Effect of Neonatal Phototherapy on Eosinophil Levels in Nonsevere Hyperbilirubinemia

2019 ◽  
Vol 37 (09) ◽  
pp. 929-932
Author(s):  
Ceren Can ◽  
Şahin Hamilcıkan
Keyword(s):  
Serum Bilirubin ◽  
Total Serum ◽  
Female Ratio ◽  
Term Neonates ◽  
Significant Difference ◽  
Delivery Route ◽  
Cell Series ◽  
The Impact ◽  
Male To Female ◽  
Spontaneous Delivery

Objective The purpose of the research was to determine the impact of phototherapy (PT) on eosinophil levels in neonates with nonsevere bilirubin levels (<20 mg/dL) treated with PT. Study Design This observational pilot study included term neonates with early neonatal hyperbilirubinemia. Results Ninety-six term neonates were included in the study. The male-to-female ratio was 1.23. Hyperbilirubinemia was most frequently related to ABO group incompatibility (49%). Fifty-two neonates (54.1%) were born by normal spontaneous delivery. After PT, while total serum bilirubin, hemoglobin, hematocrit, leukocyte, and neutrophil levels were found to be significantly decreased, eosinophil levels were significantly increased (p = 0.01). No significant difference was found regarding lymphocyte and basophil levels after PT. A statistically significant correlation was found between bilirubin and eosinophil levels before PT (r 2 = 0.28, p = 0.03). No correlation between eosinophil levels and treatment age, gender, diagnosis of hyperbilirubinemia, and delivery route before PT was found. After PT, eosinophil levels increased, while other blood cell series were found to be decreased. The correlation between the bilirubin levels and eosinophil was found to be negative (r 2 = − 0.32, p = 0.02) after PT. Conclusion PT may increase serum eosinophil levels in term neonates with nonsevere hyperbilirubinemia.

Efficacy and Safety of Fenofibrate in Uncomplicated Hyperbilirubinemia in Newborn: A Randomized Trial, with a 6-month Follow-up

2020 ◽  
pp. 37-42
Author(s):  
Jayendra R. Gohil ◽  
Vishal S. Rathod ◽  
Bhoomika D. Rathod
Keyword(s):  
Single Dose ◽  
Serum Bilirubin ◽  
Total Serum Bilirubin ◽  
Total Serum ◽  
Control Group ◽  
Term Neonates ◽  
Significant Difference ◽  
Group A ◽  
Group B

Objective: To study the effect and safety of Fenofibrate in uncomplicated hyperbilirubinemia in newborn with 6-month follow-up. Materials and Methods: This is a randomized controlled clinical trial conducted in 60 normal term neonates admitted for uncomplicated hyperbilirubinemia in NICU at Sir T G Hospital, Bhavnagar from January 2012 to December 2012. The data included: age, sex, total serum bilirubin (TSB), weight and duration of phototherapy. All neonates enrolled in the study received phototherapy. They were divided in two groups of 30 each: control group A and group B receiving Fenofibrate (100 mg/kg single dose). There was statistically insignificant difference between the parameters of age, sex, weight and TSB between the two groups at hospitalization. Data was analyzed by using appropriate statistical methods. Results: Mean values for total serum bilirubin in Fenofibrate group B at 24 and 48 hours after admission were significantly lower than those for control group A (p<0.0001,  p=0.0001). There was no significant difference in fall of TSB between 24 and 48 hours. The mean duration of phototherapy in Fenofibrate group (44.8h: 24-72h) was significantly shorter than that in control group (55.2 h: 24‐96 h) (P=0.02). There were no side effects of the drug observed during the study and during 6 months follow up period. Conclusion: Fenofibrate as a single 100 mg/kg dose in healthy full term neonates, is effective and a safe drug (till six-month follow-up) for neonatal hyperbilirubinemia, that can decrease the time needed for phototherapy and hence hospitalization. Effect of a single dose seems to wane after 24 hours.

scholarly journals Effects of season of birth and meteorological parameters on serum bilirubin levels during the early neonatal period: a retrospective chart review

2020 ◽  
Author(s):  
Shigeo Iijima ◽  
Toru Baba ◽  
Miyuki Kondo ◽  
Tomoka Fujita ◽  
Akira Ohishi
Keyword(s):  
Neonatal Jaundice ◽  
Meteorological Parameters ◽  
Serum Bilirubin ◽  
Cold Season ◽  
Total Serum ◽  
Season Of Birth ◽  
Male Population ◽  
Female Population ◽  
Term Neonates ◽  
Significant Difference

Abstract Background: Neonatal jaundice can be influenced by many factors. Several studies have suggested that the severity of neonatal jaundice may vary with the season, but conclusive data on this issue are currently lacking. The aim of the present study was to establish whether serum bilirubin levels vary in healthy term neonates according to seasonal variation and meteorological factors.Methods: We retrospectively studied 3,344 healthy term neonates born between 2013 and 2018. Using the capillary technique, total serum bilirubin (TSB) levels were measured on the fourth day after birth. The monthly and seasonal variations in TSB levels and clinical and meteorological effects on TSB levels were assessed.Results: In the enrolled neonates, the median gestational age was 39.4 weeks, median birthweight was 3,025 g, and median TSB level was 195 µmol/L. The TSB level peaked in December and was the lowest in July, but the variation was not statistically significant. The TSB level was significantly higher in the cold season (October to March) than in the warm season (April to September; p=0.01). Comparing the seasonal differences according to sex, TSB levels were significantly higher in the cold season in male infants (p=0.001), whereas no significant difference was observed in female infants. In only the male population did a weakly negative but significant association exist between TSB levels and daily mean air temperature (r=-0.07, p=0.007); in the female population, no significant correlation was found between TSB levels and meteorological parameters.Conclusions: Season of birth appears to be an etiological factor in neonatal jaundice, with an additional influence of sex. However, the contradictions observed in various studies highlight the need for further research on this topic.

scholarly journals Effects of Season of Birth and Meteorological Parameters on Serum Bilirubin Levels during the Early Neonatal Period: A Retrospective Chart Review

2021 ◽  
Vol 18 (5) ◽  
pp. 2763
Author(s):  
Shigeo Iijima ◽  
Toru Baba ◽  
Miyuki Kondo ◽  
Tomoka Fujita ◽  
Akira Ohishi
Keyword(s):  
Seasonal Variations ◽  
Meteorological Parameters ◽  
Serum Bilirubin ◽  
Warm Season ◽  
Total Serum ◽  
Season Of Birth ◽  
Male Population ◽  
Female Population ◽  
Term Neonates ◽  
Significant Difference

To establish whether serum bilirubin levels vary in healthy term neonates according to seasonal variations and meteorological factors, we retrospectively studied 3344 healthy term neonates born between 2013 and 2018. Total serum bilirubin (TSB) levels were measured on the fourth day after birth. The monthly and seasonal variations in TSB levels and clinical and meteorological effects on TSB levels were assessed. In the enrolled neonates, the median TSB level was 195 µmol/L. The TSB level peaked in December and was the lowest in July, but the variation was not statistically significant. The TSB level was significantly higher in the cold (October to March) than in the warm season (April to September; p = 0.01). The comparison between seasonal differences according to sex showed TSB levels were significantly higher in the cold than in the warm season in male infants (p = 0.001), whereas no significant difference was observed in female infants. A weakly negative but significant association existed between TSB levels and the mean daily air temperature (r = −0.07, p = 0.007) in only the male population; the female population showed no significant correlation between TSB levels and meteorological parameters. The season of birth is an etiological factor in neonatal jaundice, with an additional influence from sex.

Role of Cord Blood Carboxyhemoglobin in Detecting Significant Hyperbilirubinemia in Term Neonates with ABO Alloimmunization

2021 ◽  
Author(s):  
Mahir Tıraş ◽  
Emrah Can ◽  
Şahin Hamilçıkan
Keyword(s):  
Cord Blood ◽  
Total Serum ◽  
Healthy Controls ◽  
Term Neonates ◽  
Group Iii ◽  
Group I ◽  
Significant Difference ◽  
Group Ii ◽  
Positive Direct ◽  
Severe Hyperbilirubinemia

Objective This study aimed to assess whether cord blood carboxyhemoglobin (COHb) levels in jaundiced term neonates with and without a positive direct Coombs test (DCT) and in healthy controls could be used as a predictor of severe hyperbilirubinemia. The percentage of cord blood COHb should be higher among neonates with Coombs-positive ABO hemolytic disease than among those with Coombs-negative ABO incompatibility and higher than that of ABO-compatible control neonates. Study Design This cross-sectional descriptive study of 198 term neonates comprised three subgroups: group I featured 68 DCT-positive ABO-incompatible neonates (ABO + DCT), group II featured 60 DCT-negative ABO-incompatible neonates with hyperbilirubinemia (ABO–DCT), and group III featured 70 healthy controls. COHb was determined by an OSM3 hemoximeter. Results Group I differed from groups II and III for cord blood bilirubin, cord blood hemoglobin, and cord blood hematocrit. Groups I and II had higher mean total serum bilirubin (TSB) levels than group III, while there was no difference in the mean TSB levels between groups I and II. There was no significant difference between the COHb group means for groups I, II, and III (p = 0.98). The area under the receiver operating characteristic curve calculated for group I/group III and group II/group III were found to be 0.62 and 0.54, respectively. Conclusion COHb levels did not prove to be superior to the DCT for predicting the risk of developing severe hyperbilirubinemia in term neonates. Key Points

EFFECT OF PHOTOTHERAPY ON SERUM CALCIUM LEVELS IN NEONATAL JAUNDICE

2021 ◽  
pp. 17-19
Author(s):  
Aradhana Gupta ◽  
Anand Kumar Bhardwaj ◽  
Anisha Aggarwal ◽  
Gauri Chauhan
Keyword(s):  
Serum Calcium ◽  
Neonatal Intensive Care ◽  
Neonatal Jaundice ◽  
Serum Bilirubin ◽  
Calcium Supplementation ◽  
Clinical Signs ◽  
Total Serum ◽  
Medical Sciences ◽  
Term Neonates ◽  
Unconjugated Hyperbilirubinemia

Background :To study the effect of phototherapy on serum calcium levels in neonates with unconjugated hyperbilirubinemia. Methods : This hospital based longitudinal interventional study was conducted on 100 neonates with neonatal hyperbilirubinemia admitted to Neonatal Intensive Care Unit at Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala. Total serum bilirubin and serum calcium levels of each participants were checked before and at the end of phototherapy. Neonates were also checked for the clinical signs of hypocalcemia i.e. jitteriness, irritability, lethargy, and convulsions. Results : Atotal of 100 neonates with neonatal jaundice were included with 55% boys and 45 % girls whose mean age was 3.0 ± 0.95 days. Mean S.Bilirubin level before phototherapy was 13.92 ± 2.32 mg/dl which was reduced to 8.87 ± 2.18 mg/dl. S.Calcium levels pre-phototherapy were 8.66 ± 0.65 mg/dl which were reduced to 7.94 ± 1.05 mg/dl. It was found that 32% of the participants in total exhibited symptoms related to hypocalcemia. More term neonates (56.3%) experienced symptoms related to hypocalcemia compared to pre-terms (43.8%). Conclusion : It can be deduced that phototherapy induced hypocalcemia is a signicant concern and hence, neonates requiring phototherapy may be considered for calcium supplementation.

scholarly journals Glucose-6-Phosphate Dehydrogenase (G6PD) Status in Neonatal Jaundice and its Relationship with Severity of Hyperbilirubinemia

1970 ◽  
Vol 4 (2) ◽  
pp. 71-76
Author(s):  
Nilufa Akhter ◽  
Noorzahan Begum ◽  
Waqar Ahmed Khan
Keyword(s):  
Bilirubin Level ◽  
G6pd Deficiency ◽  
Serum Bilirubin ◽  
Serum Bilirubin Level ◽  
Total Serum ◽  
Control Group ◽  
Term Neonates ◽  
Group A ◽  
The Difference ◽  
Enzyme Deficient

Background: G6PD deficiency is one of the common inherited enzymatic disorder associated with high incidence of severe neonatal hyperbilirubinemia. Objectives: To observe G6PD status in male, term neonates with jaundice and its correlation with serum level of bilirubin. Methods: This cross sectional study was conducted on 90 male, term neonates with jaundice, age ranged from 3 to 12 days (Group B) in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University (BSMMU) between July 2007 to June 2008. On the basis of total serum bilirubin (TSB) level, study group was further divided into B1(TSB <15mg/dl), B2(TSB 15-20mg/dl) and B3 (TSB>20mg/dl). For comparison age and sex matched 30 apparently healthy neonates (Group A) were also included in the study. Erythrocyte G6PD level was measured by Spectrophotometric method by using kit of Randox. Serum bilirubin level was measured by standard laboratory technique. For statistical analysis ANOVA, independent sample "t" test and Pearson's correlation coefficient test were performed as applicable by using SPSS windows version-12. Results: In this study, erythrocyte G6PD levels were significantly lower in moderate (p<0.01) and severe (p<0.001) hyperbilirubinemic group in comparison to that of control group . However, this enzyme level was lower in mild group compared to that of control but the difference was statistically non significant. Again, this enzyme levels were significantly lower in moderate (p<0.05) and severe (p<0.01) group than that of mild group and also between severe and moderate hyperbilirubinemic group (p<0.05). In this study, G6PD enzyme deficient were found in 1(3.33%) and 6(20%) subjects of group B2 and B3 respectively. Though, percentage of the subjects with enzyme deficiency were higher in severe group ( B3 ) compared to that of moderate group( B2 ) but the difference was statistically not significant. However, no enzyme deficient patient were found in control group (A) and mild hyperbilirubinemic group (B1). Serum bilirubin level showed significant (p<0.05) positive (r=+.429) correlation with erythrocyte G6PD level in control group (A). On the other hand, this level was negatively correlated with G6PD enzyme in groups B1 (r= -.127), B2 (r=-.120) and B3 ( r= -.671) but significant negative correlation in group B3 (p<0.01). Conclusion: The results of the study revealed that severity of hyperbilirubinemia depends on degree of G6PD deficiency. Therefore, early detection of this enzymopathy and close surveillance of the affected neonates may be important in reducing the complications of severe hyperbilirubinemia. Key words: Glucose-6-PD, Hyperbilirubinemia, Neonates DOI: 10.3329/jbsp.v4i2.4176 J Bangladesh Soc Physiol. 2009 Dec;4(2): 71-76  

scholarly journals Characteristics of predominantly right-sided colonic diverticulitis without need for colectomy

2020 ◽  
Author(s):  
Zhi Chen ◽  
Bing Zhang ◽  
Dan Wu ◽  
Ye Jin
Keyword(s):  
Hospital Stay ◽  
Recurrence Rate ◽  
Sigmoid Diverticulitis ◽  
Colonic Diverticulitis ◽  
Abdominal Drainage ◽  
Female Ratio ◽  
Uncomplicated Diverticulitis ◽  
Significant Difference ◽  
Male To Female ◽  
Acute Colonic Diverticulitis

Abstract Background: In China, diverticulitis is more often located in the right colon, mainly in the cecum and ascending colon. Here we study the characteristics of acute colonic diverticulitis and compare various treatments for acute right-sided colonic diverticulitis.Methods: A retrospective analysis of 123 patients with acute colonic diverticulitis treated in our hospital from April 2013 to April 2020, including 114 cases of right-sided colonic diverticulitis, was performed. The characteristics of acute colonic diverticulitis were analyzed, and the therapeutic effects of different treatments for acute right-sided colonic diverticulitis were compared.Results: 111 cases of caecal and ascending colonic diverticulitis were identified (90.2% of cases, male to female ratio 2.26:1, average age 39.6 ± 14.4 years, surgery ratio 24.3%, mean hospital stay 7.4 ± 4.3 days, recurrence rate 3.6%). Three cases of transverse colonic diverticulitis and three cases of descending colonic diverticulitis were found. Six cases of Sigmoid diverticulitis (4.9% of cases, male to female ratio 1:1, average age 67.7 ± 4.5 years, surgery ratio 33.3%, mean hospital stay 11.7 ± 5.5 days, recurrence rate 0%) were found. 13 patients underwent right-sided colonic diverticulitis resection and repair, while zero patients underwent colectomy. Abdominal drainage was performed in 15 patients with right-sided colonic diverticulitis. There was no significant difference in the length of hospital stay among the three treatments for right-sided colonic diverticulitis (P = 0.05). There was no significant difference in the recurrence rate among the three treatments of right-sided colonic diverticulitis ( P = 0.358). While the recurrence rate of right-sided colonic diverticulitis was only 3.5%, relapse usually occurred within the first year following treatment.Conclusions: In our patients, right-sided colonic diverticulitis is more common in young and middle-aged patients than in elderly patients and we see a higher incidence in males. Acute right-sided complex diverticulitis is rare. While non-surgical treatment is preferred for acute right-sided uncomplicated diverticulitis, no significant difference in outcome was observed between the three different treatments we compared. Resection and repair of diverticulum or abdominal drainage can also be used to treat patients with acute uncomplicated diverticulitis.

scholarly journals Intranasal Splint in Nasal Septal Surgery: Is It Necessary?

2020 ◽  
Vol 32 (2) ◽  
pp. 126-129
Author(s):  
Jahangir Alam Mazumder ◽  
Md Golam Mustafa ◽  
AHM Delwar ◽  
Shazibur Rashid ◽  
Md Mostafizur Rahaman ◽  
...  
Keyword(s):  
Complete Healing ◽  
College Hospital ◽  
Female Ratio ◽  
Medical College ◽  
Septal Surgery ◽  
Significant Difference ◽  
Group A ◽  
Medicine Today ◽  
Group B ◽  
Male To Female

Introduction: After SMR/septoplasty with or without turbinate surgery, it needs to keep apart the septum and turbinates upto their complete healing otherwise there is a chance of adhesion (synechia) formation. To prevent this there are variousprocedures. To place an intranasal splint in one or both sides of the septum is one of them. Nowadays there raised thequestion of whether the splinting is necessary or not. There is no significant difference in result with or without anintranasal splint. Weighing against the co-morbidities the routine use of an intranasal splint can no longer be justified. Materials and Methods: This is a randomized control study of 200 patients of SMR/septoplasty, done for nasal septaldeviation causing symptoms in Cumilla Medical College Hospital in the period of January 2016 to December 2019. Theywere equally divided into two groups, group-A were operated placing an intranasal splint and group-B with no intranasalsplint. They were followed up for 6 weeks to detect any synechia and co-morbidities. Result: The age of our patients wasranged from 13-49 years with a mean age of 22.45 years. The male to female ratio is 1.78:1. Synechia was found in 4% ofthe splinted group and 6 of the nonsplinted groups. Co-morbidities were detected more in the splinted group than that ofnon-splinted. In INS group these were found as follows: pain in the nose, face and head (26%), faint during removal ofnasal splint (6%), nasal obstruction (38%), the anxiety of splint removal in the postoperative period (35%) and vestibulitisdue to persistent irritation by a splint (17%). Conclusion: There is little significant advantage of using intranasal splintroutinely in septal surgery to prevent synechia formation. Medicine Today 2020 Vol.32(2): 126-129

scholarly journals Colorectal Cancer in Octogenarian and Nonagenarian Patients: Clinicopathological Features and Survivals

2020 ◽  
Vol 36 (5) ◽  
pp. 323-329 ◽  
Author(s):  
Soo Min Lee ◽  
Jun Sang Shin
Keyword(s):  
Colorectal Cancer ◽  
Elderly Patients ◽  
Univariate Analysis ◽  
Survival Rates ◽  
The Elderly ◽  
Clinicopathological Parameters ◽  
Female Ratio ◽  
Significant Difference ◽  
Differentiation Stage ◽  
Male To Female

Purpose: Elderly population will comprise a substantial proportion of colorectal cancer (CRC) patients. We examined patients older than 80 years according to their clinical and pathological characteristics to fully understand the elderly patients.Methods: CRC patients, 60 years or older at diagnosis, admitted between 2009 and 2014 at our hospital were enrolled. The patients were divided into 2 groups: elderly (aged > 80 years, n = 133), and controls (aged 60 to 79 years, n = 596). Patient’s demographics, risk factors for prognosis of CRC, Clinicopathological parameters, treatment, and survival rates were compared.Results: The mean ages were 83.9 and 64.8 years, respectively. Male-to-female ratio and tumor sidedness were comparable in both groups. Prognostic factors found in univariate analysis; differentiation, stage, lymphovascular invasion, and carcinoembryonic antigen showed no statistical difference. The microsatellite instability status and number of retrieved lymph nodes were also similar (17.2 vs 21.6, P = 0.505). A significant difference was found in the treatment approach for chemotherapy as the elderly patients with stage III and IV tend to have omitted adjuvant (43.6% vs. 92.8%, P < 0.001) or palliative (35.8% vs. 89.4%, P = 0.016) chemotherapy. Except in stage I, elderly patients showed significantly lower overall survival rates.Conclusion: Current study shows far-elderly patients with CRC were less likely to receive standard treatments, which might have resulted in an inferior outcome. As the number of elderly patients with CRC increase, our results provide a basis for further clinical and molecular investigations of elderly CRC patients.

scholarly journals Role of serum bilirubin as a marker of acute gangrenous appendicitis

2012 ◽  
Vol 1 (2) ◽  
pp. 89-92 ◽  
Author(s):  
P Ghimire ◽  
P Thapa ◽  
N Yogi ◽  
P Ghimire
Keyword(s):  
Logistic Regression ◽  
Leucocyte Count ◽  
Total Bilirubin ◽  
Serum Bilirubin ◽  
Total Bilirubin Level ◽  
Total Serum ◽  
Total Leucocyte Count ◽  
Serum Total Bilirubin ◽  
Gangrenous Appendicitis ◽  
Significant Difference

Background: This study has compared the difference in serum bilirubin between patients with gangrenous and non-gangrenous appendicitis. Methods: A prospective analytical study of, 141 patients who underwent appendectomy, from March 2010 to March 2011 in Manipal Teaching Hospital, Pokhara, Nepal was carried out. Clinico-demographic data, Alvarado’s score, total serum bilirubin, total leucocyte count and histopathological report of all the cases were collected in a prestructured proforma. Comparison between gangrenous and non-gangrenous appendicitis groups was carried out using independent sample t test, Chisquare test, and direct logistic regression. The data was analyzed using SPSS 11.6 software. Result: Around 43% (61 out of 141) patients had gangrenous appendicitis and statistically significant difference was found between the two groups in total Alvarado’s score, total count and total bilirubin level. The effect size as indicated by eta square statistics was large for total bilirubin (eta squared=0.39) as compared to total Alvarado’s score (0.09) and total leucocyte count (0.05). Direct logistic regression model showed serum total bilirubin as the only independent variable to make a unique statistically significant contribution in predicting gangrenous appendicitis. Conclusion: Pre-operative assessment of serum total bilirubin can serve as an important maker of acute gangrenous appendicitis. DOI: http://dx.doi.org/10.3126/njms.v1i2.6606 Nepal Journal of Medical Sciences. 2012;1(2): 89-92

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