Indian Journal of Emergency Medicine

Guillain-Barre Syndrome (GBS) usually present as1 symmetrical ascending muscle weakness associated with areflexia and flaccidity with or without sensory symptoms. However,2 in some patients it may present atypically and one of the rare variant is Pharyngeal-cervical-brachial variant, usually presented as muscle weakness extending from cervical area to the upper extremities often affected with proximal muscle groups.A 20-year-old male presented in ER with complaints of weakness over bilateral upper limb, dysphagia and difficulty in speaking followed by quadriparesis and breathing difficulty. Diagnosis of PCB variant was made by CSF and nerve conduction study and all other possible differentials were excluded.The patient improved by administration of iv immunoglobulin and other supportive measures. Physicians should think about PCB variant of GBS, whenever a patient presenting with symmetrical upper limb weakness and bulbar palsy.

Spontaneous pneumomediastium refers to the presence of air in the mediastinum without any obvious cause. It is an uncommon condition occurring due to alveolar rupture as a result of increased intrathoracic pressure. In this report, we present a case of Subcutaneous Emphysema and Spontaneous Pneumomediastium. Although there are several causes responsible for this condition, it is extremely rare to occur spontaneously with no prior trauma or Predisposing factors, especially in older age groups.

 

Objectives: The Emergency Department (ED) is one of the most important places in a hospital in which patients are full of pain and stress because of its hectic nature. Consequently, there are a lot of quarrels and fights in the emergency department. This study intends to assess the effect of exhibition of educational messages as a way to decrease the violence in the Emergency Room (ER).

Methods: We conducted a cross-sectional prospective survey at the Emergency Room (ER) of Shariati hospital of Tehran in September 2016. Data collection was carried out via distributing a qualitative questionnaire among the Emergency Department (ED) staff at baseline and 3 months after the educational intervention. We measured the total and mean number of various types of violence per survey. We utilized SPSS software version 16 in analysis of data using Mann-Whitney Test.

Results: The analysis showed 47.5% verbal violence before the intervention vs 60% after that (p-value=0.598), 20.8% financial violence pre- ervention versus 43.8% post intervention (p-value=0.253), both of which were notsignificant statistically; however, physical violence considerably decreased from 83.9% to 47.6% during the study (p-value=0.01). During the semi-structured interviews with personnel, it was found that this presentation had some positive effects on controlling the stress of the environment practically, although it did not appear in the analysis.

Conclusion: This type of public education in the hospital does not seem to be independently effective in reducing the violence in the Emergency Room (ER). According to the results, most violence indexes, except Physical violence, have not been mitigated after the intervention significantly. Perhaps, it could be more efficient by using audiovisual media, animation, and other captivating methods.

Aims and objectives: In this Research, we study the difficulties faced by postgraduate trainee doctors while
conducting research and the measures that can be taken to assist post-graduate trainee doctors in conducting
research.
Material and Methods: A questionnaire based survey was carried out among Post-graduate trainee doctors (DNB
& MD PG residents) from teaching hospitals in Kolkata duration of the study was approximately 1 year between July
2018 - June 2019. 170 postgraduate trainee doctors from the clinical and pre/para clinical specialty were evaluated,
difficulties faced by them in conducting research, and suggestions on how research can be promoted among PG
residents was taken.
Results: In the present study, residents reported significant reasons for not conducting adequate research during
residencies, such as lack of time, inadequate guidance from teaching staff, and lack of financial support, inadequate
support by mentors/assistants, and lack of research curriculum. Among personal reasons, 51.8% of the respondents
reported that inadequate research facilities were the main reason for not conducting research/lack of research
interest. The respondents of both the groups stated that lack of time due to the vast curriculum of PG subjects was
also one of the reasons for not conducting research/ lack of research interest.
Among institutional reasons, 44.1% of the respondents reported that a lack of research curriculum was the main
reason for preventing PG residents from conducting research
Conclusion: In the present study, the participants were asked about what can be done for research promotion in
institutions, majority of the respondents wanted 2-3 months of allocated time for supervised research and provision
of a research stipend. Others suggested the provision of research grants and the creation of an active research
cell. About MCI body measures, incorporation of compulsory research methodology workshops in PG curriculum,
providing a paid fellowship in research, giving priority for students who have participated in part-time research,
enter super speciality courses were also suggested.

Millions of people sustain head injuries by different MOIs due to various causes most of them being preventable. Head injuries mostly end up in either mortality or de-capacitating disabilities, often persisting lifelong. They cause the society to pay the heavy penalty of “the global loss of economy and human resources.” The study of the profiles of the head injury patients throws light on many important causes for concern to formulate strategies for patient management and injury prevention, as proved by studies. Early institution of appropriate management and care based on the head injury severity per GCS scores and timely transfers of patients to facilities that can cope with the patients’ needs play a pivotal role in preventing the worsening of primary and occurrence of secondary neuronal damages.