All India Institute of Medical Sciences Raipur

We evaluated occupational radiation exposure associated with ¹⁸F-FDG injection using a traditional manual approach versus an automated injection system. Methods: Wrist and whole-body radiation exposure of nuclear medicine personnel using a manual injection method versus an automated injection system for ¹⁸F-FDG administration were assessed using electronic personal dosimeters. Radiation exposure while configuring both systems was also evaluated. The dose administered met the requirements of the "as low as reasonably achievable" principle. Radiation exposure during initial setup and dose administration, residual activity, dose accuracy, presence of contamination, and frequency of extravasation were compared between methods. Results: Compared with the traditional manual method, use of the automated injection system resulted in significantly lower mean radiation exposure to medical physicists' wrists (P < 0.01). Radiation exposure was 79.41% lower at the wrist while using the automated injection system. Differences in whole-body radiation exposure were not significant between injection methods (P < 0.56). The overall radiation dose per injection at the wrist and in the whole body and mean residual activity after injection were noticeably lower with the automated system (P < 0.01), with mean residual activity decreasing by 73.58%. Conclusion: The overall radiation exposure for nuclear medicine personnel was significantly decreased when administering ¹⁸F-FDG via an automated injection system.

A late preterm infant of South Indian ethnicity born of a second-degree consanguineous marriage presented on the fourth day of life with severe neonatal hyperbilirubinaemia (NNH), rapidly progressing to bilirubin encephalopathy. The underlying cause was G6PD deficiency, a significant contributor to severe NNH, especially in late preterm neonates. The infant underwent an urgent double-volume exchange transfusion to manage hyperbilirubinaemia. Despite the intervention, long-term follow-up revealed complications of bilirubin-induced neurological dysfunction, including dystonia and bilateral sensorineural hearing loss. This case highlights the critical need for early screening and management of G6PD deficiency to prevent chronic morbidities. It underscores the importance of universal newborn screening, which is not well established in South Asian countries, including India, and vigilant postnatal monitoring, particularly in preterm infants, to mitigate the risk of long-term neurodevelopmental disabilities. Prompt intervention through measures such as exchange transfusion can be life-saving, but preventive strategies remain the cornerstone for better outcomes.