Goa Medical College

Obesity is a global health crisis affecting developing nations, including India. The management of obesity continues to evolve with newer drugs, metabolic and bariatric surgery and endoscopic interventions, requiring family physicians and specialists to adapt their clinical practice accordingly. There is an urgent need for a standardized algorithm to diagnose, stage, and treat obesity. The Endocrine Society of India (ESI) and the Obesity Surgeons Society of India (OSSI) appointed a steering committee to develop an evidence-based algorithm for managing patients with obesity in India. This was put to vote by 80 specialists (38 from OSSI and 42 from ESI) in a physical meeting. A proposed stage-wise algorithm based on Edmonton Obesity Staging System, Asian definition of obesity, and resources in India, received 100

Extracorporeal carbon dioxide removal (ECCO₂R) has emerged as a supportive therapy for patients with acute respiratory failure, particularly when refractory hypercapnia and respiratory acidosis persist despite standard management. This narrative review summarizes the physiological rationale, current evidence, and clinical applications of ECCO₂R in modern critical care practice. ECCO₂R removes carbon dioxide directly from the bloodstream, thereby facilitating lung-protective ventilation strategies and potentially reducing ventilator-induced lung injury. The technique has been primarily evaluated in patients with acute respiratory distress syndrome (ARDS) and acute exacerbations of chronic obstructive pulmonary disease (AECOPD). In these settings, ECCO₂R may enable the use of lower tidal volumes and reduced airway pressures, and in selected patients, it may decrease the need for invasive mechanical ventilation. Although ECCO₂R has been shown to improve carbon dioxide clearance, correct respiratory acidosis, and optimize ventilatory parameters, randomized trials have not demonstrated a definitive mortality benefit. Its clinical application is also limited by device-related complications, including bleeding, thrombosis, and hemolysis. Furthermore, outcomes are influenced by technical factors such as cannula configuration, blood flow rate, membrane efficiency, and anticoagulation strategy. Ongoing technological advancements and well-designed clinical trials are needed to better define the role of ECCO₂R in contemporary critical care practice.

Background: Tetanus is a life-threatening, yet vaccine-preventable disease that continues to contribute in morbidity and mortality, especially in low- and middle-income countries. Despite the availability of an effective vaccine, and inclusion of booster doses at 10 and 16 years under the UIP, gaps in awareness and vaccination practices persist. Objective of the study was to assess the knowledge, attitude and practice (KAP) regarding tetanus vaccination among first-year MBBS and nursing/paramedical students of Government Medical College (GMC), Anantnag. Methods: A cross-sectional analytical study was conducted among 235 first-year MBBS and nursing/paramedical students at GMC Anantnag from June to July 2025. Data was collected using a structured, self-administered questionnaire assessing KAP related to tetanus vaccination. Data was analyzed using descriptive and inferential statistics. Results: The overall mean KAP score was 47.7%, with knowledge (42.5%) and practice (43.0%) scores being suboptimal despite a relatively higher attitude score (63.0%). Female participants demonstrated marginally higher knowledge and attitude scores, whereas males had significantly higher practice scores (p=0.02). No significant gender difference was observed in overall KAP scores. Conclusions: The study revealed inadequate knowledge and practices regarding tetanus vaccination with slightly better attitude scores among first-year students. Strengthening school-based and adolescent health programs, along with routine verification of immunization status during primary care visits, can help improve booster coverage and prevent gaps in protection against tetanus.

BACKGROUND:Cardiovascular diseases (CVDs) are the leading cause of mortality globally and a growing burden in India. This study aimed to assess prescribing patterns for CVDs across government and private healthcare sectors in Goa, India, focusing on rational drug use and safety. RESEARCH DESIGN AND METHODS:A retrospective, cross-sectional prescription audit of 400 CVD-related prescriptions (200 each from government and private facilities) was conducted between February to April 2025. Data were sourced from digitized prescription records and dispensing databases of government and private healthcare pharmacies. All data were extracted in an anonymized and de-identified format to ensure patient privacy. Primary outcomes measured included polypharmacy, National list of essential medicines (NLEM) compliance, generic and branded drug use, fixed dose combination (FDC) frequency, high-risk drugs used, drug-drug interactions (DDI), and prescribing errors. All records were validated by experienced healthcare professionals. Mann-Whitney U test was employed to evaluate the statistical significance between the prescribing patterns across government and private healthcare sectors. RESULTS:There were significant (U = 8813.5, Z = -9.69, p < 0.001) sectoral disparities observed in prescribing trends. Government prescriptions exhibited use of generic drugs, and fewer FDCs, but had higher incidence of polypharmacy and prescription errors. Private prescriptions exhibited lower NLEM adherence, fewer drugs per prescription, greater use of branded drugs, fixed dose combinations, high-risk medications and potentially greater drug-drug interactions. CONCLUSION:Substantial sectoral differences in prescribing patterns highlight the need for standard guidelines and prescriber education on rational drug use to optimize patient safety in both healthcare settings.