The catheters in the index study lasted on an average for 39 h. Phenytoin, mannitol, blood and blood products were found to significantly influence the survival of the catheters.

Background: Diabetic ketoacidosis (DKA) is characterized by a spectrum of clinical manifestations due to deficiency of insulin which results in hyperglycemia, ketonemia with ketonuria, and metabolic acidosis. Administration of insulin inhibits the production of keto acids and facilitates their metabolism, thereby helps in correcting the acidosis. However, in some situations, the acidosis takes longer to get corrected. Objectives: The aim of this study is to evaluate the factors at admission predicting the duration of acidosis in a child presenting with DKA. Methods: Study Type: This was a retrospective case record review. Inclusion Criterion: All children <15 years who were admitted under the pediatric intensive care unit of a tertiary care hospital from April 2012 to January 2016 with DKA were included in this study. Their demographic data, investigations, treatment details, and length of hospital stay were noted in a predesigned pro forma. Prolonged acidosis was defined as acidosis taking longer than 24 h to resolve. Results: Forty-eight cases met the inclusion criteria; of the 48 cases, 27 (56%) had prolonged acidosis. The median duration of correction of acidosis was 31 h (interquartile range 18.75-48 h/range of 6-192 h). On univariate analysis, children with prolonged acidosis had a low pH (7.1 vs. 7.25), a low serum bicarbonate (4.69 vs. 7.49 mEq/L), base excess (?22.7 vs ?17.04), a high total leukocyte count (TLC) (24,275 vs. 13,557 cells/mm3), and platelet count (450,651 vs. 316,140 cells/mm3) at admission (t-test, p<0.05). On stepwise logistic regression analysis, only low pH and a high TLC were associated with prolonged acidosis.The presence of rhabdomyolysis and myocardial impairment and degree of dehydration at admission which could contribute to prolonged acidosis were not measured in this study. Conclusion: Prolonged acidosis (lasting more than 24 h) was associated with a high TLC and a low pH at admission.

Background: Although the coronavirus pandemic has spared children in terms of severity of disease, it has affected them in other ways by school closure and home confinement.Objectives: To identify dietary and lifestyle changes during and after lockdown and their association with any sociodemographic factors.Method: This was a cross sectional study with an online questionnaire which collected information on meals, vegetable intake, fruit intake, junk food intake and sugary drinks, hours of sleep during the day and night, screen time, time spent on outdoor, indoor, leisure activities and household chores before, during and after lockdown. Results:Our study found a statistically significant increase in number of meals, vegetable and fruit intake, decrease in junk food intake, increase in daytime and night sleep, increase in screen time, decrease in outdoor physical activity and increase in time spent on indoor play, leisure activities and household chores. Change in sleep was more among older children and girls. Post lockdown, boys had an increase in outdoor physical activity and girls had an increase in screen time for educational purposes. Conclusions:The lockdown implemented to contain the pandemic has had a negative effect on the dietary habits and lifestyle of children with a decrease in outdoor physical activity and increase in screen time contributing to an overall increase in sedentary behaviour. There was an increase in time spent on sleep especially in children more than 9 years of age.

Background: Scoring systems in an intensive care unit (ICU) help in monitoring the patient, evaluating the performance of the ICU and in determining the prognosis of the patient. Pediatric Logistic Organ Dysfunction-2 (PELOD-2) is a new scoring system describing organ dysfunction in paediatric intensive care unit (PICU) which has gained importance as a mortality predictor.Objectives: To assess the performance of PELOD-2 in predicting mortality and compare it with Pediatric Risk of Mortality-III (PRISM-III) scoring system.Method: This prospective observational study was carried out in a tertiary care PICU. All consecutive patients with critical illness were scored according to the 2 scoring systems within 24 hours of admission and followed up until discharge or death. Patients admitted for post-surgical care, PICU stay less than 2 hours, death within 8 hours of admission and patients leaving against medical advice were excluded from the study.Results: A total of 550 patients with critical illness was included in study with a median (IQR) age of 60 (12,132) months and a M: F ratio of 1.6. Predicted mortality using PELOD-2 and PRISM-III score was 62 and 63 patients respectively whereas actual mortality was 67 patients. Area under the ROC was 0.992 for PELOD-2 and 0.98 for PRISM-III with a mean difference of 0.0118 with 95% CI (0.00325 to 0.0204) p value of 0.007. Hosmer and Lemeshow goodness of fit test also showed good calibration in predicting mortality for both scoring systems (PELOD-2: ꭓ 2 = 6.051, p value of 0.301, PRISM-III -ꭓ 2 = 9.391, p value= 0.153

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