c Intraventricular hemorrhage with congenital cytomegalovirus (CMV) infection is rare and has been reported only in extremely premature infants or in association with thrombocytopenia. We report the first case of a full-term male infant with congenital CMV infection and intraventricular hemorrhage with a normal platelet count and coagulation profile. The infant also had a left subependymal cyst and bilateral occipital cysts without any other manifestations of CMV infection. CASE REPORTT he mother of our patient was a 31-year-old woman (gravida 2, para 1) who was rubella and varicella immune, and all of her other serologic findings were negative. The parents were nonconsanguineous, and there was no family history of any bleeding disorder. Ultrasound examinations done at 12, 19, and 30 weeks of gestation showed normal fetal anatomy with a fetus appropriate for its gestational age.The pregnancy was uneventful until 38 weeks of gestation, when the mother felt that fetal movement had decreased. An ultrasound examination revealed asymmetric intracranial ventriculomegaly with the left lateral ventricle larger than the right and strands visible across both ventricles. The occipital horn of the right ventricle was also dilated, and there was echogenicity of the left choroid plexus suggestive of a blood clot (Fig. 1A). Fetal biometry was appropriate for the gestational age, the amniotic fluid index was normal, and the biophysical profile was 8/8.As an intraventricular hemorrhage was suspected, delivery was by cesarean section at 39 weeks of gestation with Apgar scores of 9 and 9 at 1 and 5 min, respectively. His birth weight was 2,790 g, his head circumference was 34 cm, and his length was 48 cm, all of which were appropriate for his gestational age. Except for mild hypotonia, the infant was normal upon examination.Magnetic resonance imaging (MRI) done on day 2 of life showed a moderately dilated left lateral ventricle with a subependymal cyst at the left foramen of Munro extending along the caudothalamic notch, consistent with a previous intraventricular hemorrhage. There were bilateral occipital cysts compressing the occipital horns with a thin intervening septation (Fig. 1B). A small-volume intraventricular hemorrhage was visible in the dependent portion of the left lateral ventricle (Fig. 1C). Myelination was appropriate for a term infant, and magnetic resonance spectroscopy was noncontributory.Given his history and neuroimaging findings, the infant was investigated for a bleeding disorder and bacterial and viral infections. Complete blood counts showed a platelet count of 190 ϫ 10 9 /liter (normal range, 150 ϫ 10 9 to 400 ϫ 10 9 /liter) with normal hemoglobin and white cell counts. The partial thromboplastin time was 46.6 s, and the international normalized ratio was 1.4, both of which were within the normal range for a term infant. Bacterial cultures and tests for parvovirus B19-specific IgM and IgG and toxoplasma-specific IgM and IgG were negative. Both the rapid plasma reagin assay and a line immunoassay (Innogene...

Background. Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common X-linked inherited erythroenzymopathy in Thailand. The clinical and hematological manifestations of G6PD deficiency are variable. Objective. This study aimed to characterize the genotype-phenotype correlation of G6PD mutations in Thai pediatric patients who were followed-up in Phramongkutklao Hospital, a tertiary center in central Thailand. Material and Method. A total of 102 children including 73 males (71.6%) and 29 females (28.4%) were included in our study. Mutation analysis was performed by direct DNA sequencing of all coding exons of the G6PD gene. Ninety-one patients (89.2%) were presented with neonatal hyperbilirubinemia and 11 patients (10.8%) were presented with acute hemolytic anemia beyond the neonatal period. Results. Molecular analysis of the G6PD gene in 102 G6PD-deficient Thai children identified 12 different mutations. G6PD Viangchan (871G > A) and G6PD Canton (1376G > T) were the first (46.2%) and the second (15.4%) most common identified mutations among both male and female G6PD-deficient individuals, respectively. All affected males were hemizygous for G6PD mutations and had an average G6PD level of 16.7 ± 11.5 (3–76) IU/ml.RBC. Majority of female patients (27 in 29, 93.1%) were heterozygous for G6PD mutations and had an average G6PD level of 133.6 ± 43.4 (9–195) IU/ml.RBC. Two female patients (6.9%) were either homozygous or compound heterozygous for the mutations and had G6PD level in the affected male range (35 and 10 IU/ml.RBC). Only 1 in 27 heterozygous females (3.7%) had G6PD level in the affected male range (9 IU/ml.RBC) which is possibly explained by nonrandom X-chromosome inactivation. The correlation of genotypes, G6PD levels, and clinical phenotypes was not demonstrated in our study in which all of the included G6PD-deficient patients were presented with neonatal hyperbilirubinemia and acute hemolytic anemia, since the genotype-phenotype correlation is normally demonstrated in chronic nonspherocytic hemolytic anemia (CNSHA) G6PD-deficient individuals. Conclusion. This study characterizes the molecular heterogeneity of G6PD variants causing G6PD deficiency in Thai children. Our study demonstrated the efficiency of direct DNA sequencing which can identify 12 missense mutations in Thai children.

from the present study may be beneficial for ameliorating the complications of hypoglycemia in newborn infants and suggest a new safe and simple way of management.

Background/Aim: The critical drop of body temperature in neonatal termed "hypothermia" increases risk of morbidity and mortality. In order to minimize hypothermia during delivery room to nursery transportation, we trialed for appropriate alternative means of aluminum coated fabric (ACF), cotton swaddle, and their combination. The aim of the present study was to compare the efficacy of aluminum coated fabric, cotton swaddle, and combined method to prevent neonatal hypothermia. Patients and Methods: One hundred and seventy-four of eligible infants (birth weight more than 2,500 g) were randomized into three groups (55 infants in aluminum coated fabric, 60 in combined aluminum coated fabric with cotton swaddle, and 59 in cotton swaddle as a control). Rectal temperature was determined before swaddling and arriving at nursery. Results: There was no significant difference in antenatal and perinatal factors. Normothermia was detected in 50, 52, and 55 infants and decrease body temperature from its baseline were evidenced in 25, 24, and 14 infants swaddling with aluminum coated fabric, combined aluminum coated fabric with cotton swaddle and cotton swaddle, respectively (p=0.425 and p=0.210). Interestingly, results indicated that the use of cotton swaddle, ACF, and their combination could reduce the number of hypothermic infants from 4, 3, and 6 to 0, 5, and 1, respectively, pointing that the use of cotton swaddle exhibited the maximum hypothermia recovery potential. Conclusion: The cotton swaddle showed the dominant hypothermal control over ACF and combination of cotton swaddle and ACF. These findings may benefit the development of new strategies for hypothermia prevention in newborns.

Astaxanthin, a potent antioxidant compound, is well recognized for its beneficial effects to protect from oxidative stress and free radicals. However, the effects of long period of use of astaxanthin on biological parameters, health indicators, and energy intake are still largely unknown. A total of 33 healthy participants aged 21–54 years with body mass index in the range of 18.50−24.90 kg/m2 were enrolled in this randomized controlled trial and were assigned into astaxanthin and placebo groups. The participants in the astaxanthin group received 4 mg of astaxanthin once daily for 12 consecutive weeks. Dietary intakes, as well as blood levels of astaxanthin and biological parameters, were investigated at baseline and week 12. The significant elevation of blood astaxanthin level in the astaxanthin group was notified at week 12. Regarding basic characteristics of blood biochemical parameters, results indicated that the fasting blood glucose, total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol were not significantly different between astaxanthin and placebo groups at week 12. Interestingly, the significant decrease in total energy and carbohydrate intakes of the participants in the astaxanthin group (P < 0.05) was found after 12-week supplementation, compared to the baseline. The findings support the safety of long-term supplementation and reveal potential dietary intake lowering effect of astaxanthin in healthy individuals.