The effect of exchange transfusion on prooxidant-antioxidant balance in newborns Jaundice

Introduction: Newborns have a limited amount of antioxidant protection. Exchange transfusion may affect Prooxidant-Antioxidant Balance (PAB). The present study is conducted to investigate the effect of the exchange transfusion on PAB in newborn jaundice. Methods: The present study is based on a clinical trial which is conducted at Ghaem Hospital in Mashhad, Iran during 2015-2016 that involved sampling on 22 jaundiced newborns (high bilirubin of 17 mg/dL) over a course of 35 weeks. Data collection for the study questionnaire included maternal blood group, neonatal characteristics (age, sex, weight, gestational age, Apgar score, etc.), and laboratory assessment (bilirubin, hematocrit, direct and indirect Coombs testing, reticulocytes, Glucose-6-phosphate dehydrogenase (G6PD), thyroxine (T4), thyroid stimulating hormone (TSH), and PAB). The amount of PAB and serum total bilirubin (STB) of newborns before, after and 6 hours after the exchange transfusion were investigated. Data analysis was performed via statistical tests (paired t-test) using SPSS version 19. Results: The average bilirubin before the exchange transfusion was 22.02±5.80 mg/dL, after the exchange transfusion was 11.56±3.95 mg/dL, and at 6 hours after the exchange transfusion was 14.99±4.20 mg/dL. The average PAB before the exchange transfusion was 19.06±11.91 HK units, after the exchange transfusion was 29.40±17.70 HK, and at 6 hours after the exchange transfusion was 40.82±18.79 HK. Conclusion: The results of the study show that the Prooxidant-Antioxidant balance in the exchange transfusion changes in favor of prooxidants and also intensifies even up to 6 hours after the exchange transfusion.

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Neonatal Hyperbilirubinemia Associated With Glucose-6-Phosphate Dehydrogenase Deficiency in Sephardic-Jewish Neonates: Incidence, Severity, and the Effect of Phototherapy

PEDIATRICS ◽

10.1542/peds.90.3.401 ◽

1992 ◽

Vol 90 (3) ◽

pp. 401-405

Author(s):

Michael Kaplan ◽

Ayala Abramov

Keyword(s):

Exchange Transfusion ◽

Serum Bilirubin ◽

Statistical Significance ◽

Neonatal Hyperbilirubinemia ◽

Control Group ◽

Serum Total Bilirubin ◽

Study Group ◽

Show Evidence ◽

Term Newborns ◽

Glucose 6 Phosphate Dehydrogenase

Glucose-6-phosphate dehydrogenase (G-6-PD) deficiency is frequently associated with neonatal hyperbilirubinemia, and sometimes kernicterus, often in the absence of any identifiable trigger or hematological evidence of hemolysis. The aim of this study was to compare the incidence and severity of, and the effect of phototherapy on, jaundice in G-6-PD-deficient vs G-6-PD-normal neonates in the Sephardic-Jewish community. Healthy term newborns, born to mothers of families stemming from geographic areas known to be "at risk" for G-6-PD deficiency, were screened for the condition and surveyed for hyperbilirubinemia. Seventy-five G-6-PD-deficient neonates formed the study group, while 266 neonates with normal levels of the enzyme formed the control group. Neonates with any other identifiable cause for jaundice were excluded. Phototherapy was commenced when the serum bilirubin levels reached 16 mg/dL (274 µmol/L) or more, and it was discontinued at 12 mg/dL (205 µmol/L) or less. Hyperbilirubinemia developed in 27 (36%) of the deficient neonates (serum total bilirubin >13.9 mg/dL [238 µmol/L]), compared with 50 (18.8%) of control neonates (P = .002), while 20 (26.7%) of the study group required phototherapy, compared with 31 (11.7%) of control neonates (P = .002). Two neonates in the study group required exchange transfusion (serum bilirubin >20 mg/dL [342 µmol/L]), vs 0 in the control group (not significant). Further analysis was performed on male neonates only: despite a tendency for the hyperbilirubinemia to behave differently with regard to peak bilirubin levels, age at the time of the peak, duration of phototherapy, and rate of bilirubin decrease during phototherapy, these differences failed to attain statistical significance. Values for hematocrit and reticulocyte count did not show evidence of overt hemolysis. Routine daily clinical evaluation and use of phototherapy according to the above criteria made it possible to keep the need for exchange transfusion to a minimum and to prevent kernicterus in this population.

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Newborn Screening for Congenital Hypothyroidism, Congenital Adrenal Hyperplasia, and Glucose-6-Phosphate Dehydrogenase Deficiency for Improving Health Care in India

Journal of Pediatric Intensive Care ◽

10.1055/s-0039-1698424 ◽

2019 ◽

Vol 09 (01) ◽

pp. 040-044 ◽

Cited By ~ 1

Author(s):

Jyotsna Verma ◽

Papai Roy ◽

Divya C. Thomas ◽

Geetu Jhingan ◽

Azad Singh ◽

...

Keyword(s):

Congenital Adrenal Hyperplasia ◽

Newborn Screening ◽

Congenital Hypothyroidism ◽

G6pd Deficiency ◽

Screening Program ◽

Thyroid Stimulating Hormone ◽

Adverse Outcomes ◽

Adrenal Hyperplasia ◽

Birth Prevalence ◽

Glucose 6 Phosphate Dehydrogenase

AbstractNewborn screening (NBS) aims toward early detection of treatable congenital disorders. From January 2008 through December 2017, 13,376 newborns were screened for congenital hypothyroidism (CH), congenital adrenal hyperplasia (CAH), and glucose-6-phosphate dehydrogenase (G6PD) deficiency at Sir Ganga Ram Hospital, India, by measuring G6PD activity, thyroid-stimulating hormone, and 17-hydroxyprogesterone on dried blood specimens. The birth prevalence of 1:2,000 for CH, 1:2,500 for CAH, and 1:125 for G6PD deficiency indicates the latter as the most prevalent. Performance evaluation of testing reveals a robust screening program with 100% sensitivity and >99% specificity. Hence, we recommend NBS for early diagnosis and treatment to prevent adverse outcomes.

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Donor Blood Glucose 6-Phosphate Dehydrogenase Deficiency Reduces the Efficacy of Exchange Transfusion in Neonatal Hyperbilirubinemia

PEDIATRICS ◽

10.1542/peds.2008-2021 ◽

2009 ◽

Vol 123 (1) ◽

pp. e96-e100 ◽

Cited By ~ 17

Author(s):

S. Samanta ◽

P. Kumar ◽

S. S. Kishore ◽

G. Garewal ◽

A. Narang

Keyword(s):

Blood Glucose ◽

Exchange Transfusion ◽

Dehydrogenase Deficiency ◽

Neonatal Hyperbilirubinemia ◽

Donor Blood ◽

Glucose 6 Phosphate Dehydrogenase

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Excessively high bilirubin and exchange transfusion in very low birth weight infants

Yearbook of Neonatal and Perinatal Medicine ◽

10.1016/j.ynpm.2011.07.088 ◽

2011 ◽

Vol 2011 ◽

pp. 144-145

Author(s):

J. Neu

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Exchange Transfusion ◽

Very Low Birth Weight ◽

Low Birth Weight Infants ◽

High Bilirubin

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327 Excessively High Bilirubin and Exchange Transfusion in Very Low Birth Weight Infants

Pediatric Research ◽

10.1203/00006450-201011001-00327 ◽

2010 ◽

Vol 68 ◽

pp. 168-168

Author(s):

J Kuint ◽

A Maayan-Metzger ◽

V Boyko ◽

L Lerner-Geva ◽

B Reichman

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Exchange Transfusion ◽

Very Low Birth Weight ◽

Low Birth Weight Infants ◽

High Bilirubin

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Risk factors and outcome of neonatal jaundice in a tertiary hospital

Ibrahim Medical College Journal ◽

10.3329/imcj.v4i2.6500 ◽

1970 ◽

Vol 4 (2) ◽

pp. 70-73 ◽

Cited By ~ 3

Author(s):

Bedowra Zabeen ◽

Jebun Nahar ◽

N Nabi ◽

A Baki ◽

S Tayyeb ◽

...

Keyword(s):

Risk Factors ◽

Gestational Age ◽

G6pd Deficiency ◽

Exchange Transfusion ◽

Neonatal Jaundice ◽

Complete Blood Count ◽

Birth Asphyxia ◽

Tertiary Hospital ◽

Thyroid Stimulating Hormone ◽

History Of

Neonatal jaundice is a common cause of newborn hospital admission. The risk factors, the characteristics and outcomes related to neonatal jaundice in Bangladesh has not been studied so far. This study addressed the outcomes, characteristics and risks of the jaundiced newborn admitted into hospital. The babies who had significant jaundice and required phototherapy and /or exchange transfusion were investigated. A detailed history of delivery with gestational age was noted and clinical examination of the admitted newborn was done. Birth weight was recorded. The investigations included complete blood count, ABO and Rh compatibility, serum bilirubin, glucose 6 phosphate dehydrogenase (G6PD), thyroid stimulating hormone (TSH) and ultrasonography (USG) of brain. The newborns were closely monitored for the prognosis. The requirement of individualized phototherapy and exchange transfusion were also noted. Finally, the outcomes were recorded. Overall, 60 (m v. f = 58.3 v. 41.7%) newborns were found who developed significant jaundice and were investigated. Of them, 35% had gestational age less than 32wks and only 32% had equal to or greater than 35wks. Regarding delivery, 83.3 % had the history of caesarean section. ABO- and Rh– incompatibilities were found in 13.3% and 3.3%, respectively. Septicemia was diagnosed among 26.7% though blood culture yielded growth only in 20%. Compared with the higher gestational age-group (? 35 wks) the lower group (<32 wks) showed significantly higher rate of septicemia (12.5 v. 68.8%, p<0.005). G6PD deficiency was found in only one (1.7%) case. Birth asphyxia was found as a concomitant factor in three patients. Exchange transfusion was done only in 2 (3.3%) babies. Among them one was preterm IDM with septicemia and other had G6PD deficiency. None of these babies developed kernicterus. Five (8.3%) babies died, all of them had septicemia and one baby also had intraventricular hemorrhage (IVH) with PDA. The study revealed that a substantial number of neonatal jaundice had the history of lower gestational age in Bangladeshi newborns; and the lower gestational age is significantly associated with septicemia and possibly with hyperbilirubinemia. More study is needed to establish the study findings. DOI: 10.3329/imcj.v4i2.6500Ibrahim Med. Coll. J. 2010; 4(2): 70-73

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Relation between Circulating Vitamin k2 level and Osteoporosis in Post-Menopausal Women

QJM ◽

10.1093/qjmed/hcab116.002 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Dina M Abdel Aziz ◽

Hala A Saleh ◽

Neven M Taha ◽

Mohga A Elbadawy

Keyword(s):

Bone Mineral Density ◽

Bone Mineral ◽

Liver Function Tests ◽

Thyroid Stimulating Hormone ◽

Vitamin K2 ◽

Mineral Density ◽

Laboratory Assessment ◽

Cross Sectional ◽

Post Menopausal Osteoporosis ◽

Post Menopausal

Abstract Objective We aimed to measure the serum level of vitamin k2 in postmenopausal osteoporotic patients to determine its role in the disease. Patients and Methods Our study was designed as a cross sectional study, with 15 postmenopausal osteoporotic patients (with reduced bone mineral density BMD), aged between 54-58 years old compared to 15 healthy controls (with normal BMD at all of lumbar spine, femoral neck and hip) matched in age with the patients. All participants were subjected to full medical history taking, physical examination and functional assessment of the activity of daily livings (ADL). Biochemical assays of thyroid stimulating hormone, parathyroid hormone, total calcium, phosphorus, alkaline phosphatase (ALP), 25-hydroxyvitamin D (25 (OH) D), erythrocyte sedimentation rate, Kidney and liver function tests and serum levels of vitamin k2 were performed. Results The patients showed highly significantly lower vitamin k2 levels (P < 0.05) and non-significant correlations between vitamin k2 and the activity of daily living (ADL) nor the other laboratory assessment parameters (P > 0.05) among the patient’s group. Conclusion Vitamin K deficiency is highly prevalent in the majority of our patients and should be considered an associating factor in the etiology of postmenopausal osteoporosis. Vitamin k2 deficiency could result in a decrease in the bone mineral density in postmenopausal women, so vitamin k2 levels should be checked in post-menopausal osteoporosis and any deficiency must be treated and corrected to improve the bone mineral density.

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Screening of New Born Babies for Thyroid Stimulating Hormone, Glucose-6-Phosphate Dehydrogenase, 17-Hydroxyprogesterone and Sickle Cell Disease

Annals of Clinical Chemistry and Laboratory Medicine ◽

10.3126/acclm.v1i2.13253 ◽

2015 ◽

Vol 1 (2) ◽

pp. 27-30

Author(s):

Mukunda Raj Kalouni ◽

Z G Badade ◽

Nimain Mohanty ◽

Bhup Dev Bhatta ◽

Bhupendra R Pandey ◽

...

Keyword(s):

Sickle Cell Disease ◽

Congenital Adrenal Hyperplasia ◽

Sickle Cell ◽

Colorimetric Assay ◽

Thyroid Stimulating Hormone ◽

Adrenal Hyperplasia ◽

Cell Disease ◽

Blood Samples ◽

Glucose 6 Phosphate Dehydrogenase ◽

Stimulating Hormone

BACKGROUND: The expanded newborn screening programme has now initiated worldwide. Many of the countries around the world made this programme mandatory. The effect of such screening system gives the advantage or betterment to the society as well as the nation.METHODS: Samples were collected from babies aged 48-72 hours by heel prick method in a filter paper provided by Bio-Rad. The written consent was taken from the parents before collecting the blood samples. Blood samples were assayed for TSH and17-OHP by Enzyme Immuno Assay (EIA), G-6-PD was estimated by colorimetric assay provided by Bio-Rad Laboratories, USA and Sickle Cell Disease by sickling testRESULTS: A total of 715 newborns were screened for TSH, G-6-PD, 17-OHP and Sickle cell disease. Out of which 1 neonate found abnormal (increased) thyroid stimulating hormone (1/715), and 8 neonates were G-6-PD deficient (8/715). We did not find any cases of congenital adrenal hyperplasia and sickle cell disease.CONCLUSIONS: In this study the prevalence of Congenital Hypothyroidism and Glucose-6-Phosphate dehydrogenase deficiency was found to be 1:715 and 1:89 respectively. No cases of congenital adrenal hyperplasia and sickle cell disease were found.

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