scholarly journals EFFECT OF PHOTOTHERAPY ON SERUM CALCIUM LEVELS IN NEONATAL JAUNDICE IN FULL TERM NEONATES

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Ashish Kumar
Keyword(s):  
Standard Deviation ◽  
Serum Calcium ◽  
Neonatal Jaundice ◽  
Calcium Concentration ◽  
Full Term ◽  
Total Serum ◽  
Close Monitoring ◽  
Term Neonates ◽  
Unconjugated Hyperbilirubinemia ◽  
Significant Difference

Introduction: The most prevalent anomalous physical finding during the first week of life is neonatal hyperbilirubinemia (NNH). It is estimated that more than two thirds of newborn babies have acquired clinical jaundice. It was also discovered that in the unconjugated hyperbilirubinemia of most neonates represents a common or exaggerated physiological syndrome. The physical immaturity of infants to handle increased production of bilirubin is referred to as Jaundice. This becomes potentially neurotoxic if severe unconjugated hyperbilirubinemia is left untreated. One of the routine strategies for treating hyperbilirubinemia is known as phototherapy. However it is not a harmless interference. This can produce negative results, such as dehydration, temperature volatility, blood flow redistribution, genotoxicity, rashes on the skin, loose skin, stools, damage to retinas, hypocalcemia and bronze baby syndrome. One of the lesser known but which has a potential adverse effect of phototherapy is hypocalcemia. A total serum calcium concentration of < 7 mg / dl or ionised calcium concentration < 4mg / dl (< 1mol / L) is classified as neonatal hypocalcemia. Hypocalcemia increases the permeability of cells to sodium ions and increases the excitability of cell membranes. Material & Methods: 60 full term neonates were included in present cross sectional study who was admitted to Neonatal Intensive Care Unit (NICU). Full term neonates who completed 37 weeks of gestation with unconjugated hyperbilirubinemia who require phototherapy. Under the normal protocol, traditional phototherapy equipment containing four blue light fluorescent lamps with wavelengths of 410-470 nm was mounted at a distance of 25-35 cm from the skin surface of neonates with entirely covered eyes and genitals. At 15μW / cm2 /nm at the level of the infant's skin, the irradiance during phototherapy was assessed and maintained consistently. Results: Among 60 neonates included in this study there were 27 (45%) male whereas 33 (55%) female neonates. In present study the mean levels of serum calcium before phototherapy was 9.21 with standard deviation of 0.83 while the serum calcium levels after phototherapy were 8.36 with standard deviation of 0.78. There was a statistically significant difference between serum mean calcium levels before and after phototherapy (p=0.001). Conclusion: A major issue is phototherapy induced hypocalcemia. Before beginning and during phototherapy for neonatal jaundice and close monitoring of neonates for signs of hypocalcemia, careful calcium status calculation should be carried out.. After phototherapy, there is a substantial reduction in the amount of serum calcium, but the risk of hypocalcemia in stable full-term neonates is minimal.

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 Phototherapy and serum calcium levels in full term neonates with hyperbilirubinemia

2021 ◽  
Vol 61 (1) ◽  
pp. 8-11
Author(s):  
Carissa Lidia ◽  
I Made Kardana ◽  
Gusti Ayu Putu Nilawati ◽  
Ida Bagus Subanada ◽  
I Gusti Agung Ngurah Sugitha Adnyana ◽  
...  
Keyword(s):  
Serum Calcium ◽  
T Test ◽  
Full Term ◽  
Total Serum ◽  
Term Neonates ◽  
Total Serum Calcium ◽  
Before And After ◽  
Total Serum Calcium Level ◽  
Severe Hyperbilirubinemia ◽  
Paired T Test

Background Hyperbilirubinemia is one of the most common problems in newborns. Severe hyperbilirubinemia, known as kernicterus, can suppress O2 consumption and oxidative phosphorylation, as well as damage brain cells, resulting in neuronal dysfunction and encephalopathy. Phototherapy is a common therapy for neonatal hyperbilirubinemia, but may rarely lead to the adverse effect of hypocalcemia. Objective To investigate serum calcium levels in full term neonates with hyperbilirubinemia, before and after phototherapy. Methods This cohort study compared total serum calcium level before and after phototherapy in full term neonates with hyperbilirubinemia. Subjects were full term neonates aged 2-14 days with high total serum bilirubin levels, according to the Bhutani curve, and were treated with phototherapy at Sanglah Hospital, Denpasar, Bali, Indonesia. Paired T-test was used to compare serum calcium levels before and after phototherapy. Results There were 35 subjects in this study. Paired T-test revealed that subjects’ serum calcium significantly decreased after phototherapy [before: 9.47 mg/dL vs. after: 9.23 mg/dL; mean difference 0.24; (95%CI 0.03 to 0.46; P=0.025)]. None of our subjects had hypocalcemia after phototherapy. Conclusion Full term neonates with hyperbilirubinemia have reduced serum calcium levels after phototherapy.

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

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.

Cord Blood Alkaline Phosphatase as a predictor of Neonatal Jaundice in full term neonates

2020 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
Samah Esmail ◽  
Ali Abdo ◽  
Sherief Elgebaly ◽  
Marwa Mostafa
Keyword(s):  
Alkaline Phosphatase ◽  
Cord Blood ◽  
Neonatal Jaundice ◽  
Full Term ◽  
Term Neonates

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

A Membrane Ultrafiltration Procedure for Determining Diffusible Calcium in Serum

1970 ◽  
Vol 16 (3) ◽  
pp. 226-228 ◽  
Author(s):  
Genevieve Farese ◽  
Milton Mager ◽  
William F Blatt
Keyword(s):  
Serum Calcium ◽  
Calcium Concentration ◽  
Simple Procedure ◽  
Total Serum ◽  
High Flux ◽  
Ultrafiltration Membranes ◽  
Serum Calcium Concentration ◽  
Normal Value ◽  
Total Serum Calcium ◽  
The Mean

Abstract A rapid, simple procedure is described for separating diffusible from proteinbound serum calcium by centrifugation through high-flux ultrafiltration membranes. The mean normal value for ultrafilterable calcium was 57.1% (range 52 to 61%) of the total serum calcium concentration.

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 Effect of early and delayed cord clamping on hemoglobin and hematocrit among full term neonates.

2021 ◽  
Vol 28 (08) ◽  
pp. 1114-1119
Author(s):  
Saqib Aslam ◽  
◽  
Sadaf Minhas ◽  
Muhammad Azhar Farooq ◽  
Beenish Bashir Mughal ◽  
...  
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Full Term ◽  
P Value ◽  
Delayed Cord Clamping ◽  
Term Neonates ◽  
Cord Clamping ◽  
Significant Difference ◽  
Early Cord Clamping ◽  
The Mean

Objective: To compare the mean hemoglobin levels and frequency of polycythemia in full term neonates after early and delayed cord clamping. Study Design: Randomized Controlled Trial. Setting: KRL General Hospital Islamabad (Labor Room/ Neonatology). Periods: December 2017 to June 2018. Material & Methods: 190 full term neonates were selected and divided into 2 equal groups randomly: Early cord clamping group after delivery and late cord clamping group. Two hours after clamping the venous blood samples were taken for the hemoglobin and hematocrit levels. Mean and standard deviation were calculated for gestational age, birth weight, hemoglobin and hematocrit. Frequency and proportions were calculated for gender and polycythemia. Results: Mean gestational age of the mothers was 39.27 ± 1.50 weeks. Of 190 neonates, 91 (47.9%) were males, 99 (52.1%) were females. Mean birth weight was 3.64 ± 0.72 kg while mean Hb and HCT levels were 16.07 ± 2.30 g/dl and 63.26 ± 5.32% respectively. Keeping cut off value of 13.5 g/dl of Hb to label anemia or no, 35 (18.4%) neonates were anemic in this study. The polycythemia (HCT >65%) was present in 72 (37.9%) of neonates. There was no difference between groups in terms of gender, anemia, gestational age and birth weight (p values 0.663, 0.852, 0.700 and 0.491 respectively). The distribution of polycythemia was different among groups (p value 0.007). The mean hemoglobin level in group A was 15.52 ± 1.90 g/dl while in group B it was 16.62 ± 2.53 g/dl (p value 0.001). Mean Hb levels were statistically not different among some of the groups (gestational age <40 weeks, birth weight <4 kg) while HCT levels are significantly different among male group and category of birth weight >4 kg. Rest of the stratification groups showed significant difference. Conclusion: The delayed cord clamping in neonates results in increased mean hemoglobin and hematocrit levels with increased frequency of polycythemia as compared to early cord clamping.

scholarly journals A Study of Serum Calcium and Magnesium Levels in Idiopathic Epilepsy Patients of Hubli, Karnataka, India

2021 ◽  
Vol 8 (25) ◽  
pp. 2187-2191
Author(s):  
Chandrashekar Kachapur ◽  
Seetaram N. Kallimani ◽  
Gayathri B.H ◽  
Ishwar S. Hasabi ◽  
Zahura M. Devarhoru
Keyword(s):  
Serum Calcium ◽  
Calcium Influx ◽  
Serum Magnesium ◽  
Idiopathic Epilepsy ◽  
Total Serum ◽  
Cross Sectional ◽  
Total Serum Calcium ◽  
Study Results ◽  
Significant Difference ◽  
Calcium And Magnesium

BACKGROUND Magnesium is a potential modulator of seizure activity because of its ability to antagonize the excitatory calcium influx through N-methyl-D-aspartate (NMDA) receptor which is thought to play a role in many human forms of epilepsy. When the extracellular concentration of calcium ion falls below normal, the nervous system becomes more excitable, allowing easy initiation of action potentials. Consequently, hypocalcaemia causes seizures because of its action of increasing excitability in the brain. We wanted to estimate the serum concentration of calcium and magnesium in idiopathic epilepsy patients and its co-relation. METHODS 94 cases of idiopathic epilepsy with breakthrough seizures admitted to KIMS Hospital, Hubli, meeting the inclusion criteria were considered for the study which was for 2-years’ time period. It’s a single centred, time bound and cross sectional study. RESULTS Mean serum calcium was low 8.36 ± 0.45 mg / dL and mean serum magnesium was 1.79 ± 0.28 mg / dL. 64.9 % had total serum calcium less than 8.5 mg / dL and 44.7 % had serum magnesium of < 1.8 mg / dL. 35.1 % had both low calcium and magnesium. There was significant difference in mean serum calcium with respect to number of episodes. There was no significant difference in mean serum magnesium with respect to number of episodes. CONCLUSIONS Serum calcium and magnesium levels which play a role in seizure initiation should be measured in all idiopathic epilepsy patients with breakthrough seizures as a seizure trigger. Considering the role of calcium and magnesium in the pathophysiology of seizures and by evaluating the results from the present study, breakthrough seizure could be provoked by hypocalcaemia and hypomagnesemia. Hence they may be used for the treatment of intractable seizures. KEYWORDS Calcium, Magnesium, Idiopathic Epilepsy

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