Newborn haemostasis

A study of the coagulation system of twenty full term, fifteen premature were compared to twenty normal adults receiving no medication. The fibrinogen level is proved to be normal in fullterm [274 +/- 61 mg/dl] and preterm infants [268 +/- 64 mg/ dl] when compared to the adult group [283 +/- 58 mg/dl]. Prothrombin and protein C are vitamin-K dependent proteins with important roles in haemostasis. The work showed that levels of both proteins are significantly lower than the adult and related to gestational age. Protein C level in the full term [45.6 +/- 10.2], premature [35.5 +/- 6.8] was lower than the adult [95.6 +/- 8.4] also the prothrombin level in the full term [60.4 +/- 12.9], premature [41.3 +/- 5.4] was low when compared to the adult [98.9 +/- 4.1]. A deficiency of antithrombin 111 in the newborn [59.5 +/- 14.3], preterm [41.2 +/- 12.2] is shown by comparison to the adult [89.7 +/- 10.1], the level of antithrombin III in the neonate is commensurate with the level of the vitamin K factors that it inhibits. So normally there is a delicate balance between procoagulants and inhibitors of clotting mechanism in infants. The normal ranges of the levels of prothrombin, protein C, Anti 111, total and free protein S have to be studied in later infancy and the age at which adult levels are reached need to be established

Thyroid hormone levels in infants of diabetic mothers

Infants born to diabetic mothers have decreased activity of many metabolic pathways which might be regulated by thyroid hormone. Serum Thyrotropin [TSH], Thyroxine [T4], triiodothyronine [T3] and reverse T3 levels were measured in maternal and cord sera of twenty normal full term infants and thirty infants of diabetic mothers [I.D.M]. Thyroxine of diabetic mothers 9.4 +/- 1.2 micro g/dl was significantly less [P less than 0.005] than the mean T4 normal mothers 14.2 +/- 2.2 micro g/dl. Mean T3 of diabetic mothers [148 +/- 14 ng/dl] was significantly less [P less than 0.001] than that of normal mothers [184 +/- 13ng/dl]. Mean T4 of neonatal specimens was lower in infants of diabetic mothers [I.D.M] but this difference achieved statistical significance at the 12 hour sample [P less than 0.001]. Infants of I.D.M had significantly lower mixed cord serum T3 than control infants 60 +/- 5 ng/dl versus 96 +/- 18 ng/dl [P less than 0.001]. At each time interval, mean T3 concentration in infants of diabetic mothers was significantly lower than that of full term infants. Levels of reverse trioidothyronine [rT3] were significantly increased in cord blood of infants of diabetic mothers [186 +/- 9 ng/dl] versus cord blood of normal full term infants [150 +/- 10 ng/dl] [P less than 0.001]. These data open the way that maybe some of the metabolic alternations seen in neonates born to diabetic mothers may be due to decreased thyroid hormone levels during the first day of life

Serum cord prolactin levels in infants of diabetic preeclamptic mothers

Serum prolactin was measured by R I A. in mixed cord of 18 infants of diabetic mothers [I D.M], 18 infants of pergnancy induced hypertension compared to 20 normal full term newborns. The cord prolactin level of infants of women with pregnancy induced hypertension was higher 345 +/- 34.2 ng/ml when compared to cord blood of full term infants 280 +/- 20.4 ng/ml. Infants of diabetic mothers had significantly lower mixed cord serum prolactin levels than control infants 220 +/- 15 ng/ml versus 280 +/- 20.4 ng/ml [less than 0.001]. Fetal Apgar score was lower in I D.M. than controls more significant at one minute than 5 minutes. One infant from the 18 infants of diabetic mothers was reported to develop respiratory distress syndrome [R D.S] with serum prolactin 150 ng/ml, estradiol 5.9 ng/ml, cortisol 68 ng/ml. Serum prolactin considered one of the several hormones responsible for fetal lung maturation was found to be lower in I D.M. than control. These findings raise the possibility than decreased fetal prolactin levels may be associated with or contribute to, the delayed lung maturation reported with diabetic pregnancies

Pyridoxal phosphate in cord blood of pre-eclamptic infants

Pyridoxal phosphate [vitamin B[6]] was measured in maternal and cord blood. The average plasma concentration in thirty women with normal pregnancy was 3.8 +/- 1.3 ng/ml, in thirty women with preeclampsia 2.5 +/- 0.8 ng/ml and in non pregnant women 6.2 +/- 1.7 ng/ml. The average cord blood concentration of normal infants was 12.65 +/- 3.09 ng/ml whereas that of infants of preeclamptic mothers was 6.02 +/- 7.6 ng/ml. This two fold difference of the concentrations was statistically significant. A positive correlation was found between Apgar scores and cord vitamin B[6] as well as maternal vitamin B[6] in the normal fullterm newborn and the newborn of preeclamptic pregnancy. We suggest that dietary supplementation with vitamin B[6] should be instituted in women at high risk for development of toxemia of pregnancy as one step in protecting the neurologic development of the fetus

Lymphocyte reactivity to mitogens and serum IgE level in asthmatic children

The total leucocytic count, lymphocytic and eosinophilic counts, the lymphocytic response to mitogenic effect of phytohemagglutinin [PHA] and concanavalin A [Con A] and serum IgE level were studied in 20 asthmatic children and in 12 controls. No significant differences in total leucocytic and lymphocytic counts were found between the asthmatic and normal children. Eosinophilic counts, both percentage and absolute were significantly higher in asthmatic than in normal children [P < 0.025 and P < 0.05 respectively]. When cultured with PHA or Con A, lymphocytes of asthmatic children responded significantly lower than normal lymphocytes [P < 0.001 for both PHA and Con A]. The mean level of IgE was significantly higher in asthmatic than in normal children [P < 0.001]. With increase of Ig E level there was a decrease in lymphocytic response to Con A which suggests that IgE synthesis is controlled by suppressive mechanism and that suppressor T cell defect is the main immune mechanism responsible for increased production of IgE due to antigenic stimulation

study on serological survey of Malta fever [brucellosis]

Brucellosis is mainly an occupational disease, a highly significant difference could he detected between workers in contact with dairy animals and those not in contact with animals by Standard Tube Agglutination Test [S.A.T] and Rose Bengal Plate Agglutination. [R.B.P.A.] Children are affected very much less often than adults, the odd low incidence in children is unexplained, the age group of 14-53 years showed higher positivity rate than the other groups. Brucella agglutinating antibodies are found in a high proportion of the studied population [25.5 percent] which may suggest that exposure to brucella organisms is widespread in Egypt

Cell mediated immunity in diabetes mellitus

The percentage of peripheral T lymphocytes was determined in twenty Insulin Non Dependent Diabetes Mellitus [N.I.D.D.M.] and twenty controls. The mean percentage of Erosette formation was lower in I.D.D.M. [68.75 percent] N.I.D.D.M. [69.9 percent] by comparison to the controls [73.6 percent]. I.D.D.M, [63.8 percent], N.I.D.D.M. [73.5 percent] had a significantly decreased mean response to phytohemagglutinin stimulation by comparison to the control subjects [80 percent]. These findings support the concept of depressed cell-mediated immunity in the diabetic and might explain the propensity of the uncontrolled diabetic to increased frequency and severity of bacterial infection