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Purpose Our retrospective study is aimed to analyze the efficacy and outcomes between high-vacuum suction drain (HVSD) over passive drainage in the setting of percutaneous image-guided thoracocentesis, with a secondary aim to determine if preprocedural computed tomography (CT) can aid decision-making.

Arsenic present in water bodies causes devastating effects on aquatic organisms and indirectly poses a hazardous threat to human existence. There is an urgent need to develop potential and convincing technologies to troubleshoot this problem. In the present study, an adsorbent has been prepared using the waste red mud from hazardous aluminium industry and doping it with calcium-alginate beads (ARMCB) for the effective removal of As(III) from wastewater. The concentration of As(III) was reduced from 0.101 mg/L to 0.008 mg/L after adsorption which effectively met the economic and environmental conditions imposed by WHO (>0.01 mg/L). Further, the statistical Response Surface Methodology (RSM) is adopted to analyze the combined effects of four operational parameters namely: pH, sorbent dosage, contact time and initial concentration on the adsorption of As(III) from the synthetic contaminated water samples. A high correlation coefficient (R2) value of 0.9672 projected by ANOVA confirmed the satisfactory regression of the developed model. The maximum adsorption capacity is found to be 1.807 mg/g at optimum operating conditions. The surface characterization of the adsorbent before and after adsorption by SEM, EDX, XRD, and FTIR confirms the potentiality of the adsorbent towards As(III) ions. Thermodynamic, adsorption isotherms and kinetic analysis respectively projected the endothermic Langmuir model adsorption of As(III) and the pseudo-second-order rate kinetics of the sorption mechanism. The current study aids the implementation of the developed robust technique for the successful removal of As(III) from industrial and domestic polluted water samples. [ABSTRACT FROM AUTHOR]

Water is essential for all living organisms. The addition of Chemicals will become a prime source for contamination of groundwaters near Agricultural activity areas. Keeping in view the hectic agricultural activity in West Godavari District of AP, India, it is proposed to assess the chemical toxicity of waters to suggest the remedial measures to protect the quality of waters to safeguard the health of the public residing in the nearby habitations of Agricultural activity areas. 16 Groundwater samples were collected and characterized for physicochemical parameters viz., pH, EC, TDS, TA, TH, DO, CO32-, HCO3-, Cl-, SO42-, PO43-, NO3-, Ca2+, Mg2+, Na+, K+ to evaluate the quality of waters to assess their potentials for application. The waters were characterized for metal ions viz., Cr, Mn, Fe, Co, Ni, Cu, Zn, Pb, As and Hg. Some waters are observed with Arsenic concentration while the concentrations of other metals are within the permissible limit. Further, the groundwaters were characterized to assess the microbial contamination and the waters were found to contain pathogenic bacterial species which can cause water-borne diseases. A health survey was carried out and the results revealed the sufferings of the people from health problems which are correlated with the presence of pathogenic bacterial species. The research results revealed that waters are with chemical and microbial contamination and proper treatment is to be done for controlling the toxicity. [ABSTRACT FROM AUTHOR]

BackgroundFew single center studies from resource-poor settings have reported about the epidemiology, clinical feature and outcome of multisystem inflammatory syndrome in children (MIS-C). However, larger data from multi-center studies on the same is lacking including from Indian setting.MethodsThis retrospective collaborative study constituted of data collected on MIS-C from five tertiary care teaching hospitals from Eastern India. Children ≤ 15 years of age with MIS-C as per the WHO criteria were included. Primary outcome was mortality.ResultsA total of 134 MIS-C cases were included (median age, 84 months; males constituted 66.7%). Fever was a universal finding. Rash was present in 40%, and conjunctivitis in 71% cases. Gastro-intestinal and respiratory symptoms were observed in 50.7% and 39.6% cases, respectively. Co-morbidity was present in 23.9% cases. Shock at admission was noted in 35%, and 27.38% required mechanical ventilation. Fifteen (11.2%) children died. The coronary abnormalities got normalized during follow-up in all except in one child. Initial choice of immunomodulation had no effect on the outcomes. Presence of underlying co-morbidity, lymphopenia, thrombocytosis, hyponatremia, increased LDH (>300 U/L), and hypoalbuminemia were the factors significantly associated an increased mortality.ConclusionsMIS-C has myriad of manifestations. Underlying co-morbidity, lymphopenia, thrombocytosis, hyponatremia, increased LDH (>300 U/L), and hypoalbuminemia were associated with an increased mortality. No difference in outcome was noted with either steroid or IVIg or both. Coronary artery abnormalities resolved in nearly all cases.

Multi Inflammatory Syndrome (MIS-C) associated with Corona Virus Disease (COVID) in children and young adults presents with a varied clinical spectrum; from that mimicking Kawasaki disease (KD), Incomplete Kawasaki disease to even Hemophagocytic Lymphohistiocytosis. A 14-year-old girl, presented to us, with headache, fever, bilateral uveitis, unilateral cervical lymphadenopathy, oral mucosal changes and abdominal pain. A disproportionate increase in inflammatory markers and Interleukin – 6, in the setting of a negative COVID real-time reverse transcription polymerase chain reaction (RTPCR) and significantly elevated COVID antibody titre confirmed our diagnosis. She was treated with intravenous Immunoglobulin and oral steroids with which she recovered. We want to highlight considering the possibility of MIS-C in children presenting with uveitis at a time when COVID-19 has been conquering the world with community spread.

Introduction: Serum lactate is an important parameter to assess adequacy of microcirculation in septic shock. However, prediction of outcome in pediatric septic shock with mutli organ dysfunction (MODS) based on serial lactate levels and it's clearance is not well studied. Materials and Methods: In this prospective study from a tertiary PICU in India, 43 children with septic shock and MODS aged 1month to 16 years were enrolled over one year. Our objective was to predict early ICU mortality (within 72 hours) as well as in-hospital mortality using serial serum lactate levels and it's rate of clearance. Serial serum lactate levels were measured at admission to PICU (0 hours) and 6 hourly for initial 24 hours and 12 hourly till 120 hours. Results: The median (IQR) age of enrolled children was 32 (4.5,96) months. Median (IQR) PRISM-12 score was 16.5 (12,22). Seventeen children died. Serum lactate ≥2.6 mmol/L at 24 hours predicted early ICU mortality with sensitivity and specificity of 83.3% and 85.7% (AUC: 0.873, 95% CI 0.727, 1.000). In hospital mortality could be predicted with sensitivity and specificity of 60% and 73% (AUC: 0.734, 95% CI 0.571, 0.897) when serum lactate ≥1.8 mmol/L at 24 hours. Percentage of lactate clearance (median, IQR) at 24 hours of ICU stay were 15.1 (-21.4, 24.6) and -33.2 ( -262, 0.4) (p=0.04) between survivors and non-survivors at 72 hours of ICU stay. Conclusion: Pediatric septic shock and MODS carries high mortality and serum lactate of ≥2.6 mmol/L predicted early ICU mortality with good precision.

Background: Postinfectious bronchiolitis obliterans (PIBO) is a chronic obstructive lung disease with scanty information in literature on etiology, clinical profile, treatment, and outcome. Objective: The objective of the study is to describe the clinical profile and course of children diagnosed with PIBO. Methods: A chart review of children below 18 years of age diagnosed as PIBO over the past 9 years was carried out. Details of clinical profile, laboratory investigations, imaging, treatment received, and outcome were recorded. Results: Eight children (boys 4) with PIBO were identified. Median (interquartile range [IQR]) age at the first episode of acute severe bronchiolitis such as illness and diagnosis of PIBO was 15 (6, 23.5) and 30 (16.5, 60) months, respectively, indicating a delay in diagnosis. The most common symptoms were recurrent episodes of cough (100%), fast breathing (100%), wheezing (87.5%), and fever (62.5%). Median (IQR) number of hospitalizations and episodes of antibiotic use prior to diagnosis were 2.5 (2, 5.5) and 2 (2, 4), respectively. Three (37.5%) children received mechanical ventilation during previous hospitalizations. Chest computed tomography revealed mosaic attenuation in 8 (100%), ground-glass opacities in 2 (25%), and bronchial wall thickening in 2 (25%). After diagnosis, 7 received oral steroids, 7 received hydroxychloroquine, 5 received azithromycin, and 2 received azathioprine. The median (IQR) duration of follow-up (n = 6) was 6 (1.5, 9.5) months. Median (IQR) number of pulmonary exacerbations in follow-up was 2 (1, 5). Conclusion: PIBO is still an under-recognized entity with substantial delay in diagnosis and unnecessary use of antibiotics. Clinical course with imaging findings may help to diagnose and manage this entity.

The application of natural polysaccharides in controlled drug delivery systems to deliver the bioactive agents has been hampered by the synthetic polymers. The main benefits of the natural polysaccharides are their being non-toxic, biodegradable, biocompatible, abundantly available, and less expensive and most importantly esuriently. Due to the advances in drug delivery technology, natural polysaccharides are included in controlled drug delivery to fulfill multitask functions and in some cases directly or indirectly influence the extent and/or rate of drug release. Some natural polysaccharides have even shown environmental-responsive gelation characteristics in order to achieve controlled drug release according to specific therapeutic needs. This article gives an overview of natural polysaccharides that are used or investigated as versatile excipients in controlled drug delivery systems. [ABSTRACT FROM AUTHOR]

Trichotillomania is an uncommon paediatric psycho-dermatological condition in children. Contrary to the prevalence reported in western literature, it is relatively uncommon in paediatric clinics of Indian subcontinent: mostly due to under reporting because of parental ignorance and associated social stigma. Here, authors report a 10-year-old girl who presented with extreme trichotillomania and other psychological comorbidities like intellectual disability, learning disorders and nocturnal enuresis leading to school absenteeism. She responded well to behavioural therapy without pharmacotherapy. In follow-up at two months, there were no relapses. This case emphasises the recognition of trichotillomania in children and importance of active family participation in successful therapy.