ABSTRACT
A patient with a huge ovarian cyst weighing 38 kg was operated successfully with utmost care to avoid all possible intra and postoperative complications. The same has been presented and the salient features of management have been discussed.
Subject(s)
Anesthesia, Inhalation/instrumentation , Cystadenoma/pathology , Female , Humans , Intraoperative Care , Middle Aged , Ovarian Neoplasms/pathology , Postoperative Care , Preoperative CareABSTRACT
To assess the value of unbound bilirubin (UB) and saturation index (SI) in serum and CSF as indicators of Kernicterus, we studied 50 icteric neonates (serum indirect bilibrubin (IB) greater than or equal to 7 mg/dl) and 20 controls (IB less than 7 mg/dl) during the first week of life. Serum and CSF were obtained simultaneously in all neonates. Of 36 neonates with IB greater than 12 mg/dl 19 had evidence of kernicterus. UB was estimated by Sephadex gel filtration and SI by salicylate displacement technique. Positive correlation (r = +0.85) was obtained between serum and CSF UB levels. There was a significant difference (p less than 0.05) between mean serum and CSF UB levels in kernicterus and non-kernicterus neonates (kernicterus serum UB = 0.71 +/- 0.22) mg/dl, CSF UB = 0.16 +/- 0.06 mg/dl: non-kernicteric serum UB = 0.40 +/- 0.10 mg/dl, CSF UB = 0.10 +/- 0.03 mg/dl). A critical serum UB level 0.5 mg/dl and a danger zone of CSF UB (0.1 to 0.15 mg/dl) was observed in presence of kernicterus. Neonates with kernicterus and 30% non-kernicteric had serum SI greater than or equal to 8. Mean values of serum and CSF SI were comparable in all neonates. The serum and CSF UB and SI, and the mean percentage cross over of UB from serum to CSF when statistically compared were not significantly influenced by risk factors.
Subject(s)
Bilirubin/blood , Humans , Infant, Newborn , Jaundice, Neonatal/metabolism , Kernicterus/diagnosis , Risk FactorsABSTRACT
Over a period of 1 1/2 years, 9 infants ages ranging between 3 weeks and 7 months presented with the syndrome of late hemorrhagic disease related to vitamin K deficiency. All were exclusively breast fed and had not received vitamin K at birth. Four of these had acute intracranial hemorrhage, of which 2 expired and the surviving 2 have residual neurologic handicap. Of the remaining 5 who had skin and mucosal bleeds, all recovered on administration of vitamin K.