ABSTRACT
OBJECTIVES: HIV, hepatitis B, and hepatitis C remain significant causes of morbidity and mortality in low resource settings. Emergency department (ED)-based screening has proven effective in decreasing the spread of undiagnosed disease, although such programs are rare in low-middle income countries. METHODS: A prospective, cross sectional study of all adult patients presenting to the ED in a 600-bed teaching hospital in Tamil Nadu, India. This study used an opt-in strategy in which patients were offered testing at the end of their ED visit. Costs of testing were paid out of pocket by patients. Patients with known HIV, hepatitis B, or hepatitis C were excluded from the study. RESULTS: During the study period 26,465 patients presented to the ED, and 18,286 patients consented to participate (68.9%). Among the 18,286 patients tested, 174 were positive for either HIV (39, 0.21%), hepatitis C (52, 0.28%), or hepatitis B (83, 0.45%). Three patients tested positive for both HIV and hepatitis C, and 1 patient tested positive for both HIV and hepatitis B. A total of 69.2% of patients with HIV, 61.2% of patients with hepatitis B, and 83% of patients with hepatitis C presented for reasons unrelated to their underlying diagnosis. CONCLUSION: Although limited to only 1 hospital in southern India, this study represents the largest ED-based screening program for HIV, hepatitis B, and hepatitis C ever conducted in India or any other low-middle income countries. The majority of patients presented for reasons unrelated to their underlying diagnosis. Future research is needed on implementation strategies, cost feasibility, and linkage to care.
ABSTRACT
How to cite this article: Senthilkumaran S, Jena NN, Thirumalaikolundusubramanian P. Super Vasmol Poisoning: Dangers of Darker Shade. Indian J Crit Care Med 2019;23(Suppl 4):S287-S289.
ABSTRACT
The realities, recognition, and remedial aspects of anisocoria at the bedside were highlighted by Adhikari et al.,1 which is almost similar to an earlier report from India.2 Since this condition involves patient safety and clinical assessment, we would like to touch upon 3 Ps (physiological, pathological, and pharmacological) of anisocoria. First and foremost is to elicit a thorough clinical history and then to assess the case in detail which not only rules out injuries, infections, instillation, or ingestion of medicines and instigating mechanisms but also helps rule out various other life-threatening conditions. HOW TO CITE THIS ARTICLE: Senthilkumaran S, Jena NN, Balamurugan N, Florence B, Thirumalaikolundusubramanian P. Anisocoria: Realities, Recognition, and Remedial Aspects. IJCCM 2019;23(11):543.
