Open versus Closed Suctioning Among Mechanically Ventilated Pediatric Patients: A Randomised Control Trial.

OBJECTIVES: To compare the difference in efficacy of closed tracheal suction system (CTSS) to open tracheal suction system (OTSS) in reducing incidence of ventilator associated pneumonia (VAP). Also to evaluate their efficacy in stabilizing cardio-respiratory parameters, reducing mortality and duration of intubation. METHODS: This study was a single centre, parallel group, open label, randomized controlled study with an equal allocation (1:1) in pediatric patients requiring mechanical ventilation. A specific suction system of CTSS or OTSS was assigned to the two groups based on randomization. All the demographic, clinical, laboratory parameters and treatment outcomes were noted in the preformed sheet. RESULTS: Total 116 eligible pediatric ventilated patients were studied. Total incidence of VAP was 9 (7.75%) of which 3 occurred in open and 6 in closed suction group. Rate of VAP was similar among both the groups with RR 2.11 (95% CI 0.50-8.9). However, significant number of infection-related ventilator associated condition (IVAC) were found in CTSS (17) compared to OTSS (6) group with RR 3.5 (95% CI 1.3-9.9). SpO2 was better maintained in the CTSS group post-suction (p = 0.001). Incidence of mortality and intubation days were similar between both groups. CONCLUSIONS: Incidence of VAP was similar between open and closed suction groups.

Overt and Covert Delinquency: Socio-Demographic Correlates in Justice-Involved Adolescent Males.

Delinquent offenses among adolescents is an important public health concern worldwide and has been increasing at an alarming rate in India. The study aimed to assess the prevalence and pattern of delinquency among justice-involved adolescent (JIA) males and determine the associated socio-demographic factors. This cross-sectional study was carried out during the year 2016 to 2019 among 178 male inmates (aged 10-18 years) of an observation home situated at Berhampur city in the state of Odisha, India. More than half (52.8%) of the JIA males committed overt delinquent acts and 47.2% committed covert delinquent acts. Drug trafficking (34.5%) tops the list among different covert delinquent acts followed by stealing things (33.3%) whereas rape (62.8%) was the most frequently committed overt delinquent act followed by murder (25%). Results of the multivariate analysis revealed that older age {adjusted odds ratio (aOR): 4.05; 95% CI [1.73, 9.51]}, lower education status of mother (aOR: 2.81; 95% CI [1.09, 7.22]), single parenthood (aOR: 4.58; 95% CI [1.27, 16.58]), and non-supportive parenting (aOR: 3.13, 95% CI [1.44, 6.80]) were significantly associated with overt delinquency in JIA males. The prevalence of overt delinquency among JIA males was high. Interventional measures incorporating these determinants should be designed to address overt delinquency in this population.