Pediatric Sepsis Phenotypes and Outcome: 5-Year Retrospective Cohort Study in a Single Center in India (2017-2022).

OBJECTIVES: To describe mortality associated with different clinical phenotypes of sepsis in children. DESIGN: Retrospective study. SETTING: PICU of a tertiary care center in India from 2017 to 2022. PATIENTS: Six hundred twelve children (from 2 mo to 17 yr old) with a retrospectively applied diagnosis of sepsis using 2020 guidance. METHODS: The main outcome was mortality associated with sepsis subtypes. Other analyses included assessment of risk factors, requirement for organ support, and PICU resources used by sepsis phenotype. Clinical data were recorded on a predesigned proforma. INTERVENTIONS: None. MEASUREMENTS AND RESULTS: Of the 612 children identified, there were 382 (62%) with sepsis but no multiple organ failure (NoMOF), 48 (8%) with thrombocytopenia-associated MOF (TAMOF), 140 (23%) with MOF without thrombocytopenia, and 40 (6.5%) with sequential MOF (SMOF). Mortality was higher in the SMOF (20/40 [50%]), MOF (62/140 [44%]) and TAMOF (20/48 [42%]) groups, compared with NoMOF group (82/382 [21%] [ p < 0.001]). The requirement for organ support and PICU resources was higher in all phenotypes with MOF as compared with those without MOF. On multivariable analysis elevated lactate and having MOF were associated with greater odds of mortality. CONCLUSIONS: In this single-center experience of sepsis in India, we found that sepsis phenotypes having MOF were associated with mortality and the requirement of PICU resources. Prospective studies in different regions of the world will help identify a classification of pediatric sepsis that is more widely applicable.

Study on Evolution of Micropipes from Hexagonal Voids in 4H-SiC Crystals by Cathodoluminescence Imaging.

This paper presents an investigation on micropipe evolution from hexagonal voids in physical vapor transport-grown 4H-SiC single crystals using the cathodoluminescence (CL) imaging technique. Complementary techniques optical microscopy, scanning electron microscopy, and energy-dispersive spectroscopy (EDS) are also used to understand the formation mechanism of hexagonal voids along with the origin of pipes from these voids. The ability of CL to image variations along the depth of the sample provides new insights on how micropipes are attached to hexagonal voids that lie deep within the bulk single crystals. CL imaging confirms that multiple micropipes can originate from a single hexagonal void. EDS mapping shows that the inside of the micropipe walls exhibits higher levels of carbon. Investigation of the seed region by optical imaging shows that improper fixing of the seed to the crucible lid is the root cause for the formation of hexagonal voids that subsequently lead to micropipe formation.

Assessment of quality of sleep and its association with body mass index among medical consultants working in a medical college in northern India.

BACKGROUND: Medical specialist/consultants are exposed to various factors such as long duty hours, call duties, academics, meetings and regulation of departmental work which has adversely affected their sleep quality. OBJECTIVE: To assess sleep quality and association of body mass index with quality of sleep among medical consultants working in medical college. METHOD AND TOOL: This is a cross-sectional study and was done by convenient sampling technique. Pittsburg Sleep Quality Index (PSQI) was used as the assessment tool which categorizes sleep as good or poor according to the score. Chi-square test was applied to establish an association with the variables. RESULTS: A total of 67 responses were obtained, of which 28 showed good sleep on PSQI. Among consultants having good quality sleep, the majority were females (n=18); aged above 40 years (n=17). No relationship was seen with BMI and chronic disease. Consultants spending more than 85% of the time in bed sleeping (p< 0.006) and those going to bed before 10.30 pm (p<0.026) had good sleep quality. CONCLUSION: Good quality of sleep was observed in females, people above 40 years and those who don't have any chronic disease, though this association of sleep quality with the factors was not significant. Going to bed early (before 10:30 pm) had a positive effect on sleep quality (p<0.026). In general, poor sleep quality was seen among medical consultants.

Removal of sulphur mustard, sarin and simulants on impregnated silica nanoparticles.

Silica nanoparticles of diameter, 24-75 nm and surface area, 875 m(2)/g were synthesized using aero-gel route. Thereafter, nanoparticles were impregnated with reactive chemicals, and used as reactive adsorbent to study the removal of toxic nerve and blister chemical warfare agents and their simulants from solutions. Trichloroisocyanuric acid impregnated silica nanoparticles showed the best performance and indicated physisorption followed by chemisorption/degradation of toxicants. This indicated their suitability as universal decontaminant for nerve and blister agents. This system showed a decrease in t(1/2) from 1210 to 2.8 min for the removal of king of chemical warfare agents, i.e., sulphur mustard. Hydrolysis, dehydrohalogenation and oxidation reactions were found to be the route of degradation of toxicants over impregnated silica nanoparticles.