Phototherapy Induced Hypocalcaemia in Neonates with Jaundice

Introduction: Neonatal hyperbilirubinemia is seen mainly in the first week of life and in many of the cases it is only in physiological range which requires no intervention. Approximately 5-10% of them have clinically significant jaundice that requires phototherapy and even exchange transfusion. Phototherapy can produce various adverse effects; hypocalcaemia is one of the lesser known effects. So, estimation of calcium levels before and after phototherapy should be done in neonates with jaundice. Aims: The aim of this study is to determine hypocalcaemia, in neonates receiving phototherapy, by measuring serum calcium levels. Methods: This cross sectional study was conducted, from February 2020 to August 2020, on 50 neonates admitted in Neonatal Intensive Care Unit of Nepalgunj Medical College, Kohalpur with unconjugated hyperbilirubinemia requiring phototherapy. Serum calcium levels were evaluated before and after phototherapy. Neonates were assessed for clinical features of hypocalcaemia i.e. jitteriness, irritability/ excitability and convulsions. Data were analyzed using SPSS version 25.P value <0.05 was taken as significant. Results: Frequency of hypocalcaemia after phototherapy was 26%. There was significant change in serum calcium levels before and after phototherapy (p<0.01). Among hypocalcaemic neonates, 56% were symptomatic; 38% developed jitteriness, 18% developed irritability / excitability and none of them developed convulsions. Conclusion: Neonates undergoing phototherapy are at increased risk for hypocalcaemia. Monitoring for hypocalcaemia and its complications should be considered. However, universal recommendation of calcium supplementation is yet to be established but seems reasonable.

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Phototherapy Induced Hypocalcemia in Neonates with Unconjugated Hyperbilirubinemia

Journal of Bahria University Medical and Dental College ◽

10.51985/gubk9588 ◽

2021 ◽

Vol 11 (1) ◽

pp. 4-8

Author(s):

Amna Khan ◽

Anila Farhat ◽

Hamayun Anwar ◽

Sajid Shamim ◽

Mujeeb Ur Rehman ◽

...

Keyword(s):

Serum Calcium ◽

Calcium Level ◽

Serum Calcium Level ◽

Neonatal Intensive Care ◽

Cross Sectional Study ◽

Categorical Variables ◽

P Value ◽

Cross Sectional ◽

Unconjugated Hyperbilirubinemia ◽

Before And After

Objective: To determine the frequency of hypocalcemia in neonates with unconjugated hyperbilirubinemia receivingphototherapy.Study design and setting: Cross sectional study conducted at neonatal intensive care unit, King Abdullah Teaching Hospital,Mansehra for one year from December 2017 to November 2018.Methodology: Total 213 full term stable neonates of either gender with jaundice were studied in this study. Out of which,143 with unconjugated hyperbilirubinemia were exposed to phototherapy while 70 neonates with exaggerated physiologicalhyperbilirubinemia taken as control were not exposed to phototherapy. Serum calcium level was determined through bloodtest before and after 24 hours of phototherapy. SPSS version 22 was used to analyze the data. Frequency and percentageswere used to describe categorical variables like gender and hypocalcemia. Hypocalcemia was stratified by age and genderto see effect modifiers. Post stratified chi-square test was applied in which p value = 0.05 was considered as significancevalue.Results: In study group, 143 neonates who received phototherapy had mean age of 7 days ± 2.62 SD. Total 65% neonateswere male and 35% neonates were female. Mean serum calcium level of neonates before and after provision of phototherapywas 9.28 mg/dl ± 0.23 and 8.54 mg/dl ± 0.68 respectively, which is statistically significant. The frequency of hypocalcemiawas 40% in neonates with unconjugated hyperbilirubinemia after 24 hours of phototherapy.Conclusion: Hypocalcemia is an important complication in neonates with unconjugated hyperbilirubinemia after continuousphototherapy. Hypocalcemia has clinical impact and adds to morbidity, and if left untreated, can lead to mortality.

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Phototherapy Induced Hypocalcemia in Neonates with Unconjugated Hyperbilirubinemia

Journal of Bahria University Medical and Dental College ◽

10.51985/bhrtu3452 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Amna Khan ◽

Anila Farhat ◽

Hamayun Anwar ◽

Sajid Shamim ◽

Mujeeb Ur Rehman ◽

...

Keyword(s):

Serum Calcium ◽

Calcium Level ◽

Serum Calcium Level ◽

Neonatal Intensive Care ◽

Cross Sectional Study ◽

Categorical Variables ◽

P Value ◽

Cross Sectional ◽

Unconjugated Hyperbilirubinemia ◽

Before And After

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Study of Patients with First unprovoked Seizure in the Eastern Part of Nepal

Journal of Nobel Medical College ◽

10.3126/jonmc.v8i1.24471 ◽

2019 ◽

Vol 8 (1) ◽

pp. 22-26

Author(s):

Dilli Ram Kafle ◽

Surendra Sah ◽

Miluna Bhusal

Keyword(s):

Recurrence Risk ◽

Cross Sectional Study ◽

P Value ◽

Seizure Recurrence ◽

Unprovoked Seizure ◽

Cross Sectional ◽

Medical College ◽

Increased Risk ◽

Neuro Imaging

Background: About 5-10% of the population get at least one seizure in their lifetime. Treatment is started in patients with first unprovoked seizure if the risk of seizure recurrence is predicted to be high. If patients with first seizure are not treated 40-50% of patients develop recurrence within 2 years of the initial seizure. Starting treatment may cause reduction in the risk of recurrence by almost one half. The aim of the study was to identify the factors causing recurrence in patients with first unprovoked seizure. Materials and Methods: It is a prospective cross-sectional study conducted at Nobel Medical College from March 2015 to March 2019. Patients who presented to Nobel Medical College with first unprovoked seizure were enrolled in the study with follow up during the hospital visit. Results: Eighty six patients participated in our study. Recurrence of seizure occurred in 21(24.4%) patients within the study period of 4 years. Abnormal Electroencephalography was significantly associated with recurrence of seizure in patients with first seizure. (P value<0.001) Neuro imaging abnormality was also associated with increased risk of seizure recurrence (Pvalue<0.001) .Starting an antiepileptic after first seizure reduced the risk of further seizure. Conclusion: Recurrence of seizure was observed in almost a quarter of patients within the study period of four years. Recurrence risk was higher in those patients with abnormal Electro encephalography and in those patients with identified cause than those patients whose seizure was assumed to be idiopathic.

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Role of Physiotherapy in Hospitalised Patients of COVID-19 disease

International Journal of Medical Research and Review ◽

10.17511/ijmrr.2021.i03.04 ◽

2021 ◽

Vol 9 (3) ◽

pp. 154-159

Author(s):

Dr. Sanjay Kumar Bharty ◽

◽

Dr. Jitendra Kishore Bhargava ◽

Dr. Brahma Prakash ◽

Dr. Vikas Patel ◽

...

Keyword(s):

Severity Index ◽

Cross Sectional Study ◽

P Value ◽

Cross Sectional ◽

Medical College ◽

Breathing Exercises ◽

Hospitalised Patients ◽

Before And After ◽

Respiratory Physiotherapy

Introduction: Respiratory physiotherapy is one of the therapeutic methods in various respiratoryviral infections. Breathing exercises with other interventions, could enhance the total lung capacityand symptom alleviation in patients with virus-related acute respiratory distress syndrome (ARDS).Aim: To study the clinical evaluation of the role of physiotherapy in hospitalised patients of covid-19diseases. Method: This was an Observational (prospective, cross-sectional) study. 187 patientswere recruited and diagnosed as COVID-19 as per RTPCR at NSCB Medical College, Jabalpur (MP).Patients were randomised into the physiotherapy group and controlled group. Patients in thephysiotherapy group were undergone positional changes, prone ventilation, Breathing exercise,Resistive training, Passive joint motion, Muscle stretching, Bedside standing training, enduranceexercise by a specialized physiotherapist. Mean cough severity index, MMRC grade, respiration rateand peripheral blood saturation were recorded before and after intervention and compared with thecontrolled group. Result: There was significant improvement found in MMRC grade and respirationrate after physical therapy in the physiotherapy group (p-value < 0.05). Exertional dyspnoea andcough severity index significant deceased in physiotherapy group. The positive change was found inperipheral blood saturation. There was decreased in hospitalization stay in the physiotherapy groupas compared to the controlled group. Conclusion: Our study revealed the positive effect ofphysiotherapy on covid-19 disease in terms of symptoms and hospitalization duration among thephysiotherapy group. Physiotherapy exerts a beneficial role in the management of the covid-19disease.

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Effect of phototherapy on serum calcium levels in neonates receiving phototherapy for neonatal jaundice

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20182275 ◽

2018 ◽

Vol 6 (6) ◽

pp. 1992

Author(s):

Sumit Goyal ◽

Anshuman Srivastava ◽

Prasun Bhattacharjee ◽

Isha Goyal ◽

Khushbu Malhotra

Keyword(s):

Serum Calcium ◽

Neonatal Intensive Care ◽

Serum Bilirubin ◽

Calcium Supplementation ◽

Total Serum ◽

Term Neonates ◽

Unconjugated Hyperbilirubinemia ◽

Medical College ◽

Before And After ◽

The Difference

Background: To study the occurrence of hypocalcaemia in neonates with physiological unconjugated hyperbilirubinemia after 48 hours of phototherapy or at the end of phototherapy, in case duration of phototherapy was less than 48 hours.Methods: This prospective study was conducted on 100 term neonates (61 males and 39 females) admitted to Neonatal intensive care unit of Teerthankar Mahaveer Medical College, Moradabad with unconjugated hyperbilirubinemia and requiring phototherapy. Total Serum bilirubin levels and serum calcium levels were checked before and after phototherapy. Neonates were assessed for clinical features of hypocalcemia i.e. jitteriness, irritability/excitability, lethargy and convulsions.Results: After phototherapy, there was hypocalcemia in 35.0% neonates. The difference between pre and post phototherapy serum calcium levels were found to be statistically significant (p <0.001). 2.86% of neonates developed jitteriness among those who had hypocalcemia. Hypocalcemia was more in subjects who received phototherapy for longer duration.Conclusions: Hypocalcaemia is a common complication of phototherapy. Therefore, calcium supplementation should be done in all neonates undergoing phototherapy.

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Low Serum Calcium Levels in Pre-eclampsia

Journal of SAFOG with DVD ◽

10.5005/jp-journals-10006-1341 ◽

2015 ◽

Vol 7 (3) ◽

pp. 126-129

Author(s):

Bushra Rashid ◽

Mariam Malik Richard ◽

Gul-E-Rana LNU

Keyword(s):

Pregnant Women ◽

Serum Calcium ◽

Calcium Supplementation ◽

Venous Blood ◽

Cross Sectional Study ◽

Control Group ◽

P Value ◽

Case Group ◽

Cross Sectional ◽

Low Serum

ABSTRACT Background Pre-eclampsia remains the most threatening obstetric complication in Pakistan, resulting in high fetomaternal morbidity and mortality. Etiology of pre-eclampsia is not still clearly established. Association of low serum calcium levels with pre-eclampsia may be a factor in poorly nourished women, and some preventive measures may help to reduce the burden of disease. Objective To compare mean serum calcium levels in preeclamptic and normotensive pregnant women at third trimester of gestation. Study design Cross-sectional study. Place and duration of study The Department of Obstetrics and Gynecology, Unit-1, Sir Ganga Ram Hospital, Lahore, from July 2012 to July 2013. Methodology Two hundred patients were enrolled in the study. One hundred each in case and control group. History and examination performed. Proteinuria was checked by dip stick methods. Peripheral venous blood samples were taken to determine mean serum calcium levels of both the groups. Oral calcium supplementation was analyzed through stratification. Data was analyzed through SPSS by applying student's t test and calculating p-value. Results The mean serum calcium levels of the case group were 8.313 ± 0.377 while that of control group were 9.40 ± 0.427 with p-value 0.016. With increasing proteinuria (determined by dipstick method) and so the severity of pre-eclampsia, a gradual fall in serum calcium levels was observed. Conclusion Serum calcium levels in pre-eclamptic pregnant women are lower than in normal pregnant women and so hypocalcemia is associated with pre-eclampsia. How to cite this article Rashid B, Richard MM, Gul-E-Rana. Low Serum Calcium Levels in Pre-eclampsia. J South Asian Feder Obst Gynae 2015;7(3):126-129.

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Frequency of Metabolic Abnormalities of Vesical Calculus in Children Younger than 10 Yrs of Age

10.53350/pjmhs211561243 ◽

2021 ◽

Vol 15 (6) ◽

pp. 1243-1245

Author(s):

H.U Rahman ◽

S. F. Shah ◽

A. J. Sheikh ◽

I. U. Memon ◽

W. S. Bhatti ◽

...

Keyword(s):

Cross Sectional Study ◽

P Value ◽

Metabolic Abnormalities ◽

Urine Ph ◽

College Hospital ◽

Cross Sectional ◽

Vesical Calculus ◽

Medical College ◽

Presenting Symptoms ◽

Calcium Magnesium

Aim: To assess the metabolic abnormalities in children younger than 10 years of age with vesical calculus. Study design: Retrospective cross-sectional study Place and duration of study: Department of Urology, Khairpur Medical College Hospital, Khairpur from 1st October 2014 to 30th September 2016. Methodology: Two hundred and six children age <10 years of age and either gender presented with vesical calculus were enrolled. Demographic information like age, gender, residence, serum electrolytes, calcium, magnesium, phosphate, uric acid, blood, and urine pH were recorded for the purpose of metabolic workup. Results: The mean age was 4.76±1.22 years and 157 (76.2%) were males and 49 (23.8%) were females. The frequency of metabolic abnormalities was observed in 153 (74.3%) of the patients. A significantly higher prevalence of metabolic abnormalities was observed with male gender (p-value 0.006), dark colored urine as presenting symptoms (p-value 0.022), frequent urination (p-value 0.045), and hematuria (p-value 0.016). Of 153 patients with metabolic abnormalities, hypercalciuria was observed in 45 (29.4%), hypocitraturia in 73 (47.7%), hyperoxaluria in 21 (13.7%), and hyperuricosuria in 14 (9.2%) patients. Conclusion: The frequency of metabolic abnormalities was high among children with vesical calculus. Moreover, hypocitraturia in these children was observed in majority followed by hypercalciuria, hyperoxaluria, and hyperuricosuria. Keywords: Metabolic abnormalities, Children, Vesical calculus

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ROLE OF ABSOLUTE EOSINOPHIL COUNT AS A MODALITY OF INVESTIGATION IN SUSPECTED CASES OF HELMINTHIC INFESTATION IN CHILDREN AGED BETWEEN 5 TO 15 YEARS WITH COMPARISON TO STOOL ROUTINE AND MICROSCOPY

10.36106/gjra/6111669 ◽

2021 ◽

pp. 112-113

Author(s):

Meghashree N ◽

Rohini D ◽

Mahendar Reddy M ◽

A.M Koppad

Keyword(s):

Eosinophil Count ◽

Stool Specimen ◽

Cross Sectional Study ◽

Research Centre ◽

P Value ◽

College Hospital ◽

Cross Sectional ◽

Mean Values ◽

Medical College ◽

Absolute Eosinophil Count

Introduction: Eosinophilia is a well-known host immune response in helminthic infestation. This study was carried out to investigate whether a correlation exists between absolute eosinophil count in children with stool specimen positive for helminthic infestation. Aim And Objective: To determine average raised absolute eosinophil count in children who were having various helminthic infestation with stool specimen positive. Materials And Methods: A hospital based cross sectional study done at Navodaya medical college hospital and research centre during 2019 October to 2020 September for a period of 12 months. Both blood and stool samples were obtained from a total of 69 suspected children after examined, categorised into 2 groups. Among them 24 cases were positive of helminthic infestation and 45 cases were negative. T-test and descriptive statistics were used to analyse the data. Results: The study revealed that children infested with helminths found to have higher absolute eosinophil count (mean 4644/µl (95%CI; 3474-4212) than not infested (mean 801/µl (95%CI; 616-945) with p value <0.001. In this helminth's family; nematodes, trematodes, cestodes showed mean values of absolute eosinophil count were 5206/µl (4806-7151/µl), 4930/µl (4500-5382/µl) and 2179/µl (2500-1669/µl) respectively. Conclusions: Raised absolute eosinophil count has been observed in stool specimen positive cases of helminths, especially more in nematodes. Therefore, should be considered for a single dose of albendazole.

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Peak expiratory flow rate among smokers and non-smokers working in Kathmandu Medical College

Journal of Chitwan Medical College ◽

10.3126/jcmc.v10i2.29667 ◽

2020 ◽

Vol 10 (2) ◽

pp. 33-35

Author(s):

Preetu Gurung

Keyword(s):

Cigarette Smoking ◽

Peak Expiratory Flow ◽

Flow Rate ◽

Peak Expiratory Flow Rate ◽

Cross Sectional Study ◽

P Value ◽

Cross Sectional ◽

Medical College ◽

Significant Difference ◽

Expiratory Flow

Background: Cigarette smoking has remained a popular habit since ages. Most people are well aware of the deleterious effects of cigarette smoking yet continue to give a blind eye which deteriorates overall public health. The purpose of the present study was to assess Peak Expiratory Flow Rate among smoking and nonsmoking staffs who work in Kathmandu Medical College. Methods: In this comparative cross-sectional study Peak Expiratory Flow Rate was obtained using Mini Wright’s Peak Flow Meter of 108 smokers and 108 nonsmokers in the age group ranging from 25-45 years. Those who never smoked or who have quit smoking for the past 2 years were grouped as nonsmokers and the smokers with history of smoking at least five or more cigarettes per day for at least two years were included in the study for measuring their Peak Expiratory Flow Rate. Data was collected, compiled and analyzed by using Statistical Package of Social Science (SPSS) software version16. Student ‘t’ test was used for group comparison. Results: The Peak Expiratory Flow Rate value was significantly reduced in the smokers (p value< 0.05). Mean Peak Expiratory Flow Rate was reduced with increasing age of the smokers. However, no significant difference was observed in Peak Expiratory Flow Rate with increase in the number of cigarettes smoked (p value> 0.05). Conclusions: In the study Peak Expiratory Flow Rate among smokers (367.13 ± 74.182) was lower than nonsmokers (471.39±60.842), which was statistically significant proving that cigarette smoking reduced peak expiratory flow rate.

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Tablet and web-based audiometry to screen for hearing loss in adults with cystic fibrosis

Thorax ◽

10.1136/thoraxjnl-2019-214177 ◽

2020 ◽

Vol 75 (8) ◽

pp. 632-639 ◽

Cited By ~ 2

Author(s):

Anitha Vijayasingam ◽

Emily Frost ◽

Julie Wilkins ◽

Lise Gillen ◽

Presanna Premachandra ◽

...

Keyword(s):

Cystic Fibrosis ◽

Hearing Loss ◽

Intraclass Correlation ◽

Cross Sectional Study ◽

Outpatient Setting ◽

P Value ◽

Cross Sectional ◽

Web Based ◽

High Frequency Audiometry ◽

Increased Risk

IntroductionIndividuals with chronic lung disease (eg, cystic fibrosis (CF)) often receive antimicrobial therapy including aminoglycosides resulting in ototoxicity. Extended high-frequency audiometry has increased sensitivity for ototoxicity detection, but diagnostic audiometry in a sound-booth is costly, time-consuming and requires a trained audiologist. This cross-sectional study analysed tablet-based audiometry (Shoebox MD) performed by non-audiologists in an outpatient setting, alongside home web-based audiometry (3D Tune-In) to screen for hearing loss in adults with CF.MethodsHearing was analysed in 126 CF adults using validated questionnaires, a web self-hearing test (0.5 to 4 kHz), tablet (0.25 to 12 kHz) and sound-booth audiometry (0.25 to 12 kHz). A threshold of ≥25 dB hearing loss at ≥1 audiometric frequency was considered abnormal. Demographics and mitochondrial DNA sequencing were used to analyse risk factors, and accuracy and usability of hearing tests determined.ResultsPrevalence of hearing loss within any frequency band tested was 48%. Multivariate analysis showed age (OR 1.127; (95% CI: 1.07 to 1.18; p value<0.0001) per year older) and total intravenous antibiotic days over 10 years (OR 1.006; (95% CI: 1.002 to 1.010; p value=0.004) per further intravenous day) were significantly associated with increased risk of hearing loss. Tablet audiometry had good usability, was 93% sensitive, 88% specific with 94% negative predictive value to screen for hearing loss compared with web self-test audiometry and questionnaires which had poor sensitivity (17% and 13%, respectively). Intraclass correlation (ICC) of tablet versus sound-booth audiometry showed high correlation (ICC >0.9) at all frequencies ≥4 kHz.ConclusionsAdults with CF have a high prevalence of drug-related hearing loss and tablet-based audiometry can be a practical, accurate screening tool within integrated ototoxicity monitoring programmes for early detection.

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