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Parel, India

Supe A.N.,KEM Hospital
Education for Health: Change in Learning and Practice | Year: 2011

Introduction: Communicating bad news to patients and families is an essential skill for physicians but can be difficult for interns. Very little is known about skills in this area for interns in developing countries. Method: Two focus groups, consisting of a total of 12 interns were conducted in the Seth G.S. Medical College and KEM Hospital in Mumbai, India. The grounded theory approach was used to identify common themes and concepts, which related to: (1) barriers in communicating bad news, (2) interns' confidence in communicating bad news, (3) interns' perceptions about their need for such training and (4) interns' suggested methods for training. Results: Interns described barriers in time constraints, language, their personal fears, patients' illiteracy, crowded wards with no privacy and lack of training. All interns lacked confidence in breaking news of death, but seven were confident in breaking bad news about chronic diseases or cancers. Subjects reported they had received very little classroom teaching or formal instruction in this area, though they had had opportunities to observe a few instances of breaking bad news. They expressed need for increased focus on communication skills curriculum in the form of case discussions, workshops and small group teaching, in addition to clinical observation. Conclusions: Interns in our school in Mumbai reported inadequate training and low comfort and skill in communicating bad news and expressed need for focused training. © AN Supe, 2011. Source


Chaudhari S.,KEM Hospital
Indian Pediatrics | Year: 2011

There has been a marked increase in the survival of extremely low birth weight (ELBW) infants, but these babies have a long stay in the NICU. Strategies to decrease their neurodevelopmental impairment become very important. The maximum development of the brain occurs between 29-41 weeks. From the warm, dark, acquatic econiche, where the baby hears pleasant sounds like the mother's heart beat, the baby suddenly finds itself in the dry, cold, excessively bright, noisy, environment of the NICU. Noise, bright light, painful procedures, and ill-timed caregiving activities, adversely affect the infant's development. Excessive radiation from X-rays of babies on the ventilator and CT scans also affect the brain. Medications like steroids for chronic lung disease also cause damage to the brain. Aminoglycides and frusemide are known to cause hearing impairment. Hence a developmentally supportive, humanized care will go a long way in enhancing the developmental outcome of these babies. Source


Supe A.N.,KEM Hospital
Education for health (Abingdon, England) | Year: 2011

Communicating bad news to patients and families is an essential skill for physicians but can be difficult for interns. Very little is known about skills in this area for interns in developing countries. Two focus groups, consisting of a total of 12 interns, were conducted in the Seth G.S. Medical College and KEM Hospital in Mumbai, India. The grounded theory approach was used to identify common themes and concepts, which related to: (1) barriers in communicating bad news, (2) interns' confidence in communicating bad news, (3) interns' perceptions about their need for such training and (4) interns' suggested methods for training. Interns described barriers in time constraints, language, their personal fears, patients' illiteracy, crowded wards with no privacy and lack of training. All interns lacked confidence in breaking news of death, but seven were confident in breaking bad news about chronic diseases or cancers. Subjects reported they had received very little classroom teaching or formal instruction in this area, though they had had opportunities to observe a few instances of breaking bad news. They expressed need for increased focus on communication skills curriculum in the form of case discussions, workshops and small group teaching, in addition to clinical observation. Interns in our school in Mumbai reported inadequate training and low comfort and skill in communicating bad news and expressed need for focused training. Source


Hazari N.,KEM Hospital | Bhad R.,All India Institute of Medical Sciences
Journal of Psychopharmacology | Year: 2015

Depression is a highly prevalent and severely disabling condition globally. Despite being a major cause of disability worldwide, little progress has been made in the last three decades in developing rational and novel pharmacological treatment options for the management of depression. Recently there has been growing interest in the role of kynurenine pathway in pathophysiology of depression. In this paper, the potential role of kynurenine pathway inhibitors in the management of depression particularly in secondary and reactive depression and the development of novel antidepressant drugs targeting kynurenine pathway are discussed. © British Association for Psychopharmacology. Source


Vaid S.,Star Imaging and Research Center | Vaid N.,KEM Hospital
Neuroimaging Clinics of North America | Year: 2015

It is imperative for all imaging specialists to be familiar with detailed multiplanar CT anatomy of the paranasal sinuses and adjacent structures. This article reviews the radiologically relevant embryology of this complex region and discusses the region-specific CT anatomy of the paranasal sinuses and surrounding structures. Radiologists also need to know the clinical implications of identifying preoperatively the numerous anatomic variations encountered in this region and prepare a structured report according to the expectations of the referring clinician. © 2015 Elsevier Inc. Source

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