Objectives:To determine the incidence and study association of hyperglycemia with outcome of critically ill children.Setting and Design:This was a prospective observational study conducted in eight bedded pediatric intensive care unit (PICU) of a tertiary care hospital.Materials and Methods:One hundred and one critically ill non-diabetic children between ages of 1 month to 16 years were studied from the day of admission till discharge or death. Serial blood sugars were determined first at admission, thereafter every 12 hourly in all children. Blood glucose level above 126 mg/dl (>7 mmol/dl) was considered as hyperglycemia. Children with hyperglycemia were followed 6 hourly till blood glucose fell below 126 mg/dl. Hyper and non-hyperglycemic children were compared with respect to length of stay, mechanical ventilation, use of inotrops and final outcome. Survivors and non-survivors were compared in relation to admission blood glucose, peak blood glucose level and duration of hyperglycemia.Results:Seventy (69.3%) children had hyperglycemia. Requirement of ventilation [(23) 32.9% vs.(3) 9.7%], requirement of inotropic support [(27) 38.6% vs.(5) 16.1%], Mean length of stay in PICU (7.91 ± 5.01 vs. 5.58 ± 1.95 days) and mortality (28.6% vs. 3.2%) among hyperglycemic children was significantly higher (P < 0.05) than that of non-hyperglycemic. Logistic regression analysis showed Peak blood glucose level and duration of hyperglycemia has independent association with increased risk of death.Conclusion:Incidence of hyperglycemia is high in critically ill children and it is associated with high morbidity and mortality.

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Objective?The aim of this study is to validate Pediatric Risk of Mortality (PRISM) and Pediatric Index of Mortality (PIM) scoring systems in a pediatric intensive care unit (PICU) in India. Design?This is a single-center prospective cohort study. Setting?This study was conducted at an eight-bed PICU. Methods?PRISM- and PIM-based predicted mortality rates were calculated and compared in 120 pediatric patients. Results?Estimated mortality using PRISM (5.68%) and PIM (8.84%) was lower than observed (21.7%) mortality. PIM had slightly better power of calibration than PRISM. The discriminatory performance of both models was comparable. Conclusion?Both models can be validated with suitable changes according to PICU settings of India.

The pentalogy of Cantrell, a rare syndrome, consists of the defects in the anterior diaphragm, diaphragmatic pericardium, lower sternum and supraumbilical abdominal wall, along with congenital cardiac abnormalities. Till date, only few patients with full spectrum of this syndrome have been reported with only 2 cases showing associated exencephaly and spinal dysraphism. We report extremely rare association of complete pentalogy of Cantrell syndrome with exencephaly and spinal dysraphism on antenatal sonogram and autopsy in a 18 weeks fetus of a 19 year-old primi gravida female.