scholarly journals Effectiveness of short duration phototherapy in government hospital setup

2021 ◽  
Author(s):  
Revanasiddappa Bhosgi ◽  
Kirankumar Harwalkar
Keyword(s):  
American Academy ◽  
Short Duration ◽  
Serum Bilirubin ◽  
Effective Means ◽  
Neonatal Hyperbilirubinemia ◽  
P Value ◽  
Government Hospital ◽  
Normal Limits ◽  
American Academy Of Pediatrics ◽  
Set Up

Background: Neonatal hyperbilirubinemia is most common presentation of neonates. Phototherapy remains standard treatment for neonatal hyperbilirubinemia. Overcrowding in government hospital makes it difficult to give phototherapy for more than 1-2 days. The objectives of the study were to determine the effectiveness of short duration of phototherapy in treating hyperbilirubinemia and to determine the risk of rebound hyperbilirubinemia.Methods: Study was hospital based retrospective study. The study place was GIMS kalaburagi. The study was conducted from September 2019 to December 2019. All healthy full-term neonates with serum bilirubin above cut off range according to (American academy of pediatrics) nomogram were included in the study. Requirement of phototherapy was decided on serum bilirubin levels as per AAP (American academy of pediatrics) nomogram. Phototherapy was used as treatment modality.Results: Total 110 neonates were included in the study. Total of 56 neonates (50.9%) required 1 day of phototherapy to fall within normal limits for discharge and 46 neonates (41.8%) required 2 days of phototherapy to fall within normal limits for discharge with a significant p<0.05. Rebound hyperbilirubinemia requiring repeat phototherapy was seen in 6(10%) neonates who were discharged after 1 day of phototherapy and in 5 neonates (10%) who were discharged after 1 day of phototherapy with a p value of 0.05.Conclusions: Short duration phototherapy is the effective means of treatment for most neonates in government hospital set up. Serum bilirubin has to be reviewed during follow up to assess rebound hyperbilirunemia.  

scholarly journals Correlation between Neonatal Hyperbilirubinemia and Serum Magnesium and Copper Levels in Dhaka City

2020 ◽  
pp. 125-131
Author(s):  
Mohammad Anwar Hossain ◽  
Md. Ekramul Islam ◽  
Ashik Mosaddik ◽  
Md. Saiful Islam ◽  
Md. Nazmul Huda ◽  
...  
Keyword(s):  
Serum Bilirubin ◽  
Serum Magnesium ◽  
Colorimetric Method ◽  
Newborn Infants ◽  
Sulfanilic Acid ◽  
Neonatal Hyperbilirubinemia ◽  
P Value ◽  
Control Groups ◽  
Automated Method ◽  
Acid Reaction

Background: Neonatal hyperbilirubinemia is a condition when a newborn has an excessive amount of bilirubin in the blood and is one of the most prevalent problems in   neonates. Many studies reported that copper and magnesium play an important role in the pathogenesis and development of neonatal hyperbilirubinemia. Objectives: The aim of this study is to find out the correlation between the level of magnesium and copper with hyperbilirubinemia. Methodology: Serum bilirubin was assayed with colorimetric method by the use of diazotized sulfanilic acid reaction. A photometric automated method was used to determine the levels of magnesium and copper in the serum of neonates in both controls group (162) and cases group (220). Results: In the present study a significantly higher levels of Mg was found in hyperbilirubinemia of newborn infants when compared with control groups (23.67 ±2.33 mg/L versus 19.74 ±2.18 mg/L respectively and p value <0.001 which was significant) and correlation between hyperbilirubinemia and magnesium also significant (p value <0.001). Copper levels was significantly higher in hyperbilirubinemia of newborn infants (0.74 ±0.08 mg/L) compared with control groups (0.41 ±0.12 mg/L), where p value was <0.001, which was significant and correlation between hyperbilirubinemia and copper also significant (p value <0.001). Conclusion: It can be concluded that current study showed the concentrations of magnesium and copper levels were found to be significantly greater than control groups and may have a correlation with neonatal jaundice.

Drugs (e.g., Hexachiorophene), the FDA, and the AAP

PEDIATRICS ◽  
1972 ◽  
Vol 50 (2) ◽  
pp. 338-338
Author(s):  
Ira Marks
Keyword(s):  
American Academy ◽  
Drug Administration ◽  
Food And Drug Administration ◽  
American Academy Of Pediatrics ◽  
Set Up ◽  
Available Information

Although it is now six months since the Food and Drug Administration (FDA) originally approached the American Academy of Pediatrics regarding the potential dangers of hexachlorophene, the Academy (through its Committee on Fetus and Newborn) still seems to be basing its decision on three (unconfirmed) studies referred to in the FDA Bulletin of December 1971. If the Academy is to become involved in the FDA decision (and I agree that it should) is it not mandatory that we set up specific criteria that must be met before we agree or disagree with any FDA announcement? Simply because the FDA does, must we feel obliged to make decisions on the basis of a few studies which have been repeated by no one? Apparently the Committee has felt so, since it made its recommendation after "reviewing all the available information," i.e., a few unconfirmed studies.

II. PAPERS SUBMITTED IN PREPARATION FOR THE INSTITUTE ON PEDIATRIC RESIDENCY TRAINING

PEDIATRICS ◽  
1966 ◽  
Vol 38 (4) ◽  
pp. 712-755
Author(s):  
Robert Lawson
Keyword(s):  
American Academy ◽  
Vice President ◽  
National Board ◽  
Pediatric Society ◽  
Pediatric Residency ◽  
American Academy Of Pediatrics ◽  
Early Decision ◽  
Set Up ◽  
One Year ◽  
Medical Examiners

AT THE first meeting of the American Academy of Pediatrics in 1931, a committee was established to explore the possibility of Board certification. After consultation with representatives of the national societies then in existence, the American Board of Pediatrics was incorporated in 1933. The purpose was to certify a man as a specialist in the practice of pediatrics and an early decision was that the qualifications should be set up by the men practicing in the field. It is of interest that other suggestions such as separate state qualifying boards, certification by the National Board of Medical Examiners, or certification by a board run by the medical schools were all rejected. The decision was made that the Board be formed by appointment of three men by each of the prominent pediatric groups of the time, the American Academy of Pediatrics, the Section on Pediatrics of the American Medical Association, and the American Pediatric Society. Once appointed, the Board members would not be responsible to the appointing societies. After discussion by the three societies, the Board was formed. Dr. Borden Veeder, to whom I am indebted for some of this background, was the first president, Dr. Henry Helmholz, vice president, and Dr. C. Anderson Aldrich, secretary. Because of the need for more help in the actual examinations, the Board appointed additional interested pediatricians as official examiners. In general, succeeding appointments to the Board were made from this latter group. In 1960, the charter and by-laws were modified to spell out the method of appointment so that at present the term of appointment is six years. After the lapse of one year a man may be appointed for one more term.

Home Phototherapy: Not Seeing the Light

PEDIATRICS ◽  
1993 ◽  
Vol 91 (1) ◽  
pp. 147-147
Author(s):  
RONALD L. POLAND
Keyword(s):  
American Academy ◽  
Risk Ratio ◽  
Neonatal Hyperbilirubinemia ◽  
The Other ◽  
American Academy Of Pediatrics ◽  
Other Hand ◽  
At Home

In this issue of Pediatrics, Meropol and her associates1 report an interesting survey of the opinions and practices of urban pediatricians regarding home phototherapy. They report that fewer than a third of pediatricians in their survey used home phototherapy in their practices. A variety of reasons for nonuse were elicited, mostly related to difficulties in getting phototherapy done at home. A minority of nonusers were concerned about potential complications, such as dehydration. On the other hand, many of the reasons given by nonusers were not experienced as actual problems by the pediatricians who reported using home phototherapy. In their conclusions, the authors suggest that until more is known, the American Academy of Pediatrics guidelines for home phototherapy should be followed and that we should strive to improve the benefit-risk ratio for the treatment of neonatal hyperbilirubinemia.

Risk Factors for Serum Bilirubin Rebound After Stopping Phototherapy in Neonatal Hyperbilirubinemia

2021 ◽  
pp. 097321792110483
Author(s):  
Abhishek Yadav ◽  
Baljeet Maini ◽  
Bablu Kumar Gaur ◽  
Rupa R Singh
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Neonatal Sepsis ◽  
G6pd Deficiency ◽  
Serum Bilirubin ◽  
Neonatal Hyperbilirubinemia ◽  
P Value ◽  
Inclusion Criteria ◽  
Abo Incompatibility

Objective: To identify the factors affecting rebound increase in bilirubin levels after stopping phototherapy in neonatal hyperbilirubinemia. Setting: Tertiary-level neonatal unit. Patients: This was a hospital-based cross-sectional observational study. The study was conducted in neonatal division of rural tertiary care hospital. All neonates who were admitted for hyperbilirubinemia treatment and fulfilled the inclusion criteria were included in the study. Inclusion Criteria: All neonates 1.5 kg and above and treated in newborn intensive care unit for hyperbilirubinemia. Exclusion Criteria: (a) Critically ill patients requiring respiratory support any time after delivery, (b) neonates presenting with life-threatening surgical conditions, (c) patient with congenital malformation, (d) conjugated bilirubin elevation, (e) patients with birth asphyxia. Statistical Analysis: All the data were entered into a Microsoft Excel sheet. Appropriate tests of significance were applied. The various variables were sorted and presented as a number or percentage. The categorical variables used in the analysis were evaluated using the chi-square test (Yates’s correction and Fischer exact test were employed where applicable). The continuous data were analyzed by “t” test. The P value of less than 0.05 was taken to be level of statistical significance. Results: One hundred and fifty patients of neonatal hyperbilirubinemia were included in this study. In this study, 81 newborns (54.0%) were male and 78 (52%) of them were born by normal vaginal delivery. One hundred and nine babies (72.6%) were term babies. Fifty babies (33.3%) were low birth weight. Out of 150 neonates, 18(12%) had ABO incompatibility, 13(8.7%) Rh incompatibility, 23(15.7%) neonatal sepsis, and 4 (2.6%) had polycythemia. Out of 150 patients, 15(10%) babies had rebound hyperbilirubinemia at 24 h of life requiring phototherapy prematurity (particularly <34 weeks) ( P value: .03), low birth weight (particularly <2.0 kg) ( P value:.009), onset of jaundice requiring phototherapy before 72 h of life ( P value .04), blood group (both Rh and ABO) incompatibility ( P values: .001 and .002), neonatal sepsis ( P value: .004) were significantly associated with rebound hyperbilirubinemia. Glucose 6 phosphate dehydrogenase (G6PD) deficiency, polycythemia, maturity, mode of feeding, and gender did not show any statistical significant relationship with rebound hyperbilirubinemia. Conclusions: Rebound level of bilirubin need not be checked in all babies. Babies with risk factors like born preterm, low birth weight, having sepsis, requirement of phototherapy before 72 h of life, Rh and ABO group incompatibility, only need to be checked for serum bilirubin rebound. We recommend more studies with larger sample size to evaluate all these factors including polycythemia and G6PD deficiency.

ERRATA

PEDIATRICS ◽  
1992 ◽  
Vol 90 (2) ◽  
pp. 264-264
Keyword(s):  
Confidence Interval ◽  
American Academy ◽  
Lower Limit ◽  
Odds Ratio ◽  
P Value ◽  
American Academy Of Pediatrics

In the American Academy of Pediatrics statement, "Positioning and SIDS," appearing in the June issue of Pediatrics (1992;89:1120-1126), part of a sentence was omitted from the end of the first paragraph on p 1122. The complete sentence should read: "If the lower limit of the confidence interval is greater than 1.0, then the P value for the odds ratio is less than .05."

scholarly journals Light Emitting Diode (LED) Phototherapy versus Conventional Phototherapy in Neonatal Hyperbilirubinemia: A Single Blinded Randomized Control Trial from Coastal India

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Sreesravya Gutta ◽  
Janardhan Shenoy ◽  
Sowmini P. Kamath ◽  
Prasanna Mithra ◽  
B. Shantharam Baliga ◽  
...  
Keyword(s):  
Side Effects ◽  
Randomized Control Trial ◽  
Serum Bilirubin ◽  
Neonatal Hyperbilirubinemia ◽  
Total Serum Bilirubin ◽  
Conventional Group ◽  
Total Serum ◽  
P Value ◽  
Significant Difference ◽  
Randomized Control

Neonatal hyperbilirubinemia is a common problem with potentiality to cause irreversible brain damage. Reduction of serum bilirubin level is essential to minimize such damage. Compact fluorescent tubes, halogen bulbs, fiber optic blankets, and LEDs are commonly used light sources for phototherapy with varying efficacies. This study aimed at evaluating the effect of LED versus conventional phototherapy on (a) rate of reduction in total serum bilirubin levels, (b) effect on urinary lumirubin excretion, and (c) comparing side effects of phototherapies among neonates with hyperbilirubinemia. In this randomized control trial, 166 neonates ≥ 35 weeks of age requiring phototherapy were recruited and further divided into 2 groups [LED (83) and conventional (83)] by using computer generated random numbers. Serial total serum bilirubin levels and random urinary lumirubin levels were collected and side effects of phototherapy were noted. Rate of fall in total serum bilirubin levels (TSB, μmol/L/hour) and random urinary lumirubin levels were computed. Data were collected using a pretested proforma. Analysis was done with Statistical Package for Social Sciences (SPSS) version 11.5. Independent sample “t” test and Chi-square tests were used with p value of <0.05 being significant. Significant difference was documented in mean rate of decrease of TSB (μmol/L/hour) in LED group (5.3 ± 2.91) when compared to conventional group (3.76 ± 2.39) (p <0.001). A significant increase in mean random urinary lumirubin levels (arbitrary units) was observed in LED group (129.01 ± 33.18) when compared to conventional group (114.44 ± 44.84) (p = 0.021). Side effects were minimal and comparable in both groups. This study concludes the rates of decrease in total serum bilirubin levels and increase in urinary lumirubin levels were significant with LED when compared with conventional phototherapy, implying LED to be more efficacious.

Risk Factors and Predictors of Rebound Hyperbilirubinemia in a Term and Late-Preterm Infant with Hemolysis

2020 ◽  
Author(s):  
Hanaa Almohammadi ◽  
Nehad Nasef ◽  
Aziza Al-Harbi ◽  
Khalid Saidy ◽  
Islam Nour
Keyword(s):  
Neonatal Intensive Care ◽  
Serum Bilirubin ◽  
Independent Predictor ◽  
Late Preterm ◽  
Total Serum ◽  
P Value ◽  
Late Preterm Infant ◽  
American Academy Of Pediatrics ◽  
Retrospective Data Analysis ◽  
Key Points

Objective This study aimed to assess the incidence and predictors of rebound in term and late-preterm infants with hemolytic hyperbilirubinemia postphototherapy. Study Design A 4-year retrospective data analysis of neonates with hemolytic indirect hyperbilirubinemia admitted to the neonatal intensive care unit (NICU) of Medina Maternity and Children's Hospital was conducted. Bilirubin rebound was defined as the return of total serum bilirubin (TSB) to phototherapy threshold within 72 hours of postphototherapy. Results Of 386 identified neonates; 44 (11%) experienced rebound. Neonates in the rebound group demonstrated significantly higher levels of peak TSB, TSB at discontinuation of phototherapy, and lower value of relative TSB (difference between TSB at phototherapy termination and the American Academy of Pediatrics [AAP] threshold for phototherapy at concurrent age) compared with nonrebound group (p-value: <0.001, <0.001, and 0.007, respectively). Lower value of relative TSB at stoppage of phototherapy was the single independent predictor for rebound hyperbilirubinemia by mutivariate regression (p < 0.001). A cut-off value for relative TSB at stoppage of phototherapy of 190 µmol/L had 98% sensitivity and 32% specificity to predict rebound hyperbilirubinemia. Conclusion Relative TSB at phototherapy termination is the best predictor for postphototherapy rebound hyperbilirubinemia in neonates with hemolytic etiology. Key Points

AMERICAN ACADEMY OF PEDIATRICS, INC. PROCEEDINGS AND REPORTS

PEDIATRICS ◽  
1954 ◽  
Vol 14 (6) ◽  
pp. 675-677
Author(s):  
ROGER L. J. KENNEDY
Keyword(s):  
Infectious Diseases ◽  
American Academy ◽  
Effective Means ◽  
Accident Prevention ◽  
Reliable Information ◽  
Child Life ◽  
The Past ◽  
American Academy Of Pediatrics ◽  
Present Structure ◽  
Group A

PERIODICALLY, it appears to be appropriate and perhaps even necessary to pause for a moment to consider the question, "Where are we going and by what means are we moving along our course?" In the case of the Academy, the answers are to be found in a consideration of the present structure and activities of the components of the group. A very brief, even categorical review of the committees, liaison representatives and official subdivisions will tell us much, and will serve to remind us that we are participants in a great vital program dedicated to the health and welfare of children. Let us first consider the aims and activities of the various committees of the Academy. In the past few years, an increasing awareness of loss of child life through accidents has prompted the Committee on Accident Prevention to survey the causes and to initiate a program of prevention which has received nationwide attention. Unpleasant though it may be to contemplate the prospect of a world engaged in another holocaust of war, the need for preparedness has been recognized at all levels of our civil structure, and in consonance with the emphasis on national alertness, the Academy has established a Committee whose purpose it is to compile information as to the possible needs of children in wartime and the role that pediatricians can play in satisfying those needs, if the occasion demands it. During the lives of most of us, contagious and infectious diseases have become increasingly less common and less severe. In order that the most effective means of controlling, as well as treating, these diseases may be available to all, the Committee on Control of Infectious Diseases has issued and, at intervals, has revised a manual that contains the latest and most reliable information that can be supplied by a panel of experts in the field.

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