Evaluation of the Severity and Duration of Thrombocytopenia following Exchange Transfusion in neonatal hyperbilirubinemia

2019 ◽  
Author(s):  
Hassan Boskabadi ◽  
Mahdie Mir
Keyword(s):  
Platelet Count ◽  
Cross Section ◽  
Exchange Transfusion ◽  
Neonatal Jaundice ◽  
Month Of Birth ◽  
Recommended Treatment ◽  
Common Causes ◽  
Abnormal Increase ◽  
The Mean ◽  
Convenience Sampling

Background: Infant jaundice is one the most common causes of hospitalization in infant in the first month of birth, which is defined an abnormal increase in blood bilirubin levels. Exchange transfusion is the recommended treatment for neonatal jaundice who do not respond to phototherapy and experience dangerous complication of jaundice and signs of kernicterus. However, this treatment may lead to complications such as thrombocytopenia. This study aimed to investigate the severity and duration of thrombocytopenia following the exchange transfusion in neonatal jaundice. Material and Methods: This cross section study was performed on 217 infants. Infants with a gestational age of 35 to 42 weeks and bilirubin levels of above 17 mg/dl, who were undergoing treated with exchange transfusion, entered in this study. This study was conducted from 2012 to 2018 in the Ghaem Hospital (Mashhad, Iran). The samples were selected by convenience sampling. The platelet count was measured before exchange transfusion, right after exchange transfusion, 6 hours after exchange transfusion, and platelet count continued until platelet level was normal.  At the time of discharge, platelet levels were re-measured. Results: Among the samples, 104(53.8%) were males and 89 (46.2%) females. Of the infants who were transfused, 15 % had thrombocytopenia. After the exchange transfusion, 80 % of infants had thrombocytopenia. The mean platelet count before the exchange transfusion was 299,180 per mm3 of blood, and it was 105.140 per mm3 of blood after the exchange transfusion. With respect to severity of this complication, 86 % of the thrombocytopenia after exchange transfusion was mild to moderate. Conclusion: In this study, nearly one-sixth of the infants who needed exchange transfusions had thrombocytopenia that most of them had platelet of more than 100000.  Thrombocytopenia is associated with jaundice and can be exacerbated by phototherapy.

scholarly journals Post-Exchange Transfusion Sodium Change Within a Laboratory Reference Range of Serum in Hospitalized Severe Neonatal Jaundice Cases

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Amir-Kamal Hardani ◽  
Masood Zadkarami ◽  
Asaad Sharhani ◽  
Shirin Rashidi Mehrabadi
Keyword(s):  
Birth Weight ◽  
Serum Sodium ◽  
Exchange Transfusion ◽  
Neonatal Jaundice ◽  
Reference Range ◽  
Statistical Significance ◽  
Average Birth Weight ◽  
Blood Exchange ◽  
Laboratory Reference ◽  
The Mean

Background: Blood exchange transfusion (ECT) therapy is an essential part of the modern health care for high-risk icteric neonates. Objectives: Therefore, this study sought to examine the effectiveness of monitoring sodium disorders and the required interventions indicating the overall state of health of hospitalized jaundiced neonates. Methods: This prospective analytic study was performed on 49 neonates diagnosed with severe jaundice undergoing screened exchange blood transfusion from November 2018 to May 2019. Serum sodium ion concentrations testing was performed before the exchange, then 1 - 3 hours later, and again 24 hours after receiving ECT, using a sensitive ELISA kit in a laboratory. Using the newest version of SPSS 24 software program, the association between different numerical variables was calculated by a repeated-measure ANOVA test. P < 0.05 criterion was set as the threshold of significance. Results: Out of the total 49 neonates, 24 (48.5%) were girls and 25 (51.5%) were boys, of which 93.9% and 6.1% were term and preterm-born neonates, respectively. The average birth weight was 2843 ± 267/510 g and the mean period of hospital stay was 4.55 ± 2.399 days. The various causes of severe neonatal jaundice of all the hospitalized cases were 45% unknown, 43% combined ABO and Rh incompatibility, 10% breastfeeding pattern, and 2% G6PD deficiency. A continual fall in serum sodium was observed following banked blood exchange (P < 0.05). However, these reversible changes were outside the expected normal range. Despite a diminished sodium concentration, the mean sodium levels were within the laboratory reference range of serum (137 - 142 mEq/L) in all the three measured duration times. Moreover, variation in the amount of serum sodium was associated with an unknown underlying cause that led to neonatal jaundice (P = 0.04) and this difference did not reach statistical significance in terms of birth weight, gestational age, and other causes accounting for high bilirubin (P > 0.05). Conclusions: Given these facts, it was concluded that neonatal jaundice was significantly associated with post-exchange serum sodium changes within the laboratory reference range of serum.

scholarly journals Exchange Transfusion: Indication and Adverse Effect

2012 ◽  
Vol 36 (1) ◽  
pp. 16-19 ◽  
Author(s):  
Suraiya Begum ◽  
Md Abdul Baki ◽  
Gopen Kundu ◽  
Imnul Islam ◽  
Manik Kumar Talukdar ◽  
...  
Keyword(s):  
Adverse Effect ◽  
Adverse Events ◽  
Medical Records ◽  
Exchange Transfusion ◽  
Neonatal Jaundice ◽  
Common Complication ◽  
Abo Incompatibility ◽  
Special Care Baby Unit ◽  
Common Causes ◽  
Rh Incompatibility

Objective: To determine the indication and complications of exchange transfusion (ET) performed for neonatal hyperbilirubinaemia. Methods: The medical records of infants < 28 days old who required exchange transfusion (ET) due to neonatal jaundice in Special Care Baby Unit (SCABU), BIRDEM hospital from January 2009 to April 2010 were retrospectively reviewed. Results: Exchange transfusion was performed in 30 neonates during the study period. Indications of exchange transfusion were ABO incompatibility (30.0%), Rh incompatibility (13.3%), septicaemia (6.6%) and in majority causes, were unidentified (50%). Most common complication were thrombocytopenia (33.3%) hyperkalaemia (20%), hypocalcaemia (16.7%) Conclusion: Indication of ET was unidentified in majority cases and among identified cases most common causes was ABO incompatibility. Adverse events were common after exchange transfusion.DOI: http://dx.doi.org/10.3329/bjch.v36i1.13029Bangladesh J Child Health 2012; Vol 36 (1): 16-19

Acute and Chronic Changes in Platelet Volume and Count After Cardiopulmonary Bypass Induced Thrombocytopenia in Man

1987 ◽  
Vol 57 (01) ◽  
pp. 55-58 ◽  
Author(s):  
J F Martin ◽  
T D Daniel ◽  
E A Trowbridge
Keyword(s):  
Platelet Count ◽  
Mean Platelet Volume ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Control Group ◽  
Artery Bypass Graft ◽  
Platelet Volume ◽  
Young Males ◽  
The Mean

SummaryPatients undergoing surgery for coronary artery bypass graft or heart valve replacement had their platelet count and mean volume measured pre-operatively, immediately post-operatively and serially for up to 48 days after the surgical procedure. The mean pre-operative platelet count of 1.95 ± 0.11 × 1011/1 (n = 26) fell significantly to 1.35 ± 0.09 × 1011/1 immediately post-operatively (p <0.001) (n = 22), without a significant alteration in the mean platelet volume. The average platelet count rose to a maximum of 5.07 ± 0.66 × 1011/1 between days 14 and 17 after surgery while the average mean platelet volume fell from preparative and post-operative values of 7.25 ± 0.14 and 7.20 ± 0.14 fl respectively to a minimum of 6.16 ± 0.16 fl by day 20. Seven patients were followed for 32 days or longer after the operation. By this time they had achieved steady state thrombopoiesis and their average platelet count was 2.44 ± 0.33 × 1011/1, significantly higher than the pre-operative value (p <0.05), while their average mean platelet volume was 6.63 ± 0.21 fl, significantly lower than before surgery (p <0.001). The pre-operative values for the platelet volume and counts of these patients were significantly different from a control group of 32 young males, while the chronic post-operative values were not. These long term changes in platelet volume and count may reflect changes in the thrombopoietic control system secondary to the corrective surgery.

Efektivitas Comprehensive Breastfeeding Education terhadap Keberhasilan Pemberian Air Susu Ibu Postpartum

1970 ◽  
Vol 1 (2) ◽  
Author(s):  
Irma Nurbaeti ◽  
Kustati Budi Lestari
Keyword(s):  
Repeated Measures ◽  
Breastfeeding Support ◽  
Breastfeeding Practices ◽  
Breastfeeding Education ◽  
Repeated Measures Analysis ◽  
Post Test ◽  
Quasi Experimental ◽  
The Mean ◽  
Convenience Sampling ◽  
Postpartum Mothers

Pemberian Air Susu Ibu (ASI) masih merupakan masalah bagi pemenuhan kebutuhan nutrisi bayi baru lahir. Dukungan agar ibu menyusui bayi merupakan hal penting dalam menginisiasi dan mempertahankan pemberian ASI. Strategi dibutuhkan untuk mendukung keberhasilan menyusui. Tujuan penelitian adalah menganalisis efektivitas comprehensive breastfeeding education terhadap keberhasilan pemberian (ASI) pada periode postpartum. Jenis penelitian ini menggunakan kuasi eksperimen one group pre post test repeated measured design. Jumlah sampel sebanyak 22 ibu dengan menggunakan teknik accidental sampling. Pengumpulan data dilaksanakan pada bulan September–Oktober 2013 di Puskesmas wilayah Kota Tangerang Selatan. Intervensi dilakukan selama 30 menit. Pengumpulan data dilakukan sebelum intervensi, 3 hari setelah intervensi (post1), dan 10 hari setelah intervensi (post 2). Pengumpulan data menggunakan kuesioner dan observasi. Keberhasilan pemberian ASI berdasar pada parameter pengetahuan, langkah menyusui, perlekatan bayi, dan kecukupan ASI. Analisis data menggunakan general linear model repeated measureANOVA. Hasil penelitian menunjukkan adanya signifikansi comprehensive breastfeeding education (p=0.001). Rata-rata keberhasilan pemberian ASI sebelum dan setelah intervensi meningkat. Sebesar 93,9% intervensi memengaruhi tingkat keberhasilan. Rata-rata sebelum intervensi 56,74 (SD 5,92), post 1 sebesar 60,83 (SD 6,38) dan post2 sebesar 74,55 (SD 5,32). Subvariabel yang memiliki efek secara signifikan setelah intervensi adalah pengetahuan (p=0.001) dan langkah menyusui (p=0.001), sedangkan subvariabel perlekatan bayi (p=0.061) dan kecukupan ASI (p=0.162) tidak secara signifikan berbeda antara sebelum dan setelah intervensi. Pelaksanaanbreastfeeding education disarankan pada ibu agar dapat melakukan posisi perlekatan bayi yang benar sehingga dapat mengurangi masalah-masalah berkaitan dengan perlekatan yang tidak sesuai seperti puting perih, lecet atau berdarah, dan bayi kurang puas dalam menyusu yang bisa mengakibatkan gagalnya program ASI ekslusif.Kata kunci:Menyusui, pendidikan, perlekatan, postpartum AbstractBreastfeeding have still been problem for adequate newborn nutrition. Adequate breastfeeding support is essential for mothers to initiate and maintain optimal breastfeeding practices. A strategic needed to support successful breastfeeding. The purpose of research is to analyze the effectiveness comprehensive breastfeeding education on successful breastfeeding at postpartum periods. A quasi-experimental one group pretest, post test, repeated mesaured was used. This study was conducted at public health in Tangerang Selatan municipality in September–October 2013 among 22 postpartum mothers, convenience sampling methods. Intervention was done 30 minute. Data were collected before intervention (pretest), third day after intervention (post 1) and tenth day after intervention (repeated/post 2) using four parameter, that are knowledge, breastfeeding steps, proper lacth-on and adequate breastmilk. Using repeated measures analysis of variance there was a significant increase (p=0.001) in the overall Successful breastfeeding mean. Around 93,9% the effectiveness of intervention influence on successful. The mean before intervention is 56,74 (SD 5,92), increased at post 1:60,83 (SD 6,38) and post 2:74,55 (SD 5,32). Subvariable which has effect significantly after intervention is knowledge (p=0.001) and breastfeeding steps (p=0.001), in contrary, proper latch-on (p=0,061) and adequate breastmilk (p=0.162) have no significant effect after intervention. Suggestion to support breastfeeding education and counselling proper latch-on adequately that can decrease the problem such as painful, creaks or bloody putting.Key words: Breastfeeding, education, latch-on, postpartum

scholarly journals Hematological Profile of HIV-Infected Patients on First-Line Highly Active Antiretroviral Therapy and Its Correlation With CD4 Count

2021 ◽  
Author(s):  
John Jospeh Diamond Princy ◽  
Kshetrimayum Birendra Singh ◽  
Ningthoujam Biplab ◽  
Ningthoukhongjam Reema ◽  
Rajesh Boini ◽  
...  
Keyword(s):  
Platelet Count ◽  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Highly Active Antiretroviral Therapy ◽  
Cd4 Count ◽  
Total Leukocyte Count ◽  
Hiv Patients ◽  
Positive Correlation ◽  
Highly Active ◽  
The Mean

Abstract Introduction Human immunodeficiency virus (HIV) infection is a state of profound immunodeficiency. Disorders of hematopoietic system are a common but often overlooked complication of HIV infection. This can manifest at any stage of the disease but more commonly in the advanced stage with low CD4 count. Anemia is the most common hematological abnormality in HIV patients and prevalence ranges from 1.3 to 95%. As HIV disease progresses, the prevalence and severity of anemia also increase. Hence, this study was undertaken to assess the hematological parameters of HIV-infected patients on highly active antiretroviral therapy (HAART) at different treatment durations with the hope to improve the HAART outcome in HIV patients and its correlation with CD4 count. Methods This prospective longitudinal study enrolled 134 HIV-infected patients admitted to or attending the OPD in the Department of Medicine or Antiretroviral Therapy (ART) Center (Center of Excellence), Regional Institute of Medical Sciences (RIMS), Imphal, Manipur, from 2018 to 2020. Complete hemogram, CD4 count, and other related-blood investigations were studied. Results The mean age of the study population was 39.9 ± 11.04 years. Of the 134 patients, 75 (56%) were males and 59 (44%) were females. Twelve (9%) patients had a history of injecting drug use (IDU). TLE (tenofovir, lamivudine, efavirenz) regimen was started on 112 (83.6%) patients and the majority of them (69/134 [51.5%]) had a CD4 count of 200 to 499 cells/mm3, which increased significantly 6 months after HAART to 99 to 1,149 cells/mm3, with a mean of 445 ± 217 cells/mm3. There were significant improvements in hemoglobin (Hb) levels, total leukocyte count (TLC), absolute neutrophil count (ANC), and absolute lymphocyte count (ALC) after HAART indicating a positive correlation with CD4 count (p < 0.05). Thrombocytopenia was observed higher after HAART when compared to baseline. There was a positive correlation between platelet count and CD4 count. However, the mean corpuscular volume (MCV) and erythrocyte sedimentation rate (ESR) had a negative correlation with CD4 count. Conclusion The study inferred a strong positive correlation between CD4 and Hb levels, TLC, ANC, ALC, and platelet count after HAART with improvement in these values as CD4 count increases. Specific treatment intervention based on the changes in the immunohematological profile trends can help prevent most of the adverse effects on HIV patients in our community.

scholarly journals Sources of Variability in the Response of Labeled Microspheres and B Cells during the Analysis by a Flow Cytometer

2021 ◽  
Vol 22 (15) ◽  
pp. 8256
Author(s):  
Adolfas K. Gaigalas ◽  
Yu-Zhong Zhang ◽  
Linhua Tian ◽  
Lili Wang
Keyword(s):  
B Cells ◽  
Laser Beam ◽  
Cross Section ◽  
Mean Fluorescence Intensity ◽  
Numerical Aperture ◽  
Flow Cytometer ◽  
Fluorescence Signal ◽  
Minor Importance ◽  
Reliable Measure ◽  
The Mean

A stochastic model of the flow cytometer measurement process was developed to assess the nature of the observed coefficient of variation (CV%) of the mean fluorescence intensity (MFI) from a population of labeled microspheres (beads). Several sources of variability were considered: the total number of labels on a bead, the path through the laser beam, the optical absorption cross-section, the quantum yield, the numerical aperture of the collection optics, and the photoelectron conversion efficiency of the photomultiplier (PMT) cathode. The variation in the number of labels on a bead had the largest effect on the CV% of the MFI of the bead population. The variation in the path of the bead through the laser beam was minimized using flat-top lasers. The variability in the average optical properties of the labels was of minor importance for beads with sufficiently large number of labels. The application of the bead results to the measured CV% of labeled B cells indicated that the measured CV% was a reliable measure of the variability of antibodies bound per cell. With some modifications, the model can be extended to multicolor flow cytometers and to the study of CV% from cells with low fluorescence signal.

Effects of Pin Shape and Array Orientation on Heat Transfer and Pressure Loss in Pin Fin Arrays

1984 ◽  
Vol 106 (1) ◽  
pp. 252-257 ◽  
Author(s):  
D. E. Metzger ◽  
C. S. Fan ◽  
S. W. Haley
Keyword(s):  
Heat Transfer ◽  
Cross Section ◽  
Pressure Loss ◽  
Flow Direction ◽  
Circular Cross Section ◽  
Cycle Performance ◽  
Mean Flow ◽  
Pin Fin ◽  
The Mean ◽  
Cooling Air

Modern high-performance gas turbine engines operate at high turbine inlet temperatures and require internal convection cooling of many of the components exposed to the hot gas flow. Cooling air is supplied from the engine compressor at a cost to cycle performance and a design goal is to provide necessary cooling with the minimum required cooling air flow. In conjunction with this objective, two families of pin fin array geometries which have potential for improving airfoil internal cooling performance were studied experimentally. One family utilizes pins of a circular cross section with various orientations of the array with respect to the mean flow direction. The second family utilizes pins with an oblong cross section with various pin orientations with respect to the mean flow direction. Both heat transfer and pressure loss characteristics are presented. The results indicate that the use of circular pins with array orientation between staggered and inline can in some cases increase heat transfer while decreasing pressure loss. The use of elongated pins increases heat transfer, but at a high cost of increased pressure loss. In conjunction with the present measurements, previously published results were reexamined in order to estimate the magnitude of heat transfer coefficients on the pin surfaces relative to those of the endwall surfaces. The estimate indicates that the pin surface coefficients are approximately double the endwall values.

A theory of incoherent scattering of radio waves by a plasma

1960 ◽  
Vol 259 (1296) ◽  
pp. 79-99 ◽  
Keyword(s):  
Cross Section ◽  
Thermal Fluctuations ◽  
Incoherent Scattering ◽  
Doppler Broadening ◽  
Radio Waves ◽  
Central Frequency ◽  
Resonance Effects ◽  
Doppler Shifts ◽  
The Mean ◽  
Free Plasma

A theory is developed which describes the scattering of radio waves by the random thermal fluctuations of electron density in a collision-free plasma. The frequency spectrum, as well as the amplitude, of the scattered radiation is calculated. Particular attention is paid to the part of the spectrum which corresponds to small Doppler shifts, this being the region of greatest significance in connexion with the phenomenon of incoherent scattering from the ionosphere. The calculations are based on a generalized version of Nyquist’s noise theorem, and they lead to the following conclusions: (1) The mean scattering cross-section for the ionosphere is equal to that which would exist if each of the electrons scattered independently with a cross-section of one-half the classical Thomson cross-section. (2) The mean Doppler broadening of the scattered signal corresponds roughly to the speed of the ions rather than to that of the electrons. (3) The spectral shape of this signal is not Gaussian. There is a mild maximum in the spectrum away from the central frequency, as can be seen in figure 1. (4) Plasma resonance effects contribute only negligibly to the scattering for frequencies currently of interest.

Burden of Care and Its Relationship with Sleep Quality of Cancer Patients’ Caregivers

2021 ◽  
Author(s):  
Mohammadreza Boostaneh ◽  
Mohammad Zirak ◽  
Ramezan Fallah
Keyword(s):  
Sleep Quality ◽  
Cancer Patients ◽  
Poor Sleep ◽  
Burden Of Care ◽  
Quality Of Sleep ◽  
Study Results ◽  
Northwest Of Iran ◽  
The Mean ◽  
Convenience Sampling

Abstract Purpose: This study aimed to assess the burden of care and its relationship with sleep quality of cancer patients’ caregivers.Methods: This descriptive-correlational study was conducted in a referral center of cancer in Zanjan, northwest of Iran. 135 caregivers of cancer patients were recruited through convenience sampling method. The data were collected using a demographic characteristics questionnaire, Novak and Guest’s caregiver burden inventory and Pittsburgh sleep quality index (PSQI). The collected data was analyzed using descriptive and inferential statistics.Results: The mean (± SD) age of the participants was 39.71 (± 10.74) years. The mean (± SD) burden of care and sleep quality of the participants was 45.22 (± 17.75) and 8.88 (± 4.21), respectively. It was found that there is a significant positive relationship between burden of care and quality of sleep scores (r = 0.65, P < 0.001).Conclusion: cancer patients’ caregivers endure a remarkable burden of care and their sleep quality is undesirable. Results indicated that an increase in the burden of care reduces the caregiver’s quality of sleep. High burden of care and poor sleep quality may reduce the quality of the provided care that increase the costs and weakens the disease prognosis. According to the study results, reducing burden of care is an effective strategy regarding improving the caregivers’ quality of sleep that can improve the quality of provided cares by caregivers.

Neonatal Polycythemia: II. Plasma, Blood, and Red Cell Volume Estimates in Relation to Hematocrit Levels and Quality of Intrauterine Growth

PEDIATRICS ◽  
1981 ◽  
Vol 68 (2) ◽  
pp. 175-182
Author(s):  
Yves W. Brans ◽  
Donna L. Shannon ◽  
Rajam S. Ramamurthy
Keyword(s):  
Birth Weight ◽  
Exchange Transfusion ◽  
Intrauterine Growth Retardation ◽  
Umbilical Vein ◽  
Normal Growth ◽  
Red Cell ◽  
Intrauterine Growth ◽  
The Mean ◽  
Volume Estimates

Volumes of plasma (PV), blood (BV), and red cells (RCV) were estimated within 32 hours of birth in 39 neonates with normal growth, 14 neonates with intrauterine growth retardation, and 20 neonates with macrosomia. Total PV, BV, and RCV increased linearly with birth weight and were unaffected by deviation in the quality of fetal growth. In proportion to body weight, PV/kg, BV/kg, and RCV/kg correlated neither with birth weight nor with the quality of intrauterine growth. Neonates with umbilical vein hematocrit (UV Hct) levels 51% to 60%, 61% to 65%, and 66% to 77% had progressively lower, but not statistically different, mean PV/kg (38.1 ± 4.49, 37.6 ± 5.41, and 34.8 ± 5.16 ml/kg, respectively). On the other hand, they had progressively higher mean BV/kg (90 ± 10.1 vs 101 ± 13.7 ml/kg, P &lt; .002, and vs 110 ± 19.0 ml/kg, P &lt; .001). They also had progressively higher mean RCV/kg (52 ± 7.4, 64 ± 8.7, and 75 ± 16.4 ml/kg, P &lt; .001). Although PV/kg did not correlate with UV Hct, both BV/kg and RCV/kg increased linearly with increasing UV Hct (r = .58 and r = .79, respectively). Volume estimates were repeated after partial exchange transfusion in 29 neonates. Mean UV Hct decreased from 63 ± 5.9% preexchange to 51 ± 5.2% postexchange (P &lt; .001), mean PV increased from 37.7 ± 5.56 to 47.6 ± 7.99 ml/kg (P &lt; .001) and mean RCV decreased from 67 ± 16.5 to 51 ± 12.3 ml/kg (P &lt; .001). Despite precautions to keep the partial exchange isovolemic, mean BV decreased from 105 ± 18.7 to 98 ± 18.0 ml/kg (P = .001) and the mean PV increase (10 ml/kg) was less than the mean RCV decrease (16 ml/kg). These data suggest that neonates with polycythemia have normal PV but their RCV and BV are elevated in direct proportion to UV Hct. "Isovolemic" partial exchange transfusion decreases UV Hct, RCV, and BV and increases PV.

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