IgM and IgG anti A and anti B antibody status of 100 antenatal O group mothers (who had non O group husbands) were studied. Of these, 3 mothers had an IgM anti A antibody levels ranging from 1:512 to 1:2048 and IgG ranging from 1:1204 to 1:2048, IgM anti B ranging from 1:128 to 1:512 and IgG anti B ranging from 1:256 to 1:512. All these mothers had A + ve children and all these children suffered from ABO haemolytic disease of newborn (HDN). A 4th mother had an IgM anti A titre of 1:64 and IgG anti A titre of 1:16. The titre of IgM anti B in this mother was 1:512 and that of IgG 1:1024. The child was A + ve and did not suffer from ABO haemolytic disease of newborn.

Background Damage to the peritoneal dialysis catheter may be due to wear from long-term use, exposure to antibacterial agents (strong oxidants), and accidental injury from sharp objects. Repair of such catheter, if not associated with subsequent complications, would extend catheter life and reduce costs and patient inconvenience related to catheter replacement. Objective and Design Retrospective analysis of seven peritoneal catheters repaired 11 times over a 15-year period by splicing the old catheter with an extension tube using the Peri-Patch Repair Kit (Quinton Instrument Co., Bothwell, WA, U.S.A.). Results The life of these seven catheters was extended by a mean of 26 months (range 1 -87 months), without increasing infection rates after splicing. The peritonitis rate after catheter splicing was 0.40 per year, not higher than the overall rate (0.76 per year) in our center during the same time period. Exit-site infections occurred in 6 patients after catheter splicing. Only one infection was related to trauma during the procedure and resulted in chronic exit infection; the catheter was eventually removed. In this patient, damage to the catheter was less than 1.5 cm from the exit site. Conclusions and Recommendations Splicing of the damaged peritoneal catheter, if properly done, is a safe procedure and can significantly prolong catheter life. We recommend that measures to prevent catheter damage, such as avoiding the use of scissors and other sharp objects, should be emphasized during the initial patient education and training. Alcohol and iodine should not be used on silicone rubber catheters. We suggest that the patient should report catheter damage immediately and come to the clinic within a few hours for catheter splicing (if possible) and prophylactic antibiotic to prevent peritonitis. Finally, we recommend that repair of the catheter should not be attempted if the breakage is less than 2 cm from the exit site, unless done as an emergency procedure if immediate catheter replacement cannot be performed.

BACKGROUND Haemolytic Disease of Fetus and Newborn (HDFN) is characterised by lysis of red blood cells resulting in anaemia and its hypoxic effects thereafter. Following anaemia, the production of fetal red blood cells is drastically increased. This is followed by extramedullary haematopoiesis in a widespread manner and erythroblastosis characterized by nucleated red cells in the circulation. Since this is an illness affecting many a newborn, assessing the patterns of anaemia in both ABO and Rh-D HDFN may help in effective planning and implementation of better management protocols. METHODS This is a cross sectional study with comparative analysis. The study was performed among 154 neonates who were diagnosed to have HDFN. Setting for this study was Department of Transfusion Medicine and Pediatrics of Government Medical College, Trivandrum. During the time of delivery, 5 mL umbilical cord blood was collected. That sample was used for analyzing haemoglobin levels of the neonate. Duration of treatment of the neonate was noted down during follow up. Statistical analysis was done using SPSS software version 16. RESULTS The mean cord blood haemoglobin value in ABO haemolytic disease was 17.1 ± 2.7 g %. The mean cord blood haemoglobin value in Rh-D haemolytic disease was 14.5 ± 1.9 g %. In infants with ABO haemolytic disease, 53 (48.2 %) had undergone no treatment in ICU. Remaining 51.8 % had undergone 3 - 10 days of treatment in neonatal ICU. Infants with Rh-D HDFN 20 (45.5 %), had undergone no treatment in ICU. Remaining 54.5 % has got 3 - 9 days of treatment in neonatal ICU. Mean treatment duration in infants with ABO haemolytic disease was 3.1 ± 3.3 days. Mean treatment duration in infants with Rh-D haemolytic disease was 2.9 ± 2.9 days. A comparison of mean values of cord blood haemoglobin in neonates with both categories of haemolytic disease was performed. The p value was 0.00 and it was significant. Mean values of duration of treatment of neonates with ABO and Rh-D haemolytic anaemias were compared statistically. No significant difference was observed. CONCLUSIONS Mean haemoglobin levels in Rh-D HDFN showed a significant decrease as compared to ABO-HDFN. Duration of treatment in ABO HDFN and Rh-D HDFN presented no significant difference. KEYWORDS Haemolytic Disease of Fetus and Newborn, Umbilical Cord Haemoglobin, Anaemia, ICU Stay, ABO HDFN, Rh-D HDFN

BACKGROUND Red blood cell transfusion in neonates can be affected by diagnosis and treatment. In this research we reasoned those factors. We wanted to evaluate diagnostic and treatment related factors determining red cell transfusion among sick neonates METHODS This was a case control study done on 300 neonates admitted to the Neonatal Intensive Care Unit (NICU) of Sri Avittom Thiruna l Hospital (SATH), Government Medical College, Thiruvananthapuram for a period of one and a half years. Cases were sick neonates transfused with packed red cells. Diagnostic and treatment related characteristics known to be associated with anaemia of prematurity were recorded. It included total number of phlebotomies performed, approximate blood loss per each phlebotomy, use of other blood components, duration of mechanical ventilation, duration of oxygen supplementation, type of antibiotics given, duration of treatment, duration of hospital stay and outcome of the baby. All statistical data were analysed using SPSS software version 16. RESULTS This study was a case control study done in 300 neonates, cases (n=150) and controls (n=150). Mean number of phlebotomies in the case group was 9.5 ± 2.6 and in the control group was 4.5 ± 2.2 and was statistically significant. On analysis, 72.7 % of case group and 27.3% of the control group required mechanical ventilation and was statistically significant. Among the transfused group, 97.3% required oxygen supplementation while only 64.7% in the control group required it and was statistically significant. Mean duration of oxygen supplementation in the transfused group was 10 ±5.7 days and in the non-transfused control group was 5.4 ± 6.4 days and this was statistically significant. Inotropes were administered in 86% of the case group and in 58% of the control group and was significant. The mean duration of administration of inotropes in the study group was 6.5 ± 4.1 days and in the control group was 4.9 ± 5 days and was significant. Duration of hospital stay was significantly higher in the transfused group CONCLUSIONS Mean number of phlebotomies, requirement and duration of mechanical ventilation, mean duration of oxygen supplementation, administration of inotropes, mean duration of administration of inotropes and duration of hospital stay was significantly higher in the transfused group.

BACKGROUND Many of the neonates with low birth weight and gestational age require transfusion of red blood cells during their neonatal period. This research is assessing factors and clinical conditions for red blood cell transfusions of low birth weight (LBW) infants. We wanted to identify the birth related determinants of red blood cell transfusion in sick neonates. METHODS This was a case control study done in 300 neonates admitted to the Sri Avittom Thirunal Hospital (SATH), Government Medical College, Thiruvananthapuram. Cases were sick neonates who were transfused with red cells. The neonatal demographic and birth characteristics, details of the baby, indication for admission and transfusion, pre and post transfusion haematocrit, treatment given and outcome, complications occurring during delivery and post-natal complications also were analysed. All statistical data were analysed using SPSS software version 16. RESULTS On assessment of the age, mean age of the cases and controls were compared and there was no significance. O+ blood group was seen predominantly in the neonates who received transfusion. Mean birth weight was 1.8 ± 04 in both groups and there was no significant difference. Mean gestational age was 33.9±2.8 in the case group and 33.5± 2.7 in the control group. Statistically significant difference was not there. On comparison, APGAR score was statistically significant. On comparing the diagnosis, the prevalence of congenital pneumonia, Small for Gestational Age (SGA) (p= 0.002) and Neonatal Jaundice (NNJ) were found to be significantly higher in the case group. On assessing the intra natal complications, 78.7 % of the mothers in the case group had intranatal complications compared to 61.3% in the control group. p Value was significant. Caesarean section was significantly more in the case group. p value was significant in caesarean section and cord prolapse. Post-natal complications were significant in this study. The frequency of anaemia and cardiac diseases were significantly higher in the case group compared to the control group. When pre transfusion haematocrit was compared, mean haematocrit in the case group was 27.1 ± 4.4 compared to 54.1±6.3 in the control group. This is statistically significant. On analysis, clinical sepsis was significantly higher in the transfused group. CONCLUSIONS After analysis it was found that APGAR score, presence of congenital pneumonia, SGA, neonatal jaundice, intra natal complications, caesarean section, cord prolapse, post-natal complications, frequency of anaemia and cardiac diseases, pre transfusion haematocrit and clinical sepsis were significantly more in the case group.