ABSTRACT
Hyperbilirubinemia is frequently encountered in neonatology. This disorder causes mucocutaneous jaundice, often transient and mild. It is due to the physiological characteristics of the newborn as hepatic immaturity and fragile red blood cells with polycythemia. Sometimes it reaches levels to much high that exceed the control capacity of the organism and thus causes kernicterus with severe neurological sequelae. This is an exhaustive retrospective study on a series of cases of newborn infants with hyperbilirubinemia and registered in the service of biochemistry. We have profiled the types, etiology and assessment of risk of kernicterus in order to better situate the ideal model that ensures optimal management of neonatal jaundice. The neonatal hyperbilirubinemia were all with unconjugated bilirubin. The majority of them were due to physiological origin, but the maternal-fetal blood incompatibility and neonatal infection are not negligible. All are likely to expose to serious neurological complications. Newborns, especially premature babies with jaundice of the integument must be screened for potentially severe jaundice. The prevention of alarming levels of bilirubin not bound to albumin must be realized through a monitoring including total bilirubin and albumin, or failing that, the serum protein. The best adaptation of albumin to bilirubin becomes possible by the prompt initiation of therapy, minimally invasive, such as phototherapy or the infusion of albumin. It is imperative to integrate this action in a global screening and to implement an algorithm taking into account all risk factors
ABSTRACT
The calculi must be analyzed to find urolithiasis etiology. This investigation will allow adopting the appropriate action to avoid the stone's recurrence. Infrared spectroscopy, the reference method in calculi analysis, is unfortunately very expensive that we can't use it in our laboratory. In this study, we determine the molecular composition of urinary calculi from children using a simple and inexpensive protocol. We used the chemical method in association with optical method using binocular lens to make it more effective. We applied this protocol in studying urinary calculi collected from forty seven children and we analyzed the results according to clinical and radiological data. Our patients were aged between 2 and 16 years. The majority of them [81%] were aged over 4 years. The vesical calcui represented 51%. The calcium oxalate calculi were dominant [61,7% of cases]. The principal majority component varied according to children's age. At age less than five the major component was calcium phosphate which represented 44% while calcium oxalate represented only 22%. However, at the age of five and over, these kinds of components represented respectively 13,5% and 71% of cases. Struvite, cystin and uric acid were predominant in 6,38% of cases. This protocol allowed us to determine the molecular composition of all studied stones. It had permitted also to identify their etiology in one third of cases and to orient it in the remaining cases