Study of Bone Mineral Density in Transfusion Dependent Thalassemia, its correlation with Biochemical and Hematological parameters: A Cross-Sectional Study

2024-11-29T17:52:18+0530

Background: In thalassemic patients, bone disease is an important cause of morbidity. Patients with transfusion-dependent thalassemia (TDT) are susceptible to osteopenia and osteoporosis, the mechanism being multi-factorial. The present study was undertaken to study the prevalence of osteopenia and osteoporosis in TDT patients and describe its correlation with biochemical, hematological profile. Method: A total of 84 patients with TDT on regular PRC transfusion and iron chelation therapy aged between 5-18years were enrolled in the study. Bone mineral densities (BMD) was measured by DXA scan (DXA spine/whole body) and categorized into normal, osteopenia and osteoporosis based on WHO grading system. Results: Out of 84 subjects, 57.1% had low BMD with 38(45.2%) having osteopenia and 10(11.9%) of them having osteoporosis. The prevalence of osteoporosis was found to be more by DXA Spine than DXA whole body which was found to be statistically significant (P=0.043). A high prevalence of hypoparathyroidism, hypocalcemia, hypovitaminosis D and increased serum phosphorous levels were noted among TDT patients with low BMD. Iron overload in Myocardium by T2*MRI also showed statistically significant association with low BMD as determined by DXA Spine. Conclusion: Low bone mass is one of the most prevalent complications among TDT patients. Osteoporosis is a progressive disease with multifactorial etiology. Iron overload status by T2* Cardiac MRI may be used as an early indicator for predicting Osteoporosis along with T-scores from DXA spine for early diagnosis and interventions. Further longitudinal prospective studies are needed to better understand the etiopathogenesis of bone disease in these patients.

A Prospective Study on Screening of Congenital Heart Diseases using combined Pulse Oximetry and Clinical Examination in Neonates

2024-12-25T11:30:57+0530

Background: Congenital malformations are responsible for half of infant deaths, with congenital heart disease accounting for 10% of the fatalities. Clinical examination remains the primary method for diagnosing congenital heart disease in newborns.

Materials and Methods: The study was conducted in the postnatal ward involving 224 newborns. Asymptomatic term newborns underwent screening for cyanotic congenital heart disease using pulse oximetry and clinical examination. The pulse oximetry was performed using a GE MONITOR device.

Results: Pulse oximetry saturation levels were below 90% in 5.4%, between 91-94% in 2.2%, and above or equal to 95% in 92.4% of the newborns. The diagnoses included TOF (1; 0.5%), pulmonary stenosis (1; 0.5%), and tricuspid atresia (1; 0.5%). Among the newborns with positive pulse oximetry screening (oxygen saturation <95%), 17 were identified. Out of these, 3 had confirmed cyanotic congenital heart disease by echocardiography. Similarly, among the newborns with negative clinical examination screening (oxygen saturation ≥95%), 209 were identified. Out of these, 15 had positive clinical examination results, with 3 having confirmed cyanotic congenital heart disease by echocardiography.

Conclusion: Pulse oximetry is a valuable screening tool for the early detection of congenital heart diseases, particularly cyanotic congenital heart diseases. It emphasizes the importance of both pulse oximetry and clinical examination results for a comprehensive screening approach. The study highlights the need for further research to refine and optimize the screening process for congenital heart diseases.

Pediatric Review: International Journal of Pediatric Research

Study of Bone Mineral Density in Transfusion Dependent Thalassemia, its correlation with Biochemical and Hematological parameters: A Cross-Sectional Study

A Prospective Study on Screening of Congenital Heart Diseases using combined Pulse Oximetry and Clinical Examination in Neonates