scholarly journals Clinical profile of pathological Jaundice among neonates admitted in the National Referral Hospital, Bhutan

2021 ◽  
Vol 7 (2) ◽  
pp. 13-18
Author(s):  
Kinzang Dechen ◽  
Tenzin Lhadon ◽  
Mimi Lhamu Mynak ◽  
Phurpa Phurpa

Background: Neonatal jaundice is a common condition especially in the first week of life. There are various maternal and neonatal clinical characteristics that have been associated with pathological jaundice. Objectives: To describe clinical profile of pathological jaundice and to estimate its prevalence among newborns admitted at the National Referral Hospital. Methods: A cross-sectional descriptive study design was used to study pathological jaundice cases admitted at the Gyaltsuen Jetsun Pema Neonatal Intensive Care Unit (NICU) of Jigme Dorji Wangchuck National Referral Hospital (JDWNRH) from 7th November 2018 till 6th November 2019. Data was collected using a predesigned case proforma, entered and analyzed in Epidata after obtaining ethical clearance from the Research Ethics Board of Health (REBH), Bhutan.  Results: Facility based prevalence rate of pathological neonatal jaundice was found to be 63.66% in our setting. The median age on presentation was 4 days. Blood group ABO incompatibility and neonates less than one week of age were found to be most common neonatal profile in this study. Significant association was found between primiparous mothers and excessive weight loss. Conclusion: The prevalence of pathological jaundice was high in our setting. ABO incompatibility, neonates less than one week of age, primigravida mothers with feeding issues should be closely followed or screened for pathological jaundice especially during the first one week of life. Keywords: Pathological jaundice, Prevalence, ABO incompatibility, feeding issues, excessive weight loss

2020 ◽  
Vol 8 (1) ◽  
pp. 143
Author(s):  
Avinash Patel ◽  
Karan Saradava ◽  
Hasmukh Chauhan

Background: Etiology of hyperbilirubinemia is not only crucial for optimal management of the patient but also it may have implications for subsequent pregnancies. The objective of this study was to study the clinical profile and the underlying aetiological factors leading to neonatal jaundice in this rural setting of Kutch District, Gujarat, India.Methods: This prospective observational study was conducted in the neonatal intensive care unit (NICU) and Post Natal ward Gujarat Adani Institute of Medical Science, Bhuj, Kutch, Gujarat. Total of 150 cases were enrolled for the study. Blood grouping and Rh typing of baby and mother were done. Cord blood bilirubin and haemoglobin, direct coomb's test (DCT) and bilirubin monitoring were done whenever there was a setting for Rh incompatibility.Results: Among 150 neonates studied, majority had birth weight between 2501g and 3000g. Only 21 babies had birth weight <2.5kg (14%) (Table 2). Of the 150 neonates 85 were males and 65 were females.Conclusions: This study concludes that physiological jaundice is the most common cause of neonatal jaundice in our hospital. This is followed by ABO incompatibility, sepsis, Rh incompatibility and idiopathic cases.


2020 ◽  
Vol 8 (1) ◽  
pp. 21-23
Author(s):  
Davis Manuel ◽  
Shajahan R A

Background: In the first week of child birth, neonatal jaundice is the most common problem which leads to delayed hospital discharge and re-admissions. Recognising early neonatal hyperbilirubenemia plays a pivotal role in preventing serious complications. The aim of this study was to study the clinical profile and the aetiological factors leading to neonatal jaundice in rural areas.Subject and Method:This study is a prospective observational study  conducted in neonatal intensive care unit (NICU) and post natal ward . This study was conducted during the period of February 2017 to July 2017. Total 400 neonates were admitted in NICU and post natal ward during this period. Out of them, 100 newborns were having jaundice (Serum bilirubin > 10 mg/dl). 100 cases in total were enrolled in the study. Result:In this study,out of 100 neonates, 70% were males and 30% were females. , 92 were born at term (92%) and remaining 10 were preterm babies (10%). Physiological jaundice constituted 45%, followed by ABO incompatibility constituted 25%, followed by sepsis(1%), Rh incompatibility (8%), idioapathy (8%), prematurity (5%), cephalhematoma (4%), breast feeding (2%), haemolytic anemia (2%) were diagnosed as hereditary spherocytosis. Conclusion:Physiological jaundice is the most common cause of neonatal jaundice followed by ABO incompatibility, sepsis, Rh incompatibility and idiopathic cases. Cephalhematoma, breast feeding jaundice and haemolytic anaemia are the less common causes. Hence, it is required to monitor neonates more appropriately and accurately.


2020 ◽  
Vol 6 (1) ◽  
pp. 32-37
Author(s):  
Chhimi Wangmo ◽  
Nor Tshering Lepcha

Introduction: The aim of this hospital-based study was to assess the prevalence and associated factors of pterygium among adult patients visiting the Ophthalmology Outpatient Department (OPD) in the Jigme Dorji Wangchuck National Referral Hospital (JDWNRH), Thimphu. Methods: A cross sectional study was carried out in the ophthalmology OPD in the national referral hospital, Thimphu from 1st January, 2018 to 31st December, 2018, during which 1599 adult patients were selected through systematic random sampling. Results: The prevalence of pterygium was 12.8% (95% CI: 11.2 -14.5). Among 271 eyes with pterygium, the distribution of grade 1, grade 2 and grade 3 pterygium was 34.7%, 56.1% and 9.2% respectively. Pterygium wasmost common in the age group of 36-55 years. The significant factors associated with pterygium were age group, occupation and usage of sunglasses. Individuals who were 36-55 years (adjusted OR 2.70, 95% CI 1.82-4.0) and >55 years (adjusted OR 2.17, 95% CI 1.34-3.50) had significantly higher risk than 18-35 years (p< 0.002), and not using sunglasses (adjusted OR 1.97, 95% CI1.17-3.33, p = 0.007) significantly increased the risk of pterygium. Indoor occupation, particularly being a student was protective against pterygium (OR 0.08, 95% CI 10.02-0.33, p< 0.001). Only 14.1% used sunglasses and among them, 27.6% were aware that sunglasses can protect from ultraviolet radiation. Conclusion: This study found a high prevalence of pterygium among adults aged 18 years and above. Those aged 36-55 years and an occupation involving outdoor activities were affected more. Encouraging usage of sunglasses may reduce pterygium


2020 ◽  
Vol 2 (7A) ◽  
Author(s):  
Amarila Malik ◽  
Grasella Ong ◽  
Firsty Amanah Prasetyaningsih ◽  
Kristien Juni ◽  
Radhian Amandito ◽  
...  

Microbial colonization of a neonate’s gastrointestinal tract has significant perinatal and lifetime health consequences, with some clinical outcomes that have been linked to differences in the diversity and composition of gut microbiota. The effort to engineer intestinal ecosystem has led us to preserve the cultivable commensal microbiota. Here we investigated the association of cultivable bacterial diversity of neonates meconium from Indonesian National Referral Hospital Cipto Mangunkusumo (NRHCM) with mode of delivery and feeding patterns, as well as hyperbilirubinemia. We performed a cross-sectional study of meconium and clinical data collected from 14 Indonesian neonates born at NRHCM. Culture-dependent identification of bacterial isolates was conducted by performing simultaneous microbiological and molecular 16S rDNA PCR-Sanger sequencing methods. Phylogenetic tree and principal components analysis were employed to determine the bacterial profile and their association with clinical characteristics and outcomes. Cultivable bacterial profile indicates the predominance of Firmicutes (84,41%), with an abundant population of Staphylococcus (53.24%) with top three most significant population present are, i.e. S. hominis (12.99%), S. epidermidis (11.68%), and S. haemolyticus (10.39%). Bacterial diversity was associated with mode of delivery which showed that vaginal route populated by lower diversity of cultivable bacteria but by fewer opportunistics one than that of cesarean, with Staphylococcus hominis dominates the population, whereas with feeding patterns showed that the exclusive breast-fed was most populated by Staphylococcus, whereas non-exclusive one shared the same proportion of Staphylococcus and Bacterioides. While, non-hyperbilirubinemia group showed more abundant and diverse Staphylococcus than that of the opposite group.


2020 ◽  
Vol 25 (Supplement_2) ◽  
pp. e15-e16
Author(s):  
Wissam Alburaki ◽  
Belal Alshaikh ◽  
Kamran Yusuf

Abstract Background Approximately 43-65% of very low birth weight (VLBW) infants develop extra-uterine growth restriction (EUGR). EUGR is associated with a significant increase in the risk of neurodevelopmental impairment. Inadequate early postnatal nutrition results in excessive weight loss that cannot be explained by the physiologic contraction of body water alone. EUGR and postnatal growth failure are usually associated with negative early energy and nitrogen balance in the first week of life. Growth trajectories after initial weight loss have similar slopes regardless of gestational age, which indicates that the early excessive weight loss is a lead cause for EUGR. Objectives To study whether an early and higher parenteral lipid intake in the first week after birth would decrease the percentage of weight loss and subsequently the incidence of EUGR. Design/Methods This was a randomized, open-label, control trial of appropriate-for-gestational age VLBW infants admitted to our level III NICU. Lipid intake in the control group started at 0.5-1 g/kg/day and was increased daily by 0.5-1 g/kg/day until 3 g/kg/day was reached. The intervention group was started on 2 g/kg/day then increased to 3 g/kg/day the following day. Triglyceride levels were measured the day after the start and after each increase in lipid intake. Results Among the 176 infants assessed for eligibility, eighty-three were included in the trial. There were no significant differences between the control and the intervention group in mean gestational age (27.3 ± 2.4 vs. 27.1 ± 2.3 weeks respectively) or birth weight (1011 ± 250 vs. 1019 ± 271 g respectively). Infants in the intervention group were started on lipid earlier (13.8±7.8 vs. 17.5±7.8 h; p=0.03) and had higher cumulative lipid intake in the first 7 days of age (13.5±4.2 vs. 10.9±3.5 g/kg; p=0.004) that led to a protein to energy ratio; closer to the recommended values. Total fluid intake was similar between the two groups. Infants in the intervention group had a lower percentage of weight loss (10.4±3.6 vs. 12.7±4.6; p=0.02). The mean triglyceride level was higher in the intervention group (1.91± 0.79 vs. 1.49±0.54 mmol/L; p= 0.01), however, hypertriglyceridemia was similar between the two groups at 2 and 3 g/kg/day of lipid intake. Enteral energy and protein intake calculated weekly between the time of parenteral nutrition discontinuation and 36 weeks corrected gestational age (CGA) were similar between the 2 groups. EUGR at 36 weeks CGA was significantly lower in the intervention group (38.6% vs. 67.6%; p=0.01). Conclusion In VLBW infants, the provision of an early and higher dose of parenteral lipid in the first week of life results in less weight loss and lower incidence of EUGR.


2011 ◽  
Vol 6 (1) ◽  
pp. 39
Author(s):  
L.R. Anastâcio ◽  
E.G. Vilela ◽  
L.G. Ferreira ◽  
H.S. Ribeiro ◽  
A.S. Lima ◽  
...  

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