Pediatric Sequential Organ Assessment Score: A Comprehensive Review of the Prognostic Marker in the Pediatric Intensive Care Unit.

Critically ill children admitted to the pediatric intensive care unit (PICU) face a substantial risk of morbidity and mortality, regardless of whether they are in developed or developing countries. To aid in treatment planning, various prognostic scoring systems have been developed to predict the likelihood of morbidity and death in these young patients. While the sequential organ failure assessment (SOFA) score has been validated as an independent risk predictor for adult mortality in cases of confirmed or suspected sepsis, it is not suitable for use in children due to its lack of age normalization. Children in critical condition often exhibit significant deviations from the normal physiological balance of their bodies. These deviations from the typical range of physiological variables can be leveraged to estimate the extent of these variations and create scoring systems. In this context, the pediatric SOFA (pSOFA) score was developed by modifying the original SOFA score and incorporating age-adjusted cutoffs for various bodily systems. The objective of this review is to assess the effectiveness of the pSOFA score in predicting sepsis-related mortality in pediatric patients within the PICU setting.

Human Milk Bank in a Rural Setup - A Success Story.

Background: This article describes the experience of a rural human milk bank, with the problems faced in first 6 months including the coronavirus disease (COVID) crisis and interventions leading to success. Methods: The study included individual counselling by dedicated counsellors, focused counselling of primipara mothers seeking the help of obstetricians, counselling of pre-term mothers by neo-natal nurses, periodically delivered information in post-natal wards, and counselling of grandmothers and husbands. Results: The COVID crisis was dealt with donations from reverse transcriptase-polymerase chain reaction-negative mothers with social distancing and mask use. Younger, educated, working mothers with normal delivery and from middle-income families were easy to counsel. Periodic announcements in wards significantly increased awareness about milk banks and donation. Pre-term mothers could be motivated when their baby was nil by mouth or they saw other babies in need of milk. Lactation support to mothers with breast problems, especially in primipara, helps in getting more donors. Counselling of fathers was easier than that of grandmothers. Conclusions: Structured awareness programs and counselling strategies along with education of grandmothers and husbands were very effective in increasing human milk donation.

Perception of Medical Students about Communication Skills Laboratory (CSL) in a Rural Medical College of Central India.

INTRODUCTION: "The art of medicine is intricately tied to the art of communication." In traditional medical curriculum, communication is not taught formally and this leads to a gap in reliability and consistency of the teaching. Few studies have shown that much litigation against doctors is due to lack of communication and not because of lack of clinical expertise. Considering the importance of training in communication skills, it was included in the curriculum of students of DMIMS (DU), which has got probably the first communication skills lab in a medical college in India. AIM: To study the perception of medical students about usefulness of communication skills lab. MATERIALS AND METHODS: This observational study was carried out at Communication Skills Lab (CSL) of Jawaharlal Nehru Medical College, Sawangi (M), Wardha, Maharasthra. Feedback was obtained with the help of a prevalidated questionnaire from 65 final MBBS students about their perception about utility of the module taught in the CSL including factors which helped and which hindered in learning. Descriptive statistics was used for the quantitative data and categorization for qualitative data. RESULTS: A total of 78.46% students were of the idea that CSL posting is must for all medical undergraduates. A 93.83% perceive that the module taught was very relevant and useful and were satisfied with the duration of posting (81.47%). A 78.46% students experienced improvement in their communication skills. They opined that more emphasis should be given on communication between doctor and patient (61.53%). CONCLUSION: The students found communication skills lab very useful. They desired more emphasis on communication between doctor and patient and sought more interactivity, video demonstrations to be part of the module.