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Background: Neonatal hyperbilirubinemia is one of the most observed clinical conditions found during the rst week of life. In neonates, bilirubin tends to be deposited in body tissues, especially the skin and mucous membranes. The aim of this study was to determine the efcacy of fenobrate with phototherapy inObjective: hyperbilirubinemia in term infants and to assess the effect of fenobrate adjunct to phototherapy on duration of phototherapy and hospital stay. The study was performed in two groups of healthy and term neonates. 75 neonates wereMethodology: treated with a single oral dose of fenobrate plus phototherapy while other 75 were given only phototherapy. Serum bilirubin th th th levels were monitored at admission, 12, 24, 48 and 72 hours of admission. The mean bilirubin levels of 12 , 24 , 48 hoursResult: were signicantly decreased in the fenobrate treated group A as compared to the controlled group B. Fenobrate administration decreased total serum bilirubin, especially from the second day onwards, and also reduced hospitalization time, hospital costs and side effects from hospitalization. Although standard therapy for unconjugatedConclusion: hyperbilirubinemia includes phototherapy and exchange transfusion but pharmacological interventions are into current use. Fenobrate can be used as a primary treatment along with phototherapy with no side effects and reduced hospital duration.
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Background: Neonatal jaundice is a common condition affecting up to 60% of term and 80% of preterm newborns, often leading to delayed hospital discharge or readmission. While many cases are transient, severe hyperbilirubinemia can lead to kernicterus and irreversible neurological complications, including cerebral palsy and hearing loss. The timely diagnosis and management of neonatal jaundice are crucial to prevent such outcomes. This study aimed to assess the clinical profile and underlying causes contributing to neonatal jaundice in a tertiary care setting. Methods: From May 2021 to April 2022, a prospective observational study was carried out in the pediatric department of MKCG Medical College and Hospital in Berhampur, Odisha. Two hundred newborns admitted with blood bilirubin levels greater than 10 mg/dl were included in the study. Neonates with jaundice attending the outpatient department or discharged against medical advice were excluded. Comprehensive data were recorded, including antenatal, delivery details, and clinical examination findings. Laboratory tests assessed bilirubin levels, blood group compatibility, and additional factors like G6PD deficiency and sepsis. Data analysis was performed using descriptive and inferential statistics. Results: Out of 200 neonates, jaundice onset occurred after 72 hours in 53.5% of cases, while 30.5% developed jaundice within the first 24 hours. A higher prevalence was noted among male neonates (64.5%) and those delivered vaginally (57.5%). Etiological factors included physiological jaundice (32%), prematurity (24.5%), and breastfeeding-related jaundice (10%). ABO incompatibility (5.5%), Rh incompatibility (11%), and sepsis (4%) were also identified as contributing factors. Conclusion: Male gender, birth weight of 2500-4000 grams, vaginal delivery, and prematurity were common risk factors associated with neonatal jaundice. Early diagnosis, parent counseling, and monitoring are essential for effective management and prevention of complications associated with hyperbilirubinemia.
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Background: Neonatal hyperbilirubinemia continues to be the most common cause of hospital admissions and readmissions in the neonatal population worldwide and this pattern continues despite attempts to identify neonates at risk of pathological hyperbilirubinemia. The aim of the study was to determine the clinical profile and etiology in neonates who were treated with double volume exchange transfusion (DVET).Methods: This was a hospital based prospective observational study in neonates ?35 weeks of gestation who were treated with DVET for severe hyperbilirubinemia in a tertiary care centre over a period of six months.Results: In our study 110 neonates with severe hyperbilirubinemia were treated with DVET. Majority of the neonates were males (59.1%). Lower segment caesarean section (LSCS) was the common mode of delivery observed in 66.4% of the study subjects. Rh incompatibility (36.4%) was the commonest cause of exchange transfusion followed by ABO incompatibility (20%). The mean age of neonates at admission and mean age at DVET in days were 4.03�46 and 4.25�44 respectively. The mean birth weight of neonates treated with DVET was found to be 2.81�57. The mean total serum bilirubin at pre-exchange and post exchange were 26.13�58 mg/dl and 11.63�24 mg/dl respectively.Conclusions: Rh incompatibility was the most common cause in neonates with severe hyperbilirubinemia requiring double volume exchange transfusion.
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Background: Neonatal jaundice is the most common problem in the first week of life leading to delayed hospital discharges and readmissions. Recognizing early neonatal hyperbilirubinemia plays a pivotal role in preventing serious complications. The aim of this study was to study the clinical profile and etiological factors leading to neonatal jaundice.Methods: This prospective observational study was conducted in the neonatal intensive care unit (NICU), department of pediatrics, government medical college, Srinagar, Jammu and Kashmir, India over a period of 6 months (August 2023 to January 2024). A total of 400 cases were enrolled for the study. Data collection was done by history taking, clinical examination and relevant laboratory investigations.Results: In this study, out of 400 jaundiced neonates, 236 (59%) were males and 164 (41%) were females, 342 (85.5%) were born at term and remaining 58 (14.5%) were preterm babies. Among 400 neonates studied, majority (80%) had birth weight ?2500 gm. Only 80 (20%) had birth weight less than 2500 gm. Physiological jaundice was seen in 162 (40.5%) of the total cases. This was followed by ABO incompatibility (20%), Rh incompatibility (16.5%), sepsis (8%), idiopathic (5%), prematurity (4%), cephalhematoma (4%) and breastfeeding jaundice (2%).Conclusions: This study concludes that physiological jaundice is the most common cause of neonatal jaundice in our hospital. This was followed by ABO incompatibility, Rh incompatibility and sepsis. This highlights the importance of appropriate monitoring of neonates with these underlying risk factors.
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Background: Jaundice is one of the most common problems occurring in newborns. Severe neonatal hyperbilirubinemia is a common cause of sensory neural hearing loss. It is important to identify and treat the jaundice early, to prevent complications like encephalopathy leading to hearing loss. Early detection of hearing loss is important for early intervention. The aim of the study was to evaluate the prevalence of sensorineural hearing loss (SNHL) in children with hyperbilirubinemia and to correlate the degree of hearing loss with degree of hyperbilirubinemia. Methods: The 50 cases including newborn and young children (<12 years of age) having history of hyperbilirubinemia and exchange transfusion were included in this study. After the approval and clearance from institutional ethical committee, this study was conducted from April 2021 to March 2022 in the department of ENT, govt. medical college Amritsar in co-ordination with department of pediatrics. Results: On comparing brain stem evoked response audiometry (BERA) and otoacoustic emissions (OAE) results, it was found that out of 50 patients BERA was abnormal in 8 patients while 42 had normal BERA. 18% (9) patients had abnormal OAE results out of which 7 had bilateral REFER result while 2 had unilateral REFER result. On comparing the OAE and BERA for sensitivity and specificity, the sensitivity was 92.9% in right ear while specificity was 62.5%, whereas in left ear sensitivity was 95.2% while specificity was 75%. Conclusions: According to our study the prevalence of sensorineural hearing impairment comes out to be 16% as per BERA. BERA is more sensitive and specific as compared to OAE. But still OAE can be used as screening test considering the cost factor and ease of conducting OAE test while BERA is a confirmatory test for SNHL.
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Hyperbilirubinemia is one of the most widely seen causes of neonatal morbidity. Haemolytic disease of fetus and newborn is caused by maternal alloantibodies to the fetal RBCs. It is responsible for incompatibility between maternal and fetal blood groups, which results in destruction of fetal red blood cells causing hyperbilirubinemia. ABO and Rh incompatibility are the most common causes of severe indirect hyperbilirubinemia. Besides ABO and Rh isoimmunization, minor blood group incompatibilities such as anti-Kell, anti-C, anti-c, anti-E, anti MNS, Duffy, KIDD, P, Lutheran and Lewis have also been identified as causes of severe neonatal jaundice with an incidence of 385/1,00,000 live births in South-East Asia. We, hereby report a rare case of a full term 2.2 kg newborn presented with severe anemia with reticulocytosis and neonatal hyperbilirubinemia at second hour of life. In view of strongly positive DCT and no Rh negative or ABO setting, minor blood group incompatibility screening test was performed in the mother which revealed presence of multiple alloantibodies; however, the red cell phenotyping confirmed the presence of anti-c antibodies in maternal sera responsible for neonatal alloimmune haemolytic anemia. The baby was offered intensive phototherapy with intravenous immunoglobulin.
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Background: Phototherapy is the first line of treatment for physiological jaundice. However, it has its own set of complications. Hypocalcaemia is a less frequent but a potential complication of phototherapy. The purpose of this study was to see the effect of 24 hours of phototherapy on the serum blood calcium levels of the newborn after 24 hours of exposure and the need for supplementation in these new born babies.Methods: A cross sectional observational study was conducted at our institute on 31 newborn babies born between June 2022 to December 2022. All term neonates who developed clinically significant physiological jaundice after 48 hours of life were subjected to double surface phototherapy with LED blue light for 24 hours. These babies were screened for their serum calcium levels by venous blood sampling before the commencement of the phototherapy. The same sampling was repeated after 24 hours of exposure to the phototherapy lights to see the effect on serum calcium levels of the newborn.Results: Phototherapy was given for 24 hours. Mean serum calcium measured at 48 hours of life prior to phototherapy was 9.25�62 mg/ml. Also, mean serum calcium at 24 hours post phototherapy was 8.74�38 mg/ml. A highly significant decrease in serum calcium level was seen post phototherapy (p=0.0002). Independent samples t test was used.Conclusions: In healthy term neonates exposed for only 24 hours of phototherapy decrease in serum calcium levels to some extend was noted however it is unlikely to cause clinically significant hypocalcemia.
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Objective To investigate the effect of intensive phototherapy for neonatal hyperbilirubinemia on cellular immune function and short-term immune-related adverse effects.Methods Totally 180 infants with hyperbilirubi-nemia were treated with different light intensity,the efficacy,cellular immune function and immune adverse effects were followed up for six months after discharge.Results After phototherapy,serum interleukin-6(IL-6)in both groups were decreased and CD4+(%)and CD4+/CD8+were increased than that before phototherapy.The decrease rate of total bilirubin in the intensive phototherapy group was significantly faster than that in the conventional photo-therapy group,at the same time,the total duration of phototherapy and hospital stay were significantly shorter than that in the conventional phototherapy group(P＜0.05).No statistical significance in the incidence of diarrhea,rash,fever and hypo-calcemia during hospitalization and no immune-related adverse effects in 6 months after discharge were recorded.Conclusions Compared with conventional phototherapy,intensive phototherapy reduces serum bilirubin level more quickly and shorten the duration of phototherapy and hospital stay.No common adverse effects nor immune-related adverse effects are recorded during hospitalization and the period of six months after discharge.
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Objective:To study the correlation of uridine diphosphate glucuronosyl transferase 1A1(UGT1A1) gene polymorphism and neonatal hyperbilirubinemia among Dai ethnic group in Yunnan province.Methods:From January 2020 to December 2022, Dai neonates with unexplained neonatal hyperbilirubinemia admitted to three hospitals in Yunnan Province were prospectively enrolled into the hyperbilirubinemia group. Neonates hospitalized during the same period without hyperbilirubinemia were selected as the control group. The serum total bilirubin levels were measured and UGT1A1 gene sequencing was performed in all neonates. The differences of genotype frequency and allele frequency of UGT1A1 gene in the two groups were analyzed. Logistic regression analysis was used to analyze the effects of each mutation on hyperbilirubinemia among Dai neonates.Results:A total of 92 neonates were in the hyperbilirubinemia group and 86 in the control group. No significant differences existed between the two groups on following items: gender, age at admission, gestational age (GA), birth weight (BW), feeding pattern, white blood cell count (WBC) and hemoglobin level ( P>0.05).Three mutation loci were detected in the hyperbilirubinemia group (c.211G>A, c.1091C>T and c.1456T>G), with frequencies 45.7%, 3.3% and 2.2%, respectively. Two mutation loci were detected in the control group (c.211G>A and c.1091C>T), with frequencies 17.4% and 1.2%. Correlation analysis showed that c.211G>A frequency (45.7%) and A allele frequency (23.9%) in the hyperbilirubinemia group were significantly higher than the control group ( P<0.05). No significant differences existed in the frequencies of c.1091C>T and c.1456T>G between the two groups ( P>0.05). Logistic regression analysis showed that c.211G>A was risk factor of unexplained neonatal hyperbilirubinemia in Dai neonates ( OR=3.976, 95% CI 1.991-7.941). Conclusions:The most common mutation of UGT1A1 gene in Chinese Dai neonates with unexplained neonatal hyperbilirubinemia in Yunnan Province is c.211G>A, which increases the risk of hyperbilirubinemia.
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Objective:To investigate the effect of irisin on inflammatory response in brain tissue of neonatal rats with hy-perbilirubinemia. Method:Sixty-six neonatal SD rats were randomly divided into the normal control group(group A)and the model group(group M).Hyperbilirubinemia models were established by intraperitoneal injection of bilirubin so-lution at the age of 7 days and 10 days.After the last injection,6 rats were randomly selected from group A and M to verify the success of the model establishment,and then group M was randomly divided into group B and group C.Rats in group C were injected with 80 μg/kg irisin solution in lateral ventricles,and the oth-er groups were injected with the same amount of PBS.After the injection into lateral ventricle,groups A,B and C were further divided into three subgroups according to different points of death.Neurobehavioral tests were performed at each time point.Morphology of cortical or hippocampal nerve cells was detected by HE staining,and the concentrations of TNF-α,IL-1β and IL-6 were detected by ELISA. Result:At 12h,there was no significant difference in the time of plane righting reflex among the three groups(P＞0.05);At 24h,the rats in group B and C were longer than those in group A(P＞0.05);At 48h,group B was longer than group A and C(P＜0.05),and there was no significant difference between group A and C(P＞0.05).There was no significant difference in tropism test among the three groups at each time point(P＞0.05).Under the HE staining,the cortex neuron structure in group A were clear and complete but the number of hippocampal neurons was reduce;in group B and C,the number of neurons in cortex and hip-pocampus was decreased,the structure was disordered,and different degrees of pathological damage were ob-served.Group C was better than group B.Under the ELISA,the concentrations of TNF-α,IL-1β and IL-6 in group B were higher than those in group A at each time point(P＞0.05);the concentrations of TNF-α,IL1βand IL-6 in group C were significantly lower than those in group B at each time point(P＞0.05);the concen-tration of TNF-α in the brain tissue of group C was higher than that of group A at 12h(P＞0.05),and at 24h and 48h were lower than those in group A(P＞0.05);the concentration of IL-6 in the brain tissue of group C was lower than that of group A at 12h and 24h(P＞0.05);at 48h,there was no significant difference in the concentration of IL-6 between group C and group A(P＞0.05);the concentration of IL-1β in the brain tissue of group C was not significantly different from that of group A at the three time points(P＞0.05). Conclusion:Irisin can effectively reduce the release of TNF-α,IL-1β and IL-6 in the brain tissue of neonatal rats with hyperbilirubinemia,and play an anti-inflammatory role.
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Objective:To investigate the value of cranial ultrasound (CUS) globus pallidus to putamen gray ratio(G/P) in monitoring basal ganglia of neonatal hyperbilirubinemia.Methods:A retrospective analysis was performed on the CUS, magnetic resonance imaging (MRI, 46 cases) and clinical data of 69 neonates hospitalized in the Department of Neonatology of Children′s Hospital Affiliated to Capital Institute of Pediatrics from June 2022 to June 2023. UpToDate calculator was used to calculate the reference thresholds of phototherapy for each child, combined with the 342 μmol/L node value, the children were divided into control group, mild to moderate hyperbilirubinemia group and severe hyperbilirubinemia group; RadiAnt DICOM Viewer software was used to measure the ultrasound gray values of bilateral globus pallidus and putamen, and the ratio CUS (G/P) was calculated; MRI post-processing workstation was used to read T1 signal values of bilateral globus pallidus and putamen, and the ratio MRI (G/P) was calculated. The correlations between CUS (G/P) and total serum bilirubin (TSB)/ phototherapy threshold and TSB/ albumin ratio were analyzed; the consistency of CUS (G/P) and MRI (G/P) was analyzed; the difference of CUS (G/P) among control group, light-moderate hyperbilirubinemia group and severe hyperbilirubinemia group was compared.Results:①CUS (G/P) was positively correlated with TSB/ phototherapy threshold and TSB/albumin ( rs=0.721, 0.600, all P<0.001). ②CUS (G/P) value was consistent with MRI (G/P) value (τ=0.743, P<0.05). ③CUS(G/P) value increased sequentially in the control group, mild-moderate hyperbilirubinemia group, and severe hyperbilirubinemia group, and the differences between each two groups were statistically significant (all P<0.05). Conclusions:CUS (G/P) has dose-response relationship with TSB, diagnostic agreement with MRI (G/P) value, and shows differences in different levels of bilirubin, and can be used to monitor intracranial basal ganglia in neonatal hyperbilirubinemia.
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Introducción: las enzimas y marcadores del perfil hepático permiten evaluar la funcionalidad y condición del hígado. Sus elevaciones pueden ser silentes y con cierta prevalencia en muchos adultos. Objetivo: determinar las principales alteraciones en el hepatograma en pacientes que acuden a consulta médica de rutina. Metodología: estudio descriptivo, prospectivo y transversal realizado a partir de resultados de laboratorio de historias clínicas de 364 pacientes de todas las edades y ambos sexos pertenecientes a un policlínico del distrito de Villa el Salvador, Perú desde enero de 2021 a julio de 2022. Las variables fueron: edad, sexo, valores de transaminasa glutámico pirúvica (TGP), transaminasa glutámico oxalacética (TGO), bilirrubina directa, indirecta y total, albúmina, globulinas y fosfatasa alcalina (FA). Resultados: en el promedio total de la muestra, la TGP fue alta (51,05 U/L), así como la bilirrubina total (1,50 mg/dL) y la FA (135,84 U/L). La TGP fue alta en hombres (54,92 U/L) y mujeres (48,86 U/L). La TGO fue normal en mujeres y alta en hombres (48,24 U/L). La bilirrubina indirecta fue alta en hombres (1,33 mg/dL). La FA fue más alta en ambos sexos (143,28 U/L en hombres y 126,38 en mujeres). Según grupo etario, los valores de TGO fueron más altos en el grupo de edad igual o mayor a 40 años (49,99 U/L). Los valores de TGP fueron elevados en ambos sexos (55,96 U/L en hombres y 50,90 U/L en mujeres), así como en la bilirrubina total, la que fue más alta en el grupo de edad igual o mayor a 40 años (2,03 mg/dL). La bilirrubina indirecta, albúmina y FA fueron normales en el grupo de edad igual o menor de 39 años, pero fueron elevadas en el grupo de edad igual o mayor a 40 años (1,13 mg/dL, 5,77 gr/dL y 147,95 U/L, respectivamente). Conclusiones: existen alteraciones en el perfil hepático en pacientes asintomáticos en la muestra estudiada. A pesar de no ser elevaciones significativamente grandes, se recomienda identificar y tratar las posibles causas que pudieran desencadenar dichas elevaciones, así como la realización de más estudios similares a nivel nacional para caracterizar el perfil hepático de nuestra población.
Introduction: The enzymes and markers of the liver profile allow us to evaluate the functionality and condition of the liver. Their elevations may be silent and have a certain prevalence in many adults. Objective: To determine the main alterations in the hepatogram in patients who attend routine medical consultation. Methodology: Descriptive, prospective and cross-sectional study carried out based on laboratory results from medical records of 364 female and male patients of all ages attending a polyclinic in the district of Villa El Salvador, Peru from January 2021 to July 2022. The variables were: age, sex, values ââof alanine aminotransferase (ALT), aspartate transaminase (AST), direct, indirect and total bilirubin, albumin, globulins and alkaline phosphatase (ALP). Results: In the total average of the sample, ALT was high (51.05 U/L), as well as total bilirubin (1.50 mg/dL) and ALP (135.84 U/L). ALT was high in men (54.92 U/L) and women (48.86 U/L) while AST was normal in women and high in men (48.24 U/L). Indirect bilirubin was high in men (1.33 mg/dL) and ALP was higher in both sexes (143.28 U/L in men and 126.38 in women). According to age group, AST values ââwere highest in the age group equal to or greater than 40 years (49.99 U/L). ALT values ââwere high in both sexes (55.96 U/L in men and 50.90 U/L in women), as well as total bilirubin, which was highest in the age group equal to or greater than 40 years (2.03 mg/dL). Indirect bilirubin, albumin and ALP were normal in the age group equal to or less than 39 years, but were elevated in the age group equal to or greater than 40 years (1.13 mg/dL, 5.77 gr/dL and 147.95 U/L, respectively). Conclusions: There are alterations in the liver profile of asymptomatic patients in the sample studied. Although they are not significantly large elevations, it is recommended to identify and treat the possible causes that could trigger these elevations, as well as carrying out more similar studies at a national level to characterize the liver profile of our population.
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RESUMO Objetivo Analisar a hiperbilirrubinemia como indicador para a realização do protocolo de risco na triagem auditiva neonatal (TAN) e no monitoramento auditivo em neonatos a termo e prematuros. Método Trata-se de um estudo observacional, transversal e retrospectivo. Foram incluídas 554 crianças nascidas em uma maternidade pública, subdivididas em dois grupos: (G1) com 373 recém-nascidos a termo; (G2) com 181 neonatos prematuros. Os dados foram coletados nos prontuários dos participantes, a fim de se obter informações referentes ao resultado da TAN realizada por meio do registro do Potencial Evocado Auditivo de Tronco Encefálico, às condições de nascimento, características clínicas, intervenções realizadas, resultados do primeiro exame de bilirrubina total (BT) e bilirrubina indireta (BI) e do pico de BT e BI. Realizou-se análise estatística descritiva e inferencial dos dados, com adoção do nível de significância de 5%. Resultados No teste da TAN, foram observadas taxas de encaminhamento para reteste inferiores no G1 em relação ao G2. Não houve diferença entre os grupos quanto à ocorrência do tipo de parto, sexo, presença de incompatibilidade sanguínea Rh e ABO, deficiência de enzima G6PD e realização de fototerapia. Em relação aos níveis de BT e BI no primeiro exame e no momento do pico, não houve diferenças entre os neonatos com resultado "passa" e "falha" na TAN-teste nos dois grupos. Conclusão Os níveis de bilirrubina no período neonatal abaixo dos valores recomendados para indicação de exsanguineotransfusão não estão diretamente relacionados ao resultado "falha" na TAN em neonatos a termo e prematuros.
ABSTRACT Purpose To analyze hyperbilirubinemia as an indicator for the definition of risk protocol in newborn hearing screening (NHS) and in auditory monitoring in full-term and preterm neonates. Methods This is an observational, cross-sectional and retrospective study. A total of 554 children born in a public maternity hospital were included and divided into two groups: (G1) with 373 full-terms neonates; (G2) with 181 preterm neonates. Data were collected from the participant's medical records to obtain information regarding the result of the NHS, performed by recording the automated auditory brainstem response (AABR), birth conditions, clinical characteristics, interventions performed, and results of the first test of total bilirubin (TB) and indirect bilirubin (IB) as well as the peak of TB and IB. A descriptive statistical analysis of the results was performed, and the level of significance adopted was 5%. Results On the NHS test, quotes of retest referral rates were smaller in G1 when compared to G2. There was no significant difference between the groups regarding type of delivery, gender, presence of Rh and ABO incompatibility, G6PD enzyme deficiency, and performance of phototherapy. TB and IB levels at the first exam and at peak time did not differ between neonates with "pass" and "fail" results on the NHS test in both groups. Conclusion Bilirubin levels in the neonatal period below the recommended values for indication of exchange transfusion are not directly related to the "fail" result on the NHS tests in term and preterm neonates.
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Background: Neonatal hyperbilirubinemia (NH) is the most common abnormality seen during the neonatal period. It affects nearly 60% of term and 80% of preterm neonates during the first week of life. Early discharge of healthy term and late preterm newborns after normal vaginal delivery is a common practice however there are reports of bilirubin induced brain damage (kernicterus) occurring in these infants. Therefore, to ascertain whether cord albumin can be used as a reliable indicator for predicting neonatal hyperbilirubinemia.Methods: A tertiary care hospital-based cross-sectional study was conducted in 142 healthy late preterm and term newborns of either gender with icterus appearing only after 24 hour of life with no other illness using a non-probability sampling method. Data analysis was done using statistical package for the social sciences (SPSS) version 16. Chi-square was used to determine the association between cord albumin and hyperbilirubinemia.Results: There is a significant negative correlation between cord albumin and serum bilirubin at 72-96 hours of life (p=0.001). A total of 142 healthy late preterm and term neonates included. The study group based on Cord serum albumin (CSA) levels ?2.8 g/dl, 2.9-3.3 g/dl, and ?3.4 g/dl shows 77.27%, 22.7% and none respectively developed NH requiring phototherapy. According to receiver operating curve (ROC) analysis, the cutoff point of 2.75 g/dl provides the best sensitivity and specificity result.Conclusions: Cord serum albumin level ?3.4 g/dl are probably safe for early discharge whereas cord serum albumin level <3.4 g/dl will need a close follow-up to check for the development of jaundice.
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Background: Incidence of Rh negativity in India is 5-10%. Rh negative pregnancy poses a risk only when there is incompatible mating, leading to antigen-antibody reaction, and hemolysis. However, it can be prevented by adequate measures.Methods: This prospective observational study conducted at Government Medical College hospital and J.K. Lon hospital Kota 100 women with Rh negative blood group admitted for delivery were enrolled.Results: Mean age of study participants was 26.87 years with SD of 3.62 years and the prevalence of Rh-negative pregnancy was around 2.9. Rhesus isoimmunization is a preventable cause of fetal morbidity and mortality.Conclusions: Rhesus isoimmunization is a preventable cause of fetal morbidity and mortality. Routine antenatal screening and timely management with intrauterine transfusion are lifesaving method which should be incorporated in daily obstetrics practice.
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Gilbert syndrome (GS) is benign, often familial condition characterized by recurrent but asymptomatic mild unconjugated hyperbilirubinemia in the absence of hemolysis or underlying liver disease. The coexistence of GS with other more clinically significant conditions could interfere with their diagnoses. The genetic variation described as GS may affect drug glucuronidation and could potentially precipitate. Gallstones are the commonest ailment affecting the hepato-biliary system. Associated jaundice is usually direct, commonly due to biliary obstructive lesions. Unconjugated hyperbilirubinemia with cholelithiasis is commonly seen with hemolytic disease. In the absence of hemolysis or systemic causes, congenital causes prevail, commonest of which is Gilbert’ Syndrome. Here we report a case of 21-year old male who presented to our hospital with complaint of pain abdomen and was diagnosed as gall stone induced pancreatitis which was further diagnosed as GS after genetic testing for UGT1A1 gene polymorphism.
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Background: Acute appendicitis is one of the most common abdominal emergencies requiring emergency surgery. The diagnosis based on the onset of symptoms and physical examination. Therefore, inaccuracies caused by subjective interpretation are frequent. This raises the need for tests to help diagnose acute appendicitis and predict the severity of the condition. aim of the study to investigate whether mean platelet volume, C-reactive protein, and hyperbilirubinemia can be used as inflammatory markers for the diagnosis of acute appendicitis and its correlation with histopathological examination. Methods: we prospectively analyzed 60 patients who were full fulling the inclusion criteria patients analysed for CBC, LFT and CRP and underwent for appendicectomy (Laparoscopic/open). Per-operative diagnosis was confirmed by histopathological examination from November 2020 to November 2022. Results: patients with CRP level > 6 and hyperbilirubinemia patients most likely to have acute appendicitis. Mean CRP level was 13.21±4.0 and mean bilirubin level 1.04±0.29 in case of acute appendicitis. CRP, hyperbilirubinemia levels were significantly higher in cases of acute appendicitis (p<0.01) while MPV value was not found significant. All patients was confirmed with histopathology examination. Conclusions: Serum bilirubin level and CRP estimation, which is a simple, cheap, and easily available laboratory test, can be added to the routine investigations in the diagnosis and severity of acute appendicitis and help in decreasing negative appendicectomy rates, especially in low modified Alvarado score.
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Background: Hyperbilirubinemia in newborn is quite common. Phototherapy (PT) is one of the most common noninvasive methods for the treatment of this hyperbilirubinemia. There are limited studies available on effect of PT on platelet count with contrasting results. So, this study was conducted to determine the effect of phototherapy on platelet counts of hyperbilirubinemic neonates in tertiary care hospital.Methods: This was a hospital based prospective study on 60 eligible neonates admitted in neonatal intensive care unit (NICU) for neonatal hyperbilirubinemia and phototherapy during January 2021 to June 2022. Platelet count was done before starting phototherapy, 24 hours after phototherapy and before discontinuing phototherapy. The results were analyzed statistically using Chi square test and t-test. P value <0.05 was considered as statistically significant.Results: In this study, total of 60 neonates were included of which 33 were males and 27 were females. The mean (±SD) platelet counts were 201764.92±18 before phototherapy and 156578.33±38 after phototherapy. There was a significant decline in the mean platelet count 24 hours after phototherapy and before stopping phototherapy. (p<0.05).Conclusions: In our study, the mean platelet count was decreased significantly after phototherapy. Hence, unnecessary use and prolongation of phototherapy should be avoided.
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Background: Diabetes complicating pregnancy has become common worldwide. However due to advances in the management of diabetes and its complications, there has been an overall improvement in the maternal and perinatal outcome. Diabetes occurs quite often during pregnancy even in unsuspected cases which can be either pregestational diabetes mellitus or gestational diabetes mellitus. Our objective was to study the impact of diabetes on pregnancy outcome. Methods: A prospective observational study was conducted at department of obstetrics and gynaecology of a tertiary care centre over a period of 18 months (January 2019 to June 2020). All patients were subjected to detailed history and clinical examination followed by relevant investigations such as complete blood count, blood sugars, HbA1C, renal function test, liver function test, urine albumin/sugar/ketones including ultrasonography obstetrics, congenital anomaly scan and doppler study of uterine and umbilical artery. All the data was compiled in Microsoft excel-sheet and was subjected to appropriate statistical tests. Results: Incidence of diabetes was found to be 9.72 % in our study population which included gestational diabetes mellitus (77/107) as well as overt diabetes (30). Diabetes was found to be more common in overweight and obese patients (75.7%). Macrosomia (19.6%) followed by polyhydramnios (15.6%) was the most common complication seen in pregnancy complicated by diabetes. Most common neonatal complication seen was hyperbilirubinemia 19(17.75%) and respiratory distress 18 (16.82%) in babies born to diabetic mother.Conclusions: Pregnant women with diabetes have more maternal, fetal, and neonatal complications, with overt diabetic group being more prone to complications.
ABSTRACT
El shunt portosistémico congénito es una anomalía vascular venosa que comunica circulación portal y sistémica, por la que se deriva el flujo sanguíneo, salteando el paso hepático. Es una entidad poco frecuente, cuya incidencia varía entre 1/30 000 y 1/50 000 recién nacidos. Puede cursar de forma asintomática o presentarse con complicaciones en la edad pediátrica o, menos frecuente, en la edad neonatal. Ante el diagnóstico, se deberá definir la necesidad de intervención quirúrgica o intravascular para el cierre. Esta decisión depende de las características anatómicas de la malformación, de las manifestaciones clínicas y complicaciones presentes. Se presenta el caso de un paciente de un mes de vida derivado a nuestro centro para estudio de hepatitis colestásica neonatal, con diagnóstico de shunt portosistémico extrahepático. Se realizó cierre intravascular de la lesión con mejoría significativa posterior.
Congenital portosystemic shunt is a venous vascular abnormality that connects portal and systemic circulation, resulting in diversion of the blood flow, bypassing the hepatic passage. It is a rare malformation; its incidence varies from 1:30 000 to 1:50 000 newborns. It may be asymptomatic or present with complications in the pediatric age or, less frequently, in the neonatal age. Upon diagnosis, the need for a surgical or an intravascular intervention for closure should be defined. This decision depends on the malformation anatomical characteristics, clinical manifestations, and complications. We present the case of a 1-month-old patient referred to our center for the study of neonatal cholestatic hepatitis, with a diagnosis of extrahepatic portosystemic shunt. Intravascular closure of the defect was performed with significant subsequent improvement.