scholarly journals Cholestatic Jaundice in Infants – An Experience in Tertiary Care Hospital

2014 ◽  
Vol 32 (1) ◽  
pp. 9-15 ◽  
Author(s):  
FR Chowdhury ◽  
K Chowdhury ◽  
ASMB Karim
Keyword(s):  
Birth Weight ◽  
Biliary Atresia ◽  
Tertiary Care ◽  
Age At Onset ◽  
Cholestatic Jaundice ◽  
Neonatal Hepatitis ◽  
Biliary Cirrhosis ◽  
Care Hospital ◽  
Neonatal Cholestasis ◽  
Cross Sectional

Background: Neonatal cholestasis is defined as prolonged elevation of serum levels of conjugated bilirubin beyond the first 14 days of life. Cholestasis in a newborn can be due to infectious, genetic, metabolic, or undefined abnormalities giving rise to mechanical obstruction of bile flow or to functional impairment of hepatic excretory function and bile secretion. Early detection and timely accurate diagnosis are important for successful treatment and a favorable prognosis. Objective: The present study has been designed to determine the etiology of cholestatic jaundice in infants along with their clinical profile. Methodology: This cross-sectional study was conducted from August 2010 through January 2011 in the Paediatric Gastroenterology & Nutrition Department, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. For the study purpose 40 consecutive cases of cholestatic jaundice were included who fulfilled the inclusion criteria. Result: Biliary atresia was the commonest (42.5%) cause of cholestatic jaundice followed by neonatal hepatitis/ idiopathic neonatal hepatitis. Other causes of cholestatic of the infants were term and of normal birth weight in cases of biliary atresia (BA) but in NH/INH group significant number of infants were preterm and of low birth weight. Mean age at onset of jaundice was 10.1 ± 4.18 days, and mean age at presentation was 113.7 ±15.38 days. In cases of BA Jaundice, intermittent / persistent pale stool, dark urine was found in all cases and hepatomegaly and splenomegaly were found in 88.2% and 64.8% of cases respectively. Ultrasonographically in most of the cases of BA gallbladder was found either small in size or absent or bile ducts were not visualized. In cases of NH/INH visualization of normal gallbladder while fasting and contraction was observed after meal. Histologically typical features BA were found in 12 out of 17 cases of BA and features of early biliary cirrhosis in 4 infants and 10 patients showed features of INH. Conclusion: Biliary atresia was found to be the commonest cause of neonatal cholestasis in the present study. DOI: http://dx.doi.org/10.3329/jbcps.v32i1.21029 J Bangladesh Coll Phys Surg 2014; 32: 9-15

scholarly journals Usefulness of clinical and laboratory parameters for differentiation of biliary atresia from idiopathic neonatal hepatitis: Experience in a tertiary care hospital of Bangladesh

2015 ◽  
Vol 4 (1) ◽  
pp. 30-36
Author(s):  
Kaniz Sultana ◽  
Ariful Haque ◽  
Nadira Musabbir ◽  
Syeda Afria Anwar ◽  
Faika Hussain ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Biliary Atresia ◽  
Tertiary Care ◽  
Neonatal Hepatitis ◽  
Care Hospital ◽  
Neonatal Cholestasis ◽  
Cross Sectional ◽  
Laboratory Parameters ◽  
Upper Limit ◽  
Idiopathic Neonatal Hepatitis

Background: The two most common and important causes of neonatal cholestasis (NC) are biliary atresia (BA) and Idiopathic neonatal hepatitis (INH). There is no single test that can definitely differentiate these two entities. Objective: To evaluate the diagnostic accuracy of clinical and laboratory parameters for diagnosis of biliary atresia. Methods: This cross-sectional study was conducted at the department of Pediatric Gastroenterology and Nutrition of Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, from August 2013 through July 2015 among purposively sampled infants with neonatal cholestasis. Results: Total 86 neonatal cholestatic cases were studied. Term baby and good birth weight are significantly higher in BA cases. The presence of persistent pale colored stool is significantly more in patients with BA (p 0.000). GGT is the only liver enzyme that was found to be useful differentiating BA from INH at a cut-off value ≥ 524U/L or 9.5 times higher than upper limit normal with sensitivity and specificity of 81.6% and 72.9% respectively. In the present study the diagnostic accuracy of persistent pale colored stool found to be highest (79.1 %). Conclusion: The present study showed that Persistent pale colored stool and serum level of GGT with a cut-off value ≥524 U/L or 9.5 times higher than upper limit normal can be considered as predictive markers for differentiation of Biliary atresia from Idiopathic neonatal hepatitis. CBMJ 2015 January: Vol. 04 No. 01 P: 30-36

scholarly journals Impact of determinants on nutritional status among children up to five years at tertiary care hospital, HIMS, Sitapur, Uttar Pradesh

2021 ◽  
Vol 8 (3) ◽  
pp. 1391
Author(s):  
Ravi Pachori ◽  
Jiratithigan Sillapasuwan
Keyword(s):  
Birth Weight ◽  
Child Health ◽  
Sample Size ◽  
Health Care Services ◽  
Tertiary Care ◽  
Healthy Children ◽  
Care Hospital ◽  
Cross Sectional ◽  
Child Birth ◽  
Mother’S Age

Background: Malnutrition in children occurs as a complex interplay among various factors like maternal health, dietary practices, hand washing and other hygiene practices, low birth weight, episode of diarrhoea and acute respiratory infection within the last 6 months are often associated with undernutrition in most developing nations including India. Objective of the study were to assess the determinants of maternal and child health, hygienic practice, health services for underweight and their association among apparently healthy children. Methods: The present study was hospital based descriptive cross-sectional study conducted from June 2019 to December 2019. The sample size calculated was 410, and accounting for 10% nonresponsive, the sample size calculated was 451. The data obtained were compiled and entered in MS-excel 2010 and analysed by using institutional SPSS (22.0). Results: Mother’s age at marriage <18 years belong to 68 (15.1%) children significantly low proportion as compared to marriage >18 years 383 (84.9%) including underweight 41 (22.5%) and mother’s age at child birth <18 years belong to 46 (10.2%) children significantly very low proportion in comparison to child birth >18 years including underweight 30 (16.6%). Birth weight <2.5 kg belongs to significantly 136 (30.1%) children including underweight 72 (39.8%) and significantly birth order >2 belong to 135 (29.9%) children including underweight 39 (21.6%). Exclusive breast feeding belongs to 149 (33.0%) children including underweight 62 (34.2%)Conclusions: Health education and its reinforcement especially in the area of maternal & child health care services is required.

scholarly journals Gestational Age Specific Postnatal Growth Curves for Singleton Babies in Tertiary Hospital of Western Nepal

2017 ◽  
Vol 56 (207) ◽  
pp. 325-330
Author(s):  
Santosh Pathak ◽  
Nagendra Chaudhary ◽  
Prativa Dhakal ◽  
Shyam Kumar Mahato ◽  
Sandeep Shrestha ◽  
...  
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Economic Status ◽  
Tertiary Care ◽  
Growth Curves ◽  
Tertiary Hospital ◽  
Care Hospital ◽  
Cross Sectional ◽  
Intrauterine Growth ◽  
Geographical Regions

Introduction: Measurement of birth weight (BW), crown heel length (CHL), head circumference (HC) and chest circumference used to assess the intrauterine growth of a baby vary with altitude, race, gender, socio economic status, maternal size, and maternal diseases. The study aimed to construct centile charts for BW, CHL and HC for new born at different gestational ages in western Nepal. Methods:  This was a descriptive cross sectional study done over a period of 15 months in a tertiary care hospital of western Nepal. BW, length, HC and CC were measured within 12-24 hours of birth. Gestational age was estimated from first day of last menstrual period, maternal ultrasonology and New Ballard’s scoring system. Microsoft 2007 Excel and SPSS-16 was used for data analysis. Cole’s Lambda Mu Sigma method was used for constructing centile curves. Results: Out of 2000 babies analysed, 1910 samples were used to construct smoothed intrauterine growth curve of BW, CHL, and HC from 33-42 weeks of gestation. 57.35% (1147) were male, mean gestational age was 38.13 ±2.44 weeks, where 21.5% were preterm and 1.7% post term. The means of BW, CHL, HC and CC were 2744.78 gm, 47.80 cm, 33.18 cm, and 30.20 cm with standard deviations of 528.29, 3.124, 1.78, and 2.35 respectively. These data vary as compared to the Kathmandu data, in case of birth weight for 10th and 90th centiles, and at 90th centile in case of length. Conclusions: This necessitates the update in the existing growth charts and develop in different geographical regions of a country.

scholarly journals A cross sectional study on demographic factors affecting low birth weight

2019 ◽  
Vol 6 (11) ◽  
pp. 4896
Author(s):  
Renu Sulakhe Vasant ◽  
Lavanya K. M. Rao ◽  
Nageswara Rao V.
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Tertiary Care ◽  
Income Group ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Sectional Study ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Factors Affecting

Background: Low birth weight (LBW) is one of the commonest cause for infant and childhood morbidity and mortality. The majority of low birth weight in developing countries is due to intrauterine growth retardation, while most low birth weight in industrialized countries is due to preterm birth. LBW is the single most important factor determining the survival chances of the child. The objectives of the study were to assess the proportion of low birth weight among babies delivered by mothers at a tertiary care hospital and to analyse the relationship between low birth weight and certain socio-demographic factors.Methods: A cross-sectional study conducted in a tertiary care centre for a period of six months.Results: The prevalence of LBW was 23.5%. The proportion of mothers having low birth weight was maximum in women aged less than 18 years (35%) and more than 30 years (26.5%). Muslim women had a higher proportion of LBW (28.8%). LBW was more in women belonging to joint family (30.0%), low per capita income group and illiterates.Conclusions: The prevalence of LBW still continues to be high, almost one fourth of the babies are LBW. Different socio-demographic characteristics of the population are still the important factors determining the occurrence of LBW.

scholarly journals Socio-demographic factors associated with low birth weight in a tertiary care hospital of Odisha

2018 ◽  
Vol 5 (5) ◽  
pp. 1797
Author(s):  
Pradip Kumar Bhue ◽  
Himansu Prasad Acharya ◽  
Subrat Kumar Pradhan ◽  
Pratima Biswal ◽  
Amit Pritam Swain ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
World Health ◽  
Care Hospital ◽  
Chi Square ◽  
Cross Sectional ◽  
Medical College ◽  
Health Organization

Background: World Health Organization has defined low birth weight (LBW) as birth weight less than 2,500 grams. Giving birth to a LBW infant is influenced by several factors. Objective of the study was to measure the proportion of low birth weight babies delivered in V.S.S medical college and hospital, Burla and its association with socio-demographic factors.Methods: Hospital based cross -sectional study comprising of 1030 postnatal women who delivered single live baby in V.S.S Medical College and Hospital, Burla. Selection of study participants was done by systematic random sampling in the study period October 2012 to September 2014. Chi-square test was used to measure association between LBW and socio-demographic factors.Results: The proportion of LBW was found to be 27.76%. The proportion of LBW babies was high and significant in extremes of age i.e. teenage (44.19%) and 30 years and above age group (39.56%) and Muslim mothers (36.36%), illiterate mothers (53.52 %), manual labourer (67.14%), socioeconomic class IV and V (32.98%), consanguinity history (60.58%), smoky fuel (30.02%), consumption of tobacco (49.11%).Conclusions: The proportion of LBW (27.76%) was found to be higher than national average (21.5%).

scholarly journals Correlation of neonatal gestational age with foot length and right nipple to umbilicus distance

2020 ◽  
Vol 7 (6) ◽  
pp. 1319
Author(s):  
Ajay K. Keshwani ◽  
Swati S. Suroshe
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Tertiary Care ◽  
Large For Gestational Age ◽  
P Value ◽  
Care Hospital ◽  
Cross Sectional ◽  
Systematic Analysis ◽  
Neonatal Deaths ◽  
Foot Length

Background: India contributes to one fifth of global live births and more than a quarter of neonatal deaths. A systematic analysis of global, regional and national causes of child mortality in 2013 identified preterm birth complications and infections to be the two major causes of neonatal deaths in India. So, there is need of a simple, easy to use and reliable screening tool for assessment of gestational age at peripheral level for early referral of a neonate to a tertiary care hospital, thereby reducing neonatal mortality.Methods: A hospital based observational cross-sectional study included 350 live new-borns within 48 hours of birth, from September 2018 to February 2019. Gestational age assessed by new ballard score, birth weight, foot length and right nipple to umbilicus distance were noted. Babies categorised as per the gestational age profile as small, appropriate and large for gestational age using fenton charts. Data analysis done, correlation coefficient, and p value calculated to obtain results.Results: Out of 350 babies, males (185) outnumbered females (165); 154 were LBW, 89 VLBW and 76 were ELBW. AGA neonates were 193, and 157 belonged to SGA. There were no post-term and large for gestational age newborns. Both foot length and right nipple to umbilicus distance correlated well with gestational age in all age groups (p<0.001).Conclusions: Foot length as well as right nipple to umbilicus distance can be used as a reliable tool for assessment of gestational age and birth weight of newborns by any health care professional to identify and refer high risk neonate.

scholarly journals Burden and risk factors associated with low birth weight among newborns in a tertiary care hospital Karachi, Pakistan

2021 ◽  
Vol 8 (11) ◽  
pp. 5202
Author(s):  
Azeem Khan ◽  
Vikram Kumar ◽  
Erum Choudry ◽  
Sana Niaz ◽  
Mareena Ahmad ◽  
...  
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Disease Burden ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Cross Sectional ◽  
Factors Associated ◽  
Developed World ◽  
Perinatal Survival

Background: Birth weight is one of the significant determinants of perinatal survival and infant morbidity and illnesses during early childhood. The burden of LBW neonates in the developed world is around 7%, whereas it is more than double at around 16.5% in developing countries.Methods: The retrospective cross-sectional study was conducted at the Indus Hospital and Health Network, Karachi, Pakistan. Data was extracted through the electronic medical record (EMR) with specific coding related to LBW from 1st January 2019 to 31st December 2020.Results: Our study showed LBW disease burden of 7.61% equated to 7% in the developed world while, in contrast with LBW prevalence in the developing countries, 16.5%. Gestational diabetes, pregnancy-induced hypertension, and primigravida are the major risk factors associated with LBW.Conclusions: Our study concludes that antenatal care is one of the major aspects to decrease the incidence of LBW, especially in primigravida. By estimating LBW, we can plan early detection and prompt interventions against this problem, reducing the burden of morbidity and mortality in neonates.

scholarly journals INCIDENCE AND CAUSES OF ACUTE KIDNEY INJURY IN SICK NEONATE : A STUDY FROM A TERTIARY CARE NEONATAL UNIT

2020 ◽  
pp. 1-2
Author(s):  
Krishnendu Karmakar ◽  
Sumanta Laha ◽  
Bhaswati Ghoshal ◽  
Pradip Kumar Das
Keyword(s):  
Acute Kidney Injury ◽  
Birth Weight ◽  
Kidney Disease ◽  
Serum Creatinine ◽  
Perinatal Asphyxia ◽  
Tertiary Care ◽  
Kidney Injury ◽  
Care Hospital ◽  
Cross Sectional ◽  
Normal Birth

Objective To find out the incidence of Acute Kidney Injury(AKI) and various causes responsible for the AKI in sick neonates in a tertiary care hospital. Material and Method In this observational cross sectional study we included all neonates with features suggestive of AKI with exclusion criteria of extreme prematurity, chronic kidney disease and major congenital anomaly. We diagnose AKI according to the KIDIGO(Kidney Disease: Improving Global Outcome)guideline where we take serum creatinine value and urinary output as determinant. Serum creatinine value measured at 48 and 72 hrs of admission and repeated at 96 hrs if there is rising trend of creatinine..Now we find out the incidence of AKI in relation to gender, birth weight, mode of delivary . Among the AKI case we sort out the causative factors like perinatal asphyxia,sepsis, shock, prematurity etc and analysed all the results statistically. Results Out of total 1872 neonates admitted during the 18 months study period we found AKI in 111 neonates(5.93%).There is male preponderance and most neonates are of normal birth wt.Among the various causes of AKI perinatal asphyxia is the leading cause followed by sepsis and prematurity.Other imp causes are congenital heart disease,shock, PPHN , nephrotoxic drug use and RDS of newborn. We found asphyxia as the leading cause of AKI in normal vaginal delivary group whereas sepsis is the main cause of AKI in cesarean section group. Conclusion AKI is fairly common in sick neonates , even in normal birth weight babies and perinatal asphyxia and sepsis are the two most prevalent cause for AKI in this study.

scholarly journals Clinical Features of Cluster Headache: A Hospital-Based Study in Taiwan

2021 ◽  
Vol 12 ◽  
Author(s):  
Chien-An Ko ◽  
Guan-Yu Lin ◽  
Chi-Hsin Ting ◽  
Yueh-Feng Sung ◽  
Jiunn-Tay Lee ◽  
...  
Keyword(s):  
Family History ◽  
Cluster Headache ◽  
Tertiary Care ◽  
Time Lag ◽  
Age At Onset ◽  
Positive Family History ◽  
Care Hospital ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Medical College

Most previous studies on cluster headache (CH) focus on Western populations. This study aimed to investigate the clinical characteristics of CH in a neurology outpatient population in Taiwan. A cross-sectional survey was conducted from July 2015 to June 2019 in a medical college affiliated with a tertiary care hospital (Tri-Service General Hospital) in Taiwan. All consecutive patients reporting headache as their chief complaint were asked to participate in a face-to-face interview with a qualified headache specialist and to complete a detailed self-administered questionnaire. The diagnosis of CH was made according to the Third edition of the International Classification of Headache Disorders. The subjects comprised 80 consecutive new CH patients (13 women and 67 men; ratio, 1:5). The mean age at presentation was 36.0 ± 10.8 years (range, 16–64 years), mean age at onset was 27.2 ± 12.1 years (range, 5–65 years), and mean time lag before diagnosis was 9.3 ± 10.5 years (range, 0–46.4 years). Of the total CH patients, 25.3% reported feelings of restlessness during headache episodes. A seasonal predilection was reported by 18% of the CH patients. The use of tobacco was the most common (44/80 patients). Chronic CH was only observed in 5% of the patients and only one patient (1.3%) reported both a positive family history for CH and aura. Features of CH in Taiwanese patients differed from that of Caucasian patients; a lower prevalence of chronic CH, positive family history of CH, and occurrence of aura may be less common in the former than in the latter.

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