Cr-Detector: A simple chemosensing system for onsite Cr (VI) detection in water.

Due to the increase in urbanization and industrialization, the load of toxicants in the environment is alarming. The most common toxicants, including heavy metals and metalloids such as hexavalent Chromium, have severe pathophysiological impacts on humans and other aquatic biotas. Therefore, developing a portable rapid detection device for such toxicants in the aquatic environment is necessary. This work portrays the development of a field-portable image analysis device coupled with 3,3',5,5'-tetramethylbenzidine (TMB) as a sensing probe for chromium (VI) detection in the aquatic ecosystem. Sensor parameters, such as reagent concentration, reaction time, etc., were optimized for the sensor development and validation using a commercial UV-Vis spectrophotometer. The chemoreceptor integrated with a uniform illumination imaging system (UIIS) revealed the system's applicability toward Cr(VI) detection. The calibration curve using the R-value of image parameters allows Cr(VI) detection in the linear range of 25 to 600 ppb, which covers the prescribed permissible limit by various regulatory authorities. Furthermore, the adjusted R2 = 0.992 of the linear fit and correlation coefficients of 0.99018 against the spectrophotometric method signifies the suitability of the developed system. This TMB-coupled field-portable sensing system is the first-ever reported image analysis-based technology for detecting a wide range of Cr(VI) in aquatic ecosystems to our knowledge.

Routine Echocardiography is not Required in Neonates with Arterial Ischemic Stroke.

OBJECTIVE: Current guidelines suggest routine echocardiography (ECHO) in the acute phase to exclude a cardiac source for neonatal arterial ischemic stroke (NAIS). However, the commonly assumed embolic origin from a cardiac source for NAIS is challenged and the need for ECHO in NAIS remains questionable, especially during the era of standard fetal anomaly scanning. Our hypothesis is that any complex cardiac defects potentially causing NAIS would likely be detected during routine prenatal scans, thus possibly making routine postnatal ECHO redundant. This study aimed to determine the prevalence of significant cardiac risk factors and evaluate the necessity of routine postnatal ECHO in NAIS during the routine use of prenatal fetal sonography. STUDY DESIGN: Retrospective review of 54 infants diagnosed with NAIS via brain magnetic resonance imaging who underwent an ECHO evaluation during the acute period to exclude potential cardiac origins for NAIS. RESULTS: Postnatal ECHO revealed no intracardiac thrombus or vegetation, and only identified structural heart anomalies in three (5%) infants. Interestingly, these three cases had already been diagnosed with syndromic conditions or chromosomal malformations prenatally. In the remaining infants, postnatal ECHO was either normal or showed minor abnormalities unlikely to have contributed to the stroke. The detection rates of complex cardiac anomalies from prenatal scans and postnatal ECHO were statistically similar (p = 0.617). CONCLUSION: The probability of ECHO to exclude cardiac sources for NAIS is so low that in the era of standard fetal anomaly scanning, routine postnatal ECHO may not be necessary for all NAIS infants, except when chromosomal malformations are detected. KEY POINTS: · Guidelines recommend an acute phase ECHO to identify a cardiac source of NAIS.. · ECHO not effective at excluding NAIS's cardiac origin for infants with normal fetal scans.. · Routine postnatal ECHO is unnecessary in NAIS infants, except with genetic abnormalities..

Salt stress resilience in plants mediated through osmolyte accumulation and its crosstalk mechanism with phytohormones.

Salinity stress is one of the significant abiotic stresses that influence critical metabolic processes in the plant. Salinity stress limits plant growth and development by adversely affecting various physiological and biochemical processes. Enhanced generation of reactive oxygen species (ROS) induced via salinity stress subsequently alters macromolecules such as lipids, proteins, and nucleic acids, and thus constrains crop productivity. Due to which, a decreasing trend in cultivable land and a rising world population raises a question of global food security. In response to salt stress signals, plants adapt defensive mechanisms by orchestrating the synthesis, signaling, and regulation of various osmolytes and phytohormones. Under salinity stress, osmolytes have been investigated to stabilize the osmotic differences between the surrounding of cells and cytosol. They also help in the regulation of protein folding to facilitate protein functioning and stress signaling. Phytohormones play critical roles in eliciting a salinity stress adaptation response in plants. These responses enable the plants to acclimatize to adverse soil conditions. Phytohormones and osmolytes are helpful in minimizing salinity stress-related detrimental effects on plants. These phytohormones modulate the level of osmolytes through alteration in the gene expression pattern of key biosynthetic enzymes and antioxidative enzymes along with their role as signaling molecules. Thus, it becomes vital to understand the roles of these phytohormones on osmolyte accumulation and regulation to conclude the adaptive roles played by plants to avoid salinity stress.

Two-Dimensional MOF Modulated Fiber Nanogenerator for Effective Acoustoelectric Conversion and Human Motion Detection.

The real-time application of piezoelectric nanogenerators (PNGs) under a harsh environment remains a challenge due to lower output performance and poor durability. Thus, the development of flexible, sensitive, and stable PNGs became a topic of interest to capture different human motions including gesture monitoring to speech recognition. Herein, a scalable approach is adapted where naphthylamine bridging a [Cd(II)-µ-I4] two-dimensional (2D) metal-organic framework (MOF)-reinforced poly(vinylidene fluoride) (PVDF) composite nanofibers mat is prepared to fabricate a flexible and sensitive composite piezoelectric nanogenerator (C-PNG). The needle-shaped MOF was successfully synthesized by the layering and diffusion of two different solutions. The incorporation of single-crystalline 2D MOF ensures a large content of electroactive phases (98%) with a resultant high-magnitude piezoelectric coefficient of 41 pC/N in a composite nanofibers mat due to the interfacial specific interaction with -CH2-/-CF2- dipoles of PVDF. As an outcome, C-PNG generates high electrical output (open-circuit voltage of 22 V and maximum power density of 24 µW/cm2) with a very fast response time (tr ≈ 5 ms) under periodic pressure imparting stimuli. Benefiting from bending and twisting functionality, C-PNG is capable of scavenging biomechanical energy by mimicking complex musculoskeletal motions that broaden its application in wearable electronics and fabric integrated medical devices. In addition, C-PNG also demonstrates an efficient acoustic vibration to electric energy conversion capability with an improved power density and acoustic sensitivity of 6.25 µW and 0.95 V/Pa, respectively. The overall energy conversion efficiency is sufficient to operate several consumer electronics without any energy storage unit. This acoustic observation is further validated by the finite element method-based theoretical simulation. Overall, the 2D MOF-based device design strategy opens up a new possibility to develop a human-motion compatible energy generator and a self-powered acoustic sensor to power up electronic gadgets as well as low-frequency noise detection.

Transient neonatal myasthenia gravis: refining risk estimate for infants born to women with myasthenia gravis.

OBJECTIVE: Transient neonatal myasthenia gravis (TNMG) can render a neonate vulnerable to catastrophic respiratory depression. Our aim was to describe the clinical manifestations of TNMG, and to determine when the myasthenic signs become apparent in TNMG. METHODS: We reviewed our own experience of infants who underwent routine inpatient monitoring for TNMG and combined our local data with observations from previous studies. RESULTS: Only three case series (n = 110) reported both the type and timing of onset of myasthenic signs. Adding local data (n = 37) yielded 147 infants born to women with MG. Fifteen infants (10%) developed signs of TNMG with onset being 1.5 ± 2.6 days (mean ± 3SD) after birth. Feeding difficulties and low tone were the commonest presenting signs, and only 1 of the 147 infants needed intubation for hypoventilation. CONCLUSIONS: TNMG signs were mostly not life-threatening. We suggest only 4 days of routine postnatal observation for infants born to women with MG.

Brainstem hypoxic-ischemic lesions on MRI in infants treated with therapeutic cooling: effects on the length of stay and mortality.

OBJECTIVE: To test the hypothesis that brainstem hypoxic-ischemic injury on magnetic resonance imaging (MRI) would be independently associated with short-term outcomes in cooled asphyxiated infants. METHODS: A total of 90 consecutively cooled asphyxiated infants who survived to have brain MRI were reviewed. A neuroradiologist who was masked to outcomes evaluated MRI images for brainstem involvement. Outcomes were mortality and length of stay. RESULTS: Brainstem lesions were present on post-cooling brain MRI in 20 of the 90 infants (22%). Overall, four infants died before discharge, and all four had brainstem involvement. The infants with brainstem involvement had longer hospital stay (29 days, IQR 20-47 versus 16 days, IQR 10-26; P = 0.0001), compared to infants without brainstem lesions (n = 70); and upon multivariate analysis, brainstem involvement remained independently associated with prolonged hospital stay (ß = 12.4, P = 0.001). CONCLUSION: This study demonstrates the importance of recognizing brainstem injury for the prediction of short-term outcomes in cooled asphyxiated infants.

Three-Dimensional MOF-Assisted Self-Polarized Ferroelectret: An Effective Autopowered Remote Healthcare Monitoring Approach.

In recent years, flexible and sensitive pressure sensors are of extensive interest in healthcare monitoring, artificial intelligence, and national security. In this context, we report the synthetic procedure of a three-dimensional (3D) metal-organic framework (MOF) comprising cadmium (Cd) metals as nodes and isoniazid (INH) moieties as organic linkers (CdI2-INH═CMe2) for designing self-polarized ferroelectret-based highly mechano-sensitive skin sensors. The as-synthesized MOF preferentially nucleates the stable piezoelectric ß-phase in poly(vinylidene fluoride) (PVDF) and also gives rise to a porous ferroelectret composite film. Benefiting from the porous structure of 3D MOFs, composite ferroelectret film-based ultrasensitive pressure sensor (mechano-sensitivity of 8.52 V/kPa within 1 kPa pressure range) as well as high-throughput ( power density of 32 µW/cm2) mechanical energy harvester (MEH) has been designed. Simulation-based finite element method (FEM) analysis indicates that the geometrical stress confinement effect within the interpore region of the ferroelectret structure synergistically influences the mechano-electrical property of the MEH. In addition, 143 pC/N (∼4.5 times higher than commercial piezoelectric PVDF films) piezoelectric charge coefficient (d33) magnitude and superior response time (tr ∼ 8 ms) of this composite ferroelectret film enable the detection of different physiological signals such as coughing, pronunciation, and gulping behavior, making it a promising candidate for early intervention of healthcare, which may play a significant role in accurate alert of influenza and chronic obstructive pulmonary disease (COPD)-related symptoms. In addition, MEH enables the tracking of the subtle pressure change in the wrist pulse, indicating its usefulness in effective mechano-sensitivity. Since the cardiovascular signal is one of the vital parameters that can determine the on-going physiological conditions, the wireless transmission of the detected wrist pulse signal has been demonstrated. All of these features coupled with wireless data transmission indicate the promising application of MOF-assisted composite ferroelectret films in noninvasive real-time remote healthcare monitoring.

Multiple Organ Dysfunction During Therapeutic Cooling of Asphyxiated Infants.

The main purpose of therapeutic cooling is neuroprotection of asphyxiated infants with significant hypoxic-ischemic encephalopathy. However, to improve the overall outcome, it is necessary to properly manage the full range of multiple organ system complications found in asphyxiated infants undergoing therapeutic cooling. Every physiologic process in an asphyxiated infant can potentially be affected by the cooling treatment. The purpose of this review is to discuss the effect of cooling on neonatal physiology in the current recommended cooling range and the management thereof.

Incidence and Risk Factors of Early Onset Neonatal AKI.

BACKGROUND AND OBJECTIVES: Neonatal AKI is associated with poor short- and long-term outcomes. The objective of this study was to describe the risk factors and outcomes of neonatal AKI in the first postnatal week. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The international retrospective observational cohort study, Assessment of Worldwide AKI Epidemiology in Neonates (AWAKEN), included neonates admitted to a neonatal intensive care unit who received at least 48 hours of intravenous fluids. Early AKI was defined by an increase in serum creatinine >0.3 mg/dl or urine output <1 ml/kg per hour on postnatal days 2-7, the neonatal modification of Kidney Disease: Improving Global Outcomes criteria. We assessed risk factors for AKI and associations of AKI with death and duration of hospitalization. RESULTS: Twenty-one percent (449 of 2110) experienced early AKI. Early AKI was associated with higher risk of death (adjusted odds ratio, 2.8; 95% confidence interval, 1.7 to 4.7) and longer duration of hospitalization (parameter estimate: 7.3 days 95% confidence interval, 4.7 to 10.0), adjusting for neonatal and maternal factors along with medication exposures. Factors associated with a higher risk of AKI included: outborn delivery; resuscitation with epinephrine; admission diagnosis of hyperbilirubinemia, inborn errors of metabolism, or surgical need; frequent kidney function surveillance; and admission to a children's hospital. Those factors that were associated with a lower risk included multiple gestations, cesarean section, and exposures to antimicrobials, methylxanthines, diuretics, and vasopressors. Risk factors varied by gestational age strata. CONCLUSIONS: AKI in the first postnatal week is common and associated with death and longer duration of hospitalization. The AWAKEN study demonstrates a number of specific risk factors that should serve as "red flags" for clinicians at the initiation of the neonatal intensive care unit course.

Methylammonium Lead Iodide Incorporated Poly(vinylidene fluoride) Nanofibers for Flexible Piezoelectric-Pyroelectric Nanogenerator.

This work introduces a piezoelectric-pyroelectric nanogenerator (P-PNG) based on methylammonium lead iodide (CH3NH3PbI3) incorporated electrospun poly(vinylidene fluoride) (PVDF) nanofibers that are able to harvest mechanical and thermal energies. During the application of a periodic compressive contact force at a frequency of 4 Hz, an output voltage of ∼220 mV is generated. The P-PNG has a piezoelectric coefficient (d33) of ∼19.7 pC/N coupled with a high durability (60 000 cycles) and quick response time (∼1 ms). The maximum generated output power density (∼0.8 mW/m2) is sufficient to charge up a variety of capacitors, with the potential to replace an external power supply to drive portable devices. In addition, upon exposure to cyclic heating and cooling at a temperature of 38 K, a pyroelectric output current of 18.2 pA and a voltage of 41.78 mV were achieved. The fast response time of 1.14 s, reset time of 1.25 s, and pyroelectric coefficient of ∼44 pC/m2 K demonstrate a self-powered temperature sensing capability of the P-PNG. These characteristics make the P-PNG suitable for flexible piezoelectric-pyroelectric energy harvesting for self-powered electronic devices.

UIISScan 1.1: A Field portable high-throughput platform tool for biomedical and agricultural applications.

The colorimetric sensing technology has evolved into an essential tool for high-throughput analysis including portability and cost-effectiveness among available biomedical and agricultural screening approach. In this endeavor, the objective of work is to focus on the development of a field-portable instrument based on an Uniform Illumination Imaging System (UIIS), which will facilitate the colorimetric biochemical sensing. The developed field-portable, wavelength independent UIIS has been exploited for (a) rotavirus detection using commercial enzymatic immunoassay based microplate kit; (b) pesticide residue detection and quantification; The proposed system exhibited a good correlation in comparison to another two conventional techniques, i.e., multi-plate reader (r = 0.9991938) and LC-MS/MS (r = 0.998877399) with a short analysis time of 5 min for 95 test samples. Moreover, the feasibility of UIIS system has also been explored as field-portable enzyme-linked immunosorbent assay (ELISA) plate reader. By incorporating the Mahalanobis distance calculation, the advanced algorithm has been investigated and developed to analyze the data. The overall dataset was transformed into a matrix format to give a good correlation with a conventional plate reader, i.e., r = 0.915389612. Internet of things (IoT) enabled decision support system can be exploited by using big data analytics. Finally, test results can be shared with concerned stakeholders and the remote users. Thus, the developed UIIS will help to identify potential public health threats expeditiosly compared to conventional time consuming process of sample submission to the laboratory for analysis.

Rapid Evaluation of Integral Quality and Safety of Surface and Waste Waters by a Multisensor System (Electronic Tongue).

The paper describes a wide-range practical application of the potentiometric multisensor system (MS) (1) for integral safety evaluation of a variety of natural waters at multiple locations, under various climatic conditions and anthropogenic stress and (2) for close to real consistency evaluation of waste water purification processes at urban water treatment plants. In total, 25 natural surface water samples were collected around St. Petersburg (Russia), analyzed as is, and after ultrasonic treatment. Toxicity of the samples was evaluated using bioassay and MS. Relative errors of toxicity assessment with MS in these samples were below 20%. The system was also applied for fast determination of integral water quality using chemical oxygen demand (COD) values in 20 samples of water from river and ponds in Kolkata (India) and performed with an acceptable precision of 20% to 22% in this task. Furthermore, the MS was applied for fast simultaneous evaluation of COD, biochemical oxygen demand, inorganic phosphorous, ammonia, and nitrate nitrogen at two waste water treatment plants (over 320 samples). Reasonable precision (within 25%) of such analysis is acceptable for rapid water safety evaluation and enables fast control of the purification process. MS proved to be a practicable analytical instrument for various real-world tasks related to water safety monitoring.

Late onset neonatal acute kidney injury: results from the AWAKEN Study.

BACKGROUND: Most studies of neonatal acute kidney injury (AKI) have focused on the first week following birth. Here, we determined the outcomes and risk factors for late AKI (>7d). METHODS: The international AWAKEN study examined AKI in neonates admitted to an intensive care unit. Late AKI was defined as occurring >7 days after birth according to the KDIGO criteria. Models were constructed to assess the association between late AKI and death or length of stay. Unadjusted and adjusted odds for late AKI were calculated for each perinatal factor. RESULTS: Late AKI occurred in 202/2152 (9%) of enrolled neonates. After adjustment, infants with late AKI had higher odds of death (aOR:2.1, p = 0.02) and longer length of stay (parameter estimate: 21.9, p < 0.001). Risk factors included intubation, oligo- and polyhydramnios, mild-moderate renal anomalies, admission diagnoses of congenital heart disease, necrotizing enterocolitis, surgical need, exposure to diuretics, vasopressors, and NSAIDs, discharge diagnoses of patent ductus arteriosus, necrotizing enterocolitis, sepsis, and urinary tract infection. CONCLUSIONS: Late AKI is common, independently associated with poor short-term outcomes and associated with unique risk factors. These should guide the development of protocols to screen for AKI and research to improve prevention strategies to mitigate the consequences of late AKI.

Predicting the need for home gavage or g-tube feeds in asphyxiated neonates treated with therapeutic hypothermia.

BACKGROUND: Asphyxiated infants treated with therapeutic cooling can have persistent oral feeding difficulty because of involvement of neural pathways in the brainstem, cortex, and basal ganglia. The goal is to predict the composite adverse outcome of death or persistent oral feeding difficulty using precooling/cooling attributes, and the severity and distribution of hypoxic-ischemic lesions, especially brainstem lesions on post-cooling brain magnetic resonance imaging (MRI). METHODS: Retrospective review of 86 asphyxiated infants cooled from January 2006 to August 2014. Persistent feeding difficulty was defined as needing feeding support (gastrostomy tube (g-tube) or home gavage feeds) after discharge. Clinical and laboratory risk factors, and the brain MRI abnormalities including the presence of brainstem lesions were compared between infants with and without adverse outcome using univariate analysis. Significant variables were then analyzed in a stepwise logistic regression (LR) model. RESULTS: Infants with adverse outcome (n = 31, 4 died pre-discharge) had longer hospital stay (26 days, interquartile range (IQR) 19-43 vs. 13 days, IQR 9-20; p < 0.01) and reached goal enteral feeds (oral/gavage) later (11 days vs. 8 days, p < 0.01) compared to 55 infants discharged on full oral feeds. The former infants were more likely to have cord pH ≤ 7.15, severely abnormal neurological examination, bleeding diathesis, continued need for ventilation, and positive MRI findings including brainstem lesions. In LR analysis, brainstem lesions on MRI (p = 0.00, odds ratio 19, 95% confidence interval 4-85) was independently associated with the adverse outcome. CONCLUSIONS: Brainstem involvement on post-cooling brain MRI was predictive of adverse outcome. Early identification of these infants may facilitate discussion of home feeding plans between clinicians and parents earlier, thereby potentially reducing the length of hospital stay.

Outcome of Preterm Infants with Transient Cystic Periventricular Leukomalacia on Serial Cranial Imaging Up to Term Equivalent Age.

OBJECTIVE: To determine the outcome of preterm infants whose cystic periventricular leukomalacia "disappeared" on serial screening cranial imaging studies. STUDY DESIGN: Infants ≤26 weeks of gestation born between 2002 and 2012 who had cranial imaging studies at least twice, the most abnormal study at <28 days of age and another closest to 36 weeks, were reviewed. The outcome of late death (after 36 weeks postmenstrual age) or neurodevelopmental impairment (NDI) in surviving infants at 18-26 months corrected age was compared between the infants with no cystic periventricular leukomalacia on both studies and cystic periventricular leukomalacia that disappeared (cystic periventricular leukomalacia at <28 days but not at 36 weeks), persisted (cystic periventricular leukomalacia on both studies), or appeared late (cystic periventricular leukomalacia only at 36 weeks). Predictors of NDI were evaluated by logistic regression. RESULTS: Of 7063 eligible infants, 433 (6.1%) had cystic periventricular leukomalacia. Among the 433 infants with cystic periventricular leukomalacia, cystic periventricular leukomalacia disappeared in 76 (18%), persisted in 87 (20%), and 270 (62%) had late cystic periventricular leukomalacia. Loss to follow-up ranged between 3% and 13%. Death or NDI was more common in infants with disappeared cystic periventricular leukomalacia compared with those with no cystic periventricular leukomalacia (38 of 72 [53%] vs 1776 of 6376 [28%]; OR [95% CI] 2.8 [1.8-4.6]). Disappeared, persistent, and late cystic periventricular leukomalacia were all also independently associated with NDI (OR 1.17, 1.21, and 1.16, respectively). CONCLUSIONS: Infants with "disappeared" cystic periventricular leukomalacia are at increased risk of adverse outcome similar to infants with persistent or late cystic periventricular leukomalacia.

Screening Cranial Imaging at Multiple Time Points Improves Cystic Periventricular Leukomalacia Detection.

OBJECTIVE: The aim of this study is to determine whether the cystic periventricular leukomalacia (cPVL) detection rate differs between imaging studies performed at different time points. DESIGN: We retrospectively reviewed the prospectively collected data of 31,708 infants from the NICHD Neonatal Research Network. Inclusion criteria were infants < 1,000 g birth weight or < 29 weeks' gestational age who had cranial imaging performed using both early criterion (cranial ultrasound [CUS] < 28 days chronological age) and late criterion (CUS, magnetic resonance imaging, or computed tomography closest to 36 weeks postmenstrual age [PMA]). We compared the frequency of cPVL diagnosed by early and late criteria. RESULTS: About 664 (5.2%) of the 12,739 infants who met inclusion criteria had cPVL using either early or late criteria; 569 using the late criterion, 250 using the early criterion, and 155 patients at both times. About 95 (14.3%) of 664 cPVL cases seen on early imaging were no longer visible on repeat screening closest to 36 weeks PMA. Such disappearance of cPVL was more common in infants < 26 weeks' gestation versus infants of 26 to 28 weeks' gestation (18.5 vs. 11.5%; p = 0.013). CONCLUSIONS: Cranial imaging at both < 28 days chronological age and closest to 36 weeks PMA improves cPVL detection, especially for more premature infants.

Management of neonatal morbidities during hypothermia treatment.

Although the primary goal of therapeutic hypothermia is to improve the neurodevelopmental outcome in asphyxiated infants, optimal management of the full range of multi-organ system complications typically presented by such infants during cooling treatment is necessary for improvement of the overall outcome. For this reason, adequate knowledge of how cooling affects all organ systems of asphyxiated infants with multi-organ hypoxic-ischemic injury is essential. Adequate diagnostic resources, readily available subspecialty consultant services and trained multidisciplinary staff to monitor and manage multi-organ system complications in asphyxiated infants during therapeutic cooling must be ensured during implementation of a cooling program. As therapeutic hypothermia is being used more widely, centers should consider participation in national or international benchmarking of outcomes and short-term adverse events during cooling to facilitate continuous quality improvement efforts.

Assessment of oral health status of Santal (tribal) children of West Bengal.

CONTEXT: Santal is the third largest tribal community of India leading a very poor standard of education and life style. There are, however, few population-based studies evaluating the oral health status among Santal children in West Bengal. AIMS: The aim of the study was to evaluate the oral health status of Santal children of West Bengal by assessing prevalence of dental caries and inflammatory condition of gingival. SETTINGS AND DESIGN: Santal children aged between 2-14 years (N = 1205) were randomly selected from different Santal communities of West Bengal for this study. The children were divided into three different groups according to dentition. MATERIALS AND METHODS: Caries for permanent dentition Decayed Missing Filled Tooth (DMFT), for deciduous dentition decayed extracted filled (def index was used. For mixed dentition DMF and def was measured respectively and then added together. Inflammatory condition of gingival was assessed by papillary marginal attachment (PMA) index. STATISTICAL ANALYSIS USED: the data was analyzed statistically by SPSS software version 11. RESULTS: The study showed there was no significant difference (P > 0.05) between the average decayed extracted filled teeth (deft)/DMFT for boys and girls in deciduous and permanent dentition. But in mixed dentition this value for the boys was significantly higher (P < 0.001) than girls. 'Z' values were found to be non significant when compared mild, moderate and severe gingivitis between boys and girls in each dentition group, but mild gingivitis significantly increases from deciduous dentition to mixed to permanent dentition (P <0.001).

Does maternal intrapartum antibiotic treatment prolong the incubation time required for blood cultures to become positive for infants with early-onset sepsis?

BACKGROUND: We hypothesized that maternal intrapartum antibiotic treatment delays the growth of the organism in the blood culture obtained during the work-up for infants with suspected early-onset sepsis (EOS). METHODS: Single center, retrospective review of infants with blood culture-proven EOS over 13.5 years period. EOS was defined by isolation of a pathogen from blood culture obtained within 72 hours of birth and antibiotic treatment for ≥ 5 days. RESULTS: Among 81 infants with positive blood cultures, 38 were deemed to have EOS and 43 were deemed contaminants. The organisms grown were as follows: Escherichia coli in 17 infants, Group B streptococcus in 10 infants, and others in 11 infants. Overall, 17 infants with EOS did not receive intrapartum antibiotics and had blood cultures drawn for being symptomatic after birth. The other 21 infants who received intrapartum antibiotics had blood culture drawn primarily for maternal chorioamnionitis. The median (interquartile range [IQR]) incubation time to blood culture positivity was not different in infants who received intrapartum antibiotics compared with infants who did not (19.6 hours, IQR 16-28 hours vs. 19.5 hours, IQR 17.2-21.6 hours, p = 0.7489). CONCLUSION: Maternal intrapartum antibiotic treatment did not delay the time to blood culture positivity in infants with EOS.

Assessment of association between rapid fluctuations in serum sodium and intraventricular hemorrhage in hypernatremic preterm infants.

AIM: This study aims to determine the association between the rapid fluctuations in serum sodium and intraventricular hemorrhage (IVH) or death in hypernatremic preterm infants. STUDY DESIGN: Single center observational study including 216 infants < 1,000 g birth weight and <29 weeks gestational age, who had serum sodium levels monitored at least every 12 hours. Logistic regression analyses were used to identify which of the commonly cited risk factors for IVH, including the rapid (to the extent of ≥10 and ≥15 mmol/L/d) rise or fall in serum sodium, was associated with the primary outcome of any IVH, or the secondary composite outcome of severe IVH or death during the first 10 days of life in hypernatremic infants. RESULTS: Of 216 infants, 126 (58%) studied developed hypernatremia (serum sodium ≥ 150 mmol/L). IVH was more frequent in hypernatremic infants (p = 0.01). Presence of hypernatremia was an independent risk factor for IVH on logistic regression analysis (p = 0.022, odds ratio 2.0, 95% confidence interval: 1.1-3.8). Rapid (≥ 10 and ≥ 15 mmol/L/d) rise or fall in serum sodium in hypernatremic infants was not associated with the outcomes. CONCLUSION: Hypernatremia per se, but not the rapid fluctuations (not exceeding 10-15 mmol/L/d) in serum sodium was independently associated with IVH.