Objectives: The aim of this study was to compare the efficacy and safety of intravenous iron with oral iron in the treatment of iron deficiency anemia of pregnancy.

Methods: A randomized experimental study was conducted at K. J.

Cerebrotendinous xanthomatosis: a treatable cause of metabolic ataxia.

Cerebrotendinous xanthomatosis is an exceptionally rare condition in Indian subcontinent, however, it is potentially treatable if diagnosed. We present and discuss the clinical presentation and investigations in a case of cerebrotendinous xanthomatosis (CTX).