Childhood Obstructive Sleep Apnea.

Obstructive sleep apnea (OSA) is a common condition in childhood and can result in severe complications if left untreated. It is showing a rising trend in India. A significant association with obesity has been observed; however, some children with enlarged tonsils and/or adenoids may even be underweight. The patient usually presents with snoring and other respiratory problems like mouth breathing, choking and gasping episodes in night. Poor school performance and neurocognitive deficits have been reported. Pulmonary hypertension and cor pulmonale are seen in severe cases. Besides the history and clinical examination, for definitive diagnosis an overnight polysomnographic evaluation is the gold standard. In all cases, the specific treatment ranges from simple lifestyle modifications and medications to surgeries like adenotonsillectomy. Early diagnosis is vital.

Cytokine generation in stored platelet concentrate: comparison of two methods of preparation.

BACKGROUND & OBJECTIVES: Contaminating white blood cells (WBCs) in stored platelet concentrates (PC) are the main source of pro-inflammatory cytokines including interleukin-6 (IL-6), interleukin- 8 (IL-8) and tumour necrosis factor-alpha (TNF-alpha) that are implicated in transfusion reactions. We compared the levels of these cytokines in stored platelet preparations prepared by two methods. Effect of pre-storage leucofiltration on these cytokine levels was also studied. METHODS: Twelve units of pooled PCs were prepared by platelet rich plasma (PRP) method and buffy-coat (BC) method each and stored for 5 days. IL-6, IL-8 and TNF-alpha levels were measured in platelet supernatants on day 0, 1, 3 and 5 of the storage using commercially available immunoassays. Pre-storage leucofiltration was done in 4-pooled units of PRP-PC and cytokine levels compared with unfiltered PCs. RESULTS: Median IL-6 levels increased from day 0 to day 5 in both PRP-PC and BC-PC. In PRP-PC, IL-8 increased from <3 pg/ml on day 0 to 817 pg/ml on day 5, while in BC-PC the corresponding levels were 10 and 346.5 pg/ml, respectively. No significant increase in levels of TNF-alpha was observed in BC-PC during storage period, while levels increased significantly in PRP-PC on day 1 only. There was no significant change in the levels of all three cytokines in leucofiltered PCs over 5 days of storage. INTERPRETATION & CONCLUSION: Findings of our study showed that method of preparation and WBC content are the critical factors in determining the cytokine levels in stored PCs.