Pediatric Index of Mortality and PIM2 Scores Have Good Calibration in a Large Cohort of Children from a Developing Country

Objective. Our objective was to validate the Pediatric Index of Mortality (PIM) and PIM2 scores in a large cohort of children from a developing country. Design. Prospective observational study. Setting. Pediatric intensive care unit of a tertiary care teaching hospital. Patients. All children aged <18 years admitted between June 2011 and July 2013. Measurements and Main Results. We evaluated the discriminative ability and calibration as measured by the area under the receiver operating characteristic (ROC) curves, the HosmerLemeshow goodness-of-fit (GOF), and standardized mortality ratio (SMR), respectively. Of the 819 children enrolled, 232 (28%) died. The median (IQR) age of the study subjects was 4 years (0.8, 10). The major reasons for ICU admission as well as mortality were sepsis/severe sepsis. The area under ROC curves for PIM and PIM2 was 0.72 (95% CI: 0.67-0.75) and 0.74 (95% CI: 0.70-0.78), respectively. The goodness-of-fit test showed a good calibration across deciles of risk for the two scores with values being >0.05. The SMR (95% CI) was 0.99 (0.85-1.15) and 1 (0.85-1.16) for PIM and PIM2, respectively. The calibration across different age and diagnostic subgroups was also good. Conclusion. PIM and PIM2 scores had good calibration in our setup

Research Article Pediatric Index of Mortality and PIM2 Scores Have Good Calibration in a Large Cohort of Children from a Developing Country

Copyright © 2014 Jhuma Sankar et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Objective. Our objective was to validate the Pediatric Index of Mortality (PIM) and PIM2 scores in a large cohort of children from a developing country.Design. Prospective observational study. Setting. Pediatric intensive care unit of a tertiary care teaching hospital. Patients. All children aged <18 years admitted between June 2011 and July 2013.Measurements and Main Results. We evaluated the discriminative ability and calibration asmeasured by the area under the receiver operating characteristic (ROC) curves, theHosmer-Lemeshow goodness-of-fit (GOF), and standardized mortality ratio (SMR), respectively. Of the 819 children enrolled, 232 (28%) died. The median (IQR) age of the study subjects was 4 years (0.8, 10). The major reasons for ICU admission as well as mortality were sepsis/severe sepsis.The area under ROC curves for PIM and PIM2was 0.72 (95%CI: 0.67–0.75) and 0.74 (95%CI: 0.70–0.78), respectively. The goodness-of-fit test showed a good calibration across deciles of risk for the two scores wit

Clinical spectrum of congenital heart diseases in a tertiary care hospital

Introduction- In developing countries congenital heart diseases (CHDs) causes deaths of thousands of children. A study is necessary to understand incidence and clinical spectrum of CHDs so that early diagnosis and intervention can be done. Material and Methods – Newborns and children up to the age of 14 years attending pediatric OPD as well as admitted in ward with CHDs enrolled for study. Data were analyzed using SPSS system version 21. Results- A total of 400 children with CHDs included for final analysis. Male to Female ratio is 1.78:1.Most common CHDs was Ventricular septal defect followed by Tetralogy of fallot. Major symptoms were cough, difficulty in breathing, poor weight gain and suck rest suck cycle. Maternal risk factors found were consanguinity, maternal diabetes mellitus, maternal hypertension, maternal seizure disorder, maternal obesity, systematic lupus erythematosus etc. Conclusion- VSD is most common acyanotic CHD. Males are more affected with CHDs. Consanguinity and Maternal Diabetes are important risk factors for CHDs

Clinical spectrum of Pediatric HIV across A.R.T. centers in Chhattisgarh

Introduction: Pediatric HIV is a major world health problem, which is progressing at an alarming rate. Few studies have been done about variable clinical manifestation of pediatric HIV infection in children. This study intends to know the clinical profile of HIV infection in children of Chhattisgarh, evaluate the seroconversion rates of babies born to HIV seropositive women, possible maternal, obstetrical, and feeding factors influencing them, patient’s adherence to ART and opportunistic infections in affected children. Methods: All pediatric HIV cases from 1½ year to 14 year registered in A.R.T. centres of Chhattisgarh. Data were analysed using SPSS system version 21. Result: A total of 414 children were evaluated from different A.R.T. centres in Chhattisgarh for final analysis. Male to female ratio is 1.38:1. Most common mode of transmission is from mother to child. Tuberculosis, Recurrent and Persistent Diarrhoea, Recurrent Pneumonia and Oral Candidiasis are common infection in most of the children. Conclusion: Average age of diagnosis of pediatric HIV is around 7.5 ± 2.1years. Majority of children are diagnosed in stage 3. Adherence therapy to A.R.T. is good. Vertical transmission is most common mode of transmission

Statistical validity of interleukin-6 as a biomarker for the diagnosis of early-onset neonatal sepsis

Use of empirical antibiotics in neonates with risk factors of early-onset neonatal sepsis (EOS) is a common practice. A laboratory parameter is needed to help in the accurate diagnosis of EOS to avoid unnecessary use of antibiotics. The aim of this prospective observational cohort study was to compare the statistical validity of cord blood interleukin-6 (IL-6) with conventional sepsis screening as an early diagnostic marker for EOS. Eighty-seven neonates with antenatal risk factors for sepsis were followed up for 72 h for the development of EOS. Cord blood was collected for measurement of IL-6 concentrations. Blood culture and conventional sepsis screening (total leukocyte count, absolute neutrophil count, C-reactive protein and micro-erythrocyte sedimentation rate) were sent for analysis soon after delivery. The study group comprised of symptomatic neonates with positive blood culture (n=36). An equal number of gestational-age matched asymptomatic neonates without risk factor of sepsis served as controls. Statistical validity of IL-6 was compared with sepsis screening parameters as the diagnostic marker for EOS. Gram negative organisms were the predominant cause of EOS. The most commonly isolated organism was <em>Acinetobacter baumanii</em>. The sensitivity and specificity of IL-6 with a cut-off value of 40.5 pg/mL and area under curve of 0.959 were 92.3 and 90.48%, respectively. In contrast, the sensitivity and specificity of different parameters of sepsis screening ranged from 37.5-68.75% and 47.95-57.35%, respectively. In conclusion, cord blood IL-6 can be used as a highly sensitive and specific early diagnostic marker of EOS at a cut-off concentration of 40.5 pg/mL

Pediatric Index of Mortality and PIM2 Scores Have Good Calibration in a Large Cohort of Children from a Developing Country

Objective. Our objective was to validate the Pediatric Index of Mortality (PIM) and PIM2 scores in a large cohort of children from a developing country. Design. Prospective observational study. Setting. Pediatric intensive care unit of a tertiary care teaching hospital. Patients. All children aged <18 years admitted between June 2011 and July 2013. Measurements and Main Results. We evaluated the discriminative ability and calibration as measured by the area under the receiver operating characteristic (ROC) curves, the Hosmer-Lemeshow goodness-of-fit (GOF), and standardized mortality ratio (SMR), respectively. Of the 819 children enrolled, 232 (28%) died. The median (IQR) age of the study subjects was 4 years (0.8, 10). The major reasons for ICU admission as well as mortality were sepsis/severe sepsis. The area under ROC curves for PIM and PIM2 was 0.72 (95% CI: 0.67–0.75) and 0.74 (95% CI: 0.70–0.78), respectively. The goodness-of-fit test showed a good calibration across deciles of risk for the two scores with P values being >0.05. The SMR (95% CI) was 0.99 (0.85–1.15) and 1 (0.85–1.16) for PIM and PIM2, respectively. The calibration across different age and diagnostic subgroups was also good. Conclusion. PIM and PIM2 scores had good calibration in our setup

Abstracts of National Conference on Research and Developments in Material Processing, Modelling and Characterization 2020

This book presents the abstracts of the papers presented to the Online National Conference on Research and Developments in Material Processing, Modelling and Characterization 2020 (RDMPMC-2020) held on 26th and 27th August 2020 organized by the Department of Metallurgical and Materials Science in Association with the Department of Production and Industrial Engineering, National Institute of Technology Jamshedpur, Jharkhand, India. Conference Title: National Conference on Research and Developments in Material Processing, Modelling and Characterization 2020Conference Acronym: RDMPMC-2020Conference Date: 26–27 August 2020Conference Location: Online (Virtual Mode)Conference Organizer: Department of Metallurgical and Materials Engineering, National Institute of Technology JamshedpurCo-organizer: Department of Production and Industrial Engineering, National Institute of Technology Jamshedpur, Jharkhand, IndiaConference Sponsor: TEQIP-