Eternal Hunt: Unravelling the Challenge of CRE, the Quest for Perfection Continues!

How to cite this article: Salotagi S, Kannan A, Jindal A. Eternal Hunt: Unravelling the Challenge of CRE, the Quest for Perfection Continues! Indian J Crit Care Med 2024;28(5):513-514.

Lung Ultrasound Score: Does It Really Predict Extubation Failure?

How to cite this article: Salotagi S, Kannan A, Jindal A. Lung Ultrasound Score: Does It Really Predict Extubation Failure? Indian J Crit Care Med 2023;27(11):855-856.

Predisposition, Insult, Response, and Organ Dysfunction: A Well-constructed Score!

How to cite this article: Kannan A, Jindal A. Predisposition, Insult, Response, and Organ Dysfunction: A Well-constructed Score! Indian J Crit Care Med 2023;27(2):150.

Coronavirus-19 and its Epidemiology in Children - An Ambispective Observational Study from Central India.

This ambispective observational study, was conducted at a tertiary care centre in Central India. Children aged <16 y who tested positive for SARS-CoV2 between 1st April 2020 to 30th April 2022 were included. The prevalence of coronavirus disease-19 (COVID-19) infection was 1.2%. Of 525 children, median age was 60 mo; 88 (16.7%) were infants. Comorbidities were noted in 89 (16.9%) children. About 59% (n=309) were asymptomatic. Among symptomatic (n=216) children, fever (57.9%) was the most common symptom followed by cough (37%), running nose (21.3%) and shortness of breath (13.9%). Forty-three (8.2%) children required pediatric intensive care unit (PICU) admission, among which 21 required invasive ventilation. Patients with comorbidities were independently associated with need for invasive mechanical ventilation. Among PICU admitted children, 20 patients died. In multivariate logistic regression, children presenting with fever, shortness of breath and vasoactive requirement were found to be significantly associated with mortality. As the number of waves progressed, number of admissions were less but severity, association with comorbidities, need of ICU, mechanical ventilation and death rate increased.

Infections in Critically Ill Children.

Health care-associated infections (HAI) directly influence the survival of children in pediatric intensive care units (PICU), the most common being central line-associated bloodstream infection (CLABSI) 25-30%, followed by ventilator-associated pneumonia (VAP) 20-25%, and others such as catheter-associated urinary tract infection (CAUTI) 15%, surgical site infection (SSI) 11%. HAIs complicate the course of the disease, especially the critical one, thereby increasing the mortality, morbidity, length of hospital stay, and cost. The incidence of HAI in Western countries is 6.1-15.1% and in India, it is 10.5 to 19.5%. The advances in healthcare practices have reduced the incidence of HAIs in the recent years which is possible due to strict asepsis, hand hygiene practices, surveillance of infections, antibiotic stewardship, and adherence to bundled care. The burden of drug resistance and emerging infections are increasing with limited antibiotics in hand, is still a dreadful threat. The most common manifestation of HAIs is fever in PICU, hence the appropriate targeted search to identify the cause of fever should be done. Proper isolation practices, judicious handling of devices, regular microbiologic audit, local spectrum of organisms, identification of barriers in compliance of hand hygiene practices, appropriate education and training, all put together in an efficient and sustained system improves patient outcome.

Comparison of the Efficacy of Three Different Bone Regeneration Materials: An Animal Study.

OBJECTIVE: The proposed study aimed to evaluate and compare the bone regeneration between commercially available hydroxyapatite-ß-tricalcium phosphate (Ossifi; Equinox, the Netherlands), powdered polylactic acid (powdered PLA; Sigma-Aldrich, United States), and three-dimensionally printed PLA (3D-printed PLA; Cubex, SC, United States) using 3D printer (Cube X trio) in an animal model. MATERIALS AND METHODS: Eighteen New Zealand rabbits were divided into three groups with six animals each. Platelet-rich fibrin (PRF) was collected from the venous blood and preserved. Bone defect (4 mm × 2 mm) without disturbing the bone marrow was created and filled with bone graft material (group 1-Ossifi, group 2-powdered PLA, and group 3-3D-printed PLA), over which PRF membranes were placed. The graft material and the barrier were stabilized using resorbable sutures, and all the animals were maintained for 4, 8, and 12 weeks, after which they were euthanized, and bone samples were retrieved. Retrieved bone samples were subjected to radiological and histological analysis. RESULTS: The radiographic and histological changes of 3D-printed PLA in comparison with other two materials (Ossifi and powdered PLA) seemed to have a significant difference. CONCLUSION: 3D-printed PLA scaffolds showed positive signs of bone regeneration around the material in continuity defects. PLA material can be a promising alternative bone regenerative material.