In vitro lipid peroxidation of tissue cultured and tissue culture derived mentha plant.

The effect of tissue cultured and tissue culture derived Mentha species viz. Mentha piperita(PPR611), Mentha arvensis (SH) and Mentha spicata (SPR 8) on antioxidant potential using lipid peroxidation model was studied. The extracts prepared were analyzed for total phenols and flavonoids. Tissue cultured derived plants were found to have higher content of total phenols and flavonoids. Furthermore, Mentha spicata (SPR 8) was found to possess higher content of total phenols, however, flavonoid content of tissue cultured samples was more compared to tissue culture derived plants in Mentha arvensis (SH) and Mentha spicata (SPR 8).Tissue cultured plants of all the three species were more potent in lipid peroxidation inhibition model. Tissue cultured derived plants were less effective in preventing lipid peroxidation and inhibition potential decreased with development period in all the three species.

Invasive candidiasis in pediatric intensive care units.

Candidemia and disseminated candidiasis are major causes of morbidity and mortality in hospitalized patients especially in the intensive care units (ICU). The incidence of invasive candidasis is on a steady rise because of increasing use of multiple antibiotics and invasive procedures carried out in the ICUs. Worldwide there is a shifting trend from C. albicans towards non albicans species, with an associated increase in mortality and antifungal resistance. In the ICU a predisposed host in one who is on broad spectrum antibiotics, parenteral nutrition, and central venous catheters. There are no pathognomonic signs or symptoms. The clinical clues are: unexplained fever or signs of severe sepsis or septic shock while on antibiotics, multiple, non-tender, nodular erythematous cutaneous lesions. The spectrum of infection with candida species range from superficial candidiasis of the skin and mucosa to more serious life threatening infections. Treatment of candidiasis involves removal of the most likely source of infection and drug therapy to speed up the clearance of infection. Amphotericin B remains the initial drug of first choice in hemodynamically unstable critically ill children in the wake of increasing resistance to azoles. Evaluation of newer antifungal agents and precise role of prophylactic therapy in ICU patients is needed.

Negative pressure ventilation in pediatric critical care setting.

Invasive ventilation is associated with both pulmonary and non-pulmonary complications. There has been a renewed interest in the use of negative pressure ventilation (NPV) for various medical conditions to minimise the complications associated with positive pressure ventilation. The routine use of NPV in an ICU setting still requires further studies and research. In this article, the authors review the clinical applications of NPV together with associated risks and limitations. Case reports of patients with cardiac, neuromuscular and respiratory diseases managed with NPV on our unit are described. NPV improved the clinical condition in each of these patients and decreased the requirement for invasive therapy.

Ventilatory strategies and adjunctive therapy in ARDS.

Acute respiratory distress syndrome, a diagnosis based on physiologic and radiological criteria, occurs commonly in critical care setting. A major challenge in evaluating therapies that may improve survival in ARDS is that it is not a single disease entity but, rather, numerous different diseases that result in endothelial injury, where the most obvious manifestation is within the lung resulting in pulmonary oedema. It has been shown that poor ventilatory technique that is injurious to the lungs can propagate systemic inflammatory response and adversely affect the mortality. The current data suggest that high tidal volumes with high plateau pressures are deleterious and a strategy of ventilation with lower tidal volumes and lower plateau pressure is associated with lower mortality. There may be a role for recruitment manoeuvres as well. Other forms of respiratory support still require further research. The present understanding of optimal ventilatory management and other adjunctive therapies are reviewed.

Clinical and microbiological profile of nosocomial infections in the pediatric intensive care unit (PICU).

This study was conducted in PICU of a teaching hospital to estimate the incidence of nosocomial infections, establish the clinical and bacteriological profile and identify probable exogenous source from the environment and personnel. 95 suspected cases of nosocomial infections were studied prospectively, identified as per the guidelines laid down by CDC. The rate of nosocomial infections was 27.3% with an incidence of 16.2 per 100 patient days. The incidence of urinary, respiratory and intravascular catheter related infections was 56.52%, 34.78%, 10.52% respectively. Klebsiella (33.33%) was the most common isolate with maximum sensitivity to amikacin. During the study, an outbreak of MRSA nosocomial infection was encountered and the source was traced to portable suction pump. The risk of nosocomial infection was directly related to the duration of stay in the PICU and duration of placement of indwelling catheters,tubes.