Indian Journal of Emergency Medicine

Rapid advances have been witnessed in the understanding and management of dyslipidemia which has led to widespread use of statins. Statins have been proved to be beneficial in primary prevention of cardiovascular diseases and in secondary prevention of cardiovascular diseases and stroke. Preliminary studies have also documented benefit of statins in lipid independent conditions. The rate of occurrence of adverse events determines the risk benefit ratio of statins in low risk individuals. Hence, the irrational overuse of statins is a matter of concern. Statins for all will be a reality only if backed by clinical reasoning and quality evidence.

KEYWORDS: Statins; Primary prevention; Cardiovascular diseases.

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We report the case of a male with Aorto arteritis (Takayasu’s) with extensive calcification of aorta and its branches. Extensive calcification of the arteries is unusual in Takayasu’s  arteritis. A variety of mechanisms may play a role in this phenomenon of calcification, and we attempt to elucidate some of them.

KEYWORDS: Vasculitis; Aortoarteritis; Vascular calcification; Takayasu.

Background: In recent years, several studies done in the western world shows that prevalence of burnout syndrome are increasing among doctors.[1]  The aim of our study, which is the first in India, to analyze the factors that impact on psychological health of Emergency Physicians. Methods: We did a cross-sectional email questionnaire based survey on 195 Emergency Physicians of different Emergency Departments of India. Results: Out of the 195 Emergency Physicians who participated in the study, 72.31% suffered from moderate to severe depression by the Becks modified depression inventory. Our study identified that interruption of family and social life, lack of perception by other speciality, night shifts, resource inadequacy and lack of career development as major causes of stress amongst Emergency Physicians in India. 8 hour shift (48.89%), regular discussion on medical & administrative issues (31.79%), regular exercise & de addiction (36%), adequate financial compensation (71.79%), academic development (70%), recognition in Indian healthcare system (65.3%), development of Emergency Departments of International Standard (35.3%) and Pre hospital Care (55.3%) were the major recommendations by the participants to reduce stress and promote psychological wellbeing. Conclusion: There is considerable number of factors causing high levels of stress amongst Emergency Physicians working in India. Cope-up strategies recommended by the participants of our study should draw attention of other Emergency Physicians, administrators and policy on the above developmental issues where changes may be met. Further similar studies should be planned on a wider scale.

KEYWORDS: Psychological Wellbeing; Stress; Depression; Emergency Physicians.

Background: Although it is a realised need, most hospitals in India tend to avoid dealing with medico legal formalities during emergencies. In a busy Emergency Room physicians tend to overlook legal formalities mostly as an oversight owing maybe to lack of training and lesser supervision. Aim: To find out the perception among Emergency Physicians of India regarding legal issues concerning Emergency Medical Practice. Materials and Method: A pre-structured, pre-tested questionnaire was devised and sent by e mail to member physicians of the Society of Emergency Medicine in India chosen by simple random sampling requesting them to fill up the forms and send it back by e mail. Sample size was calculated to be 84. Statistical Analysis: The study showed overall mean perception of 69% with a confidence interval of (70.5 to 67.3). The individual perception scores of questions have been given in the statistical analysis portion of the dissertation. The majority of study population were in their third decade. Result: The study came up with an interesting fact that majority of the younger age group of emergency physicians had more perception than their elder counter parts. This proves that the older emergency physicians need some form of legal training in order to improve their perception regarding the legal scenario in India. Conclusion: The study paves a path for further studies to occur.

KEYWORDS: Emergency physician of India; Dealing of legal issues in emergency department.

Background: Emergency Medicine is an emerging specialty in the Indian medical scenario. Our study, which is first in India and second worldwide, assessed the perception of other specialties regarding the present status, purpose and the future of Emergency Care in India. Method: A multicentre, questionnaire based survey was conducted amongst 106 randomly selected consultants from other specialties in four tertiary care hospitals in Kolkata, India. Results: 97.17% of respondents felt that the official term for the specialty should be ‘‘Emergency Medicine’’ (40.57%) OR “Emergency Medicine & Accident /Trauma Care” (56.60%). 93.40% of the participants perceived that at least 1 Emergency Physician per shift, registrars and 12 beds would be needed for a “fully equipped ED”. 85.05% and 51.72% of the respondents felt that Resuscitation and Rapid sequence intubation should be done by Emergency physicians. Most of the respondents (96%) felt that ED physician(s) had excellent resuscitation skills. Most of the respondents (90%) felt that emergency medicine has an excellent future as an independent specialty. Conclusion: The principal finding our study is that Emergency Medicine, as a specialty in India, is accepted by other departments. The expectations are high and there are potential areas with significant scope of improvement. The perceived purposes and strengths provide a focus on proper training and development of Emergency Medicine, while opinions on new practices and weaknesses indicate scope of improvement. The results can contribute to decision-making for structuring proper Emergency Departments. Further similar studies on a wider scale involving other parts of India need to be done to ensure generelizability of the results.

KEYWORDS: Emergency Medicine.

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