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Finally, the review explored the possible contribution of bowel cleansing in post-colonoscopy syndrome that can be related by a transient alteration of gut microbiota. Moreover, the study underlined several points needed to further investigations.In this editorial, the roles of orosomucoid (ORM) in the diagnoses and follow-up assessments of both nonneoplastic diseases and liver tumors are discussed with respect to the publication by Zhu et al presented in the previous issue of World Journal of Gastroenterology (2020; 26(8) 840-817). ORM, or alpha-1 acid glycoprotein (AGP), is an acute-phase protein that constitutes 1% to 3% of plasma proteins in humans and is mainly synthesized in the liver. ORM exists in serum as two variants ORM1 and ORM2. Although the variants share 89.6% sequence identity and have similar biological properties, ORM1 constitutes the main component of serum ORM. An interesting feature of ORM is that its biological effects differ according to variations in glycosylation patterns. This variable feature makes ORM an attractive target for diagnosing and monitoring many diseases, including those of the liver. Recent findings suggest that a sharp decrease in ORM level is an important marker for HBV-associated acute liver failure (ALF), an ORM can be used in histopathological differential diagnosis.[This corrects the article on p. 557 in vol. 25, PMID 34177176.].How to cite this article Das AK, Sharma A, Kothari N, Goyal S. Opium Addiction Practical Issues in ICU. Indian J Crit Care Med 2021;25(9)1082-1083.How to cite this article Anand A, Saigal S, Panda R, Kodamanchili S, Shrivastava P, Das A, et al. Simple Mobile Application for Calculating "Ergotrauma" Made Using an Excel Sheet. Indian J Crit Care Med 2021;25(9)1081.How to cite this article Nath S, Baidya DK. Mucormycosis in COVID-19 Is Zinc a Silent Killer in India? Indian J Crit Care Med 2021;25(9)1079-1080.The world at large cannot afford to miss even a single case of COVID-19 because of its far-reaching consequences; therefore, the diagnostic development to achieve test with much higher sensitivity should be made available at a mass level as early as possible.

Garg SK. Differing Sensitivity of COVID-19 PCR Tests and Consequences of the False-negative Report A Small Observation. Indian J Crit Care Med 2021;25(9)1077-1078.

Garg SK. Differing Sensitivity of COVID-19 PCR Tests and Consequences of the False-negative Report A Small Observation. Indian J Crit Care Med 2021;25(9)1077-1078.How to cite this article Gopaldas JA, Kumar AKA. Ventilator-associatedPneumonia and Lung Ultrasound Finally, What is between the EarsMatters. Indian J Crit Care Med 2021;25(9)1075-1076.How to cite this article Burad J, Kodange S. Neuroleptic Malignant Syndrome due to Atypical Antipsychotics in a COVID-19-positive Pregnant Woman. Indian J Crit Care Med 2021;25(9)1073-1074.The hereditary form of pulmonary alveolar proteinosis (PAP) is an uncommon entity. We report a case of PAP due to colony-stimulating factor 2 receptor alpha (CSF2RA) gene mutation. The standard of care includes whole lung lavage (WLL). We faced two challenges Firstly, a severely hypoxemic patient, and secondly, the nonavailability of appropriate size of double-lumen endotracheal tube for pediatric patients for a WLL while permitting single-lung ventilation. Hence, we performed WLL using venovenous extracorporeal membrane oxygenation (VV ECMO) with a successful outcome. The patient has been discharged and is off oxygen support since more than a year. There are only a few case reports of children having hereditary PAP treated with WLL using ECMO in Indian and Western literature.

Prabhudesai P, Khosla I, Kulkarni S, Arya MK, Pandey A, Yadav N. Bilateral Whole Lung Lavage in Hereditary Pulmonary Alveolar Proteinosis in a 4-year-old Child Using Extra corporeal Membrane Oxygenation. Indian J Crit Care Med 2021;25(9)1069-1072.

Prabhudesai P, Khosla I, Kulkarni S, Arya MK, Pandey A, Yadav N. selleck chemicals llc Bilateral Whole Lung Lavage in Hereditary Pulmonary Alveolar Proteinosis in a 4-year-old Child Using Extra corporeal Membrane Oxygenation. Indian J Crit Care Med 2021;25(9)1069-1072.

Immune dysregulation is one of the main reasons for mortality and morbidity in coronavirus disease 2019 (COVID-19). Mycobacterium w (Mw) is recently approved for gram-negative sepsis. Moreover, it is also found effective in COVID-19 patients in previous studies. The traditional route of administration for Mw is intradermal, which has a limitation of administering 0.1 mL per injection and local injection site reaction. Intravenous (IV) administration of Mw has not been explored in COVID-19. We report the retrospective analysis of six critically ill COVID-19 patients who received Mw (IV).

At baseline, all patients in this case series required O

supplementation, and their inflammatory biomarkers were elevated. All patients received 0.6 mL Mw (high-dose) in normal saline along with the standard-of-care treatment.

After Mw administration, gradual improvement in O

requirement was observed and patients were discharged from the hospital with no mortality. A reduction in mean C-reactive protein (CRP) (51.48-18.52 mg/dL), interleukin-6 (IL-6) (260.22-14.47 pg/mL), and FiO

(81.67-43.33) was also observed. No side effects were observed with the use of Mw by IV route.

Use of 0.6 mL Mw by IV route in this case series was associated with decreased O

supplementation without any side effects in critically ill patients of COVID-19.

Patel PS, Patel S, Shah V, Aswani V, Narwaria M. Early Experience of High-dose Intravenous

in Critically Ill Patients of COVID-19. Indian J Crit Care Med 2021;25(9)1066-1068.

Patel PS, Patel S, Shah V, Aswani V, Narwaria M. Early Experience of High-dose Intravenous Mycobacterium w in Critically Ill Patients of COVID-19. Indian J Crit Care Med 2021;25(9)1066-1068.

Identifying ventilated patients ready for extubation is a challenge for clinicians. Premature extubation increases risks of reintubation while delayed weaning increases complications of prolonged ventilation. We compared the duration of mechanical ventilation (MV) and extubation failure in children extubated using a weaning protocol based on pressure support spontaneous breathing trial (PS SBT) vs those extubated after nonprotocolized physician-directed weaning.

A prospective randomized controlled trial was conducted in the pediatric intensive care unit of a tertiary care hospital in children ventilated for ≥24 hours. All eligible patients underwent daily screening and were randomized once found fit. The intervention group underwent PS SBT of 2 hours duration followed by a T-piece trial and extubation. Controls underwent conventional weaning with synchronized intermittent mandatory ventilation mode and a T-piece trial before extubation.

Eighty patients were randomized into two groups of 40 each. About 7ng on Duration of Mechanical Ventilation A Randomized Controlled Trial. Indian J Crit Care Med 2021;25(9)1059-1065.

This study presents a real-world scenario for prescription pattern, efficacy, and safety data on the current clinical use of intravenous fosfomycin in critically ill patients in Indian settings.

This was a retrospective cohort study conducted for a period of 10 months among critically ill patients admitted to hospital's critical care unit. The primary objective of the study was to analyze the prescription pattern of intravenous fosfomycin, and the secondary objective was to evaluate the safety profile and patient outcomes.

A total of 309 patients were enrolled, and they were diagnosed with bacteremia (45.3%), pneumonia (15.85%), septic shock (14.24%), and urinary tract infections (UTI) (13.91%). The average dose of fosfomycin given was 11.7 ± 4.06 gm/day. The average duration of the therapy was 4.85 ± 3.59 days with a median duration of 4 days. Fosfomycin was given at 8 hourly dosing frequency to maximum (45.6%) cases. Hypokalemia was the most observed adverse event. The overall survival was seen in 55% of patients.

Our data suggest that UTI, infection caused by

and a daily dose of >12 g were associated with better clinical outcomes. The overall survival of critically ill patients receiving fosfomycin was 55%.

Zirpe KG, Mehta Y, Pandit R, Pande R, Deshmukh AM, Patil S,

. A Real-world Study on Prescription Pattern of Fosfomycin in Critical Care Patients. Indian J Crit Care Med 2021;25(9)1055-1058.

Zirpe KG, Mehta Y, Pandit R, Pande R, Deshmukh AM, Patil S, et al. A Real-world Study on Prescription Pattern of Fosfomycin in Critical Care Patients. Indian J Crit Care Med 2021;25(9)1055-1058.

The aim of this review is to evaluate the global scientific literature on the utility of plasma presepsin (PSP) as a prognostic biomarker in a homogeneous group of coronavirus disease 2019 (COVID-19) positive cases.

A systematic review utilizing Medline (PubMed interface), LitCovid NLM, World Health Organization (WHO)-global literature on coronavirus disease, and EBSCO CINAHL Plus was undertaken. The study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) group guidelines. The quality of individual evidence and possible risk of bias were assessed using the Quality in Prognosis Studies (QUIPS) tool. A narrative synthesis-based conclusion was compiled.

A total of three articles passed through the predefined screening criteria and were included in the review. Methodological quality was evaluated to be acceptable. The aggregate study population was summed up to be 167 COVID-19 positive cases, who had undergone analysis of plasma PSP levels for the prediction of severity and mortality. Based on different PSP cutoffs utilized, a statistically significant association between PSP and COVID-19 severity was reported.

PSP appears as a promising prognostic biomarker of COVID-19 progression. As data are scarce on its utility, large cross-sectional studies are needed.

Ahmed S, Mansoor M, Shaikh MS, Siddiqui I. Presepsin as a Predictive Biomarker of Severity in COVID-19 A Systematic Review. Indian J Crit Care Med 2021;25(9)1051-1054.

Ahmed S, Mansoor M, Shaikh MS, Siddiqui I. Presepsin as a Predictive Biomarker of Severity in COVID-19 A Systematic Review. Indian J Crit Care Med 2021;25(9)1051-1054.Compassion has been one of the greatest virtues of healthcare professionals. In the early phase of the pandemic, a lot of caution was essential, and restrictions were imposed on the hospital visitation of the COVID-19 patients by their family members. The healthcare system was overburdened, and the healthcare workers were apprehensive about the new virus and the rising mortality. Compassion and family-centered care took a step back as survival of the pandemic became the ultimate goal of mankind. "COVID-19 patients admitted to the critical care units, their loved ones and the healthcare professionals caring for these patients took the brunt of the emotional and psychological impacts of the pandemic." However, as we have moved more than a year into the pandemic, knowledge and resources we gained may be leveraged to provide family-centered critical care for COVID-19 patients. Family presence in intensive care units (ICUs) has been associated with higher satisfaction with care, collaboration with the medical team, shared decision-making, reduced delirium, and optimized end-of-life care of COVID-19 patients.