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Background: Standard treatment for symptomatic chronic subdural hematoma (CSDH) is a burr-hole evacuation. However, in patients in whom surgical evacuation carries a very high risk, we do not have an established practice guideline. Objective: To analyze the outcome of symptomatic CSDH treated only by tranexamic acid. Material and Methods: A total of 22 admitted patients with symptomatic chronic subdural hematoma from 2018 to 2019 were included in the study. All patients were managed conservatively with oral tablet tranexamic acid 250 mg thrice daily till the resolution of hematoma. Patients were followed up every month with CT scan brain. Data regarding the volume of hematoma, resolution of hematoma, and recurrence of hematoma were anonymized and analyzed. Results: The median duration of treatment was 60 days (range 30-98). The median volume of hematoma before the initiation of the therapy was 74 ml (range 66-96), and it was reduced to 2 ml after the therapy with tranexamic acid. The median midline shift before the initiation of the therapy was 15 mm (range 10-20), and it was zero in all patients following the treatment. There was no progression or recurrence of hematoma in any one of patients. No major complications (thromboembolic events) due to the use of tranexamic acid were seen in any patient. Conclusion: Even symptomatic patients with chronic subdural hematoma can be effectively managed with tranexamic acid when the surgical drainage is risky or not possible. It can be used as an alternative to surgery when there is no immediate threat to life. Keywords: Burr-hole evacuation, chronic subdural hematoma, tranexamic acid, Author(s): Raghavendra Nayak (corresponding author) [1]; Ashwin Pai [1]; Arjun Anand [1]; Geeta Sunder [1]; Shivaprakash Gangachannaiah [2] Key Message: Even in patients with symptomatic subdural hematoma when surgical intervention [...]

Purpose: This study aims to review the computational framework of SDGs in India, so that a mid-course correction can be contemplated. Design/methodology/approach: This study deploys, inter alia, econometric analysis to probe the robustness of indicators of SDG India Index 3.0. Methodologically, the study intensively probes the robustness of SDG India index and extensively refers to the global SDG indexes for cross-checking. Findings: Though the three editions of SDGI index mark significant efforts taken towards measuring the progress of SDGs in India, the paradigm suffers from the problem of too many indicators chasing only few targets, quantitative and qualitative issues with indicators, vintage pollution, partial coverage of targets and robustness issues. Research limitations/implications: This study has the limitation that it could not check the robustness of SDG scores with different weights assigned to indicators and future researchers can take up that interesting assignment. Practical implications: Since measuring the SDG progress through SDG index is a global endeavour, the findings of this study are important for almost all countries of the world, as it is still not too late to do mid-course correction because it is not the measurement that matters at the end of the day, rather it is the outcome of sustainable development that every country cares about. Social implications: The obfuscation of layers of SDG index in crafty, glossy and power-point-presentation-oriented SDG reports should get the reality check through such review of the computational framework of SDGs. Originality/value: This is the first study that unpacks the layers of SDG index computation in general and comprehensively reviews the Indian SDG indexing method in particular. [ABSTRACT FROM AUTHOR]

Aims and Objectives: 1. To estimate the number of graduates who had exposure to family medicine specialty. 2. To estimate the number of graduates who consider family medicine as the carrier option. 3. To compare the perception of family medicine as career option among the young graduates who had exposure to family medicine during their training or practice with no exposure. Materials and Methods: It is a cross-sectional, questionnaire-based study. The doctors graduated 2018 onwards were contacted through SIMSA (South Indian Medical Students Association) and WhatsApp groups (students doing the rural health service and intern WhatsApp). Subjects who consented for the study filled the google form. Filled Google forms were evaluated. Results: First choice of among the graduates is general medicine followed by general surgery and paediatrics. Family medicine is 4th in the order. There is overall a very positive perception about the family medicine among the respondents irrespective of exposure to family medicine. Majority of them feel that it gives good financial gain (55.55%), interesting (67.03%), work and family balance (75.55%), which contributes to individual and community health (84.07%) and essential part of healthcare system (83.33%). Graduates feel that career growth (26.66%) and academic growth (33.70%) are less and it is not popular (38.88%). If there is an opportunity, majority would choose family medicine (54.44%). Conclusions: Around 5.9% are open to choose family medicine as the career option. Medical graduates perceive family medicine subject to give them good work and family balance and the subject is essential part of healthcare system and contributes to the individual and community health, and at the same time, it may not give them great financial gain, academic and career growth. [ABSTRACT FROM AUTHOR]

Background: Diabetes mellitus (DM) is a major health problem in family practice causing multiple micro and macrovascular complications; the prevention of which should be the main aim of treating physicians. Lack of proper assessment can hasten the complications and a meticulous screening system is a prerequisite in every diabetic patient's evaluation. Objective: The aim of this study was to assess the pattern of screening for non-glycemic parameters in type 2 DM patients by physicians in an outpatient setting. Methods: A cross-sectional study was conducted in a teaching hospital during December 2019. A total of 254 patients with type 2 DM without any complications were randomly selected for screening as per the criteria developed by RSSDI [Research Society for the Study of Diabetes in India]. Results: Complete history and physical examination were done by physicians in all the participants. Measurement of blood pressure at every visit was done in about 95% of patients and 90% of them were counseled for cessation of smoking. But only about 60% or less of patients were screened for microalbuminuria, diabetic retinopathy, and peripheral neuropathy. Advice on comprehensive foot care was also not a regular practice among physicians. Conclusion: This clinical audit showed that 90% of the patients had undergone only 4 of the 9 RSSDI recommended screening. The other parameters had been carried out in only among 40 to 60% of the patients. Thus, primary care physicians have to emphasize on the subtle but important criteria like ophthalmic examination, peripheral neuropathy and microalbuminuria during regular outpatient visits. [ABSTRACT FROM AUTHOR]