Hemolytic disease of the fetus and newborn caused by anti-D and anti-S alloantibodies: a case report

<p>Abstract</p> <p>Introduction</p> <p>Hemolytic disease of the fetus and newborn is most commonly caused by anti-D alloantibody. It is usually seen in Rhesus D (RhD)-negative mothers that have been previously sensitized. We report here a case of hemolytic disease of the fetus and newborn in a newborn baby caused by anti-D and anti-S alloantibodies, born to a mother who was RhD negative, but with no previous serological evidence of RhD alloimmunization.</p> <p>Case presentation</p> <p>A one-day-old Chinese baby boy was born to a mother who was group A RhD negative. The baby was jaundiced with hyperbilirubinemia, but with no evidence of infection. His blood group was group A RhD positive, his direct Coombs' test result was positive and red cell elution studies demonstrated the presence of anti-D and anti-S alloantibodies. Investigations performed on the maternal blood during the 22 weeks of gestation showed the presence of anti-S antibodies only. Repeat investigations performed post-natally showed the presence of similar antibodies as in the newborn and an anti-D titer of 1:32 (0.25 IU/mL), which was significant. A diagnosis of hemolytic disease of the fetus and newborn secondary to anti-D and anti-S was made. The baby was treated with phototherapy and close monitoring. He was discharged well after five days of phototherapy.</p> <p>Conclusions</p> <p>This case illustrates the possibility of an anamnestic response of allo-anti-D from previous sensitization in a RhD-negative mother, or the development of anti-D in mid-trimester. Thus, it highlights the importance of thorough antenatal ABO, RhD blood grouping and antibody screening, and if necessary, antibody identification and regular monitoring of antibody screening and antibody levels for prevention or early detection of hemolytic disease of the fetus and newborn, especially in cases of mothers with clinically significant red cell alloantibody.</p

Removal of lead(II) from aqueous solution using polyacrylonitrile/zinc oxide activated carbon nanofibers

This study aimed to prepare activated carbon nanofibers (ACNFs) from polyacrylonitrile (PAN) and zinc oxide (ZnO) via electrospinning process for removal of lead from aqueous solution. The ACNFs/ZnO were characterized in term of its morphological changes, specific surface area and functional groups analysis using Field Emission Scanning Electron Microscope (FESEM), Brunauer–Emmett–Teller (BET) and Fourier Transform Infrared (FTIR) analysis, respectively. The results showed that the specific surface area (SSA) of the ACNFs/ZnO were higher than the neat ACNFs which were 163.04 m2/g as compared to 67.6 m2/g, accordingly. FESEM analysis illustrated that composite ACNFs possessed more compact fibers with presence of ZnO beads and smaller fiber diameter whereas neat ACNFs possessed more aligned nanofibers with larger fiber diameter. Adsorption study showed that the composite ACNFs possessed higher capacity which was 120.3 mg/g as compared to 77.6 mg/g of neat ACNFs. This excellent adsorption performance of ACNFs PAN/ZnO exhibits the potential of this composite adsorbent to solve the environmental issue of heavy metal contamination

Preparation of composite activated carbon nanofibers (ACNFs) for adsorption of heavy metals

The objective of this study is to prepare a new and highly efficient nanomaterial for heavy metals adsorption. Owing to that, activated carbon nanofibers (ACNFs) from precursor polyacrylnitrile (PAN) and manganese oxide (MnO2) have been prepared via electrospinning process for removal of heavy metals (lead and cadmium) from aqueous solution. The PAN/MnO2-based ACNFs were characterized in term of its morphological changes, specific surface area and functional groups analysis using SEM, BET and FTIR analysis respectively. The results showed that the specific surface area (SSA) of the electrospun composite ACNFs was higher than the neat ACNFs which is 499m2/g as compared to 800m2/g. SEM analysis illustrated that composite ACNFs have more compact fibers with presence of MnO2 beads and smaller fiber diameter of 437.2 nm whereas neat ACNFs possessed more aligned nanofibers with average fiber diameter of 575.5 nm. From adsorption study, the removal of Pb (II) and Cd (II) using both ACNF/MnO2 and ACNFs were higher than the commercial GAC with the removal efficiency is 100% for Pb (II) and 97% for Cd (II). The high removal efficiency of ACNFs/MnO2 is attributed by its larger SSA, presence of functional groups that play role in adsorption process such as hyroxyl and carboxyl groups and the role of manganese oxide as adsorbent itself (Han,2006). This excellent adsorption performance of ACNFs exhibits the potential of this composite adsorbent to solve the environmental issue of heavy metal contamination

The paediatric iron deficiency assessment with reticulocyte haemoglobin equivalent (Ret-He) in comparison with biochemical markers of serum ferritin and transferrin saturation

Diagnosis of iron deficiency anaemia (IDA) is a challenge as the conventional methods often diagnose the disease at the later stage. Haemoglobin content of reticulocytes is useful to identify IDA at earlier stage. The objective of this study was to evaluate reticulocyte-haemoglobin equivalent (Ret-He) in diagnosing IDA in children and to compare it with other conventional methods. This prospective study was conducted on 120 paediatric patients aged 12 years and below, who attended Hospital Sultanah Aminah Johor Bahru, Malaysia with haemoglobin <12 g/dL. Ret-He and serum iron, ferritin and transferrin saturation were measured. Using a cut-off point of 20% for transferrin saturation, 81 out of 120 subjects (67.5%) were found as iron deficient. Based on the diagnosis of IDA, cut-off value for Ret-He using the Receiver Operating Characteristics (ROC) curve analysis was found as 22.65 pg. Ret-He showed a good sensitivity and specificity of 77.8% and 66.7%, respectively. As compared with Ret-He, serum ferritin showed a sensitivity of only 18.9%. However, a good specificity of 100% suggest it is useful for ruling in the disease but not suitable for screening. Transferrin saturation showed a good sensitivity and specificity, but it is biologically variable and not cost effective as a screening tool. Correlation study showed serum iron and transferrin saturation have significant positive correlation with Ret-He (r=0.415 to 0.518). However, there was no correlation between Ret-He and serum ferritin (r=0.051, p=0.578). This study shows that Ret-He at a cut-off point of 22.65 pg has a better sensitivity and potentially be useful as a screening tool in the paediatric population

Preparation and characterisation of polyethersulfone/ hydrous ferric oxide mixed matrix membranes with improved hydrophilicity for treatment of oily waste water

The rapid growth in oil and gas industry has led to the large production of oily wastewater. The massive amount of oily wastewater derived from the industry has raised concerns in community especially its adverse impact to the environment. Membrane technology has been in the spotlight in recent advancement to treat the oily wastewater. The major obstacle regarding the membrane technology is fouling due to surfactant adsorption and/or oil droplets plugging the pore, which would lead to a severe decline of the flux and rejection rate. HFO nanoparticles are incorporated into the PES membrane matrix with the aim to improve the hydrophilicity, water permeability as well as the antifouling properties of the membrane. HFO is abundant and easily obtained making it the perfect candidate in developing economical and energy saving membrane operation. Hydrous ferric dioxide (HFO) nanoparticles were synthesised via chemical precipitation method and incorporated in polyethersulfone (PES) to fabricate nanocomposite mixed matrix membranes (MMMs) for ultrafiltration (UF). The resulting membranes were characterised by SEM, FTIR, contact angle goniometer, before further subjected to water permeation test. It was found that contact angle of membrane decreased remarkably with an increase in HMO nanoparticle loading (state the value/ percentage decrement). The pore size at the skin layer however decreased as observed by SEM. As for the UF experiments, pure water permeation rate increased remarkably with increasing nanoparticle loading

Idiopathic hypereosinophilic syndrome with unusual presentation : two case reports and review of literature

Idiopathic hypereosinophilic syndrome (HES) is an uncommon disorder which usually presents with prolonged and significant primary eosinophilia with end-organ dysfunction. Damaging proteins released by the eosinophilic granules are responsible for the tissues and organ system damage. Here we report two cases of idiopathic HES. Both the patients were young lady presented with high grade fever and concomitant symptoms. Laboratory findings showed leucocytosis with predominant neutrophilia and marked eosinophilia. A diagnosis of idiopathic HES was made after excluding secondary causes of eosinophilia. However, the first patient was complicated with multiple venous thrombosis and intravenous heparin was started which was later changed to subcutaneous low molecular weight heparin (LMWH). The patient developed pleural effusion and consolidation. Intravenous Tazoscin, tablet Prednisolone and tablet Hydroxyurea was started and the patient responded well. Despite treatment, two weeks later, suddenly the patient collapsed and unfortunately succumbed. On the other hand, the second patient was complicated with fever, thrombocytopenia, haemolytic anaemia, acute renal failure and neurological deficit which were part and parcel of thrombotic thrombocytopenic purpura (TTP). Plasma exchange was commenced and patient’s condition had slowly improved. Nevertheless, the hypoxia which she sustained during the multiple episodes of fits had resulted in permanent brain injury and thus requiring a tracheostomy for prolonged ventilatory support. Currently, there is no cure for HES. The main aim of treatment is to minimise the tissue damage caused by the hypereosinophilia. Early diagnosis and intervention are therefore crucial in preventing the spread of the disease and the end-organ damage

Photocatalytic degradation of industrial dye wastewater using zinc oxide polyvinylpyrrolidone nanoparticles

Due to the lack of studies regarding the potential of polyvinylpyrrolidone (PVP) as capping agent in precipitation of zinc oxide (ZnO) nanoparticles, this research focused on the performance of ZnO nanoparticles with presence of PVP loading on photocatalytic degradation treatment for industrial dye wastewater. Three different samples of ZnO-PVP were successfully synthesized via precipitation method. The degradation rate of dye approached 90.61% under pH7 in the presence of ZnO-PVP (0.025g/L of PVP). The chemical bonds in ZnO-PVP was analysed using Fourier Transform Infrared Spectroscopy (FTIR)

Photocatalytic degradation of palm oil mill secondary effluent

Palm oil industry is one of the industries that has major disposal problem in disposing the lignocelluloic biomass such as oil palm trunks (OPT), oil palm fronds (OPF), empty fruits bunches (EFB) and palm pressed fibres (PPF), palm shells and palm oil mill effluent (POME) [1]. Amongst all waste produced, POME is the most difficult waste to treat due to its high volume generated [2]. POME consists of 95-96% water, 0.6-0.7% of oil and 4-5% and total solid. Although it was said that POME is nontoxic, however the abundance of POME in water stream could lead to oxygen depletion in water stream as POME contains high amount of nitrogen (N), phosphorous (P), potassium (K), magnesium (Mg), and calcium (Ca) which later on could lead to plant growth in aquatic region. POME also consists of sterilizer condensate, separator sludge and hydrocyclone (DOE 1999). The treatment of POME generally undergo ponding system, open tank digester and extended aeration system, or closed anaerobic digester and land application system. Palm oil mill secondary effluent (POMSE) is the result of treatment of POME and is characterized by having a thick, brownish color and bad odor wastewater. Although POME was claimed to be treated with one of the systems, several studies showed that the POMSE still exceed the standard discharge limit set by both Department of Environment (DOE) Malaysia and Environment Quality Act (EQA) 197

Palm oil mill secondary effluent (POMSE) treatment via photocatalysis process in presence of ZnO-PEG nanoparticles

Palm oil mill secondary effluent (POMSE) has high colour intensity, turbidity and organic load of biochemical oxygen demand which still not achieved the discharged requirement by department of environment and led to detrimental to the aquatic life. Photocatalysis process is one of the promising method in wastewater treatment due to its advantages. This study reports on the POMSE treatment using photocatalysis process in presence of ZnO-polyethylene glycol (ZnO-PEG) nanoparticles. The characterization results using fourier-transform infrared spectroscopy, X-Ray diffraction and transmission electron microscopy show that there are no impurities present in the samples and presenting the nature and chemical bonds of ZnO-PEG besides having less agglomeration and smaller average in size (25–150 nm) compared to commercial ZnO (25–200 nm). ZnO-PEG nanoparticles have a great potential in degradation of POMSE and this is supported with the results obtained from the experimental works. Four potential factors which are different type of (A) photocatalysts, (B) pH of the POMSE, (C) ZnO-PEG loading and (D) concentration of POMSE were evaluated for the significance design of experiment. It is found that all the main factors were significant, with contributions of (A)66%, (B)73%, (C)84% and (D)84% respectively, to the POMSE degradation. Accordingly, the most favorable condition for the photocatalysis degradation process of POMSE is under pH 6.5 in presence of 0.5 g/L ZnO-PEG for the 50% of POMSE dilution. It is believed that this integrated approach can be implemented in the industry to achieve discharged standard of POMSE and maintain the green environment for future generation