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Background: The second wave of coronavirus disease (COVID‑19) in 2021 was devastating for low‑ and middle‑income countries (LMICs). This led to increased suicide rates among the young, economically productive age group. We analyzed the cohort of attempted suicidal hangings needing admission to the intensive care unit (ICU) and compared the data from the pre‑COVID‑19 era. Materials and Methods: We conducted a retrospective, observational, cohort study of suicidal hanging cases according to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Six‑month data of such cases admitted to the neurological ICU after the lockdown of the second wave of COVID‑19 from July 2021 to January 2022 were collected. Demographic data along with the cause of attempted hanging, severity of sickness from hanging, and its outcome were gathered and compared with similar data acquired during 2003–2015 by the same authors in the same ICU. Results: There was a threefold increase in the incidence of suicidal hangings needing ICU care, from 9 to 27% in the pre‑ and post‑COVID‑19 era. A shift toward older aged males, in the third decade of life, was observed. The common cause of attempted suicide was a familial dispute (P = 0.03). Among the younger age group (18–25 years), increased screen time led to fights in the family. The cohort was also sicker with more severe lung involvement, longer ventilation, and hospital stay (P < 0.001). Conclusion: The increased incidence of hanging among young adults, amid the socioeconomic effects of COVID‑19, needs urgent attention. Suicide prevention measures need novel strategies aimed at de‑addiction from electronic gadgets and reducing screen time. [ABSTRACT FROM AUTHOR]

Background: During the pandemic, traditional family meetings were replaced by remote telecommunications. We assessed the families' satisfaction with these communications using a survey-based questionnaire. Methods: The study involved 20-minute telephonic surveys conducted with the family member who was updated during the hospitalization of the patient. A thematic-based questionnaire with responses on a scale of 5 ranging from very dissatisfied to very satisfied was used. The responses were dichotomized into bad and good reports for analysis. Results: A total of 196 patients were eligible. Only 154 patients' family representatives consented to the study. The frequency and content of the telephonic updates were satisfactory. The bad report was assigned to 5% of families only. Among features assessing empathy of communication providers, the satisfaction rate was much higher with 3% of families alone providing a bad report. The response was significantly biased against the final outcome of the patient with poor review often provided by relatives of patients who had succumbed to the illness. The dissatisfaction rate was much higher, above 12% for the trust of communication and ICU visitation. However, the final outcome of the patient did not affect the trust in the information conveyed by the physician. Interpretation: This study highlights several drawbacks in the communication strategy during the second surge of coronavirus disease-2019 (COVID-19). The final outcome of the patient was the key decisive factor for the response to most of the questionnaire. Sustained faith in communication by the physician despite the final outcome of the patient, re-emphasizes the need for emotional connection and training for breaking bad news. [ABSTRACT FROM AUTHOR]

Byline: Ajith. Sivadasan, Mathew. Alexander, Sanjith. Aaron, Vivek. Mathew, Shalini. Nair, Karthik. Muthusamy, A. Prabhakar, Rohit. Benjamin, Atif. Shaikh, Gideon. Rynjah Introduction: There is scarce literature regarding the clinical course, [...]

Background: Gynaecological surgeries refer to surgery on the female reproductive system. Woman may undergo a Gynaecological surgery for different reasons, including; Uterine prolapse, Cancer of the uterus, cervix, or ovaries, Endometriosis, Bleeding, Adenomyosis etc.Gynaecological surgeries includes procedures such as hysterectomy, oopherectomy, salphingectomy, myomectomy, ovarin cystectomy, etc. The Physiotherapy referral is essential in such cases but most of time the patients are not referred for Physiotherapy. Hence the current study was undertaken. Thus the objective is to find out the Effectiveness of Physiotherapy management over quality of life in post-operative Gynaecological patients. Methods: 32 females who underwent Gynecological surgery were taken into the study and divided conveniently into Group A and Group B consisting of 16 females each. Physiotherapy intervention given to Group A includes- Breathing exercises, Coughing techniques, Circulatory exercises, Knee rolling, log rolling, patient made to sit, Abdominal exercises, Pelvic tilting, Getting in and out of the bed, Pelvic floor exercises and mobilization inside the ward, outside the ward and stair climbing where as conventional treatment which includes Breathing exercises and Back care were given to Group B for a period of 5 days. Outcome measures used were VAS (Visual Analog Scale) and ASIS (Abdominal Surgery Impact Scale). Results: There was a significant difference in post test score of VAS (p=0.0001) and ASIS (p=0.0001) in Group A as compared to Group B. Conclusion: This study revealed that physiotherapy intervention performed immediately after Gynecological surgery improves quality of life of the patients and a scheduled exercise program benefits the patient more than conventional Physiotherapy management and it should be emphasized to all the post Gynecological surgery Patients.

Byline: Shalini. Nair, Mathew. Joseph Normal saline has been the commonest intravenous fluid used both for resuscitation and as a maintenance fluid in emergency departments, operating rooms and intensive care [...]

To the Editor: Artemisinin resistance (ART-R) in Plasmodium falciparum phenotypes may have evolved independently in various areas of the Greater Mekong Subregion (1,2), prompting the World Health Organization to change [...]

Byline: Ramanan. Rajagopal, Shalini. Nair A 47-year old gentleman presented 8 hours after an alleged history of a road traffic accident. At presentation, his pupils were 4 mm and nonreactive [...]

Background and Aims: To compare the performance characteristics of C-MAC video, McCoy, and Macintosh laryngoscopes in elective cervical spine surgery. The primary objective was to assess the ease of intubation with the three study devices. The secondary objectives were the time to intubation and hemodynamic responses during intubation. Material and Methods : The prospective observational comparative study was conducted in a tertiary care hospital. Adult ASA 1 and 11 patients who underwent elective cervical spine surgery were included in the study. Patients with unstable spine and trauma were excluded. The analysis of variance, Bonferroni test, Chi square test and multiple comparison tests were used to compare the performance characteristics of laryngoscopes. Results: The C-MAC video laryngoscope improved glottis view by improving the modified Cormack–Lehane (CL) score and the percentage of glottis opening (POGO) score compared to McCoy and Macintosh laryngoscopes. The ease of intubation was better with the C-MAC video laryngoscope compared to the McCoy and Macintosh laryngoscopes. The time to intubation was comparable between the three laryngoscopes. The C-MAC video and McCoy laryngoscopes had 100% successful first attempt intubations while it was 90% for the Macintosh laryngoscope. Hemodynamic variables observed during intubation were comparable between the three groups. Conclusion: The use of C-MAC video laryngoscope resulted in better visualization of the glottis and easier tracheal intubation as compared to the Macintosh and McCoy laryngoscopes in cervical spine surgery. Both C-MAC video and McCoy laryngoscopes had 100% successful first attempt intubation. [ABSTRACT FROM AUTHOR]

Byline: Shalini. Nair, Bijesh. Nair, Ajay. Vidyasagar, Mathew. Joseph Background and Aims : The routine management of coagulopathy during surgery involves assessing haemoglobin, prothrombin time (PT), activated partial thromboplastin time [...]

Byline: Ajith. George, Shalini. Nair, Jayanthi. Karthic, Mathew. Joseph Introduction: Deep venous thrombosis (DVT) is thought to be less common in Asians than in Caucasian population. The incidence of DVT [...]

Byline: Vijay. Anand, Shalini. Nair The increasing use of beta and calcium channel blockers for management of cardiac comorbidities has led to more frequent complications in the postoperative period. Anesthetic [...]

Byline: Shalini. Nair, Tony. Chandy Sir, We agree with the comments [sup][1] of the reader that all the criteria for the serotonergic syndrome were not fulfilled. In the clinical context, [...]