Focal segmental glomerulosclerosis (FSGS) is a common cause of nephrotic syndrome affecting adults and children. Collapsing focal segmental glomerulosclerosis (FSGS), one of five histologic variants of FSGS is described as segmental or global collapse and sclerosis of the glomerular tufts and has been frequently associated with human immunodeficiency virus-associated nephropathy (HIVAN). Its association with other viral and non-viral causes, medications and other disease states has since been established. Due to its resistance to therapy, rapid progression to end-stage renal disease (ESRD) and overall poorer prognosis, identification with electron microscopy examination of the kidney biopsy sample is required during evaluation.

Introduction Admission to a pediatric intensive care unit (PICU) with a Staphylococcus aureus (SA) infection is associated with considerable mortality and morbidity. There is paucity of data about epidemiology of SA infection in a PICU. This study was aimed at elucidating the clinicoepidemiological profile and outcome of children admitted to ICU with S. aureus infection. Methods This study was carried out in a PICU at a tertiary care hospital in northern India. Children admitted with culture positive S. aureus infection were enrolled in this study. Children suspected of having S. aureus infection on clinical grounds only without a positive culture were excluded from the study. Baseline characteristics of the subjects were recorded on admission and daily follow up maintained till death or discharge from PICU. The course during PICU stay, ensuing complication, and outcome was recorded. Results There were 2,480 total admissions to the PICU during study period of one year, out of which 120 (4.83%) admissions had a culture proven S. aureus infection. Fifty-six (46.6%) were male and 64 (53.3%) were female. Most of the subjects fell in the age groups of 1–5 years and 10–15 years having 56 (46.6%) and 40 (33.3%) subjects, respectively. Pneumonia (43.3%), septicaemia (20.8), and bone/joint space infections (15%) were the three main clinical manifestations. Forty-two (35%) of specimens were reported as methicillin resistant. Incidence of methicillin resistant SA (MRSA) infection was 1.6 and that of methicillin sensitive SA (MSSA) 3.1 per 100 admissions to PICU. On sensitivity testing, none of the specimens was found to be vancomycin resistant. There were 240 total deaths in PICU during study period out of which 25 (10.4%) were observed from the study group. Mortality rate was 20.8%. Mortality was high in the MRSA group. Conclusion The incidence of S. aureus infection and associated mortality is high in PICU. MRSA infection was more common in children admitted with chronic disease and is associated with higher mortality. Our study found a bimodal age distribution for serious staph infection, a finding that needs further evaluation. How to cite this article Qadri I, Malik I, Ahmed K. Staphylococcus aureus Infection in A Pediatric ICU: A Hospital Based Prospective Observational Study. Indian J Crit Care Med 2019;23(5):210-212.

Objective: The rapid emergence of the SARS-COV2 virus that caused COVID-19 pandemic in early 2020 led to authorities instituting lockdown protocols to curb spread of the virus. Prior studies in patients with T1DM have demonstrated a short-term favorable or neutral effect of the lockdown on glycemic parameters; however, data is limited in T2DM patients. We sought to identify how the lockdown affected the glycemic control of adult patients with T2DM within a specific region of New York Design & Methods: In this retrospective cohort study, we analyzed data from patients with regular outpatient visits within an integrated-delivery health system in South Bronx, New York who had A1C levels measured within 6 months prior to the initiation of lockdown (Mar ’20) and a repeat A1C within 3 months after the first phase of reopening in New York (June ’20). Analysis of comparison between pre- and post-lockdown HbA1c values was performed using paired samples T-test. Results: A total of 2489 adult patients with an established diagnosis of T2DM and A1C levels available during the study period were identified. 632 patients were excluded due to pregnancy, prediabetes, new-onset diabetes, residency in long-term care facility or hospital admission during the study period. Age range was 18 to 95 years with a mean age of 61. 58% of the patients were female and 41% male. Mean pre-lockdown A1C was 7.64% and mean post-lockdown A1C was 7.76%, indicating an increase of 0.122% (95% CI, 0.0613-0.1827) Conclusions: The COVID-19 lockdown was associated with a small but statistically significant increase in HbA1C levels (0.122%) in a large cohort of community-dwelling adult patients with type 2 diabetes in South Bronx. Interruptions to regular outpatient care, difficulty in obtaining medications from pharmacies, changes in physical activity or diet and psychological stress related to the pandemic may have been potential contributing factors and need to be addressed to avoid further worsening of diabetes control in the longer term. Disclosure I. O. Malik: None. K. Naher: None. K. Thrupthi: None. B. Zaidi: None. V. Leung: None.