Interpretation of 17-hydroxyprogesterone levels in early neonatal period by dissociation-enhanced lanthanide fluorescent immunoassay technique in a tertiary care centre

Background: Mass screening for CAH is controversial worldwide because of the low positive predictive value. The cut off levels of 17 OHP in NBS are based on birth weight and or gestational age. Both RIAs and ELISAs have been almost replaced in most European countries by DELFIA. We used DELFIA technique. The aim and objective was to determine optimal cut off values of 17 OHP levels in early neonatal period based on gestational age and birth weight.Methods: The study was conducted in the neonatal unit of RSRM Hospital Stanley Medical College as Prospective cross sectional study. All new borns with a gestational age of 34 weeks or more were included in the study. Sample was collected after getting informed consent after 48 hours of age till 7 days of age. 1695 babies who met the inclusion criteria were enrolled, the blood sample were collected by heel prick on filter paper. Neonates less than 34 weeks of gestational age, babies mothers who had received antenatal steroids, babies who had received blood transfusion prior to sampling and refusal of consent were excludedResults: As the gestational age increases the mean 17 OHP values declines and plateaus at 37 weeks and beyond. Similarly analysis based on weight shows a decline in mean values of 17 OHP with increasing birth weight and plateaus from 2500 gm.Conclusions: The study demonstrates clearly that there is linear trend in mean 17 OHP values in relationship to gestational age when compared to birth weight.

Clinical profile and factors determining outcome of intramural very low birth weight babies in a tertiary care centre: a retrospective study

Background: Very low birth weight (VLBW) babies are at increased risk of a number of complications both immediate and late. Worldwide it has been observed that these babies contribute to a significant extent to neonatal mortality and morbidity. Aim of the study was to study the risk factors contributing to mortality in VLBW babies and to evaluate the morbidity pattern in these infants.Methods: A retrospective analysis of data retrieved from the case records of VLBW babies admitted in the NICU of Kilpauk Medical College between January 2015 to December 2015. Out of the 2360 intramural babies admitted during the study period, 99 babies were less than 1500 gms. The risk factors for these babies were analyzed for their association with the outcome. Data were statistically analyzed.Results: In present study, we found that sex of the baby, gestational age, obstetric score, birth asphyxia, pulmonary haemorrhage, ROP and presence of shock were found to be associated with increased mortality. By logistic regression analysis it was observed that birth weight of the baby (p value 0.002), duration of stay (p value 0.0006), presence of shock (p<0.0001), were the risk factors significantly associated with poor outcome.Conclusions: Among the maternal and neonatal factors analyzed in the study using logistic regression analysis, birth weight, duration of hospital stay and presence of shock were significantly related to poor outcome. Of these presence of shock was the single most important factor that predicted increased mortality

Real-time Processor-in-Loop investigation of a modified non-linear state observer using sliding modes for speed sensorless induction motor drive in electric vehicles

Tracking performance and stability play a major role in observer design for speed estimation purpose in motor drives used in vehicles. It is all the more prevalent at lower speed ranges. There was a need to have a tradeoff between these parameters ensuring the speed bandwidth remains as wide as possible. This work demonstrates an improved static and dynamic performance of a sliding mode state observer used for speed sensorless 3 phase induction motor drive employed in electric vehicles (EVs). The estimated torque is treated as a model disturbance and integrated into the state observer while the error is constrained in the sliding hyperplane. Two state observers with different disturbance handling mechanisms have been designed. Depending on, how they reject disturbances, based on their structure, their performance is studied and analyzed with respect to speed bandwidth, tracking and disturbance handling capability. The proposed observer with superior disturbance handling capabilities is able to provide a wider speed range, which is a main issue in EV. Here, a new dimension of model based design strategy is employed namely the Processor-in-Loop. The concept is validated in a real-time model based design test bench powered by RT-lab. The plant and the controller are built in a Simulink environment and made compatible with real-time blocksets and the system is executed in real-time targets OP4500/OP5600 (Opal-RT). Additionally, the Processor-in-Loop hardware verification is performed by using two adapters, which are used to loop-back analog and digital input and outputs. It is done to include a real-world signal routing between the plant and the controller thereby, ensuring a real-time interaction between the plant and the controller. Results validated portray better disturbance handling, steady state and a dynamic tracking profile, higher speed bandwidth and lesser torque pulsations compared to the conventional observer

Plasma Vitamin D levels in correlation with circulatory proteins could be a potential biomarker tool for pulmonary tuberculosis and treatment monitoring

Background: Tuberculosis (TB), a life-threatening immune challenging disease to the global human community has to be diagnosed earlier and eliminated in the upcoming era. Vitamin D, a fat-soluble micronutrient, mainly from epidermal cells of the skin and a few dietary sources, is associated with the immune system in various disease management. Therefore, a better understanding of vitamin D metabolism and immune function in tuberculosis should be studied for the consideration of biomarkers. Methods: The study consist of Pulmonary Tuberculosis (PTB) patients (n = 32) at two-time points: Baseline (PTB BL) and after 6 months of anti-TB treatment (ATT) (PTB PT), latently Mtb infected (IFNγ + ) group (n = 32) and a non-LTB healthy control (IFNγ-) group (n = 32). Vitamin D levels were measured using High-performance liquid chromatography (HPLC). The cytokine data from the same participants assayed by ELISA from our earlier in�vestigations were used to correlate it with serum Vitamin D levels. Results: The assayed serum Vitamin D levels between the groups showed significantly lowered levels in PTB BL when compared with IFNγ + and IFNγ- groups. And, the Vitamin D levels in the PTB group after ATT were significantly lower than the baseline levels. The Vitamin D data were compared with pro- and anti-inflammatory cytokines and adipokines levels by performing a principal component regression analysis. Based on the PC scores, the study group showed distinct clusters for the TB group and control group. And, the correlation analysis be�tween the study group and immunological indices showed significant correlations. Vitamin D significantly correlated with IFNγ, TNFα, IL17A, IL-4 and Resistin in the TB group, whereas IL-6 and G-CSF in the control group. Conclusion: The baseline measurement of Vitamin D levels was significantly decreased in the PTB group when compared with IFNγ + and IFNγ- groups showing the importance of Vitamin D as a preventive factor against the TB disease progression. The six-month post-treatment of TB showed a further decrease in Vitamin D levels in PTB. The significantly correlated immunological indices with Vitamin D levels are the biomarker profile that could predict TB

Interpretation of 17-hydroxyprogesterone levels in early neonatal period by dissociation-enhanced lanthanide fluorescent immunoassay technique in a tertiary care centre

Background: Mass screening for CAH is controversial worldwide because of the low positive predictive value. The cut off levels of 17 OHP in NBS are based on birth weight and or gestational age. Both RIAs and ELISAs have been almost replaced in most European countries by DELFIA. We used DELFIA technique. The aim and objective was to determine optimal cut off values of 17 OHP levels in early neonatal period based on gestational age and birth weight. Methods: The study was conducted in the neonatal unit of RSRM Hospital Stanley Medical College as Prospective cross sectional study. All new borns with a gestational age of 34 weeks or more were included in the study. Sample was collected after getting informed consent after 48 hours of age till 7 days of age. 1695 babies who met the inclusion criteria were enrolled, the blood sample were collected by heel prick on filter paper. Neonates less than 34 weeks of gestational age, babies mothers who had received antenatal steroids, babies who had received blood transfusion prior to sampling and refusal of consent were excluded Results: As the gestational age increases the mean 17 OHP values declines and plateaus at 37 weeks and beyond. Similarly analysis based on weight shows a decline in mean values of 17 OHP with increasing birth weight and plateaus from 2500 gm. Conclusions: The study demonstrates clearly that there is linear trend in mean 17 OHP values in relationship to gestational age when compared to birth weight. [Int J Res Med Sci 2016; 4(5.000): 1522-1528