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There are too many problems associated with clinical alarm system in Intensive Care Unit. This study was undertaken to identify and propose rectification to these problems to optimise alarm system performance. The objective of the study is to identify the problems associated with clinical alarm system in Intensive Care Units (ICU), determine the contributing factors and propose ways to improve clinical alarm. In conducting the study it would also be interesting to explore the difference in the way doctors and nurses respond towards alarm system problems. A survey was conducted with 161 clinicians, 137(85%) were registered nurses and medical assistants (MA) and 24(15%) were medical doctors from ICU. Prospective observation study was carried out for a total of 120hrs. Thereon interview sessions with focus group were conducted followed with task analysis to identify the root cause of alarm problems in ICU. In this survey, responses to triggered alarm show that there is no significant difference in the response to clinical alarm system by doctors and nurses. Findings show that 14% of the respondent ignored or switched off the alarm. Outcome of the survey and observation study show that too many alarms is the main problem identified by 78% (n=161, p<0.001) of the respondent. The task analysis indicates this problem is due to lack of integration and harmonisation, improper limit setting, lack of physiological information, no prioritisation of alarms and lack of consideration of human factor in alarm design. Incorporation of these factors in the design can minimise the frequency of alarm triggered thereby improving the performance of the alarm system.)

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To identify the incidence, type, severity and risk factors of common infections in children with type 1 diabetes mellitus (DM). In this prospective observational study design, 125 children with type 1 DM (group1) and age and sex matched 125 non-diabetic children (group2) were followed up for 12 months from a tertiary care children hospital in Chennai. Infections encountered were documented in both the groups throughout the study period. Risk factors were analyzed. Among the diabetic children 46.2% had infections and the total episodes of infections were significantly high (p=0.006). Skin and soft tissue infections (p=0.03) and urinary tract infections (UTI) (p=0.002) were significantly higher in diabetic children and they were more prone to recurrent infections. Mean HbA1c was significantly higher among the diabetic children with skin infections. Children with type 1 DM are more prone to skin and soft tissue infections and UTI. Skin infections are more severe and these children have higher HbA1c levels.Type 1DM accounts for approximately two thirds of all cases of diabetes in children [1]. Adults with diabetes are prone to infections and improved glycemic control decreases the mortality and morbidity associated with severe infections [2]. However contrary to the popular belief this association is not supported by strong evidence in children. Some studies have failed to prove a clear causal relationship between hyperglycemia and infections [2]. Our concern is whether children <12 years with type 1 DM, are more prone for common infections. Current evidence does not favour the fact that infections occur in children with DM in comparison to non diabetic children [3]. Infections of the urinary tract, respiratory tract and soft tissues occur with increased frequency in the overall diabetic population [4]. Available evidence supports the concept that hyperglycemia per se or the metabolic abnormality of diabetes is sufficient to explain the impaired immune response in patients responding to infections. Impaired polymorph function, chemotaxis and killer activities have been found to be responsible for infections in diabetes. The study was undertaken to find out whether children <12 years of age with type 1 DM are at increased risk for common infections. Materials and methodsThis was a prospective observational study conducted at a tertiary care children hospital from Chennai, which provides free medical care to children from the lower socioeconomic strata. The objectives of the study were to identify the incidence, type and severity of common infections in children with type 1 DM and to evaluate the risk factors for infections. 125 Children with diabetes mellitus attending the diabetic clinic (GROUP 1) and an equal number of age and sex matched children without diabetes mellitus were enrolled from the Integrated Child Development Centre (ICDS) and the Corporation school, Egmore, Chennai as the control group (GROUP 2). Children

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