Prevalence and Etiology of Neonatal Jaundice in a Tertiary Care Hospital

2021 ◽  
Vol 18 (2) ◽  
pp. 35-38
Author(s):  
Niraj Acharya ◽  
Chandra Prasad Paneru
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Sepsis ◽  
Neonatal Intensive Care ◽  
Neonatal Jaundice ◽  
Serum Bilirubin ◽  
College Teaching ◽  
Total Serum ◽  
Common Cause ◽  
Medical College

Introduction: Neonatal jaundice is a major clinical condition worldwide occurring in upto 60% of term and 80% preterm newborn in the first week of life. Neonatal jaundice is defined as total serum bilirubin level above 7 mg/dl. Aims:  This study was done to find out the prevalence and etiology of neonatal jaundice in neonates admitted to Neonatal Intensive Care Unit (NICU) of Nepalgunj Medical College Teaching Hospital (NGMCTH) Kohalpur, Banke. Methods: It was a prospective cross sectional hospital based study conducted from November 2018 to November 2019 in Neonatal Intensive Care Unit of Nepalgunj Medical College Teaching Hospital. All neonates with clinical jaundice and hyperbilirubinemia with total serum bilirubin of ≥7 mg/dl were subjected to complete history taking, through physical examination and investigations. Results: Out of 892 neonates who developed clinical jaundice, 640 neonates whose parents gave consent were included in the study. The prevalence of neonatal jaundice was found to be 39.85% with male to female ratio of 1.79:1. In the present study pathological jaundice was seen in 74.94% whereas physiological jaundice in 23.66%. Among the various etiologies of pathological jaundice, neonatal sepsis (44.52%) was found to be the most common cause followed by ABO incompatibility (12.18%) and Rh incompatibility (7.03%). Conclusion: The prevalence of neonatal jaundice in present study was 39.85% and the most common cause was neonatal sepsis .The prevalence of jaundice was more in preterm than in term neonates. Neonatal jaundice is very common morbidity in NICU especially in preterm babies.

scholarly journals Outcome of Respiratory distress in Neonates with Bubble CPAP at Neonatal Intensive Care Unit of a Tertiary Hospital

2019 ◽  
Vol 57 (216) ◽  
Author(s):  
Sunil Raja Manandhar
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Continuous Positive Airway Pressure ◽  
Neonatal Intensive Care Unit ◽  
Respiratory Distress ◽  
Airway Pressure ◽  
Neonatal Intensive Care ◽  
Positive Airway Pressure ◽  
College Teaching ◽  
Medical College

Introduction: Respiratory distress is one of the commonest problem seen in neonates during admission in Neonatal Intensive Care Unit. Hyaline Membrane disease, Meconium Aspiration Syndrome, septicemia, congenital pneumonia, Transient Tachypnea of Newborn are the major causes of respiratory distress in neonates. Bubble Continuous Positive Airway Pressure is a non-invasive respiratory support delivered to a spontaneously breathing newborn to maintain lung volume during expiration. The main objective of this study was to observe the outcome of respiratory distress in neonates with Bubble Continuous Positive Airway Pressure. Methods: This was a descriptive cross-sectional study conducted at Kathmandu Medical College Teaching Hospital over six months (October 2018 – March 2019) period. All preterm, term and post term babies with respiratory distress were included. Ethical clearance was received from Institutional Review Committee of Kathmandu Medical College and statistical analysis was done with SPSS 19 version. Results: Sixty three babies with respiratory distress were included in this study with 45 (71%) male predominance. The mean birth weight receiving Bubble Continuous Positive Airway Pressure was 2661.75±84 gms and gestational age was 36.67±3.4 wks. The Bubble Continuous Positive Airway Pressure was started at 8.05±2 hr of life and duration of Bubble Continuous Positive Airway Pressure required for settling respiratory distress was 95.71±3 hrs. Out of 63 babies, improvement of respiratory distress in neonates with Bubble Continuous Positive Airway Pressure was 39 (61%) with confidence interval of (38-62) whereas 24 (39%) babies required mechanical ventilation and other modalities. Conclusions: This study concludes usefulness of Bubble Continuous Positive Airway Pressure in neonates with respiratory distress.

scholarly journals The forehead is a better site than the sternum to check transcutaneous bilirubin during phototherapy in sick infants

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Jaesung Jeon ◽  
Gina Lim ◽  
Ki Won Oh ◽  
Na Mi Lee ◽  
Hye Won Park ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Birth Weight ◽  
Neonatal Intensive Care Unit ◽  
Gestational Age ◽  
Neonatal Intensive Care ◽  
Serum Bilirubin ◽  
Total Serum Bilirubin ◽  
Total Serum ◽  
Transcutaneous Bilirubin

Abstract Background To confirm the accuracy of transcutaneous bilirubin (TcB) in the neonatal intensive care unit both with and without phototherapy, and compare forehead and sternum as the TcB assessment site. Methods We simultaneously assessed the total serum bilirubin (TSB) and TcB at the forehead and sternum, using a JM-103 bilirubinometer. We analyzed the correlation between the TSB and TcB assessed at the forehead and sternum, with measurements classified as ‘without phototherapy’ (before phototherapy and > 24 hours after phototherapy discontinuation) and ‘with phototherapy’ (after 24 hours of phototherapy). Results There were 1,084 paired forehead and sternum TcB measurements, with the corresponding TSB measurement, from 384 infants. Their mean gestational age of 35.4 ± 3.2 weeks (62% were preterm) and a mean birth weight of 2434 ± 768 grams, and TSB was 6.61 ± 3.56 mg/dL. Without phototherapy, TcB values at the forehead and sternum were correlated well to the TSB value (r = 0.925 and 0.915, respectively). With phototherapy, TcB values at the forehead and sternum were significantly correlated with the TSB value, but TcB at the forehead (r = 0.751) was a better match to the TSB than was TcB at the sternum (r = 0.668). Additionally, Bland-Altman plots showed a greater degree of underestimation of the TSB by TcB at the sternum with phototherapy. Conclusions TcB was more accurate in infants not receiving phototherapy. During phototherapy, it is better to assess TcB at the forehead rather than at the sternum.

scholarly journals Clinical Profile and Outcome of Asphyxiated Newborn in a Medical College Teaching Hospital

2016 ◽  
Vol 4 (1) ◽  
pp. 1
Author(s):  
Kiran Panthee ◽  
Kiran Sharma ◽  
Balkrishna Kalakheti ◽  
Kul Thapa
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Survival Rate ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Perinatal Asphyxia ◽  
College Teaching ◽  
Inclusion Criteria ◽  
Mortality And Morbidity ◽  
Medical College

Introduction: Perinatal asphyxia, a major topic in neonatology, is a severe condition which has a high impact on neonatal mortality and morbidity and neurological and intellectual development of the infant. It is defined by WHO as "failure to initiate and sustain breathing at birth". It is estimated that around four million babies are born asphyxiated and among those one million die and an equal number of babies develop serious neurological consequences ranging from cerebral palsy and mental retardation to epilepsy. This study was done to identify the occurrence, clinical profile and, immediate outcome of perinatal asphyxia in Lumbini Medical College Teaching Hospital.   Methods: It was a retrospective study where 82 cases who fulfilled the inclusion criteria were included between December 2014 to November 2015. Inclusion criteria included newborns with: a) Apgar score equal to or less than six at five minutes, b) requirement of  more than one minute of positive pressure ventilation, c) signs of fetal distress (heart rate of less than 100 beats per minute, late decelerations).   Results: Out of total 425 neonatal intensive care unit (NICU) admissions, 82 (19.3%) cases were of asphyxia among which 56 were inborn and 26 were referred from outside. Of those 82 cases, 47 (57.3%) cases developed hypoxic ischemic encephalopathy (HIE); HIE stage I had good outcome with survival rate of 95% and HIE stage III had poor outcome with survival rate of only 25%.   Conclusion: Despite advances in management of neonates, perinatal asphyxia is still the leading cause of neonatal intensive care unit admission and mortality and morbidity in neonates.

scholarly journals Trends in bacteriological profile of neonatal sepsis in Neonatal Intensive Care Unit of a referral center of western Nepal

2020 ◽  
Vol 9 (4) ◽  
pp. 182-187
Author(s):  
Bikash Bhandari ◽  
Kiran Panthee ◽  
Prabal KC ◽  
Neha Siddique
Keyword(s):  
Intensive Care Unit ◽  
Staphylococcus Aureus ◽  
Intensive Care ◽  
Neonatal Sepsis ◽  
Neonatal Intensive Care ◽  
Antibiotic Sensitivity ◽  
Medical College ◽  
Bacteriological Profile ◽  
Highly Sensitive ◽  
Culture Positive

Background: Neonatal sepsis is one of the major causes of neonatal morbidity and mortality in developing countries like Nepal. In order to lower the morbidity and mortality of newborns in Neonatal Intensive Care Unit (NICU), it is essential to study the bacteriological profile and antibiotic sensitivity. Objective: This study aims to study the common bacteriological profile and their antibiotics susceptibility pattern in the NICU of medical college of western Nepal. Methodology: A descriptive cross-sectional study was conducted in NICU of Devdaha Medical College and Research Institute, Nepal among all blood culture positive neonates admitted between April 2020 to September 2020. Convenient sampling was done. All clinically suspected neonates were identified and laboratory data including bacteriological profile and antibiotic sensitivity were recorded and analyzed using Statistical Package for the Social Sciences (SPSS) version 20. Results: Among 215 neonates admitted in the NICU, 45 (20.9%) had culture positive sepsis. Most isolates were early onset sepsis (62.22%) and low birth weight (57.78%). The majority of isolates were Gram positive, predominantly Staphylococcus aureus (37.78%). Staphylococcus aureus showed higher resistance to Cloxacillin (57.1%) and had higher sensitivity to Vancomycin and Linezolid (100%). Similarly, Gram negative isolates, Escherichia coli and Klebsiella sps, showed higher resistance to Ceftriaxone (100%) and Cefoperazone and were highly sensitive to Imipenem (100%) and Colistin (100%). Conclusion: Staphylococcus aureus was the most common organism causing neonatal sepsis in current study with increasing resistance to commonly used Cloxacillin and Ampicillin and highly sensitive to Vancomycin and Linezolid. There is higher risk of emergence of antibiotic resistance. Thus, rational use of empirical antibiotics is necessary to prevent drug resistant sepsis.

Presepsin - New Marker of Sepsis Romanian Neonatal Intensive Care Unit Experience

2019 ◽  
Vol 70 (8) ◽  
pp. 3008-3013
Author(s):  
Silvia Maria Stoicescu ◽  
Ramona Mohora ◽  
Monica Luminos ◽  
Madalina Maria Merisescu ◽  
Gheorghita Jugulete ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Sepsis ◽  
Predictive Value ◽  
Neonatal Intensive Care ◽  
Complete Blood Count ◽  
Clinical Manifestations ◽  
Receiver Operating Curve ◽  
Predictive Values

Difficulties in establishing the onset of neonatal sepsis has directed the medical research in recent years to the possibility of identifying early biological markers of diagnosis. Overdiagnosing neonatal sepsis leads to a higher rate and duration in the usage of antibiotics in the Neonatal Intensive Care Unit (NICU), which in term leads to a rise in bacterial resistance, antibiotherapy complications, duration of hospitalization and costs.Concomitant analysis of CRP (C Reactive Protein), procalcitonin, complete blood count, presepsin in newborn babies with suspicion of early or late neonatal sepsis. Presepsin sensibility and specificity in diagnosing neonatal sepsis. The study group consists of newborns admitted to Polizu Neonatology Clinic between 15th February- 15th July 2017, with suspected neonatal sepsis. We analyzed: clinical manifestations and biochemical markers values used for diagnosis of sepsis, namely the value of CRP, presepsin and procalcitonin on the onset day of the disease and later, according to evolution. CRP values may be influenced by clinical pathology. Procalcitonin values were mainly influenced by the presence of jaundice. Presepsin is the biochemical marker with the fastest predictive values of positive infection. Presepsin can be a useful tool for early diagnosis of neonatal sepsis and can guide the antibiotic treatment. Presepsin value is significantly higher in neonatal sepsis compared to healthy newborns (939 vs 368 ng/mL, p [ 0.0001); area under receiver operating curve (AUC) for presepsine was 0.931 (95% confidence interval 0.86-1.0). PSP has a greater sensibility and specificity compared to classical sepsis markers, CRP and PCT respectively (AUC 0.931 vs 0.857 vs 0.819, p [ 0.001). The cut off value for presepsin was established at 538 ng/mLwith a sensibility of 79.5% and a specificity of 87.2 %. The positive predictive value (PPV) is 83.8 % and negative predictive value (NPV) is 83.3%.

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