Search

Background & Objective: At emergency department (ED) at different point of time different teams are involved in management of patients as per their posting/duty roster. So, a robust system should be in place to avoid major mishaps. The current study was an attempt to improve pediatric care at our Emergency Department through third-level Kirkpatrick’s evaluation model after training of pediatric resident doctors to use newly developed structured proforma while doing initial assessment of sick children at ED. Materials & Methods: This Quasi-experimental study included all departmental pediatric resident doctors and as per sample size calculation, 36 (pre-intervention) and 36 (post-intervention) computer-generated random selection records were reviewed from the total of serially arranged admissions of pediatric patients. The intervention was the implementation of a Structured proforma, and training of all departmental residents. All raters scored the records of patients on 47 & 51 items of documentation pre-and post-intervention periods respectively on a scale 0-2, 0 meaning ‘no mention’, 1-incomplete/improper mention and 2-complete/proper mention. Mean, standard deviation (SD) of scores were calculated item-wise, raters-wise and overall. Bland Altman analysis was done to find agreement in scoring among raters both in pre-and post-intervention. Results: The mean (SD) and percentage of mean score were 32.93 (4.50) and 35.03% before intervention whereas 89.64 (4.35) and 87.88% post-intervention. This indicated 53.5% improvement post-intervention. Bland Altman analysis found good agreement post-intervention. Conclusion: The introduction of Educational tool along with the training of pediatric resident doctors to implement it, has improved documentation process significantly.

Myxedema crisis is a condition with high mortality. It affects adults more often than children. Patients present with low blood pressure, low pulse, low body temperature, hypoventilation, and gastrointestinal dysfunction. Here, we present a case report of a teenage girl who was diagnosed with acquired hypothyroidism at the age of 7 years and was effectively treated with oral thyroxine in myxedema crisis.

Introduction: Medical graduates skill assessment in simulation is underdeveloped and needs due attention in making them proficient. The mini-Clinical Evaluation Exercise (mini-CEX) could be an important tool in assessing and making them perfect, through Competency-Based Medical Education (CBME). Aim: To determine utility of mini-CEX as a definitive and reliable assessment tool in high fidelity medical simulation. Materials and Methods: This pilot study was conducted at School of Virtual Learning (SVL) affiliated with JNMC, Datta Meghe Institute of Medical Sciences (Deemed to be University) Sawangi (M), Wardha, Maharashtra, India between 1st November 2021-31st December 2021, on 50 medical interns. The learners were taught of basic clinical examination on SimMan simulator along with training in mini-CEX. The case scenarios on Hypertensive, Valvular, Acute Coronary artery disorders and dysrhythmias cardiac medical emergencies were allotted and the performance of administrators and learners were assessed by mini-CEX. The mini-CEX rating form was used to evaluate the competence and student satisfaction score form was sent to learners for their feedback. The data was collected on online Google form and was tabulated and analysed, descriptive statistics, mean with standard deviation was calculated. Results: The mean age of participants was 22.5±0.53 years. There were 15 males (30%) and 35 females (70%). Average satisfaction score for the assessors was 7.4±1.2 and for the interns was 8.2±0.2. Conclusion: Excellent level of satisfaction was observed in the learners, as well as, the administrators by use of mini-CEX format. Hence, this exercise can be applied in accessing high fidelity simulation.

The entire world is coping up with the challenges imposed by COVID-19 pandemic caused by a novel coronavirus, which started from a single case in Wuhan city of China in November 2019. Its outcomes range from asymptomatic cases to most severe diseases like severe acute respiratory syndrome. Neurological manifestations have also been reported as an outcome of coronavirus infection and Guillain–Barre Syndrome (GBS) is one of them. In our present case, we describe the correlation of GBS with subclinical SARS-CoV-2 in a pediatric patient. The patient was successfully managed with intravenous immunoglobulin and physiotherapy. In the current pandemic, any case of GBS should be evaluated for recent or remote SARS-CoV-2 infection.

Pheochromocytomas (PCCs) are rare catecholamine-secreting tumors arising from adrenomedullary chromaffin cells, usually causing hypertension, palpitation, and headache. It is usually investigated as a secondary cause of hypertension. However, rarely it can present in hypotension. In “PCC crisis,” the patient presents with hypotension, multiple organ dysfunction, leaving the physician with diagnostic difficulties. In this case, we present an adolescent male presented with hypotensive cardiogenic shock, and multiple organ dysfunction on admission, which during investigation turned out to be bilateral PCC.