Newborn screening is a public health program that screens infants shortly after birth for treatable genetic or metabolic conditions. The goal is early detection so medical treatment can be promptly initiated to prevent irreversible damage. Conditions commonly screened for include phenylketonuria, congenital hypothyroidism, galactosemia, and maple syrup urine disease. Screening methods have advanced from bacterial assays of individual conditions to tandem mass spectrometry, which can screen for over 50 conditions in a single test.
Newborn Screening | Infant Care | Health Care | Baby's First Testjohndemello7
Baby's First Test is the nation's newborn screening education center for parents, health professionals, and the public on the newborn screening system.
Visit http://www.babysfirsttest.org/
Growth charts in Neonates- Preterm and termSujit Shrestha
Growth charts in Newborn, Preterm and term neonates. All historically used charts in NICU are discussed here.
Presented by Dr Sujit, in Sir Ganga Ram Hospital
Newborn Screening | Infant Care | Health Care | Baby's First Testjohndemello7
Baby's First Test is the nation's newborn screening education center for parents, health professionals, and the public on the newborn screening system.
Visit http://www.babysfirsttest.org/
Growth charts in Neonates- Preterm and termSujit Shrestha
Growth charts in Newborn, Preterm and term neonates. All historically used charts in NICU are discussed here.
Presented by Dr Sujit, in Sir Ganga Ram Hospital
Dr. Somendra shukla is a one of the best Pediatrician & neonatologist at Gurgaon.
He has vast expierence of 9 yrs in neonatology & pediatrics. He has cleared the prestigious Diplomate of National Board (DNB) and royal college of pediatrics, london (MRCPCH) examinations in pediatrics. He has worked and honed up her skills with some of the top corporates institutes of India such as Fortis hospital, moolchand medcity and paras hospital. He has also done his Fellowship in neonatology awarded by prestigious National neonatology forum of India.He is a member of IAP and NNF and has attended various seminars and workshops and has presented several papers in various national conferences and conducted CMEs. He is an expert in newborn intensive care including care of ventilated and extremely low birth weight babies (<1000g><750g). His area of interest are childhood vaccination, growth and development and childhood asthma.
The importance of screening newborn babies for birth defectsmeenakshiclinic
Screenings of newborn babies are designed to pursue early recognition of certain disorders with an aim to prevent serious consequences in the future. However, it is important to know that these screenings are not necessarily confirmatory diagnosis and may demand further investigations.
THIS PRESENTATION IS FOCUSSES ON CONGENITAL HYPERPLASIA, ITS DEFINITION, EPIDEMIOLOGY, ITS TYPES, PATHOGENESIS DIAGNOSIS AND MANAGEMENT OPTIONS IT DESCRIBES HOW CAH AFFECTS ON BODY, AND HOW BODY RESPONSES TO THIS CONDITION THIS IS THE CONDITION IN WHICH ADRENOMEGALY IS SEEN
INFERTILITY: Failure to conceive within one or more years of regular unprotected coitus.
PRIMARY INFERTILITY: Patients who have never conceived
SECONDARY INFERTILITY : Previous pregnancies but failure to conceive subsequently
Screening for any disorder in individuals is a strategy used for identifying a disease before the onset of signs or symptoms, thus enabling earlier detection and management with the aim to reduce morbidity and mortality.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
The Gram stain is a fundamental technique in microbiology used to classify bacteria based on their cell wall structure. It provides a quick and simple method to distinguish between Gram-positive and Gram-negative bacteria, which have different susceptibilities to antibiotics
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
2. WHAT IS NEWBORN SCREENING ?
Newborn screening is a public health program
designed to screen infants shortly after birth
for a list of conditions that are treatable but
not clinically evident in newborn period.
3. WHAT FOR NEWBORN SCREENING ?
• “The goal of newborn screening is early
detection of children at increased risk for
selected metabolic or genetic diseases so that
medical treatment can be promptly initiated
to avert metabolic crises and prevent
irreversible neurological and developmental
sequelae.”
4. HISTORY OF NEW BORN SCREENING
• 1930’s George Jervis at NY identified 50 clients
with metal retardation attributed to PKU
• 1963 Robert Guthrie, microbiologist-
pediatrician at State University of New York
devised simple inexpensive which allowed
screening for PKU
• 1965 New York State law for newborn
screening, Public Health Law 2500
5. • 1970 -1980s: congenital
hypothyroidism, congenital adrenal
hyperplasia, galactosemia
• 1990s:DNA tests used as second tier – Sickle
Cell Disease screening, Cystic Fibrosis
screening
• 2000s : Tandem Mass Spectrometer (MS/MS)
Many diseases, one test
6. CARDINAL PRINCIPLES OF SCREENING
• The disorder has a relatively high incidence so that the
cost per diagnosed individual is reasonable
• An effective and not overly expensive treatment is
available.
• A relatively inexpensive screening test that is suitable
for high volume testing (preferably automatable)
• The screening test has a very high sensitivity (very low
false negatives) and high specificity (low false positives
which require expensive follow-up)
7. CRITERIA FOR NEWBORN SCREENING
• Disorder produces irreversible damage before
onset of symptoms
• Treatment is effective if begun early
• Natural history of disorder is known
8. SCREENING PROCEDURE
• SPECIMEN COLLECTION
Blood specimen is obtained from heel of infant
It should be obtained from medial or lateral side
of the heel
9. TIMING OF COLLECTION
• Normal Term Newborn: Before nursery
discharge or 3rd day of life whichever is earlier.
• Preterm or LBW: 2 wks of age or at discharge
whichever is earlier.
• Newborn who is to receive blood transfusion,
One specimen collected before transfusion &
second specimen 2 days after transfusion.
10. SCREENING TESTS
• BACTERIAL ASSAYS:
Punching of small disc from Guthrie specimen
Disc are place in agar or silica gel & contain
bacteria growth media & other necessary factors
Each bacterial plate are specified for response to a
particular metabolite.
The amount of growth around the disc is directly
proportional to the concentration of metabolite in
blood.
They are used to screen for amino acid disorders.
13. Tandem Mass Spectrometry (MS/MS) High
Impact and High Throughput
• One disease, one test is not cost-effective
• Many diseases, one test is cost-effective
• MS/MS allows for rapid, simultaneous analysis
and detection of many disorders of amino
acid, organic acid, and fatty acid metabolism
• Sample set up determines which masses and
therefore which compounds are detected
• 2 minute analysis time
• Automated data processing for results
14. MS/MS Methodology – continued
Compounds analyzed are amino acids and
acylcarnitines
–Amino acids – to identify
PKU, MSUD, homocystinuria
–Acylcarnitine – carnitine (vehicle) + fatty
acid for identification of organic acidurias
and fatty acid oxidation disorders
15. SECONDARY TEST
• An abnormal finding on newborn screening
test is not diagnostic of a disorder.
• Additional tests should be performed to
substantiate the original finding.
• Also the original specimen is retested for the
analyte that is abnormal.
16. • In screening for congenital hypothyroidism,
Low T4
TSH Immunoassay
Low TSH Normal TSH
Congenital Transient low T4
Hypothyroidism
18. PHENYLKETONURIA
• INCIDENCE: 1 IN 12000 live births
• Untreated: Mental retardation & neurological
abnormalities
• Screening is done by MS/MS
• Screening test is positive if phenylalanine level
is > 6mg/dl
• Liver disease, Galactosemia & Tyrosinemia
type 1 can also produce phenylalanine levels.
19. CONGENITAL HYPOTHYROIDISM
• INCIDENCE: 1 in 3000 to 5000 newborn
• UNTREATED: Growth retardation & delayed
cognitive development
• Two Screening approaches are used
Primary screening for low T4 with secondary
screening for high TSH
Primary screening for high TSH
20. • FALSE POSITIVE
Low T4: Premature infants, Thyroxin binding
globulin deficiency
High TSH: Perinatal stress
• FALSE NEGATIVE
Normal T4: In first 24hrs of life.
Normal TSH: In premature infants with CH it may
take 2 or more wks for TSH elevation to develop
21. GALACTOSEMIA
• INCIDENCE: 1 in 62000
• MANIFESTATIONS: Failure to
thrive, vomiting, Liver disease & death from
sepsis due to E.Coli
• 2 Screening Test
SPECIFIC ENZYME ASSAY
Measures activity of Galactose 1 Phosphate Uridyl
Transferrase
Identifies only galactosemia
22. METABOLITE ASSAY
Measures total Galactose(galactose & galactose 1
phosphate)
Identifies other galactose metabolic disorders like
Galactokinase & Epimerase deficiency
POSITIVE SCREENING TEST
RAPID CONFIRMATORY TEST
TESTING OF URINE FOR REDUCING SUBSTANCES
23. URINE CONTAINS REDUCING SUBSTANCES
DISCONTINUATION OF BREAST OR FORMULA FEEDS
SUBSTITUTION WITH NON LACTOSE FORMULA Eg, SOY
ENZYME ASSAY FOR RBC GALT ACTIVITY
24. HOMOCYSTINURIA
• INCIDENCE: 1 IN 344,000 births
• UNTREATED: Ectopia lentis, Osteoporosis
Thromboembolism, Mental Retardation
• SCREENING MARKER: Plasma Methionine
levels.
• MS/MS is used for screening
25. • Isolated Hypermethioninemia may occur in
MAT Deficiency,
Tyrosinemia type 1
Liver disease
• HOMOCYSTINURIA
Homocysteine is detectable in plasma & urine
Plasma total Homocysteine & Methionine
Plasma cysteine is reduced
27. MAPLE SYRUP URINE DISEASE
• INCIDENCE: 1 IN 185,000 births
• FULMINANT DISEASE: Severe
Ketoacidosis, Vomiting & lethargy & may
progress to coma & death
• SCREENING MARKER: 4 fold elevation of
plama leucine in NB
28. • Confirmatory plasma & urine specimens
obtained
• Plasma shows marked increase in leucine,
isoleucine & valine (branched chain amino
acids)
• Urine is strongly positive for ketones
• Maple syrup odor appears earliest in cerumen
& later in urine. Can be detected by cotton
tipped swab inserted into infant’s ear.
29. • CONGENITAL ADRENAL HYPERPLASIA
Screening Marker: Increased levels of 17OHP
• SICKLE CELL DISEASE
Screening is by means of Hemoglobin
electrophoresis.
It also identifies sickle cell trait & other abnormal
hemoglobins.
30. OTHER DISORDERS DETECTED BY
NEWBORN SCREENING
• BIOTINIDASE DEFICIENCY
• OTHER AMINO ACID DISORDERS: Eg
Citrullinemia
• LONG CHAIN & MEDIUM CHAIN ACYL CoA
DEHYDROGENASE DEFICIENCY
• CYSTIC FIBROSIS
• NEUROBLASTOMA