Indian Institute Research Articles

All India Institute of Medical Sciences (AIIMS), Delhi: Cyberattack Puts Digitalisation Under Scanner

‘I Dream of a Digital India where cyber security becomes an integral part of National Security’—Narendra Modi Fulling this dream one as to realise the fact ‘Cyber Security is not easy. But it comes down to three basic principles—PROTECT, DETECT AND RESPOND as early as possible’—Advent from AIIMS Case The All India Institute of Medical Sciences (AIIMS), a top public medical research facility and hospital with headquarters in New Delhi, India, announced a sophisticated cyber-incident on its servers on 23 November 2022. Several patient care services were rendered unavailable as a result of the incident, including registration, admission, billing and discharge. Several news sources claim that this cyber event, which affected the e-services of the AIIMS (New Delhi) starting at 7:00 a.m. on 23 November 2022, was of the ransomware variety. The testing runs of the e-hospital server were successful, and the majority of the lost data had been recovered during the previous few days, according to AIIMS authorities’ confirmation on 6 December 2022. The case provides background on the healthcare industry and a brief analysis of the incident, along with the measures taken to prevent such attacks in the future.

IJCM_380A: Shaping Medical Assessment with Expert Consensus: A Theory-Based: Summative Evaluation Blueprint for Community Medicine

Background: Despite their constraints and failure to adhere to evaluation criteria, conventional written assessment methods are still widely and often used in many medical colleges. The partiality and inclination of the topic setter are apparent. This results in the overrepresentation of certain themes while leaving many others neglected. Every examiner possesses their own bias and tends to construct questions according to their specific areas of expertise. The distribution and arrangement of the questions are still ambiguous for learners. Several authors have suggested comprehensive evaluation frameworks for different levels of cognitive domains. Objective: This study sought to create a theory-based summative evaluation blueprint by involving experts from the All-India Institute of Medical Sciences. Methodology: Twenty-five experts from 10 All India Institutes of Medical Science were invited via email and contributed for summative assessment for a theory paper. Each week, the study lead team sent an online form containing 25 topics. A total of 269 topics were selected to be included in the blueprint development. An Impact and Frequency score was obtained for each topic, with a score between 1 and 3 for both its “Impact (I)” and “Frequency” (F). Results: The overall response rate was 71%. “Principle of epidemiology” (14.7%) had the most weight, followed by “Epidemiology of communicable disease” (13.4%) and “National Health Program” (10%). These three chapters constituted more than one-third of the total weight of the summative assessment (theory). 20 out of 24 (83%) chapters have moderate-to-good interrater reliability. Conclusion: The proposed blueprint will serve as a reference for setting the question paper and will impart objectivity, uniformity, and validity to the construction of the written assessment tool.

Repurposing of dextromethorphan as an adjunct therapy in patients with major depressive disorder: a randomised, group sequential adaptive design, controlled clinical trial protocol

BackgroundTherapeutic latency, lack of efficacy and adverse drug reactions are the major concerns in current antidepressant therapies. To overcome these treatment hurdles, add-on therapy to conventional antidepressant medications may lead...

Knowledge and attitude on childhood cancer survivorship among healthcare trainees: a multicentre study from India

BackgroundThe proportion of childhood cancer survivors (CCS) in low/middle-income countries (LMICs) is rising. CCS often develop several physical and psycho-social long-term adverse effects, with unique healthcare needs. Primary healthcare providers...

HARNESSING THE SYNERGY OF HR AND MARKETING IN INDIA'S FINANCIAL SECTOR: STRATEGIES FOR SEIZING OPPORTUNITIES AND SURMOUNTING CHALLENGES TO BOOST PERFORMANCE

In the dynamic and competitive landscape of India’s financial sector, the integration of Human Resources (HR) and Marketing functions has emerged as a critical strategy to enhance organizational performance. This paper explores the synergy between HR and Marketing, highlighting how their collaboration can lead to a more cohesive brand identity, improved customer experiences, and a motivated workforce. The financial sector in India is undergoing rapid transformation, driven by technological advancements, regulatory changes, and evolving customer expectations. In this context, the alignment of HR and Marketing strategies becomes essential for organizations to stay competitive and responsive to market demands. The paper examines key strategies for harnessing this synergy, such as cross-functional collaboration, aligning employee engagement with brand values, and leveraging data-driven insights to foster innovation. It also addresses the challenges that organizations may face in implementing these strategies, including cultural barriers, resistance to change, and the need for continuous upskilling of employees. Through a comprehensive review of literature and case studies from leading financial institutions in India, this paper identifies best practices for creating a seamless integration of HR and Marketing functions. The findings suggest that organizations that successfully leverage this synergy are better positioned to seize market opportunities, enhance customer loyalty, and drive sustainable growth.

Rise in the Pathogenic Status of Coagulase-Negative Staphylococci Causing Bloodstream Infection.

Coagulase-negative staphylococci (CoNS) are one of the frequently isolated bacteria from blood cultures. Since they are part of the normal skin flora, they were previously considered contaminants. But now, they can be considered as established pathogens causing bloodstream infection (BSI). This study aims to estimate the prevalence of CoNS in BSI cases. This study was conducted at the Microbiology Department, All India Institute of Medical Sciences (AIIMS), Raipur, India, for eight months (January 2022 to August 2022). Data were collected retrospectively from medical and laboratory records. Paired blood cultures from 5085 clinically suspected sepsis cases were subjected to aerobic culture for five days in the BacT ALERT 3D system. Pathogenicity was established after recovery of CoNS from paired blood cultures of symptomatic patients. CoNS were isolated from 2.35% of patients, the most common species being Staphylococcus haemolyticus (51.67%). About 90% of isolates were methicillin-resistant. All the isolates were susceptible to linezolid, teicoplanin, and vancomycin, except one isolate of S. haemolyticus which was intermediate to vancomycin. Minimum inhibitory concentration (MIC) 50 and MIC 90 for vancomycin were 1 ug/ml and 2 ug/ml, respectively. Conclusion: Paired blood cultures are necessary to determine the pathogenicity of CoNS in BSI cases. A high prevalence of methicillin resistance, accompanied by high resistance rates to other non-beta lactam antibiotics, warrants the strict implementation of antimicrobial stewardship practices.

Development and Clinical Evaluation of a CRISPR/Cas12a-Based Nucleic Acid Detection Platform for the Diagnosis of Keratomycoses

ObjectiveThe objective of this study was to develop a rapid and accurate CRISPR/Cas12a-based molecular diagnostic assay (Rapid Identification of Mycoses using CRISPR, RID-MyC Assay) to detect fungal nucleic acids and to compare it with existing conventional mycologic methods for the diagnosis of fungal keratitis (FK). DesignThis study was structured as a development and validation study focusing on the creation and assessment of the RID-MyC assay as a novel diagnostic modality for FK. SubjectsParticipants comprised 142 individuals presenting with suspected microbial keratitis at three tertiary care institutions in South India. MethodsThe RID-MyC assay utilized recombinase polymerase amplification (RPA) targeting the 18S rRNA gene for isothermal amplification, followed by a CRISPR/Cas12a reaction. This was benchmarked against microscopy, culture, and polymerase chain reaction (PCR) for the diagnosis of FK. Main Outcome MeasuresThe primary outcome measures focused on the analytical sensitivity and specificity of the RID-MyC assay in detecting fungal nucleic acids. Secondary outcomes measured the assay's diagnostic sensitivity and specificity for FK, including its concordance with conventional diagnostic methods. ResultsThe RID-MyC assay exhibited a detection limit ranging from 13.3 to 16.6 genomic copies across four common fungal species. In patients with microbial keratitis, the RID-MyC assay showed substantial agreement with microscopy (kappa = 0.714) and fair agreement with culture (kappa = 0.399). The assay demonstrated a sensitivity of 93.27% (95% CI, 86.62% - 97.25%) and a specificity of 89.47 % (95% CI, 66.86 % - 98.70 %) for FK diagnosis, with a median diagnostic time of 50 minutes (range, 35 - 124 minutes). ConclusionThe RID-MyC assay, utilizing CRISPR-Cas12a technology, offers high diagnostic accuracy for FK. Its potential for point-of-care use could expedite and enhance the precision of fungal diagnostics, presenting a promising solution to current diagnostic challenges.

The safety and immunogenicity of a bivalent conjugate vaccine against Salmonella enterica Typhi and Paratyphi A in healthy Indian adults: a phase 1, randomised, active-controlled, double-blind trial

Enteric fever caused by Salmonella enterica Typhi and Salmonella Paratyphi A is an important public health problem, especially in low-income and middle-income countries with limited access to safe water and sanitation. We present results from, to our knowledge, the first ever human study of a bivalent paratyphoid A-typhoid conjugate vaccine (Sii-PTCV). In this double-blind phase 1 study, 60 healthy Indian adults were randomly assigned (1:1) to receive a single intramuscular dose of either Sii-PTCV or typhoid conjugate vaccine (Typbar-TCV). Safety was assessed by observing solicited adverse events for 1 week, unsolicited events for 1 month, and serious adverse events (SAEs) over 6 months. Immunogenicity at 1 month and 6 months was assessed by measuring anti-capsular polysaccharide antigen Vi (anti-Vi) IgG and IgA against Salmonella Typhi and anti-lipopolysaccharide (LPS) IgG against Salmonella Paratyphi A by ELISA, and functional antibodies using serum bactericidal assay (SBA) against Salmonella Paratyphi A. This study is registered with Clinical Trial Registry-India (CTRI/2022/06/043608) and is completed. 60 participants were enrolled. Of these 60 participants, 57 (95%) participants were male and three (5%) participants were female. Solicited adverse events were observed in 27 (90%) of 30 participants who received Sii-PTCV and 26 (87%) of 30 participants who received Typbar-TCV. The most common local solicited event was pain in 27 (90%) participants who received Sii-PTCV and in 23 (77%) participants who received Typbar-TCV. The most common solicited systemic event was myalgia in five (17%) participants who received Sii-PTCV, whereas four (13%) participants who received Typbar-TCV had myalgia and four (13%) had headache. No vaccine-related unsolicited adverse events or SAEs were reported. The seroconversion rates on day 29 were 96·7% (95% CI 82·8-99·9) with Sii-PTCV and 100·0% (88·4-100·0) with Typbar-TCV for anti-Vi IgG; 93·3% (77·9-99·2) with Sii-PTCV and 100·0% (88·4-100·0) with Typbar-TCV for anti-Vi IgA; 100·0% (88·4-100·0) with Sii-PTCV and 3·3% (0·1-17·2) with Typbar-TCV for anti-LPS (paratyphoid); and 93·3% (77·9-99·2) with Sii-PTCV and 0% (0·0-11·6) with Typbar-TCV for SBA titres (paratyphoid). Paratyphoid anti-LPS immune responses were sustained at day 181. Sii-PTCV was safe and immunogenic for both typhoid and paratyphoid antigens indicating its potential for providing comprehensive protection against enteric fever. Serum Institute of India.

Disentangling the relationship between institutional influence, transformational leadership and performance in higher educational institutions in India: a three-way interaction model

PurposeThe present study aims to investigate the relationship between institutional influence and performance, mediated through transformational leadership (TL) and moderated by barriers, situational factors, communication and implementation.Design/methodology/approachUsing a structured survey instrument, data were collected from 370 faculty members from 31 higher educational institutions in southern India. After checking the psychometric properties of the instrument, the authors used Hayes’s PROCESS to test the direct hypotheses and three-way interactions.FindingsThe results revealed that TL mediated the relationship between institutional influence and performance. Further, the findings supported the three-way interactions between (1) institutional influence, barriers and communication positively affecting TL; and (2) TL, situational factors and implementation affecting the performance of faculty members.Research limitations/implicationsThis study underscores the importance of TL for the smooth functioning of higher educational institutions and achieving superior performance, especially in the new normal context after the global pandemic.Practical implicationsThis study makes several significant recommendations to administrators in higher educational institutions, in addition to contributing to the vast literature on TL. The study suggests that administrators must invest resources in developing TL skills so that employees reach their fullest potential and contribute to achieving organizational goals. In addition, leaders in organizations need to exercise a transformational style to combat the new normal post-pandemic academic environment.Originality/valueThis study provides new insights into the importance of TL style and institutional influence to enhance performance. To the best of our knowledge, the conceptual model developed and tested the first of its kind in India, significantly contributing to theory and practice.

Comparative Analysis of Periodontal Parameters and Patient Satisfaction Utilising Different Temporary Crown Fabrication Techniques: A Parallel-Group Randomised Controlled Trial.

Aim The study aims to evaluate the efficacy of different techniques for temporary crown fabrication in maintaining periodontal health and patient satisfaction, addressing a critical gap in the existing literature and informing evidence-based clinical practices. Materials and methods This study, conducted in accordance with CONSORT guidelines, was a parallel-group randomised trial conducted at a dental institute in India. In total, 36 participants aged 18-65 requiring anterior tooth region crowns were randomly assigned to three groups: direct (control), indirect (Test Group 1) and direct-indirect (Test Group 2) fabrication techniques. Participants were selected from outpatient departments based on eligibility criteria, and interventions were allocated using randomization tables. Outcome assessments included gingival health metrics and patient satisfaction levels, with statistical analyses performed using the Kruskal-Wallis test. Results Significant differences were observed in the pink esthetic score (PES) and patient satisfaction (P=0.029) among the three groups, with the direct-indirect technique group demonstrating the highest median PES (9 out of 10). However, no significant disparities were noted in the plaque index (PI) or probing depth (PD) among the groups. Conclusion The direct-indirect technique demonstrated superior PES and patient satisfaction, indicating potential benefits for periodontal health and patient experiences. Integration of virtual preparation workflows may optimise outcomes, but further research is needed for validation and guideline development.

Understanding the Awareness of Prenatal Genetic Screening Tests Among Pregnant Women in India: A Cross-Sectional Study.

Introduction Genetic disorders pose a significant health challenge in India, with chromosomal abnormalities ranking second only to congenital anomalies in terms of disease burden. Prenatal testing offers a crucial strategy for identifying and managing these disorders. However, the awareness and understanding of prenatal screening tests among pregnant women in India remain understudied. This study aims to fill this gap by investigating the awareness quotient of prenatal screening tests for genetic disorders among pregnant women in India. Methods A hospital-based cross-sectional study was conducted at the Genetics Unit, Department of Anatomy, and Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Mangalagiri. Ethical clearance was obtained, and data were collected using a self-administered questionnaire covering demographic characteristics and awareness assessment. Descriptive statistics, chi-square tests, and logistic regression analysis were employed for data analysis. Results Among the 200 pregnant women surveyed, the majority demonstrated inadequate awareness of prenatal screening tests for genetic disorders, with only 36.5% possessing adequate knowledge. Significant associations were found between awareness levels and factors such as age, trimester of pregnancy, and education level. Notably, awareness about non-invasive prenatal testing (NIPT) was notably low at 7%, indicating a need for targeted educational interventions. Comparison with international studies revealed varying levels of awareness across different populations, highlighting the influence of socio-cultural factors and healthcare systems. Conclusion This study underscores the need for improved awareness of prenatal screening tests among pregnant women in India. Addressing disparities in awareness, particularly among younger age groups and those with lower education levels, is crucial for informed decision-making in prenatal care. Targeted educational interventions can empower pregnant women to make informed choices, ultimately contributing to better maternal and child health outcomes. Further research should explore the effectiveness of such interventions in diverse settings to enhance prenatal care delivery.

Does higher ranking ensure higher student satisfaction: evidence from higher education institutions in India

PurposeProspective students and other stakeholders in the education system use global and national rankings as a measure of the quality of education offered by different higher educational institutions. The ranking of an Institution is seen as a measure of reputation and has a significant role in attracting students. But are students happy in the top-ranked institutions? Does a high rank translate into high student satisfaction? This study answers this question taking data from top educational institutions in India.Design/methodology/approachThis study examines how the top-ranked higher education institutions in India fare on student satisfaction. Using the data on key performance indicators published by the National Institutional Ranking Framework (NIRF) and student satisfaction scores of these institutions reported by NAAC, the study explores a possible relationship between the ranking of an institution and its student satisfaction score.FindingsThe study finds no significant relationship between the ranking of an institution and its student satisfaction score. The only institutional performance dimension which has a positive correlation with student satisfaction is graduate outcome. The diversity dimension is seen to be negatively correlated with student satisfaction.Practical implicationsThe importance of modifying the ranking frameworks to account for the real drivers of student satisfaction is highlighted. The items in the student satisfaction survey should be regularly updated to reflect the actual concerns of the students. This is very important given the fact that the number of Indian students going abroad for higher education recorded a six-year high in 2022 at 750,365.Originality/valueWith more than 50,000 institutions catering to over 40 million students, India has the largest higher education system in the world. Given the high level of competition among these institutions, ranking and accreditation have become important parameters used by students for selection of an institution. But do top-ranked higher education institutions have the most satisfied student community? The assumption is disproved using the most credible secondary data. This study is the first of its kind in the Indian context. It has huge implications for the most respected ranking frameworks.

Comparison of Clinical Outcomes of Implantation of Foldable Hydrophobic Acrylic Intraocular Lens With and Without Heparin Surface Modification in Indian Diabetic Patients.

Background This study aimed to compare the clinical outcomes of a heparin surface-modified (HSM) hydrophobic acrylic foldable intraocular lens (IOL) (CT LUCIA 601PY) and non-heparin-modified hydrophobic acrylic foldable IOL (AcrySof IQ SN60WF) in diabetic patients undergoingphacoemulsification. Methodology Thisrandomized, single-surgeon, double-masked controlled trial was conducted at Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi. In this randomized controlled trial, 100 eyes of 100 diabetic patients with or without mild-to-moderate diabetic retinopathy were enrolled (HSM IOL, n = 50; non-HSM IOL, n = 50). Outcome measures were aqueous flare, visual acuity, and anterior chamber depth (ACD). These were measured preoperatively as well as one day, one week, one month, three months, six months, and one year postoperatively. Results The HSM IOL group had significantly lower anterior chamber aqueous flare values (photon count/ms) than the non-HSM IOL group on postoperative day one (9.97 ± 5.2 vs. 17.56 ± 11.3, p < 0.001), postoperative week one (11.47 ± 7.78 vs. 17.06 ± 9.4, p = 0.02), and postoperative month three (7.7 ± 4.1 vs. 12.5 ± 5.6, p = 0.004) of phacoemulsification. The corrected distance visual acuity (CDVA) was significantly better in the HSM IOL group on postoperative day one (uncorrected distance visual acuity: p = 0.022; CDVA; p = 0.005), but there was no significant difference at any other follow-ups. ACD was significantly longer in the HSM IOL group at all follow-ups. Conclusions Theimplantation of HSM IOL resulted in significantly lower inflammatory reactions in the early postoperative period in diabetics.

Impact of Cyber-Attacks on Banking Institutions in India: A Study of Safety Mechanisms and Preventive Measures

This study intends to investigate the disastrous effects of cybercrime on financial institutions, as well as the creation of a strong cybersecurity mechanism and attempts to mitigate its effects. Banks are its direct target as of late. Many banks in India are frequently the target of widespread malware attacks, which not only expose private and sensitive data but also result in significant financial losses. This study’s goals are to determine which company sectors are more vulnerable to cyberattacks and to guarantee that cyber security protocols are developed and customized. The report includes case study examination of numerous cyberthreats and crimes that have previously resulted in significant financial loss, as well as secondary data analysis from a variety of online resources, including government websites, journals, and research papers. This essay will offer cyber regime insights that will be advantageous to financial institutions, banks, and society at general.

From Allston to Ahmedabad: American hegemony in management education reexamined

Purpose This paper aims to study the origin story of Harvard Business School’s involvement with the Indian Institute of Management Ahmedabad to study the reasons for the spread of American management education. It introduces both the explicit influence of Cold War politics and Indian development imaginaries to the export of American management thought in the early 1960s. Design/methodology/approach This paper relies on archival research for its primary source material, drawing upon rich archives of documents found at the Baker Library of Harvard Business School. Findings Harvard’s role in Ahmedabad was explicitly influenced by the Cold War anti-communist foreign policy of the USA, but did so opportunistically and contrary to the Ford Foundation’s (FF) original plans. Vikram Sarabhai, who was a key player in the Indian national imaginary of development, invited Harvard on his own initiative and forced the foundation to follow his interests rather than being a mere “subaltern.” Research limitations/implications This paper could additionally add to the historical debate about the scope and periodization of the Cold War and the role of non-state actors. Originality/value This paper covers new ground in exploring the early connection between the Indian development imaginary and business education. It concludes that the export of hegemonic US management education was not successful during Cold War, and the FF was not as dominant as it was made out to be.

Strengthening research capacity of early-mid career researchers: Implementation and evaluation of the Excellence in Non-COmmunicable disease REsearch (ENCORE) program.

High-quality training and networking are pivotal for enhancing the research capacity of early- to mid-career researchers in the prevention and control of non-communicable diseases. Beyond building research skills, these professionals gain valuable insights from interdisciplinary mentorship, networking opportunities, and exposure to diverse cultures and health systems. Despite the significance of such initiatives, their implementation remains underexplored. Here, we describe the implementation and evaluation of the Excellence in Non-COommunicable disease REsearch (ENCORE) program, a collaborative initiative between Australia and India that was launched in 2016 and spanned a duration of 3 years. Led by a consortium that included the University of Melbourne and leading Indian research and medical institutions, ENCORE involved 15 faculty members and 20 early-mid career researchers. The program comprised various elements, including face-to-face forums, masterclasses, webinars, a health-technology conference, and roundtable events. ENCORE successfully trained the early-career researchers, resulting in over 30 peer-reviewed articles, 36 conference presentations, and the submission of seven grant applications, three of which received funding. Beyond individual achievements, ENCORE fostered robust research collaboration between Australian and Indian institutions, showcasing its broader impact on strengthening research capacities across borders.

Development and validation of teachers’ e-readiness scale: a study on higher education institutions in India

PurposeDue to the growing complexity involved in leveraging the endless possibilities of ICT on all levels, the technical competence of faculties of higher education institutions (HEI) and effective methods for fostering e-readiness has become questionable.Design/methodology/approachThis research has developed and validated an empirically supported e-readiness scale, which can be used by HEIs to assess faculty members’ preparedness toward online teaching. The measurement model and the structural model were developed as the results of exploratory factor analysis and confirmatory factor analysis (n = 245). The previously identified components and their indicators were validated using the structural models and the final scale was developed with five dimensions (“online technological readiness, pedagogical readiness, institutional readiness, learning and delivery readiness and content readiness”).FindingsThe faculties’ e-readiness assessment tool, as a useful tool, could aid institutions in identifying problems that affect the implementation of e-learning or digitalization in the institutions and developing strategies in response.Research limitations/implicationsLike any research this research also has some limitations and can be considered as future research probability like the responses for this research were collected from HEI in India; however, a cross-cultural study can be conducted to understand the parameters across the globe. Although the psychometric qualities of the e-readiness scale are acceptable, additional research in various higher educational environments, both nationally and internationally, is required to further establish the scale’s relevance, validation and generalizability.Originality/valueAlthough many scales have been developed to assess the readiness level in the education sector, a scale, that holistically measures, the readiness level of faculties from an overall perspective was required. This scale can be used to recognize the e-readiness level of teachers in HEIs. This scale can also help the institutions assess the readiness level of their faculty members and address any improvements required in their teaching and learning pedagogy, further acknowledging training needs.

Working of Rural Educational Institutions in India Under Right to Education Act, 2009- A Critique

Education has always been considered as a backbone of any society. India is not an exception to it. In order to strengthen the backbone Indian government has made Right to Education a fundamental right through 86th amendment Act. The new article 21 A has been incorporated in part third of the Constitution and for giving effective implementation to it Right to Education Act, 2009 was also passed. In this research paper the researcher intends to probe into the provisions of the Act of 2009 and to carve out its lacunas with reference to functioning of rural educational institutions. The researcher further has analyzed the challenges in the way of rural education and has suggested certain possible solutions to plug the said problems.

Diagnostic Accuracy of Endotoxin and Endotoxin Binding Protein in Late-Onset Neonatal Sepsis.

To evaluate the diagnostic utility of endotoxin and endotoxin binding protein (EBP) for the diagnosis of late-onset neonatal sepsis (LOS) and compare it with the diagnostic utility of C-reactive protein (CRP). This diagnostic study of neonates, both term and preterm, with clinical suspicion of LOS was conducted in a tertiary care institute in India between January 2021 and March 2023. Blood samples were collected for evaluating endotoxin and EBP along with culture. Endotoxin and EBP were measured with enzyme linked immunosorbent assay, CRP was measured by nephelometry method, and the results were compared with blood culture done with BACTEC (gold standard). Out of 160 samples, 73 showed culture positivity. Endotoxin was positive in 81 samples and showed sensitivity of 84%, specificity of 78% and diagnostic accuracy of 81% (AUC 0.837, P value <0.001). EBP was positive in 82 samples and showed sensitivity of 80.8%, specificity of 73% and diagnostic accuracy of 76% (AUC 0.824, P value <0.001). CRP was positive in 105 samples and had sensitivity of 86%, specificity of 51% and diagnostic accuracy of 67% (AUC 0.827, P value <0.001). The present study showed endotoxin and EBP have higher specificity for diagnosing neonatal sepsis. As culture takes minimum 48h, endotoxin and EBP can be utilized as biomarkers for diagnosis of sepsis.

Development of Predictive Models Based on Biochemical Parameters to Triage COVID-19 Patients: A Study Conducted in a Tertiary Care Hospital.

Background The COVID-19 disease continues to cause severe mortality and morbidity. Biochemical parameters are being used to predict the severity of the infection. This study aims to predict disease severity and mortality to help reduce mortality through timely intervention in a cost-effective way. Methods A total of 324 COVID-19 casesadmitted at our hospital (All India Institute of Medical Sciences, Patna, BR, India) betweenJune 2020 to December 2020 (phase 1: 190 patients) and April 2021 to May 2021 (phase 2: 134 patients) were recruited for this study. Statistical analysis was done using SPSS Statistics version 23 (IBM Corp., Armonk, NY, USA) and model prediction using Python (The Python Software Foundation, Wilmington, DE, USA). Results There were significant differences in biochemical parameters at the time of admission among COVID-19 patients between phases 1 and 2, ICU and non-ICU admissions, and expired and discharged patients. Thereceiver operating characteristic (ROC)curves predicted mortality solely based on biochemical parameters. Using multiple logistic regression in Python, a total of four models (two each) were developed to predict ICU admission and mortality. A total of 92 out of 96 patients were placed into the correct management category by our model. This model would have allowed us to preserve 17 of the 21 patients we lost. Conclusions We developed predictive models for admission (ICU or non-ICU) and mortality based on biochemical parameters at the time of admission. A predictive model with a significant predictive capability for IL-6 and procalcitonin values using normal biochemical parameters was proposed. Both can be used as machine learning tools to prognosticate the severity of COVID-19 infections. This study is probably the first of its kind to propose triage for admission in the ICU or non-ICU at the medical emergency department during the first presentation for the necessary optimal treatment of COVID-19 based on a predictive model.