Browsing by Author "Thelma, BK"

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    Association Between Neonatal Thyroid Stimulating Hormone Status and Maternal Urinary Iodine Status
    (Indian Academy of Pediatrics, 2019-06) Sait, Haseena; Kapoor, Seema; Jindal, Ankur; Garg, Ritika; Belwal, Ravi Shankar; Yadav, Sangita; Gupta, Sangeeta; Thelma, BK
    Background: Maternal urinary iodine concentration (MUIC) andpercentage of neonates with Thyroid stimulating hormone (TSH)>5 mIU/L are amongst the parameters suggested for assessingadequate iodine status.Objective: To assess the correlation between MUIC andneonatal TSH levels.Study design: Cross-sectional.Settings: Tertiary care center in Delhi, India, between November2015 to November 2016.Participants: Postnatal mother-neonate dyads.Methods: TSH levels assessed among neonatal samples werestratified as below and above 5 mIU/L. MUIC was measured in544 mothers, 400 mother-neonate dyads with neonatal TSHlevels >5 mIU/L (cases) and 144 mother-neonate newbornmother dyads with neonatal TSH <5 mIU/L (controls).Results: The percentage of mothers with iodine insufficiency(9.8% vs 5.6%) as well as iodine excess (54.3% vs 41.7%) weresignificant higher in cases than controls. Mean TSH was alsohigher (P=0.0002) in both the iodine deficient and iodine excessgroup. There was no correlation between neonatal TSH valuesand MUIC.Conclusions: Lack of correlation between neonatal TSH andMUIC is due to iodine excess together with iodine deficiency.
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    Newborn Screening and Diagnosis of Infants with Congenital Adrenal Hyperplasia
    (Indian Academy of Pediatrics, 2020-01) Vats, Pallavi; Dabas, Aashima; Jain, Vandana; Seth, Anju; Yadav, Sangeeta; Kabra, Madhulika; Gupta, Neerja; Singh, Preeti; Sharma, Rajni; Kumar, Ravindra; Polipalli, Sunil K; Batra, Prerna; Thelma, BK; Kapoor, Seema
    Congenital adrenal hyperplasia (CAH) is an autosomal recessive endocrine disorder which can manifest after birth with ambiguousgenitalia and salt-wasting crisis. However, genital ambiguity is not seen in male babies and may be mild in female babies, leading to amissed diagnosis of classical CAH at birth. In this review, we provide a standard operating protocol for routine newborn screening forCAH in Indian settings. A standardization of first tier screening tests with a single consistent set of cut-off values stratified by gestationalage is also suggested. The protocol also recommends a two-tier protocol of initial immunoassay/time resolved fluoroimmunoassayfollowed by liquid chromatography tandem mass spectrometry for confirmation of screen positive babies, wherever feasible. Routinemolecular and genetic testing is not essential for establishing the diagnosis in all screen positive babies, but has significant utility inprenatal diagnosis and genetic counseling for future pregnancy.