Consensus Guidelines for Pediatric Intensive Care Units in India, 2020.

BACKGROUND: Consensus Guidelines for Pediatric Intensive Care Units (PICUs) were published in Indian Pediatrics in 2002. OBJECTIVE: The current document represents a recent update in the Indian context, regarding unit design, equipment, organization, staffing as well as admission and discharge criteria for different levels of Pediatric Intensive Care and teaching units with PICU training programs, as well as nonteaching units. PROCESS: The Pediatric Intensive Care College Council (PICC), an academic wing of the Indian Academy of Pediatrics (IAP) Intensive Care Chapter took the initiative to update the guidelines with members of the PICU guidelines Committee writing group. After a great deal of discussion at conferences and through mailing and feedback with listed members, as well as with the guidance and feedback of senior PICU guidelines advisory committee members, The consensus is now updated. These guidelines are intended to serve as a reference for health Care institutions wishing to establish a new PICU or to modify an existing PICU. As a resource, experience of those members who have worked extensively in western PICUs was also taken into consideration, in addition to published guidelines in the medical literature. PICUs with teaching programs run by the IAP Intensive Care Chapter must follow these criteria for unit accreditation and teaching curricula as applicable. RECOMMENDATIONS: Unit design, equipment, organization, staffing as well as admission and discharge criteria for different levels of pediatric intensive care are updated.

Oxygen therapy in pediatrics.

Oxygen therapy is the most important aspect of supportive care in the management of a critically ill child. Knowledge of the physiology of oxygenation is a key to the proper oxygen therapy. High flow systems are more dependable devices for oxygenation and their use needs to be stressed. Patients on oxygen need close monitoring. Ventilatory support and Continuous Positive Airway Pressure (CPAP) is mandatory in some patients in addition to oxygen therapy for the prevention and treatment of hypoxia.

Characterization of a mitochondrial inorganic pyrophosphatase in Saccharomyces cerevisiae.

We have studied a mitochondrial inorganic pyrophosphatase (PPase) in the yeast Saccharomyces cerevisiae. The uncoupler FCCP (carbonyl cyanide p-trifluoromethoxyphenylhydrazone) and the ionophores valinomycin and nigericin stimulate the PPase activity of repeatedly washed yeast mitochondria 2-3-fold. We have previously cloned a yeast gene, PPA2, encoding the catalytic subunit of a mitochondrial PPase. Uncouplers stimulate the PPase activity several-fold in mitochondria from both cells that overexpress PPA2 from a high copy number plasmid and cells with normal expression. These results indicate that the PPA2 polypeptide functions as an energy linked and membrane associated PPase. The stimulation of mitochondrial PPase activity by FCCP, but not by valinomycin and nigericin, was greatly enhanced by the presence of DTT. The antibiotics Dio-9, equisetin and the F0F1-ATPase inhibitor oligomycin also increase mitochondrial PPase activity several fold. This stimulation is much higher, whereas basal PPase activity is lower, in isotonic than in hypotonic solution, which indicates that intact membranes are a prerequisite for maximal effects.

Chemical evolution of peroxidase--amino acid pentacyanoferrate (II) complexes as model.

Complexes of the type [Fe(II)(CN)5(L)]n- (where n = 3, or 4; L = glycine, histidine, imidazole, and triglycine) are proposed as evolutionary model of peroxidases. Detailed kinetic investigation for disproportionation of hydrogen peroxide catalysed by [Fe(II)(CN)5(L)]n- complexes at 40 degrees C and pH 9.18 are discussed. Decomposition of hydrogen peroxide catalysed by above complexes conforms to Michaelis-Menten type kinetics.

Chemical evolution of iron containing enzymes: mixed ligand complexes of iron as intermediary steps.

Activities of the iron complexes of evolutionary importance like K4[Fe(CN)6], K4[Fe(CN)5(gly)], and K4[Fe(CN)5(trigly)] have been tested towards some redox reactions of biological significance, namely, decomposition of hydrogen peroxide, dehydrogenation of NADH and ascorbic acid both coupled with reduction of methylene blue. It has been observed that the catalytic activities of iron (II) complexes towards the redox reactions studied at pH 9.18 followed the order, K4[Fe(CN)6] less than K4[Fe(CN)5(gly)] less than K4[Fe(CN)5(trigly)]. Decomposition of H2O2 catalysed by cyanocomplexes of iron (II) has been discussed through the formation of an innersphere complex in which loosly bound ligands like, glycine and triglycine are replaced by hydroperoxide ion. A tentative mechanism for the catalysed decomposition of H2O2 has been discussed. Based upon the experimental observations a hypothesis on the evolution of iron containing enzymes has been envisaged as: iron(II) ion----iron(II) cyanide complexes----mixed ligand iron(II) cyanide and amino acid complexes----iron(II) complexes of macromolecules----proenzyme or early enzyme containing iron(II).