Tele-ICU enabled management of an organ donor in an under-resourced setting.

A man in his 30s was involved in a road traffic crash in a small town in India, not equipped to deal with cases of brainstem death. He was declared brain-dead after a few hours. The patient's information was forwarded to organ specialists across the country, with the goal of preserving the patient's organs for donation via a tele-ICU model. The team comprising bedside doctors and remote intensivists communicating via an indigenously developed tele-ICU platform managed the patient for 24 hours, following treatment protocols and providing critical care to ensure that the patient's vital organs were optimally perfused. The following morning, specialist teams from a nearby city arrived at the local hospital to retrieve the patient's organs. This fast-tracked organ retrieval and transplant process were made possible through advances in technology and the involvement of specialists from other parts of the country through this tele-ICU model.

A Rare Case of Spontaneous Anterior Abdominal Wall Necrotizing Soft Tissue Infection Caused by Finegoldia magna.

Necrotizing fasciitis is a highly invasive disease characterized by rapidly worsening inflammation of the fascia associated with necrosis of the subcutaneous tissue. It is a rare, life-threatening disease and needs early diagnosis through acute clinical awareness. It warrants urgent and aggressive surgical management. We report a rare and fatal case of spontaneous necrotizing soft tissue infection (NSTI) of the anterior abdominal wall caused by Finegoldia magna in a chronic diabetic patient. The initial presentation and radiological features suggested a pelvic abscess. Other acute abdomen differentials were also considered, and the patient underwent an exploratory laparotomy where a necrotic anterior abdominal wall with copious purulent secretions was noted. The organism Finegoldia magna was identified from the necrotic tissue sample with other cultures coming back negative. The risk posed by NSTIs is very high, and hence though the incidence is low, clinicians should be aware of the potential dangers of this disease to avoid delays in initiating appropriate treatment.

Quality of life and probable psychological distress among male workers at a construction site, Kolar district, Karnataka, India.

INTRODUCTION: The construction industry, which mainly consists of migrant labouers is one of the largest employers in the unorganized sector in India. These workers work in poor conditions and are often vulnerable to exploitation. These workers also do not have health care benefits and often these factors lead to poor quality of life (QOL) and psychological distress. OBJECTIVES: To assess the QOL, probable psychological distress and associated factors among male construction workers. MATERIALS AND METHODS: A cross-sectional study was conducted between September 2013 and November 2013 among 404 male workers. These construction workers were enrolled by consecutive sampling at a construction area in Kolar district, Kaarnataka, India. The study tools used were World Health Organization (WHO) QOL-BREF and 12-Item General Health Questionnaire (GHQ-12) to assess QOL and probable psychological distress, respectively. The transformed scores in WHO QOL-BREF in all four domains ranged 0-100. The four domain scores are scaled in a positive direction with higher scores indicating a higher QOL. Associations were done using statistical tests such as Chi-square, correlation, regression, independent samples t-test, and analysis of variance (ANOVA). RESULTS: A total of 404 male workers with a mean age of 25.6 ± 7.3 years were studied. Mean scores of various domains of QOL were 68.5 ± 13.7 (physical), 59.9 ± 13.5 (psychological), 64.3 ± 16.4 (social), and 44.1 ± 12.8 (environmental). On the self- rating scale, 59 (14.6%) workers were rated as having poor QOL. The prevalence of probable psychological distress was 27.5%. Factors such as increasing age, being currently married, and low educational status were found to be significantly associated (P < 0.05) with poor QOL and psychological distress. There was a significant negative correlation (P < 0.05) between QOL and psychological distress and a positive correlation between income and QOL. CONCLUSION: The QOL in the environmental domain, which mainly deals with living conditions, health, and recreational facilities was found to be poor and there was a high prevalence of probable psychological distress among workers. This indicates a need for improving workplace amenities, and access to health and recreational facilities.