scholarly journals PHOTOTHERAPY

2015 ◽  
Vol 22 (12) ◽  
pp. 1541-1545
Author(s):  
Sadida Bahawal ◽  
Umm-Ul- Baneen Naqvi ◽  
Mehboob Alam Siddiqui ◽  
Dr.Shakil Ahmad ◽  
Imran Sarwar
Keyword(s):  
Serum Calcium ◽  
Tertiary Care ◽  
Full Term ◽  
Preterm Neonates ◽  
P Value ◽  
Inclusion Criteria ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Term Neonates ◽  
Paediatric Unit

Hyperbilirubinemia is the most common abnormal physical finding in first fewweeks of lif and its most common management is phototherapy. Amongst other commoncomplications a less known complication of phototherapy is hypocalcemia. Objectives: To studythe incidence of phototherapy induced hypocalcemia in neonates and to have a comparisonbetween preterm and term neonates. Study design: Descriptive cross-sectional study.Setting: Paediatric Unit II DHQ Hospital Faisalabad, which is a tertiary care centre for all kind ofpatients. Duration of study with dates: Six months from 1-11-2012 to 30-04-2013. Methods:196 neonates with hyperbilirubinemia full term / preterm neonates admitted in pediatric DHQhospital faislabad were selected. Inclusion criteria. 1) Hyperbilirubinemia. 2) No hypocalcemiaon admission. 3) Received phototherapy for hyperbilirubinemia. Serum Calcium levels weremeasured in all neonates before and 48 hours after receiving phototherapy. Incidence ofhypocalcemia among all neonates was calculated as an absolute percentage and the samplepopulation was also divided into preterm / full term neonates to evaluate the incidence ofhypocalcemia in these two groups individually. RESULTS: Mean serum calcium in neonateswas 7.5+- 1.5 mg / dl .16.84 % of neonates were found to have calcium level below the cut offvalue. 33 out of 196 developed hypocalcemia after phototherapy and out of these 54 % werepreterm and 45 % were term neonates < P-value (0.01)>. Conclusion: Phototherapy induceshypocalcemia in neonates more so in preterm neonates. Impact: Consideration for additionalcalcium supplementation should be undertaken in all neonates undergoing phototherapy andfurther randomized trials need to be done with these concerns.

scholarly journals Transport Factors Affecting the Outcome of Referred Neonates Admitted in A Tertiary Care Hospital

2018 ◽  
Vol 41 (3) ◽  
pp. 159-164 ◽  
Author(s):  
Madhabi Baidya ◽  
Mahfuza Shirin ◽  
Liton Chandra Saha
Keyword(s):  
Perinatal Asphyxia ◽  
Care Center ◽  
Tertiary Care ◽  
Preterm Neonates ◽  
P Value ◽  
Care Hospital ◽  
Cross Sectional ◽  
Neonatal Transport ◽  
Group I ◽  
Group Ii

Background: Adequate neonatal transport is a key component of care of the sick newborns who require referral to tertiary care center. Poor transportation is one of the iatrogenic factors associated with greater neonatal mortality. Neonatal transport is the greatest challenge faced today in our country. The purpose of this study was to find out characteristics of transport of referred neonates and to idention the factors that contribute to mortality.Methodology: This cross sectional study was conducted in Dhaka Shishu (Children) Hospital from June 2013 to November 2013. Both term and preterm neonates who were referred within first seven days of life were included and those with gross congenital abnormalities and left against medical advice were excluded from the study. After enrollment, data were collected using a structured questionnaire including birth details, interventions before transportation, reasons for referral, and details of transportation. Outcome & duration of hospital stay were also recorded. Neonates who were expired considered as group I and who were survived considered as group II. The study variables were analyzed for their association with immediate outcome by applying chi square test and t test. P value <0.05 was considered significant.Results: This study found that out of 332 neonates 181 were expired with 54.5% mortality rate. One eighty one neonates who were expired, considered as group I and one fifty one neonate were survived, considered as group II. The mortality was significantly high in male neonates [RR 0.80 (0.66-0.97)] and neonates those delivered at home [RR 1.34(1.10-1.64)] (p<0.05). Perinatal asphyxia, pre-term low birth weight, neonatal sepsis were the main causes of referral. It was found that transportation without any referral note [RR 1.40 (1.14- 1.71)], no advice regarding maintenance of airway[RR 1.50(1.17- 1.92)]and keeping warm [RR 1.51(1.17-1.950], resuscitation on admission [RR 1.63(1.23-2.17)] and transportation required > 3hours [RR 1.36(1.09-1.69)] were associated with significantly higher mortality among referred transported neonates(p<0.05).Conclusions: This study found that male neonates, home delivery, transportation without any referral note, no advice regarding maintenance of airway and keeping warm, resuscitation needed on admission and prolonged transportation time were significantly associated with mortality of referred transported neonates.Bangladesh J Child Health 2017; VOL 41 (3) :159-164

scholarly journals Clinico-biochemical profile of chronic kidney disease patients in elderly age group in a tertiary care centre

2019 ◽  
Vol 7 (11) ◽  
pp. 4227
Author(s):  
Atul V. Rajkondawar ◽  
Amit Yele
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Elderly Patients ◽  
Tertiary Care ◽  
P Value ◽  
Age Group ◽  
Elderly Age ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Significant Difference

Background: Chronic kidney disease (CKD) remains one of the major health problems in India. Renal function steadily deteriorates as age advances and advancing age has been indicted to have adverse implications in the disease progression to end stage renal disease (ESRD). With the present study, clinico-biochemical profiling of chronic kidney disease patients in geriatric age group as well as comparison with non-elderly patients was undertaken.Methods: In this cross-sectional observational study, 100 patients of CKD admitted in the tertiary care study centre were enrolled consecutively and assessed for symptoms, signs and biochemical parameters over two years. Study subjects were divided into two groups:- Group 1: Elderly patients- aged 60 years or more, and Group 2: Non-elderly patients- less than 60 years of age. Relevant comparisons were drawn statistically and tested for significance.Results: Pallor and pedal edema were observed to be the commonest clinical features across groups. Elderly group shows higher prevalence of severe anaemia (mean hemoglobin- 7.4 gm%). Higher prevalence of clinical and biochemical derangement was found in patients with relatively lower GFR. Elderly age group also had more prevalence of electrolyte abnormalities compared with non-elderly population, with statistically significant difference observed for hyponatremia (p value- 0.023), hypoproteinemia (p value- 0.0078) and blood urea level (p value- 0.0054).Conclusions: Understanding beforehand the biochemical abnormalities associated with old age in CKD patients helps in appropriate modifications in patient management.

scholarly journals Evaluation of mineral status in hypothyroidism in a tertiary care centre

2020 ◽  
Vol 8 (2) ◽  
pp. 667
Author(s):  
Shikha Saxena ◽  
Prem Chandra Srivastava ◽  
Rashmi Katyal ◽  
Biswajit Das ◽  
Sileena Jaideep Pannu
Keyword(s):  
Serum Calcium ◽  
Serum Magnesium ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Serum Zinc ◽  
The Body ◽  
Endocrine Disorders ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Mineral Status

Background: Hypothyroidism is known to be the commonest form of endocrine disorders and has been linked with disturbances in various minerals metabolism. Calcium, phosphorus and magnesium and trace element zinc are required for many enzymes in various metabolic pathways which are directly or indirectly regulated by thyroid hormones. Aim and objectives of the study was to estimate serum zinc, calcium, magnesium and phosphorus in hypothyroid patients, with the objectives to evaluate any relationship with TSH and to compare them with euthyroid controls.Methods: The analytical cross-sectional study included 50 hypothyroid subjects with TSH levels >4.5 mcg IU/mL and 50 euthyroid subjects of 20-50 years in RMCH, Bareilly. TSH was estimated by ECLIA, serum calcium and phosphorus were estimated by autoanalyzer and serum zinc & magnesium by the kit method using semi autoanalyzer. All the biochemical parameters were expressed as median with Interquartile Range (IQR). Mann-Whitney test was applied to compare the parameters of cases and control. Spearman’s rank correlation coefficient 2-tailed was used to correlate the parameters among the cases.Results: A significantly decreased level of serum calcium and increased level of serum magnesium and phosphorus were observed in hypothyroid cases. A significant negative correlation between TSH and serum calcium while a significant positive correlation of serum magnesium and phosphorus with TSH was observed.Conclusions: The indexed study indicates the significant effect of overt or subclinical hypothyroidism over the mineral status of the body which may have inconsistent effect over the various metabolism and enzymes and thereby clinical manifestations.

scholarly journals Effect of phototherapy on serum calcium level in term newborns

2017 ◽  
Vol 4 (6) ◽  
pp. 1975
Author(s):  
Cyril Ignatious Rozario ◽  
Preethi S. Pillai ◽  
Ranamol T.
Keyword(s):  
Birth Weight ◽  
Blood Group ◽  
Serum Calcium ◽  
Calcium Level ◽  
Serum Calcium Level ◽  
Neonatal Hyperbilirubinemia ◽  
Preterm Neonates ◽  
P Value ◽  
Term Neonates ◽  
Term Newborns

Background: Hyperbilirubinemia is one of the most prevalent problems in neonates. Jaundice is observed during first week of life in approximately 60% of term neonates and 80 % of preterm neonates. Phototherapy is one of the routine methods for management of hyperbilirubinemia. The aim of this study is to assess the effect of phototherapy on serum calcium level in term newborns with neonatal hyperbilirubinemia who undergo phototherapy and to find out the association between effect of phototherapy on serum calcium level and birth weight, postnatalage, type of feeding and blood group incompatibility.Methods: 100 newborns with neonatal hyperbilirubinemia admitted in newborn nursery were selected for the study. Serum calcium estimation was done before phototherapy. All newborns were subjected to double surface phototherapy. After 48 hours of phototherapy serum calcium was estimated and compared with earlier value.Results: Out of 100 newborns studied 67 babies had a decrease in serum calcium level after 48 hrs of phototherapy. And this reduction in calcium level was found to be statistically significant (p value <0.001). Only 3 babies developed hypocalcemia (serum calcium <7 mg/dl). None of them were symptomatic. There was no significant association between reduction in serum calcium level and birth weight, postnatalage, type of feeding and blood group incompatability.Conclusions: There is signiticant reduction in serum calcium level after phototherapy but risk of hypocalcemia is low in healthy full-term neonates. No significant association was found between reduction in serum calcium level and birth weight, postnatal age,type of feed, and blood group incompatibility.

scholarly journals Morbidity profile and immediate outcome of late preterm neonates compared to term neonates in a rural tertiary care hospital of Gujarat

2017 ◽  
Vol 4 (4) ◽  
pp. 1329 ◽  
Author(s):  
Manish Rasania ◽  
Prasad Muley
Keyword(s):  
Preterm Infants ◽  
Tertiary Care ◽  
Preterm Births ◽  
Full Term ◽  
Late Preterm ◽  
Preterm Neonates ◽  
Care Hospital ◽  
Term Infants ◽  
Term Neonates ◽  
Late Preterm Infants

Background: Late premature infants are born near term, but are immature. As a consequence, late preterm infants are at higher risk than term infants to develop morbidities. Although late preterm infants are the largest subgroup of preterm infants, there is a very limited data available on problems regarding late preterm infants in rural India.Methods: This is a retrospective cohort study using previously collected data from neonates born at Dhiraj Hospital and neonates who were born outside but admitted at SNCU of Dhiraj Hospital, Piparia, Vadodara district, Gujarat, India between January 2015 to December 2015.Results: 168 late preterm infants and 1025 term infants were included in this study. The need for SNCU admission is significantly higher in late preterm compared to full term (41.07% vs 2.04%). Morbidities were higher in late preterm neonates compared to full term neonates. Sepsis (4.76% vs 1.07%), TTN (10.11% vs 2.04%), hyperbilirubinemia (19.04% vs 9.36%), RDS (1.78% vs 0.09%), hypoglycemia (1.78% vs 0.29%), PDA (1.78% vs 0.58%), risk of major congenital malformation (2.38% vs 0.58%). Need for respiratory support was 5.95% in late preterm vs 2.04% in full term neonates. Immediate neonatal outcome in terms of death and DAMA (non-salvageable) cases was poor in late preterm neonates compared to full term neonates (1.19% vs 0.78%).Conclusions: Late preterm neonates are at higher risk of morbidities and mortalities. They require special care. Judicious obstetric decisions are required to prevent late preterm births. 

scholarly journals Out of pocket expenditure among Rashtriya Swasthya Bima Yojana beneficiary and non-beneficiary patients admitted to a tertiary care centre, Berhampur, India: a comparative study

2019 ◽  
Vol 6 (2) ◽  
pp. 376
Author(s):  
Sushree Priyadarsini Satapathy ◽  
Nivedita Karmee ◽  
Durga Madhab Satapathy ◽  
Radha Madhab Tripathy
Keyword(s):  
Health Insurance ◽  
Life Support ◽  
Insurance Coverage ◽  
Tertiary Care ◽  
Total Sample ◽  
Health Insurance Coverage ◽  
P Value ◽  
Indian Government ◽  
Tertiary Care Centre ◽  
Cross Sectional

Background: RSBY, a health insurance scheme, was launched by the Indian government to protect BPL families from incurring financial liabilities which are likely to occur due to hospitalization. Objectives was to compare over all OOPE among RSBY beneficiaries and non-beneficiaries and to estimate its extent during hospitalization in different domains among RSBY beneficiaries and non-beneficiaries.Methods: It was a cross-sectional study conducted for 2 months (January-February 2018) among BPL families residing in Ganjam district, Odisha. Multistage random sampling was done. Total sample size was 256, the number of beneficiaries and non beneficiaries taken was 128 each.Results: Non beneficiaries incurred higher overall OOPE higher i.e. 95.3% than the Beneficiaries and it was found to be statistically significant with x²=74.8 and P-value <0.001. Among beneficiaries out of pocket expenditure was found in 46.1% of the study population. 45.3% of beneficiaries had to borrow partially from friends and relatives to fulfil their hospital related expenses followed by 32% borrowing fully for their treatment. Among beneficiaries, most out of pocket expenditure was for life support services as they sought treatment mostly for surgical conditions.Conclusions: Health insurance coverage should be improved by increasing enrolment. People should be made aware about the services covered under the schemes.

scholarly journals Comparison of Retinal Sensitivity by Automated Perimetry in Middle Aged Type 2 Diabetic Patients with and without Diabetic Retinopathy - A Cross-Sectional Study in a Tertiary Care Centre in West Bengal

2021 ◽  
Vol 8 (13) ◽  
pp. 835-839
Author(s):  
Abhinav Marlapati ◽  
Sambuddha Ghosh ◽  
Swati Majumdar
Keyword(s):  
Diabetic Retinopathy ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
P Value ◽  
Diabetic Patients ◽  
Retinal Sensitivity ◽  
Automated Perimetry ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Group 2

BACKGROUND We wanted to measure and compare retinal sensitivity in central 30 degree in diabetic patients, with and without diabetic retinopathy in different stages, evaluate changes in retinal sensitivity in relation to change in HbA1c values, measure and compare GCL thickness in various stages of DR with the help of optical coherence tomography (OCT). METHODS This observational, cross-sectional study involving 100 eyes of 100 middle aged (45 - 64 years) type 2 diabetes mellitus patients (50 eyes without DR - group 1 & 50 eyes with DR - group 2) without any other ocular abnormalities was conducted in the outpatient and in-patient departments of department of ophthalmology in a tertiary care centre in West Bengal. Non-randomised sequential sampling was performed with corrected visual acuity better than or equal to 6 / 12. Fasting and postprandial blood glucose and HbA1c were estimated. Detailed ocular examination was performed using direct and indirect ophthalmoscope with + 20 D lens and slit lamp bio-microscope using + 90D lens. Retinal sensitivity was assessed by Humphrey visual field analyser by Swedish Interactive Thresholding Algorithm (SITA) standard strategy (30 - 2 programme). Spectral domain optical coherence tomography (SD OCT) was performed in all patients. SPSS version 20 has been used for the analysis. RESULTS Among DR patients, 33 had mild non-proliferative diabetic retinopathy (NPDR) (male = 15, female = 18) and 17 had moderate NPDR (male = 7, female = 10). Mean age in DR (Gr. 2) and no DR (Gr. 1) group were 52.62 and 50.74 years respectively. Mean foveal sensitivity and mean retinal sensitivity decreased significantly (P-value 0.001 and 0.002 respectively) in group 2 patients. It further decreased with increased severity of DR. Mean ganglion cell + inner plexiform layer (GC + IPL) thickness in temporal quadrant decreased in DR group compared to no DR group with significant difference between the two (P-value < 0.001). Mean retinal nerve fibre layer (RNFL) thickness was significantly reduced in DR group (P-value < 0.001). HbA1c mean in no DR (6.7 %) and DR group (8.07 %) and in mild (7.5 %) and moderate NPDR (9.17 %) shows significant association of poor control of blood sugar with severity of DR. CONCLUSIONS Retinal sensitivity decreased significantly in diabetes even without retinopathy as detected by automated perimetry. Significant decrease in retinal thickness as detected by OCT suggested that neurodegeneration occurs in diabetes even without retinopathy. So automated perimetry and OCT could be helpful in identifying persons at an early stage who are at risk of future vision loss due to diabetes. KEYWORDS Diabetic Retinopathy, Retinal Neurodegeneration, Retinal Sensitivity, Automated Perimetry, GCL + IPL Thickness, RNFL Thickness

scholarly journals A study on effect of phototherapy in term new-born in a tertiary care centre in south Rajasthan

2021 ◽  
Vol 9 (1) ◽  
pp. 94
Author(s):  
Neetu Beniwal ◽  
Nishant Dangi ◽  
Anuradha Sanadhya ◽  
Mohammed Asif
Keyword(s):  
Serum Calcium ◽  
Calcium Level ◽  
Serum Calcium Level ◽  
Prospective Observational Study ◽  
Tertiary Care ◽  
Loose Stool ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Term Neonates ◽  
Medical College

Background: Phototherapy is a safe and effective method for management of neonatal hyperbilirubinemia with no serious untoward side effects. Hypocalcemia is a common and lesser observed adverse effect of phototherapy.Methods: This study was a prospective observational study done in department of pediatrics, RNT Medical College, Udaipur (Rajasthan). Serum calcium level was observed in term neonates admitted for phototherapy.Results: Out of total 80 neonates included in study 40 received phototherapy and 40 were control. Neonates receiving phototherapy had significantly lower level of serum calcium. Other complication were rashes, loose stool, fever and dehydration.Conclusions: We can conclude from this study that hypocalcemia is a significant complication of phototherapy in newborn and probably monitoring of serum calcium level in babies under phototherapy is warranted.

scholarly journals ANALYSIS OF FACTORS ASSOCIATED WITH DELAYED GASTRIC EMPTYING AFTER WHIPPLE’S PROCEDURE

2021 ◽  
Vol 71 (Suppl-1) ◽  
pp. S235-39
Author(s):  
Talha Yasin ◽  
Nasir Mehmud Wattoo ◽  
Qasim Butt ◽  
Kamran Safdar ◽  
Muhammad Asif
Keyword(s):  
Gastric Emptying ◽  
Delayed Gastric Emptying ◽  
Tertiary Care ◽  
Military Hospital ◽  
P Value ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Whipple’S Procedure ◽  
Surgical Unit ◽  
High Bmi

Objective: To assess the frequency and analyze associated factors of delayed gastric emptying among the patients undergoing Whipple’s procedure at surgical unit of a tertiary care centre in Pakistan. Study Design: Cross sectional study. Place and Duration of Study: Pak Emirates Military Hospital and Combined Military Hospital Rawalpindi,Pakistan, Apr 2018 to Mar 2019. Methodology: A prospective study was conducted on 80 patients of both the genders who underwent Whipple’s procedure at the surgical unit of abovementioned hospitals. Delayed gastric emptying was diagnosed based on the criteria as defined by the International Study Group of Pancreatic Surgery by the consultant surgeons involved. Factors studied in our analysis included age, gender, smoking, presence of co morbidities, peroperative blood transfusion, sepsis, operative time and BMI. Results: Out of 80 patients included in the final analysis, 61 (76.25%) were male and 19 (23.75%) were female.Mean age of patients included in our study was 46.31 ± 6.711 years. Thirty six (45%) patients had delayed gastricemptying while 44 (55%) did not meet the criteria as mentioned above. With binary logistic regression we foundthat presence of sepsis and high BMI had a strong relationship (p-value <0.05) with delayed gastric emptyingafter the Whipple’s procedure. Conclusion: Delayed gastric emptying is a fairly common phenomenon among the patients undergoingWhipple’s procedure. High BMI and post-operative sepsis constitute the group which is at the highest risk ofdeveloping this post-operative complication in our study.

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