This is with reference to the recent article comparing analgesic effect of direct breastfeeding with dextrose and placebo [1]. Clinical studies have shown that calming effect of breast milk is due to components other than its sugar [2]. Oral sugar may change the facial expressions of some babies giving the impression that pain is being relieved. One randomized controlled trial measured the effect of oral sucrose on procedural pain in infants, with direct measures of brain and spinal cord activity as an outcome measure for pain. The results show that sucrose has no effect on the neural activity in sensory pain circuits in the brain or the spinal cord [3].The needle prick causes pain, discomfort and produces a sense of insecurity. Cuddling, patting and holding baby very close to the body by caretaker or mother imparts sense of security and, calms and pacifies baby. Breastfeeding can help reduce pain and calm a child because it gives the infant comforting skin-to-skin contact and imparts a sense of security. Sucrose is given because it seems to work but it probably just produces emotional blunting; the process related to pain continues with its detrimental effects.

No abstract

Transfusion-associated graft versus host disease [TAGVHD] results from the engraftment of transfused immuno-competent cells in blood transfusion recipients, whose immune system is unable to reject them. All blood products containing viable, immuno-competent T cells have been implicated in TAGVHD. Presence of a "one-way HLA match between donor and recipient" is associated with a significantly increased risk of TAGVHD. Though sharing of haplotype is the most probable explanation, it is far from adequate. Since TAGVHD is not seen in patients with AIDS, and an acute GVHD-like syndrome has been noted in some identical twins and autologous (self) transplants, some other processes, possibly of an "autoimmune" nature are responsible for TAGVHD. Most of the cases have been reported from Japan. This clustering in space and time is rather intriguing. We offer here alternative hypothesis. Foetal and then neonatal lymphocytes exhibit tolerance towards donor cytotoxic T lymphocytes; and consequently very few cases of TAGVHD have been reported in neonates than expected. This tolerance is a part of altered immunology of pregnancy. We feel that it is possible to use maternal blood for transfusion to her newborn baby by following certain protocol and procedure and TAGVHD is no barrier.

No abstract

There is a significant unmet clinical need for a reliable point-of-care (POC) estimation of the blood haemoglobin (Hb) method. Current available methods, notably pulse oximetry, have certain limitations related to design and methodology of devices. These have low sensitivity for detecting serial change in the Hb values, especially at the lower range and are inaccurate in people with darker skin.ObjectiveThis study aimed at developing a novel, non-invasive technology for the measurement of Hb and oxygen saturation.DesignThis was an observational study.RecruitmentThis was approved by the Institutional Review Board at the University of Texas at Arlington and 16 healthy adult volunteers (age 20–40 years) were recruited in this study.The investigational device (Shani) probe (United States Patent 11191460B1) consists of light emitting diodes with wavelengths ranging 520–580 nm, and a photosensor component. The probe is gently placed on the back of the subject’s wrist and reflected light is measured as an electrical signal, with digital recordings. Skin tone (or skin colour) was assessed by Von Luschan Chromatic Scale (VLS). Using a specific algorithm accounting for melanin (as determined from VLS Scale) and employing a software, the results can be displayed on screen as Hb values and ratio of tissue oxygen saturation.ResultsThe results of the investigational non-invasive (Shani) device were comparable with the invasive, point of care (POC) method (iSTAT, Abbott Inc.).