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Introduction: The objective was to delineate the clinico-epidemiological characteristics of hospitalized children with respiratory syncytial virus (RSV)-associated acute lower respiratory tract infection (RSV-ALRI) during its recent outbreak and to find out the independent predictors of pediatric intensive care unit (PICU) admission. Materials and methods: Children aged between 1 month and 12 years who tested positive for RSV were included. Multivariate analysis was performed to identify the independent predictors and predictive scores were developed from the β-coefficients. Receiver operating characteristic curve (ROC) was generated and the area under the curve (AUC) was calculated to assess the overall precision. The performance of sum scores in predicting PICU need, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and positive and negative likelihood ratios (LR+ and LR-) were calculated for each cutoff value. Results: The proportion of RSV positivity was 72.58%. A total of 127 children were included with a median [interquartile range (IQR)] age of 6 (2-12) months, of whom 61.42% were males and 33.07% had underlying comorbidity. Tachypnea, cough, rhinorrhea, and fever were predominant clinical presentations while hypoxia and extrapulmonary manifestations were present in 30.71% and 14.96% of children, respectively. About 30% required PICU admission, and 24.41% developed complications. Premature birth, age below 1 year, presence of underlying CHD, and hypoxia were independent predictors. The AUC [95% confidence interval (CI)] was 0.869 (0.843-0.935). Sum score below 4 had 97.3% sensitivity and 97.1% NPV whereas sum score above 6 had 98.9% specificity, 89.7% PPV, 81.3% NPV, 46.2 LR+, and 0.83 LR- to predict PICU needs. Conclusion: Awareness of these independent predictors and application of the novel scoring system will be beneficial for busy clinicians in planning the level of care needed, thereby optimizing PICU resource utilization. [ABSTRACT FROM AUTHOR]

Introduction: Small-for-gestational-age (SGA) is one of the important factors for neonatal mortality. Early identification and necessary intervention of these newborns is crucial to increase their chances of survival and reduce long-term disabilities. However, in low- and middle-income countries a large portion of pregnant women are unaware of their accurate gestational age (GA) due to the limited availability of ultrasonography. The purpose of our study was to build an alternative tool to identify SGA. Methods: A institutional-based, prospective observational study was conducted from August-2018 to February-2020, with 1451 live singleton-newborns of 30-40 weeks of gestation. Ultrasonography was used to evaluate accurate GA in early pregnancy and a reference chart for the Asian population, constructed by the National Institute of Child Health and Human Development (NICHD) Fetal Growth Studies was used to classify newborns as SGA. Neonatal anthropometry was measured within 48 hours of birth. Receiver operating characteristic curves were developed to identify the best cut-off point for each anthropometric parameter and the area under the curve (AUC) was estimated to assess the overall precision. Results: Prevalence of SGA was 34.3%. The AUC was 0.888 for head circumference (HC), 0.890 for chest circumference (CC), and 0.865 for mid-upper arm circumference (MUAC). The optimal cut-offs to classify SGA were ≤32.45 cm for HC, ≤29.75 cm for CC and ≤8.55 cm for MUAC with sensitivities of 85.9%, 86.9% and 85.4%, specificities of 75.5%, 85.1% and 72.1%, positive predictive values of 0.64, 0.75 and 0.61 and negative predictive values of 0.91, 0.93 and 0.90 respectively. Conclusion: All three anthropometric measurements could be used to identify SGA but, overall CC is the best. [ABSTRACT FROM AUTHOR]

To capture lapses in management, active surveillance of pediatric intensive care unit (PICU) admissions should consider as an essential tool to bring a better outcome with available resources, while there is a scarcity of data from comparatively newly set up peripheral PICU in developing countries. An observational record-based cross-sectional study was conducted in a peripheral medical college PICU over one year to evaluate morbidity pattern, outcome, and predictors of mortality. Binomial logistic regression (SPSS version-25) was used for analysis. The confidence interval (CI) of Odd's ratio was used to report the strength of association between dependent and independent variables. Pneumonia was the major cause of admission (27%), followed by septicemia (25.5%), congenital heart diseases (12.2%), bronchiolitis (6.6%), seizure disorders (8.6%), encephalitis (5%), and meningitis (4%). 51.7% were discharged, 14.6 %were referred, 3.2% were left against medical advice, and 30.4% were expired. Pneumonia (46.44%) was the most common cause of death, followed by sepsis (42.07%), congenital heart disease (15.3%), and bronchiolitis (6.01%). The mean duration of stay in PICU was five days (range 1-31 days). Patients who required ventilation (40%) or Inotropes (55.6%) had increased risk of mortality by 14 and 8 times, respectively. Age below one year, presence of bronchiolitis, pneumonia, ARDS, encephalitis, anemia, sepsis, dyselectrolytemia, and requirement of inotropes or ventilation were statistically significant risk factors for mortality (P<0.05). These predictors of morality will help to identify severe cases, prioritize resources and focus on the preventable methods in the public such as a vaccine, creating awareness about diseases, and proper referral. [ABSTRACT FROM AUTHOR]

The article presents authors' comments on the increasing investments in the field of research in nanotechnology in India and offers suggestions for country's rapid economic growth. Topics include investments in sectors such as education, infrastructure and entrepreneurship, nanotechnology funding by several Indian government bodies such as the Department of Information Technology, and insufficient human resources in the field of nantechnology in India.

Anastomotic leak (AL) is a major morbid complication after colorectal surgery. There are only few articles to find the predictors of leak after colorectal anastomoses that have been published in the literature. The aim of this study is to identify different predictors for colorectal AL in Indian set up. Historical data were collected from the hospital record of patients from June 2005 to April 2014. In prospective period, from May 2014 to February 2016, colorectal surgery patients were recruited to collect the data. Various preoperative, intraoperative, and postoperative factors for AL were analyzed using Student's t test and Chi square test. The p value less than 0.05 was considered statistically significant for all results. The AL rate was 9.1%. The predictors for AL were comorbidities like cerebrovascular accident (CVA) (p < 0.05), alcohol intake and smoking habit (p = 0.006), preoperative low albumin (AL in 21.2%), emergency surgery (AL in 25% with p = 0.016), jejuno-colic anastomosis − 1/1 (100%), and maximum AL in ligation of ileocolic artery (p = 0.019). History of CVA, smoking, alcohol, hypoalbuminemia, emergency surgery, type of surgery, and high artery ligation have significant role in causing AL in a patient of colorectal surgery. Raised temperature and tachycardia are the significant clinical signs to diagnose AL after colorectal surgery. [ABSTRACT FROM AUTHOR]

Background: Methodical and meticulous understanding of clinico-pathological procedures and decision making process of cancer diagnosis and identification of aspects that are well-suited for computer-aided analysis are first steps toward development of assistive computational tool for analysis of breast fine needle aspiration cytology (FNAC) slides. Aims: To identify variables in practice of FNAC as used for diagnosis of breast lesions and commonly perceived diagnostic significance of cytological features for diagnosis of benign or malignant condition of breast lesions. Materials and Methods: An India-wide questionnaire-based survey of cytopathologists/pathologists' breast FNAC reporting practices and their opinion on diagnostic significance of cytological features in diagnosis of benign or malignant nature of breast lesion were conducted. Results: Fifty-one experts working with various medical education institutes (~52% of participants), oncological tertiary care centers (~28%) and primary care centers/private diagnostic pathology laboratories (~20%) spread over 13 states of India have participated in the survey. Constants and variables observed in clinico-cytopathological practices and combined opinion of the participants on diagnostic significance of cytological features are presented here. Conclusions: There exist analogous as well as varied components in clinico-pathological procedures and diagnostic interpretation by individuals. These constants and variables in the practice of breast FNAC should be considered, when drawing up specifications for an assistive computational tool for analysis of breast FNAC slides. The estimate for commonly perceived significance of cytological features obtained through this study will help in their selection for computer-aided analysis of breast FNAC slides and further in selection of corresponding feature quantification techniques. [ABSTRACT FROM AUTHOR]