ABSTRACT
AIM OF THE STUDY: To compare cord blood albumin (CBA) and cord blood bilirubin (CBB) at birth as predictors for development of neonatal hyperbilirubinaemia. MATERIAL AND METHODS: CBA and CBB of 388 healthy term neonates born by lower segment caesarean section (LSCS) were determined at birth and transcutaneous bilirubin (TCB) was measured every 12 hours from birth until 7 days of life or development of hyperbilirubinaemia requiring phototherapy. RESULTS: The cut-off value of CBB and CBA as obtained by the receiver operating characteristic (ROC) curve was 1.90 mg/dl and 3.17 g/dl respectively. The sensitivity, specificity and positive predictive value (PPV) for CBB were 97.4%, 40.6% and 71.09% while for CBA they were 40.8%, 34.8% and 48.41%. The cut-off value for CBB/CBA ratio was 0.719 as obtained by the ROC curve and was determined to have 97.4% sensitivity, 62.6% specificity and a PPV of 79.61%. CONCLUSIONS: CBB/CBA is a better indicator compared to CBA and CBB alone for prediction of neonatal hyperbilirubinaemia.
ABSTRACT
Neurofibromatosis type 1 (NF-1) is an autosomal dominant disorder involving multiple systems and affects approximately 1 out of 3000 persons. Ocular manifestations are lisch nodules, plexiform neurofibroma, optic pathway gliomas. The proper diagnosis of NF-1 is a crucial task for a clinician due to the various clinical manifestations including vision and life threatening malignancies in few patients, which may arise in the different phases of life. The authors report three cases of NF-1, presenting with ophthalmic symptoms in teenager boys. On further ophthalmic and paediatric evaluation the diagnosis of NF-1 was confirmed on the basis of clinical criteria. This series also describe the abnormal facial features like telecanthus and broad nose which has been reported rarely. Case 1 was kept under regular follow-up and Case 2 and Case 3 were planned for the debulking surgery for plexiform neurofibroma of upper eye lid. A multidisciplinary approach is required to diagnose and treat such patients keeping in mind the myriad of clinical manifestations and life-long follow-up is required.
