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Ayyan SM, Anandhi D, Ganessane E, Rahman CPN. Enhancing Performance Metrics Capture in Emergency Departments through a Cost-effective Documentation System. J Emerg Trauma Shock 2023; 16:196-197. [PMID: 38292278 PMCID: PMC10824222 DOI: 10.4103/jets.jets_61_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 06/21/2023] [Accepted: 06/26/2023] [Indexed: 02/01/2024] Open
Affiliation(s)
- S. Manu Ayyan
- Department of Emergency Medicine and Trauma, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - D. Anandhi
- Department of Emergency Medicine and Trauma, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Ezhilkugan Ganessane
- Department of Emergency Medicine and Trauma, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - C. P. Nahal Rahman
- Department of Emergency Medicine and Trauma, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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Ayyan SM, Raju KNJP, Anandhi D, Jain N, Ganessane E. Effectiveness of “Resuscitation Cover All” in minimizing COVID-19 transmission to health-care workers during cardiopulmonary resuscitation: A simulation-based study. J Glob Infect Dis 2022; 14:3-9. [PMID: 35418727 PMCID: PMC8996458 DOI: 10.4103/jgid.jgid_182_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 08/30/2021] [Accepted: 11/18/2021] [Indexed: 01/25/2023] Open
Abstract
Introduction: Coronavirus disease 2019 (COVID-19) is a highly contagious disease transmitted by contact, droplets, and aerosols. Front line health-care workers (HCWs), particularly emergency physicians and acute care providers, are vulnerable to being exposed while treating their sick patients. Despite appropriate personal protective equipment use, HCW gets infected, suggesting the need for multiple layers of protection such as barrier devices. Methods: We aimed to determine the effectiveness of our novel “Resuscitation Cover All”(RCA) in reducing the exposure of HCW to simulated respiratory particles and its feasibility during cardio pulmonary resuscitation (CPR). This was a pilot simulation-based study. Five CPR simulation sessions were performed in Standard and RCA protocols, individually. Exposures through contact, droplets, and aerosols were simulated using a standardized volume of liquid detergent. Under Wood's lamp illumination, exposures of participants were compared between the protocols. Rate and depth of chest compressions, time taken to intubate, interruptions in CPR, and first-pass success were analyzed. Results: Overall mean exposure in standard protocol was 4950.4 ± 1461.6 (95%confidence interval [CI]:3135.7–6765.2) sq.pixels and RCA protocol was 2203.6 ± 1499.0 (95%CI: 342.4–4064.9) sq.pixels (P = 0.019). In standard, chest compressor had the highest exposure of 3066.6 ± 1419.2 (95%CI: 2051.3–4081.9) sq.pixels followed by defibrillator assistant 1166.4 ± 767.4 (95%CI: 617.4–1715.4) sq.pixels. Chest compressor of RCA had reduced exposure compared to that of standard (P < 0.001). Hands were the most frequently exposed body part. Airway manager of RCA had no exposure over head and neck in any session. No significant difference in CPR performance metrics was observed. Conclusion: This pilot simulation-based study shows that the novel RCA device could minimize the exposure of HCW to simulated respiratory particles during CPR. Also, it might not alter the high-quality CPR performance metrics. We need more real-life evidence.
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Rubeshkumar PC, Ponnaiah M, Anandhi D, John D. Association between exposure to artificial sources of ultraviolet radiation and ocular diseases: a systematic review protocol. JBI Evid Synth 2020; 18:1766-1773. [PMID: 32898369 DOI: 10.11124/jbisrir-d-19-00206] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The objective of this review will be to determine the association between exposure to artificial sources of ultraviolet radiation and ocular diseases. INTRODUCTION Numerous studies have established the association between natural ultraviolet radiation and ocular diseases in humans. However, the evidence of the association between artificial sources of ultraviolet radiation and ocular diseases has not been reviewed. INCLUSION CRITERIA The proposed review will include studies with participants of any age and sex, and documented exposure to artificial sources of ultraviolet radiation and incidence of ocular diseases. METHODS Databases including PubMed and Embase will be searched. Study selection and full-text screening will be done by two independent reviewers. The search results will be presented in a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram. Critical appraisal of the eligible studies for methodological quality will be conducted using JBI checklists. All studies, regardless of their methodological quality, will undergo data extraction and synthesis using standardized data extraction tools. Quantitative papers will, where possible, be pooled in statistical meta-analysis. Heterogeneity will be assessed statistically using the standard χ, and also explored using relevant subgroup analyses based on the different quantitative study designs included in this review. Where statistical pooling is not possible, the findings will be presented in narrative form including tables and figures. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO CRD42019129372.
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Affiliation(s)
- Polani Chandrasekar Rubeshkumar
- 1ICMR-National Institute of Epidemiology, Chennai, Tamil Nadu, India 2Government Tirunelveli Medical College, Tirunelveli, Tamil Nadu, India 3Campbell Collaboration, New Delhi, India
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Prakash Raju KNJ, Jagdish S, Kumar GK, Anandhi D, Antony J. Profile of Pediatric Trauma among the Patients Attending Emergency Department in a Tertiary Care Hospital in South India. J Emerg Trauma Shock 2020; 13:62-67. [PMID: 32395053 PMCID: PMC7204961 DOI: 10.4103/jets.jets_149_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Accepted: 06/11/2019] [Indexed: 11/04/2022] Open
Abstract
Background Pediatric trauma is emerging as an epidemic worldwide; the epidemiology of pediatric trauma is different in different parts of the world. There are very few studies describing the pediatric trauma in developing countries. Objectives The objectives of this study were to assess the type, mechanism, and extent of trauma among pediatric trauma patients and its association with clinical outcome. Methodology This was a prospective observational study conducted in the department of emergency medicine and trauma at a tertiary care hospital in South India from September 2015 to March 2017. All children aged <12 years with a history of injuries irrespective of the cause for attending our trauma center were included in the study. Observations and Results Of the 911 children enrolled, 63.9% sustained injuries at home. The leading modes of injury were fall at level ground (26.9%), road traffic accidents (RTAs) (25.5%), and fall from height (16.8%). Majority of RTA victims were two-wheeler pillion riders (40.5%) and pedestrians (31.9%). Nearly 49% of children had head and maxillofacial injuries. Polytrauma was found in 3.6% of children. Based on the Pediatric Trauma Score (PTS), 72.6% of children had mild trauma and 6.1% severe trauma. Totally, 18.9% of children required inpatient management, 7.5% surgical intervention, and 1.8% expired. Conclusions Most of injuries in children occurred at home. This was followed by injuries on road. The leading cause of polytrauma was RTA. RTA victims were more likely to have severe injuries and poor outcome. They were more likely to require inpatient management compared to those who fell from height or fell at level ground. Glasgow Coma Scale and PTS may be used reliably to assess the severity of injuries sustained by children.
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Affiliation(s)
- K N J Prakash Raju
- Department of Emergency Medicine and Trauma, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - S Jagdish
- Department of Emergency Medicine and Trauma, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - G Krishna Kumar
- Department of Pediatric Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - D Anandhi
- Department of Emergency Medicine and Trauma, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Jency Antony
- Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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Rubeshkumar PC, Manickam P, Anandhi D, Senthil Kumar S, Rita Hepsi Rani M, Premkumar B, Karumana Gounder K. An outbreak of bilateral photokeratitis among an indoor school event attendees attributable to unshielded mercury vapour and metal halide lights, Eruvadi village, Tirunelveli, Tamil Nadu, South India, 2018. Clinical Epidemiology and Global Health 2019. [DOI: 10.1016/j.cegh.2019.03.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Sravya MR, Anandhi D. Clinical outcome of iris-claw intraocular lens implantation. TNOA J Ophthalmic Sci Res 2019. [DOI: 10.4103/tjosr.tjosr_110_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Prakash Raju KNJ, Goel K, Anandhi D, Pandit VR, Surendar R, Sasikumar M. Wild tuber poisoning: Arum maculatum - A rare case report. Int J Crit Illn Inj Sci 2018; 8:111-114. [PMID: 29963416 PMCID: PMC6018264 DOI: 10.4103/ijciis.ijciis_9_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Arum maculatum, commonly known as wild Arum, is a woodland plant species of the Araceae family. All parts of this plant are considered toxic. We report a case of a young man who allegedly consumed poisonous wild tuber with suicidal intention. He presented to our emergency department 3 h later with features of angioedema. He was managed successfully with adrenaline and hydrocortisone. He was discharged after 4 days of observation. Later, the wild tuber plant was identified to be A. maculatum. We recommend that all patients who present with unknown substance poisoning should be managed according to the principles of intensive care, irrespective of the diagnosis.
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Affiliation(s)
- K N J Prakash Raju
- Department of Emergency Medicine and Trauma, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Kishen Goel
- Department of Emergency Medicine and Trauma, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - D Anandhi
- Department of Emergency Medicine and Trauma, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Vinay R Pandit
- Department of Emergency Medicine and Trauma, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - R Surendar
- Department of Emergency Medicine and Trauma, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - M Sasikumar
- Department of Emergency Medicine and Trauma, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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J Prakash Raju KN, Jagdish S, Anandhi D, Kumar GK, Pandit VR. Pediatric Trauma - An Emerging Epidemic. Indian Pediatr 2018; 55:259. [PMID: 29629703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
We enrolled 911 children aged <12 years presenting to the trauma center of a tertiary-care hospital (over a period of 18 months) with history of injuries. Majority (582; 63.9%) of children had sustained injuries at home; 56 (6.1%) had severe injuries based on Pediatric Trauma Score. Of road traffic accidents victims (n=232), majority (40.5%) were two-wheeler pillion riders or pedestrians (31.9%). More Indian data are required and efforts are needed to prioritize injury prevention efforts in children.
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Affiliation(s)
| | - S Jagdish
- Department of Emergency Medicine and Trauma, JIPMER, Puducherry, India
| | - D Anandhi
- Department of Emergency Medicine and Trauma, JIPMER, Puducherry, India
| | | | - Vinay R Pandit
- Department of Emergency Medicine and Trauma, JIPMER, Puducherry, India
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Abstract
Self-harm by consuming yellow oleander seeds has become more frequent in South Asian countries, especially Sri Lanka and in southern parts of India. Yellow oleander poisoning usually presents with gastrointestinal, cardiovascular, and neurological manifestations as well as electrolyte abnormalities. Cardiac effects can manifest as nearly any type of dysrhythmia and sudden death with very few premonitory signs. To our knowledge yellow oleander poisoning related acute myocardial infarction has not yet been reported. We report a 37-year-old man with yellow oleander poisoning who had normal sinus rhythm at presentation but within few hours developed acute ST-segment myocardial infarction.
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Affiliation(s)
- D Anandhi
- Department of Emergency Medicine and Trauma, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - K N J Prakash Raju
- Department of Emergency Medicine and Trauma, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - M H Basha
- Department of Emergency Medicine and Trauma, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - V R Pandit
- Department of Emergency Medicine and Trauma, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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Raju KNJP, Anandhi D, Surendar R, Shetty A, Pandit VR. Blunt Trauma Neck with Complete Tracheal Transection - A Diagnostic and Therapeutic Challenge to the Trauma Team. Indian J Crit Care Med 2017; 21:404-407. [PMID: 28701849 PMCID: PMC5492745 DOI: 10.4103/ijccm.ijccm_103_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Survival following trachea-esophageal transection is uncommon. Establishing a secure airway has the highest priority in trauma management. Airway management is a unique and a defining element to the specialty of emergency medicine. There is no doubt regarding the significance of establishing a patent airway in the critically ill patient in the emergency department. Cannot intubate and cannot ventilate situation is a nightmare to all emergency physicians. The most important take-home message from this case report is that every Emergency physician should have the ability to predict “difficult airway” and recognize “failed airway” very early and be skilled in performing rescue techniques when routine oral-tracheal intubation fails. Any delay at any step in the “failed airway” management algorithm may not save the critically ill dying patient. Here, we report a case of blunt trauma following high-velocity road traffic accident, presenting in the peri-arrest state, in whom we noticed “failed airway” which turned out to be due to complete tracheal transection. In our patient, although we had secured the airway immediately, he had already sustained hypoxic brain damage. This scenario emphasizes the importance of prehospital care in developing countries.
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Affiliation(s)
- K N J Prakash Raju
- Department of Emergency Medicine and Trauma, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - D Anandhi
- Department of Emergency Medicine and Trauma, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - R Surendar
- Department of Emergency Medicine and Trauma, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Ashwith Shetty
- Department of Emergency Medicine and Trauma, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Vinay R Pandit
- Department of Emergency Medicine and Trauma, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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