Neonatal polycythemia: risk factors, clinical manifestation and treatment applied

Polycythemia is defined as a venous hematocrit above 65%. Polycythemia is sometimes associated with hyper viscosity of blood. The etiology of polycythemia is related either to intra-uterine hypoxia or secondary to fetal transfusion. Increased viscosity of blood is associated with symptoms of hypoperfusion. Clinical features related to hyper viscosity may affect all organ systems. To evaluate the prevalence of polycythemia among neonates who were admitted to the nursery care unit, to evaluate the difference between peripheral and central hematocrit [PCV] and to have an idea about the main presentation and modes of treatment of polycythemia. A case - control study was done in the nursery care unit of AL - Kadhyimia Teaching Hospital, one hundred neonates [50 polycythemic and 50 control healthy neonates] were taken, for each neonates, information regarding [name, age, sex, gestational age, mode of delivery, body weight, length, head circumference, clinical presentation and risk factors] were taken, investigations including hematocrite [PCV], random blood sugar and total serum bilirubin were done for all neonates. The prevalence of neonatal polycythemia was [2.2%], male was affected more than female with male: female ratio equal to [1.5:1]. The difference between peripheral and central PCV was [4 - 15%] with a mean and standard deviation of [7 +/- 0.33%]. The main signs and symptoms were jaundice [58%], lethargy [30%], respiratory distress [26%] and hypoglycemia [26%]. Risk factors were preterm [36%], neonates of diabetic mother [20%], small for gestational age [18%], twin pregnancy [12%] and down's syndrome [10%]. Partial exchange transfusion was done to 28 cases [56%]. Males were affected more than females. Jaundice was the main presentation followed by lethargy, respiratory distress and hypoglycemia. Higher risk in twin pregnancy, neonates of diabetic mother, small for gestational age, preterm and down's syndrome while delivery by caesarian section reduce the risk of polycythemia.

Homocysteine, folic acid, vitamin B[12] and pyridoxine: effects on vaso-occlusive crisis in sickle cell anemia and sickle-thalassemia

Hemoglubiopathies include sickle cell anemia and the Thalassemia. S/ beta 0-Thalassemia have a clinical course similar to HbSS. Elevated concentration of Homocysteine contribute to thrombosis, a frequent event in sickle cell anemia. Vitamin B[12], Pyridoxine, and folic acid deficiencies lead to dangerous increase in plasma Homocysteine. 1-To test whether children with sickle cell anemia and Sickle cell-Thalassemia have elevated concentration of serum Homocysteine with diminished level of folate, B[6], B[12]. 2-To determine whether hyperomocysteinaemia has a correlation with the frequency of Vaso-occlusive crisis. A case-control study was carried over a period of one year from Jan.-Dec. 2010 inclusive, 30 patients were collected from the Thalassemia centre in Ibn-Al Baldy Hospital together with healthy 30 cases, age and sex matched ,were taken from Al Kadhimiyia Teaching Hospital. Venous blood sample were aspirated from both groups to estimate serum Homocysteine, Folic acid, B[12] and B[6] level. Statistical analysis was done, using the student T-test [P. value<0.05 is considered as statistically significant]. Pearson correlation analysis was performed. The age of the patients range between [5-29] years, the majority of the patients were between [10-19] years, 10 cases [38.46%]. More than one half were male, 16 cases [61.54%]. Sickle cell-Thalassemia constitute 20 cases [76.93%]. Vaso-occlusive crisis was mainly involving the large joints, 15 cases [57.69%]. Mild attacks constitute more than half of the patients, 16 cases [61.54%].Homocysteine level was higher in the patients group compared with control group with a mean and standard deviation of [44.52 +/- 23.008] and [18.65 +/- 4.56] micro mol/L respectively. Folic acid level was lower, B[12] level was higher, B6 level was lower in the patients group compared with control group with a mean and standard deviation of [11.32 +/- 3.23] and [14.71 +/- 3.39]ng /ml, [172.57 +/- 61.34] and [103.45 +/- 30.45]pg /ml, [4.43 +/- 3.93] and [10.23 +/- 2.30] ng/ml respectively, the results were statistically not significant, P. value>0.05. Significant inverse correlation was found between Homocysteine level and B6 level. A strong positive correlation between Homocysteine level and the frequency of Vaso-occlusive crisis was found. Patients with sickle cell disease have high serum level of Homocysteine with low level of folic acid and pyridoxine. This Hyperomocysteinaemia is significantly inversely correlated with pyridoxine deficiency, but positively correlated with the frequency of Vaso-occlusive crisis. Hemoglubiopathies are diseases caused by genetic

Serum concentration of cystatin C in pediatric malignancy

Malignant disease is the second most frequent cause of death between the ages of 1 and 15 years. Childhood tumors are relatively more malignant and disseminate early. Cysteine proteases are proteolytic enzymes involved in many pathological processes. Cysteine protease inhibitors constitute the final regulatory step in the control of cysteine proteases. Currently, cystatin C [CC] is the most frequently investigated family member and is involved in processes such as tumor invasion and metastasis: In such diseases the emphasis is placed on the fine balance and regulation of both the cysteine proteases and their inhibitors, with an imbalance resulting in a pathological state. To assess the status of cystatin C and the effects of chemotherapy on serum CC in patients with various malignant diseases. The present study is a case-control study done at AI-Kadhimiya Teaching Hospital in [2010]. Includes measurement of serum cystatin C in 60 patients with different malignant conditions who were classified into two groups: Patients with definitely newly diagnosed malignant tumor without chemotherapy G1: [n=30]. Patients with definitely diagnosed malignant tumor on chemotherapy G2: [n=30]. The results were compared with another 30 patients complaining from diseases other than malignancy who were included as disease-unrelated controls [G3]: [n=30]. showed a significant increase in serum cystatin C in patients with malignant tumors as compared with the controls [p < 0.001]. Moreover, serum cystatin C was significantly high in patients on no treatment G1 compared with patients on chemotherapy G2; this can be explained partly on genetic basis and partly due to DMA methylation-dependent epigenetic mechanisms may play an important role during neoplastic transformation and/or tumor progression of cystatin C gene by malignant cells. Cystatin C can be used as a tumor marker in pediatric malignancy although not specific