Double Volume Research Articles

The relevance of dark trading for information acquisition in the German stock market

The implementation of the European double volume cap (DVC) mechanism acts as an exogenous shock to help understand how restrictions on dark trading affect the price discovery process for German stocks. Using the price jump ratio as a measure of information acquisition prior to earnings announcements, we show that dark pool trading aids information acquisition. This relationship is stronger for negative earnings news, for stocks that are hard to value, and when there is uncertainty around earnings. The introduction of the DVC mechanism weakens the relationship between dark trading and pre-announcement information acquisition.

Clinico-etiological profile of neonates with neonatal hyperbilirubinmemia treated with double volume exchange transfusion

Clinico-etiological profile of neonates with neonatal hyperbilirubinmemia treated with double volume exchange transfusion

Technological Parameters of Microfiltration in the Production of Micellar Casein Concentrate

Background:: There are many different factors that influence the process of microfiltration, including membrane pore size, pressure, temperature, and membrane origin. Studying the joint influence of technological parameters in order to justify rational modes of microfiltration is relevant. Objective:: This research aimed to define the rational technological parameters of microfiltration, which allow to achieve the target parameters of retentate in the process of obtaining micellar casein concentrate. Methods:: Standard and modified methods and techniques have been used in the process of experimental research. The mathematical processing was carried out by methods of mathematical statistics according to several trials data at three stage sequence. Results:: As a result of experimental investigations, the applicability of ceramic membranes for microfiltration of skim milk has been shown. The rational pore size has been established as 0,1 μm. To obtain the micellar casein concentrate, it is advisably to carry out the microfiltration of skim milk to the mass fraction of dry solids in concentrate (13 ± 3) %, followed by two-phase diafiltration with a double volume of reverse osmosis water. The rational operating conditions, allowing to get the target value of protein fractions correlation, have been established, as described as follows: input pressure as 0,2 – 0,3 MPa, and temperature as 10 – 15°С. Conclusion:: The analysis of microfiltration concentrates and permeates composition of raw milk, including vitamins and minerals content, showed both their high nutritional and biological value and the viability of further processing into food ingredients, including the ingredients for the specialized food products.

Effects of lanthanide doping on the electrode properties and exsolution behavior of A-site deficient Sr1.9Fe1.3Ni0.2Mo0.5O6-δ double perovskites

Double perovskite oxides of the Sr2Fe1.5Mo0.5O6-δ class are promising electrodes for Solid Oxide Fuel Cells (SOFCs) and Electrolyzers (SOECs) due to their outstanding electrochemical properties and durability. Additionally, their physicochemical properties can be tuned by B-site cation doping, namely, by partially substituting Fe cations with other transition metals such as Ni, Co, Mn, or Cu. This also allows the grain-surface functionalization with metallic alloyed nanocatalysts upon reduction driven by the exsolution phenomena, leading to higher electrocatalytic activity and resistance against sintering and coking. Traditionally, A-site deficiency has been employed to improve the amount of exsolved nanoparticles and, thereby, increase the number of Triple Phase Boundaries in the electrode. However, in Ni-doped non-stoichiometric double perovskite materials (e.g., Sr1.9Fe1.3Ni0.2Mo0.5O6-δ), A-site deficiency results in undesired NiO phase segregations. This, in turn, lowers the number of exsolvable cations, decreasing the number of metallic nanocatalysts compared to the stoichiometric compound. In this work, the impact of A-site doping with lanthanides (viz. Gd, La, Nd, and Pr) on the exsolution ability and electrochemical properties of non-stoichiometric Sr1.9Fe1.3Ni0.2Mo0.5O6-δ was evaluated. The results indicate that lanthanide doping enhances the conductivity of the double perovskites both in oxidizing and reducing atmospheres. In addition, lanthanide dopants that slightly destabilize the cubic structure also improve the exsolution dispersion, which decreases with increasing the double perovskite cell volume. These results illustrate how to design more efficient and durable electrocatalysts by modifying the double perovskite structure with A-site dopants.

Modelling and optimization of Li+ extraction from brine with high Mg/Li ratio by electrochemically switched ion exchange considering thermodynamics and dynamics simultaneously

Electrochemically switched ion exchange (ESIX) technology has been proven to be an efficient and environmental-friendly method for extracting Li+ from brine lakes. To deeply understand and mathematically express the underlying physical process of Li+ extraction in ESIX, a model is developed to describe Li+ extraction from brine lakes with a high Mg/Li mass ratio (500:1) by ESIX with an electrode coated with λ-MnO2 film. The kinetics and thermodynamics of the Li+ extraction process is considered simultaneously by coupling the Frumkin-Bulter-Volmer theory modified by electroactive site concentration with a modified Gouy-Chapman-Stern model. The local sensitivity analysis indicates that the performance of ESIX in Li+ adsorption is greatly influenced by cell voltage, film mass, and Stern capacitance of carbon black film, whereas these parameters have little effect on Mg2+ adsorption. The individual parameter analysis elucidates that the mass and Stern capacitance of carbon black film can regulate the potential drop distributions in different regions of ESIX system, resulting in a maximum Li+ extraction efficiency of 90.22 % due to the increased driving force in the faradic reaction and reduced charge transfer resistance. The optimization of combined parameters indicates that the optimum operation can be achieved at the conditions with a cell voltage ranging between 1.0 and 1.2 V, a Stern layer capacitance with electric double layer volume for carbon black film of 5.4 × 107 F/L, and an initial Li+ content of the treatment solution: carbon black film: λ-MnO2 film mass ratio of 0.1 kg: 9 kg: 8 kg.

Effect of Low-volume Exchange Transfusion on Neonatal Hyperbilirubinaemia: A Retrospective Cohort Study

Introduction: A double volume exchange transfusion for hyperbilirubinaemia often requires more than one pack of compatible blood to fulfil the calculated volume. This is often unavailable, necessitating exchange transfusion using less than the calculated double-volume. During practice, the authors found that many patients had a positive therapeutic response even when the exchange blood volume was reduced. Aim: To study the effect of the reduced volume of blood used for exchange transfusion in neonates with hyperbilirubinaemia. Materials and Methods: A retrospective cohort study was conducted in the Neonatal Intensive Care Unit (NICU), Malankara Orthodox Syrian Church Medical College (tertiary level), Kerala, India, between January 2015 and December 2020. Total 116 patients who underwent exchange transfusion for hyperbilirubinaemia, regardless of gestational age, were included. Pre- and postexchange details, blood chemistry and haemogram were collected from the records and analysed. The patients were grouped into group 1 (80-≤120 mL/kg) and group 2 (>120-≤160 mL/kg) based on the volume of blood used for exchange transfusion. The correlation of exchange blood volume with the percentage drop in bilirubin, rebound rise of bilirubin at six hours, duration of phototherapy, and duration of admission was studied using Pearson’s/ Spearman’s correlation. Data were statistically analysed using Independent samples t-test, Paired sample t-test, and Chi-square test to determine, if there was a significant difference between the groups. Results: Out of 116 patients, group 1 had 67 (57.78%) patients, and group 2 had 49 (42.24%) patients. The mean±Standard Deviation (SD) gestational age was 37.6±1.57 weeks, and 59 (50.86%) were males. The mean±SD postexchange bilirubin was 13.12±3.85 mg/ dL in group 1 and 10.26±2.78 mg/dL in group 2, resulting in a bilirubin reduction of 40.74±12.81% and 53.81±11.67%, respectively. The rebound bilirubin at six hours (13.15±4.32 mg/dL vs 11.23±2.30 mg/dL) made no clinical difference in the management of the patient. The median duration of phototherapy was 48 hours, and the median duration of admission was five days in both groups. Conclusion: Exchange transfusion with a lower volume of blood, followed by phototherapy, can lead to a clinically acceptable reduction in serum bilirubin. Non availability of the exact 160 mL/kg of blood for exchange is not an adequate reason to delay exchange transfusion.

Dual scaffold delivery of miR-210 mimic and miR-16 inhibitor enhances angiogenesis and osteogenesis to accelerate bone healing

Angiogenesis is critical for successful bone repair, and interestingly, miR-210 and miR-16 possess counter-active targets involved in both angiogenesis and osteogenesis: miR-210 acts as an activator by silencing EFNA3 & AcvR1b, while miR-16 inhibits both pathways by silencing VEGF & Smad5. It was thus hypothesized that dual delivery of both a miR-210 mimic and a miR-16 inhibitor from a collagen-nanohydroxyapatite scaffold system may hold significant potential for bone repair. Therefore, this systems potential to rapidly accelerate bone repair by directing enhanced angiogenic-osteogenic coupling in host cells in a rat calvarial defect model at a very early 4 week timepoint was assessed. In vitro, the treatment significantly enhanced angiogenic-osteogenic coupling of human mesenchymal stem cells, with enhanced calcium deposition after just 10 days in 2D and 14 days on scaffolds. In vivo, these dual-miRNA loaded scaffolds showed more than double bone volume and vessel recruitment increased 2.3 fold over the miRNA-free scaffolds. Overall, this study demonstrates the successful development of a dual-miRNA mimic/inhibitor scaffold for enhanced in vivo bone repair for the first time, and the possibility of extending this ‘off-the-shelf’ platform system to applications beyond bone offers immense potential to impact a myriad of other tissue engineering areas. Statement of significancemiRNAs have potential as a new class of bone healing therapeutics as they can enhance the regenerative capacity of bone-forming cells. However, angiogenic-osteogenic coupling is critical for successful bone repair. Therefore, this study harnesses the delivery of miR-210, known to be an activator of both angiogenesis and osteogenesis, and miR-16 inhibitor, as miR-16 is known to inhibit both pathways, from a collagen-nanohydroxyapatite scaffold system to rapidly enhance osteogenesis in vitro and bone repair in vivo in a rat calvarial defect model. Overall, it describes the successful development of the first dual-miRNA mimic/inhibitor scaffold for enhanced in vivo bone repair. This ‘off-the-shelf’ platform system offers immense potential to extend beyond bone applications and impact a myriad of other tissue engineering areas.

Therapeutic plasma exchange for neonatal hepatic failure

We report a case of therapeutic plasma exchange in a neonate with fulminant liver failure. A six-day old, 2800-gram baby was referred to our medical center for evaluation and treatment of fulminant hepatic failure. The working diagnosis at admission was gestational alloimmune liver disease, and therapeutic plasma exchange was proposed. A double volume plasma exchange was successfully performed, using the Spectra Optia apheresis system, primed with packed red blood cells. Access was obtained via a radial artery catheter and a peripheral intravenous line. On hospital D-14 a diagnosis of E3 deficiency was confirmed, and disease-specific therapy was started. Automated TPE using peripheral arterial and venous catheters may be safely performed in neonates, and should be considered in the treatment of a variety of disorders including neonatal fulminant hepatic failure.

784 Advanced Nurse Practitioners Benefit Patient Care and Flow in an Elective Surgical Hub During Recovery From the COVID-19 Pandemic

Abstract Advanced nurse practitioners (ANPs) have an independent scope of practice in patient care. ANPs were introduced to an elective surgical hub during the COVID-19 pandemic in a similar capacity to senior house officers. We examined the impact of ANPs on patient care as viewed from healthcare professionals and patients, and in facilitating timely discharge to maintain flow. We constructed two separate questionnaires, one for healthcare professionals (HCPs) and one for patients. We compared the time to completion of discharge summary, adjusted for patient volume, before and after ANPs were introduced to the ward to determine patient flow. We received 27 responses from HCPs: 18 doctors, 7 nurses and 2 allied health professionals. Average score for overall impact on patient care was 9.2 out of 10. We received 9 responses from patients, of which 6 responded having never met ANPs during their care. Of the 3 responses, average score for overall impact on patient care was 5 out of 5. After ANPs were introduced, discharge summaries had an average completion time of 12:56, which was 6 minutes later than before their introduction (t-test, p = ns). We found that there were more admissions before the introduction of ANPs (25 before, 58 after), indicating a maintenance of flow despite increased workload. ANPs in this elective surgical hub form an integral part of the team who can carry out the majority of ward-based tasks independently. Despite more than double patient volume, flow was maintained. Further work is needed to increase their recognition amongst patients.

Early Onset Portal Hypertension Due to Silent Extensive Portal Vein Thrombosis Following Umbilical Vein Catheterization

Background: Umbilical vein catheterization is a routine procedure in neonatal intensive care units. This invasive procedure, though easy and useful, can result in disastrous complications. Clinical Description: A 28 day old baby boy presented with umbilical sepsis along with multiple skin abscesses. He had a history of double volume exchange transfusion for Glucose 6 Phosphate deficiency induced hyperbilirubinemia, during the postnatal period. Ultrasound whole abdomen done to look for intra-abdominal abscesses revealed extensive portal vein thrombosis including the main portal vein and its branches with cavernoma formation. Upper gastrointestinal endoscopy revealed Grade II esophageal varices suggestive of the development of portal hypertension. Management and Outcome: Baby was started on subcutaneous enoxaparin which continued for 3 months. Follow up ultrasound showed complete obliteration of portal vein, replaced by cavernomas with development of grade II esophageal varices seen on upper gastrointestinal endoscopy. Conclusion: This case highlights how umbilical vein catheterization in the neonatal period can lead to catastrophic complications such as obliteration of the entire main portal vein and its branches, formation of portal cavernoma, portal hypertension, and esophageal varices, all of which can develop silently, at a very early age.

Case report: Pyruvate kinase deficiency in an infant

Pyruvate kinase deficiency is a rare cause of hemolytic anaemia. We report a case of Non-spherocytic hemolytic anaemia due to a deficiency of the red cell Pyruvate kinase enzyme due to a homozygous type of autosomal recessive inheritance. The child underwent a double volume Exchange Transfusion and received blood transfusions for Rapid Hemolysis on the first day of life. In this report, we stress the need for consideration of Red cell Pyruvate kinase enzyme deficiency as one of the differentials of Non-immune hemolytic anaemia. The study will help human geneticists and paediatricians with early identification or screening.

Does a novel bridging collar in endoprosthetic replacement optimise the mechanical environment for osseointegration? A finite element study.

Introduction: Limb-salvage surgery using endoprosthetic replacements (EPRs) is frequently used to reconstruct segmental bone defects, but the reconstruction longevity is still a major concern. In EPRs, the stem-collar junction is the most critical region for bone resorption. We hypothesised that an in-lay collar would be more likely to promote bone ongrowth in Proximal Femur Reconstruction (PFR), and we tested this hypothesis through validated Finite Element (FE) analyses simulating the maximum load during walking. Methods: We simulated three different femur reconstruction lengths (proximal, mid-diaphyseal, and distal). For each reconstruction length one in-lay and one traditional on-lay collar model was built and compared. All reconstructions were virtually implanted in a population-average femur. Personalised Finite Element models were built from Computed Tomography for the intact case and for all reconstruction cases, including contact interfaces where appropriate. We compared the mechanical environment in the in-lay and on-lay collar configurations, through metrics of reconstruction safety, osseointegration potential, and risk of long-term bone resorption due to stress-shielding. Results: In all models, differences with respect to intact conditions were localized at the inner bone-implant interface, being more marked in the collar-bone interface. In proximal and mid-diaphyseal reconstructions, the in-lay configuration doubled the area in contact at the bone-collar interface with respect to the on-lay configuration, showed less critical values and trends of contact micromotions, and consistently showed higher (roughly double) volume percentages of predicted bone apposition and reduced (up to one-third) percentages of predicted bone resorption. In the most distal reconstruction, results for the in-lay and on-lay configurations were generally similar and showed overall less favourable maps of the bone remodelling tendency. Discussion: In summary, the models corroborate the hypothesis that an in-lay collar, by realising a more uniform load transfer into the bone with a more physiological pattern, creates an advantageous mechanical environment at the bone-collar interface, compared to an on-lay design. Therefore, it could significantly increase the survivorship of endo-prosthetic replacements.

Little known and less understood: the benefits of a lower hematocrit (~40%) in reconstituted blood for double volume exchange transfusion.

A double volume exchange transfusion (DVET) is an important, if infrequently performed, intervention to acutely lessen the total serum bilirubin (TSB) and reduce the extravascular CNS bilirubin exposure when neonatal hyperbilirubinemia poses a neurotoxicity risk. The current analysis based on the seminal works of Valaes, and Sproul and Smith, predicts that a DVET blood product of lower hematocrit (~40%) via its greater plasma volume and corresponding higher albumin content optimizes the benefits of an DVET in several ways. First, by augmenting bilirubin clearance from the extravascular space and thereby further reducing the CNS bilirubin exposure, second, by favorably positioning the intravascular albumin-bilirubin binding capacity at DVET completion to accommodate additional bilirubin equilibration and rebound hyperbilirubinemia post-exchange, and third by correcting anemia if present.

A262 NEONATAL ACUTE LIVER FAILURE DUE TO PRESUMED GESTATIONAL ALLOIMMUNE LIVER DISEASE - A CASE REPORT

Abstract Background Neonatal acute liver failure (NALF) is a rare disease that is distinct from acute liver failure seen in older children and adults. Gestational alloimmune liver disease (GALD) is the most frequent cause, is initiated in utero by sensitization of the maternal immune system to a fetal hepatocyte antigen and subsequent production of maternal immunoglobulin G antibodies that cross the placenta. Maternal IgG binds to a fetal hepatocyte antigen and initiates an innate immune response involving the terminal complement cascade and membrane attach complex. The understanding of the alloimmune origin has led to the use of intravenous immunoglobulin (IVIG) treatment and exchange transfusion, significantly increasing survival. However, approximately 25% of patients may not respond and require salvage liver transplantation. In spite of an increased rate of comorbidities, concern for technical difficulties and limited graft availability, young infants eligible for transplant have been shown to have similar overall patient and graft survival rates compared to older children with other indications for liver transplant. Purpose The primary aim of our study is to report a case of NALF with successful liver transplant. Method We present the case of a preterm girl with NALF due to GALD refractory to medical management, requiring liver transplantation. Result(s) This is a 35-week preterm girl, with scant pre-natal care, birth weight of 1.825 kg and Apgar 9/9. She is the seventh child of non-consanguineous parents, with healthy siblings. On day-of-life (DOL) 1 she presented with acute kidney injury, progressive worsening metabolic acidosis and hyperammonemia and was found to be profoundly coagulopathic (INR 6), with normal liver enzymes and liver failure was diagnosed. Initial investigation ruled out congenital infections, sepsis, neonatal hemophagocytic lymphohistiocytosis and metabolic diseases. Magnetic resonance imaging of the body demonstrated findings in keeping with iron deposition in the thyroid, liver and pancreas, suggestive of GALD. Completed double volume exchange transfusion and IVIG on DOL 9 and repeat IVIG on DOL 13 and 15, with partial improvement in INR. Due to persistent ascites, conjugated hyperbilirubinemia and hyperammonemia she was transferred for urgent liver transplant assessment. Persistent liver dysfunction in the form of hyperammonemia, hypoglycemia and progressive coagulopathy led to transplant listing on DOL 30. ABO incompatible deceased donor liver transplant was completed on DOL 62 (4.075 kg, estimated dry weight 3.5 kg). The procedure was uncomplicated, liver enzymes normalized, coagulopathy and hypoglycemia resolved. She was transferred to the ward on post-operative day (POD) 6. and weaned off sedatives and transitioned to oral feeds within 2 weeks of transplant, with complex abdominal wound closure on POD 29. Conclusion(s) Successful liver transplantation is possible in neonates with acute liver failure due to GALD refractory to medical management and weighing 4kg or less. Please acknowledge all funding agencies by checking the applicable boxes below None Disclosure of Interest None Declared MICROBIOME & MICROBIAL THERAPY

Optimization of 'on farm' hydropriming conditions in wheat: Soaking time and water volume have interactive effects on seed performance.

Seed priming is a simple and cost effective method to obtain a better plant stand under diverse environmental conditions. The current study was designed to determine the optimal priming duration and water volume for wheat seed. For this experiment, three wheat genotypes with distinct genetic and adaptive backgrounds were chosen. Seeds of each genotype were hydroprimed for 7 durations, i.e. 1, 2, 4, 8, 12, 16, and 20 hours, in three different water volumes, i.e. half, equal, and double volume with respect to seed weight and then surface dried for 1 hour. The control was unprimed (dry) seed. The germination characteristics and seedling vigour potential of hydroprimed seeds were evaluated in the lab by recording several parameters such as germination percentage and speed, seedling growth, and vigour indices at two different temperature levels. The results showed that optimal duration for hydropriming of wheat seed is 12 hours with an equal volume with respect to original seed weight, closely followed by 8 hours with double volume. Reduction in seed performance was observed at 16 and 20 hours priming particularly at double volume treatment. Effect of temperature on seed germination showed improvement in seedling vigour at 25°C when compared to 20°C, although effect on germination percentage was non-significant. Volume of water and priming duration showed significant interactive effects demonstrating that a higher volume can give equivalent results at a shorter duration and vice versa. Another experiment was also conducted to compare the on-farm priming (surface dried seed) with conventional priming (seed re-dried to original moisture) taking 3 potential durations i.e. 8, 12 and 16 hours. Results revealed that both priming methods were statistically at par in terms of germination percentage, while, surface drying resulted in better seedling vigour and speed of germination.

Novel device for automating exchange transfusions through umbilical venous route in neonates.

Our prototype of a novel device can safely automate a DVET. Further trials of this device are warranted. •Double volume exchange transfusion is often performed manually, but this is time-consuming and error-prone. •Previous attempts at automation were not widely adopted because they involved inserting two catheters and did not have mechanisms to prevent embolism. •This novel device fully automates double volume exchange transfusions through a single-lumen umbilical venous catheter. •It prevents air and clot embolism and has a screen for input and output parameters and alarms.

Comparisons of Auction Designs Through Multiagent Learning in Peer-to-Peer Energy Trading

Distributed energy resources (DERs), such as solar panels, are growing rapidly and reshaping power systems. To promote DERs, utility companies usually adopt feed-in-tariff (FIT) to pay DER owners (aka prosumers) fixed rates for supplying energy to the grid. As an alternative to FIT, consumers and prosumers can trade energy in a peer-to-peer (P2P) fashion. In this paper, we focus on a P2P market using double auctions, in which the payoffs of energy consumers/prosumers are determined by their bids and auction mechanisms. Special features of a P2P energy auction, however, including zero marginal cost and publicly-known reserve prices, may invalidate many theories on auction design and hinder market development. We discuss the impacts of such features on four specific clearing mechanisms: <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$k$ </tex-math></inline-formula> -double, Vickrey, McAfee and maximum volume matching (MVM). Furthermore, we propose an automated bidding framework based on multi-agent, multi-armed bandit learning, in which each agent only needs to utilize their own bidding history to determine how to bid in the next round through certain regret-minimizing algorithms. Numerical results show that the <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$k$ </tex-math></inline-formula> -double and McAfee auction appear to perform better in terms of bidders’ surplus. However, if the auctioneer also requires compensation, MVM can yield the most profit for the auctioneer.

Severe Hereditary Spherocytosis Presenting with Non-Immune Fetal Hydrops

Background: Hereditary spherocytosis (HS) is characterized by spherocytes on the peripheral smear and heterogeneous clinical presentation (mild, moderate, moderate/severe, and severe) depending upon the severity of hemolytic anemia, jaundice, and splenomegaly. The underlying cause is defects in various red blood cell membrane proteins due to pathogenic mutations. Genotype-phenotype correlation is known. Clinical Description: We report a consanguineous family with a healthy daughter, multiple pregnancy losses due to fetal hydrops, and the current daughter. She was diagnosed with fetal anemia at 22 weeks gestation, developed fetal hydrops, was born premature and developed respiratory distress, severe anemia, severe jaundice, and postnatal hemolysis. Management: The case was managed since intrauterine life till date by multispecialty coordination. Intrauterine transfusions were given during pregnancy. In the neonatal period, she received surfactant for respiratory distress syndrome, double volume exchange transfusion and phototherapy for the jaundice, and repeated blood transfusions for the hemolytic anemia, that is still continuing. Rational and sequential investigations were planned and a systematic approach used. She was diagnosed with severe HS due to a homozygous likely pathogenic variant in the SPTA1 gene (affecting formation of spectrin), and heterozygous variant of uncertain significance in the ANK1 gene (that encodes ankyrin). At 3 years she has transfusion dependent hemolytic anemia, moderate splenomegaly, and age appropriate growth and development. Conclusions: HS is a rare but manageable (albeit challenging) cause of nonimmune hydrops fetalis. Genetic diagnosis allows precise management and family counselling.

Association of Antenatal Corticosteroid use with Hypoglycaemia and Hyperbilirubinemia in Preterm Neonates Admitted in a Tertiary Hospital of Kolkata: A Longitudinal Study

AbstractBackground: Timely use of antenatal corticosteroids in a mother of preterm labour decreases the rates ofperinatal death, respiratory distress syndrome, intra-ventricular hemorrhage, necrotizing enterocolitis inthe new borns. However it is reported to have a causative role in neonatal hypoglycemia and hyperbilirubinemia.So the present study attempts to determine the association between the use of antenatal corticosteroids withhypoglycaemiaand hyperbilirubinemia in newborns with less than 35 weeks of gestational age.Methods: A prospective observational study was conducted during a time period of 24 months from January 2020to December 2021 in a tertiary care hospital of Kolkata on 99 preterm neonates of less than 35 weeks of gestationalage. Antenatal history of corticosteroid use, neonatal glucose level and bilirubin level were measured amongothers. Data were analyzed using MS-EXCEL.Results: Majority of neonates’ mothers (71.7%) had received antenatal corticosteroids. Only 4.0% of the cases hadhypoglycaemia at birth. But there was no cases of hypoglycaemia at 12 hour and 24 hour after birth. In 58.6% ofthe cases bilirubin level was in the phototherapy range and double surface photo therapy was required. In 14.1%of the cases double volume exchange transfusion was required.Conclusion: Antenatal corticosteroid administration is not associated with neonatal hypoglycaemia but it issignificantly related to neonatal hyperbilirubinemia.

Efficacy of single-and double-volume exchange transfusion for neonatal hyperbilirubinemia.

To investigate the efficacy and safety of singleand double-volume exchange transfusion for neonatal hyperbilirubinemia (HB) and compare their effects on the internal environment of newborns. The clinical data of 96 HB newborns admitted to and treated in our hospitals from January 2016 to October 2021 were retrospectively analyzed. Then, these newborns were divided into single volume group (80-110 mL/kg, n=48) and double volume group (150-180 mL/kg, n=48) by the exchange volume per unit body mass. The hematological indicators total serum bilirubin (TSB), peripheral blood red blood cell (RBC) count, white blood cell (WBC) count, platelet (PLT) count, serum albumin (ALB), prothrombin time (PT) and activated partial thromboplastin time (APTT), and changes in inner-environment indexes (blood gas, blood glucose, acid-base and electrolyte levels) were compared between the two groups of newborns before treatment and after once treatment. Additionally, the adverse reactions of exchange transfusion in the two groups of newborns were recorded.