Sepsis is a leading cause of death and is the most expensive condition to treat in U.S. hospitals. Despite targeted efforts to automate earlier detection of sepsis, current techniques rely exclusively on using either standard clinical data or novel biomarker measurements. In this study, we apply machine learning techniques to assess the predictive power of combining multiple biomarker measurements from a single blood sample with electronic medical record data (EMR) for the identification of patients in the early to peak phase of sepsis in a large community hospital setting. Combining biomarkers and EMR data achieved an area under the receiver operating characteristic (ROC) curve (AUC) of 0.81, while EMR data alone achieved an AUC of 0.75. Furthermore, a single measurement of six biomarkers (IL-6, nCD64, IL-1ra, PCT, MCP1, and G-CSF) yielded the same predictive power as collecting an additional 16 hours of EMR data(AUC of 0.80), suggesting that the biomarkers may be useful for identifying these patients earlier. Ultimately, supervised learning using a subset of biomarker and EMR data as features may be capable of identifying patients in the early to peak phase of sepsis in a diverse population and may provide a tool for more timely identification and intervention.

Objective: Congenital heart disease has an overall incidence of 8 per 1000 live births. It can be grouped into acyanotic congenital heart diseases (without a shunt or with a left to right shunt) and cyanotic congenital heart disease (with a right to left shunt). Cyanotic congenital heart diseases are those inborn lesions of the heart and great vessels in which there is shunting of blood from right side of the heart to the left side with the result that de-oxygenated blood enters the systemic circulation, thereby decreasing its oxygen saturation and causing cyanosis. The commonest of these diseases is Tetralogy of Fallot's. Only a few of these diseases are compatible with life beyond 12 years of age. Methods: The present study was carried out in the department of Pediatrics, Mahatma Gandhi Memorial Medical College, Indore from January 2012 to July 2013 (duration of study was one and half years). During this period thirty children with congenital cyanotic heart disease between 6 months to 5 years of age were included in this study. Blood parameters assessed were Hemoglobin (Hb gm%), Mean Corpuscular Volume (MCV) fl and Ferritin levels. Results: The mean hemoglobin in cyanotic heart disease cases was 13.39 gm/dl with a S.D. of 2.38. In the control group the mean hemoglobin was 9.57 gm/dl with a S.D. of 1.29. Mean MCV in cyanotic heart disease cases was 71.47 fl with S.D. of 9.28 and in controls it was 78.41 fl with a S.D. of 5.87. Mean Ferritin in cases was 41.63 ng/ml with S.D. of 35.04 and in controls it was 78.75 ng/ml with S.D. of 51.40. P value was 0.001 indicating a statistically significant decreased ferritin in cases. Conclusion: Iron deficiency anemia was present in 56.6% of the cases on basis of MCV. The high iron requirements of cyanotic heart disease cases due to increased erythrocytosis induces iron deficiency anemia.There was statistically significant difference in Hb and MCV values between cases and controls. The ferritin level was statistically significantly lower between cases and controls suggesting iron deficient state in CCHD patients. Iron therapy in iron deficient CCHD (based on hematological and iron indices) patients might improve clinical outcome in these patients.

The aim of this study was to evaluate the use of fluoride varnish as a prophylaxis method with self etching primer (SEP) and its comparison with pumice before orthodontic bonding. Thirty seven orthodontic patients participated in a prospective clinical trial. A split mouth technique was used in each patient, one quadrant was assigned to fluoride varnish and the contralateral quadrant to pumice prophylaxis. A total of 684 teeth were bonded with SEP (Transbond plus; 3M Unitek) and monitored for 6 months for bond failures. A total of 42 (6.1%) failures were recorded, 9 (2.6%) in the pumice group and 33 (9.6%) in the fluoride varnish group. Chi-square analysis was used to compare the number of bracket failures between the pumice and fluoride varnish groups and the number of patients in each group experiencing at least one bond failure. Statistically significant differences were found both in total number of bond failures (P < 0.001) and in the number of patients with bond failures (P < 0.05) between both groups. A significantly lower and clinically acceptable bond failure rate was observed with Transbond Plus self etching primer after pumice prophylaxis.

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