Role of Short Duration Double Phototherapy in The Treatment of Unconjugated Hyperbilirubinemia

2021 ◽  
Vol 17 (3) ◽  
pp. 251-254
Author(s):  
Benish Fatima ◽  
Syed Taqi Hassan Zaidi ◽  
Ameena Saba
Keyword(s):  
Skin Reaction ◽  
Short Duration ◽  
Serum Bilirubin ◽  
P Value ◽  
Unconjugated Hyperbilirubinemia ◽  
History Of ◽  
Series Study ◽  
Neonatal Ward ◽  
Key Words Hyperbilirubinemia

Objective: To determine the role of short duration double phototherapy in the treatment of unconjugated hyperbilirubinemia. Materials and Methods: This prospective cases series study was conducted at pediatric department of CMH hospital at Malir Karachi. All the neonates diagnosed with unconjugated hyperbilirubinemia admitted to the neonatal ward were included. All the cases underwent short duration double phototherapy. Babies were observed for side-effects of phototherapy, like skin reaction and dehydration. Serum bilirubin was checked by bilirubinometre after 6 hourly of the treatment. Al the data was collected via study proforma. Data was analyzed by using SPSS version 20 Results: Total 74 neonates were studied, most of the neonates presented within 48-72 hours after birth. Majority of the term babies as 59.5% had history of 37-40 weeks of gestation and 28.4% had gestational age history >40 weeks. Out of all, males’ babies were 58.1% and female babies were 41.9%. Neonatal bilirubin level was significantly decreased from bassline 18.35+0.97 after 6 hours of double phototherapy as 14.66+1.18 with mean difference of 3.68+1.37 (p-value 0.001). Conclusion: Short duration double phototherapy found to be the effective, reliable and safe for skin reaction in the treatment of unconjugated hyperbilirubinemia. Key words: Hyperbilirubinemia, double phototherapy, six hours  

scholarly journals Investigating Association of rs5918 Human Platelets Antigen 1 and rs1800790 Fibrinogen β Chain as Critical Players with Recurrent Pregnancy Loss

2018 ◽  
Vol 6 (4) ◽  
pp. 98 ◽  
Author(s):  
Fatemeh Karami ◽  
Maliheh Askari ◽  
Mohammad Modarressi
Keyword(s):  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Human Platelets ◽  
P Value ◽  
Increased Risk ◽  
History Of ◽  
Polymerase Chain ◽  
Β Chain ◽  
Larger Sample

Thrombophilia gene variants have been shown to be associated with higher risk of recurrent pregnancy loss (RPL). Due to the role of human platelets antigen 1 (HPA-1) and fibrinogen β chain (FGB) as critical players in the coagulation process, their most important variants including rs5918 T > C and rs1800790 G > A were selected to be studied in women affected by RPL. Three milliliters of peripheral blood were drawn from 110 women with history of at least two consecutive spontaneous abortion and 110 healthy women controls. rs5918 T > C and rs1800790 G > A of HPA-1 and FGB genes, respectively, were selected to be analyzed through polymerase chain reaction-restriction fragment length polymorphism (PCR_RFLP) following DNA isolation using QIAamp DNA Blood Mini Kit. Heterozygote genotype (TC) of HPA-1 gene rs5918 polymorphism was significantly associated with risk of RPL (p-value = 0.02). Although, rs1800790 G > A of FGB gene was not associated with RPL, its combination with rs5918 polymorphism was associated with increased risk of RPL. Owing to the critical roles of FGB and HPA-1 genes in coagulation, and thrombosis and several confinements on the meaningful association between the combination of those polymorphism with risk of RPL, including them in the thrombophilia panel may increase detection rate of hereditary thrombophilia patients. However, further studies with larger sample sizes are required to shed light on the exact role of the studied gene polymorphism, especially rs1800790 G > A of FGB gene variant in pathogenesis of RPL.

ID: 12: THE ROLE OF ALCOHOL ABUSE AND TOBACCO USE IN THE INCIDENCE OF EARLY ACUTE CORONAY SYNDROME

2016 ◽  
Vol 64 (4) ◽  
pp. 922.2-923
Author(s):  
H Alkhawam ◽  
M Mariya Fabisevich ◽  
R Sogomonian ◽  
JJ Lieber ◽  
R Madanieh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Alcohol Abuse ◽  
Synergistic Effect ◽  
Tobacco Use ◽  
P Value ◽  
Healthcare Intervention ◽  
Tobacco Abuse ◽  
History Of

BackgroundTobacco abuse and alcohol dependence have been established as risk factors for atherosclerotic heart disease (ASHD). Their potential synergistic effect, however, have not been previously evaluated.Abstract ID: 12 Table 1Alcohol abuse/ DependenceAlcoholic abuse (n=172)Alcoholic- Smoker (n=51)Alcoholic Non-Smoker (n=121)Mean age (years)55.151.156.195% CI(52–58)(48–54.2)(54.6–57.6)Non-Alcohol abuse/DependenceNon-Alcoholic (n=7904)Non-Alcoholic Smoker (n=909)Non-alcoholic Non-smoker (n=6995)Mean age (years)63.856.371.395% CI(63.6–63.9)(55–57.7)(71–71.6)p Value<0.0010.02<0.001Objective/PurposeTo investigate the synergistic role of alcohol abuse/dependence and tobacco use in the early incidence of ACS.MethodsA retrospective chart analyses of 8076 patients diagnosed with ACS between 2000 to 2014, defined by ICD-9 codes for acute MI, alcohol abuse/dependence and tobacco use. Average age of ACS was calculated for the general population. Patients were then divided into 4 subgroups based on alcohol abuse/dependence and tobacco use status as follows: non-alcoholic non-smokers, non-alcoholic smokers, alcoholic non-smokers and alcoholic smokers.ResultsThe mean age of our 8076 ACS patients population was ∼59.5 (95% CI 59.2–59.8). Patients with history of alcohol abuse/dependence appeared to develop ACS ∼8.7 years younger than their non-alcoholic counterparts. When tobacco use is incorporated as a risk factor, those with both alcohol abuse/dependence and tobacco use seemed to develop ACS ∼5 years earlier than those with history of either alone, and ∼20 years earlier when compared to those with neither alcohol abuse/dependence nor tobacco use.(table 1 summarizes mean age of ACS incidence in our study subgroups).ConclusionsAlcohol abuse/dependence appears to be a risk factor for earlier ACS. In our population, the average age of ACS incidence in alcoholic patients was significantly earlier than non-alcoholic patients. Furthermore, alcoholic patients who also used tobacco developed ACS at an even younger age when compared to those who had history of either alcohol abuse/dependence or tobacco use alone, suggesting a possible synergistic effect of these two risk factors in developing early ACS. Healthcare intervention in this population through screening, counseling and education regarding alcohol abuse/dependence and smoking cession is warranted to reduce early ACS.

INDICATIONS FOR EXCHANGE TRANSFUSION BASED UPON THE ROLE OF ALBUMIN IN THE TREATMENT OF HEMOLYTIC DISEASE OF THE NEWBORN

PEDIATRICS ◽  
1964 ◽  
Vol 33 (5) ◽  
pp. 749-757
Author(s):  
William J. Waters ◽  
Eva Porter
Keyword(s):  
Exchange Transfusion ◽  
Serum Bilirubin ◽  
Binding Capacity ◽  
Hemoglobin Concentration ◽  
Hemolytic Disease ◽  
History Of ◽  
Unnecessary Procedures ◽  
Previously Treated ◽  
Reserve Albumin

Maternal titer, history of previously treated sibling, positive Coombs, prematurity, cord serum bilirubin, and hemoglobin concentration do not by themselves indicate the need for immediate exchange transfusion in an infant who shows no signs of disease. The measurement of the reserve albumin binding capacity is a useful aid in determining the need for exchange transfusion in preventing bilirubin encephalopathy. A delay in treatment of infants who have an adequate reserve binding capacity does not increase the need for re-exchange and avoids unnecessary procedures. The rate of re-exchange among infants receiving added albumin and managed according to the criteria outlined was lower than in the conventionally treated series.

scholarly journals Efficacy of prophylactic phototherapy for prevention of hyperbilirubinemia in very low birth weight newborns

2016 ◽  
Vol 6 (2) ◽  
pp. 151
Author(s):  
M. A. Mannan ◽  
Ismat Jahan ◽  
Sadeka Choudhury Moni ◽  
Zahidul Hasan ◽  
Arjun Chandra Dey ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Birth Weight ◽  
Exchange Transfusion ◽  
Serum Bilirubin ◽  
Serum Bilirubin Level ◽  
Total Serum Bilirubin ◽  
Total Serum ◽  
Control Group ◽  
P Value ◽  
Unconjugated Hyperbilirubinemia

<p><strong>Background:</strong> Jaundice is a common clinical condition in newborn occurring in approximately 60% of term and 80% of preterm infants. Unconjugated hyperbilirubinemia is universally common in all preterm infants especially in newborns with very low biLth weight. Low birth weight and premature infants are at major risk for exaggerated hyperbilirubinemia that can lead to bilirubin encephalopathy. Significant heterogeneity in the approach to the treatment of jaundiced neonates exists throughout the world. Phototherapy is the most common treatment for neonatal hyperbilirubinemia and could be most effective in preventing the sequelae of hyperbilirubinemia if initiated prophylactically. This randomized clinical trial has been proposed with the objective of assessing the efficacy of prophylactic photo therapy in preventing significant rise of unconjugated hyperbilirubinemia in premature neonates weighing less than 1500 gram and therefore to decrease the need for exchange transfusion and finally to reduce hospital stay due to hyperbilirubinemia. <strong></strong></p><p><strong>Methods:</strong> This randomized controlled clinical trial enrolled sixty newborns with birth weight less than 1500 gram. They were divided into two groups: 1) Prophylactic group, in whom phototherapy was started within 24 hours of birth and continued for 7 days and 2) Control group in whom therapeutic phototherapy was started considering serum bilirubin level and other clinical condi­tions as per institutional guidelines. Mean value of total serum bilirubin (TSB), duration of phototherapy, the need for exchange transfusion and duration of hospital stay in both groups were analyzed.</p><p><strong>Results:</strong> The maximum mean TSB level in prophylactic group was observed on 7th day and in control group it was observed on 3rd day of life. The total serum bilirubin levels were significantly lower in the 3rd and 5th days of life in the prophylactic group in comparison to control group (P value 0.001). Total serum bilirubin level exceeded therapeutic range in 6 (21 %) and 14 (50 %) newborns of the prophylactic group and control groups respectively (P value 0.026). No documented side effects of prophylactic photo­therapy was observed.<strong> </strong></p><p><strong>Conclusion:</strong> The use of prophylactic photo therapy for infants weighing less than 1500 grn is effec­tive and sate when compared to the control group, considering satisfactory maintenance of low total serum bilimbin levels during first 7 days of life.</p>

scholarly journals A study on effect of phototherapy on platelet count in neonates with unconjugated hyperbilirubinemia: a hospital based prospective observational study

2021 ◽  
Vol 12 (5) ◽  
pp. 41-46
Author(s):  
Santi Kumar Sarkar ◽  
Biswajit Biswas ◽  
Sumanta Laha ◽  
Nirban Sarkar ◽  
Monojit Mondal ◽  
...  
Keyword(s):  
Platelet Count ◽  
Observational Study ◽  
Gestational Age ◽  
Serum Bilirubin ◽  
Statistical Tests ◽  
Positive Association ◽  
Total Serum ◽  
P Value ◽  
Severe Thrombocytopenia ◽  
Unconjugated Hyperbilirubinemia

Background: Thrombocytopenia as a side effect of phototherapy has not been mentioned in standard literature and textbooks. Though there are few studies in this regard, but results are conflicting. Aims and Objective: Hence, the present study is undertaken to find out whether any significant change in platelet count occurs following phototherapy, and if there be any, to see whether the changes are transient or not. Materials and Methods: This prospective and observational study was carried out over a period of one and half years (1st March 2019 to 31st August 2020) on 190 new-borns admitted with idiopathic unconjugated hyperbilirubinemia needing phototherapy through consecutive enrolment. Serum bilirubin (total, conjugated and unconjugated) and platelet count were done before initiation and just after completion of phototherapy, and seven days after completion of phototherapy. Appropriate statistical tests were used to make statistical comparisons with a p-value of < 0.05 taken as significant. Results: Among 190 neonates, 108(56.8%) were male and 82(43.2%) were female; 90(47.4%) were preterm and 100(52.6%) were term. Mean birth weight was (2.4725 ± 0.4782) kg. Mean gestational age was (36.4316 ± 2.4802) weeks. Mean haemoglobin level was (17.3816± 1.0784) gm/dl. Mean age at presentation was (4.5737± 1.5811) days. Mean total serum bilirubin (TSB) before initiation, after completion, and 7 days after completion of phototherapy were (17.8595 ± 3.7034) mg/dl, (8.1726 ± 2.2586) mg/dl and (5.7279± 1.5918) mg/dl respectively. The mean duration of phototherapy required was (48.1895 ± 13.6054) hours. Mean platelet count before initiation and just after completion of phototherapy were (2,49,321.0526± 89,460.2101)/μL and (2,22,436.8421 ± 88,538.7173)/μL respectively. Mean platelet count 7days after completion of phototherapy was (2,46,210.5263 ± 87,442.3038)/μL. Decrease in platelet count just after completion of phototherapy was statistically significant. Fifty-nine (31.1%) out of 190 neonates developed mild thrombocytopenia (100000- <150000/μL) just after completion of phototherapy, but none developed moderate or severe thrombocytopenia. None having thrombocytopenia manifested with clinical bleed. Platelet count raised near to pre-phototherapy level 7 days after completion of phototherapy. Fall in platelet count was found to have a positive association with increased duration of phototherapy and lower gestational age (p<0.0001). However, there was no statistically significant association (p>0.05) between reduction in platelet count with gender. Conclusions: Though the incidence of thrombocytopenia following phototherapy was significant, but it was mostly mild and transient, and clinically insignificant. There was significant association between decrease of platelet count with duration of phototherapy and lower gestational age.

scholarly journals Serum Sodium Levels Predict the Recurrence of Febrile Seizure within 24 Hours

2019 ◽  
Author(s):  
Jatuporn Duangpetsang
Keyword(s):  
Family History ◽  
Serum Sodium ◽  
Medical Records ◽  
Febrile Seizure ◽  
Serum Sodium Level ◽  
Febrile Seizures ◽  
P Value ◽  
Seizure Recurrence ◽  
History Of

Objective: Febrile seizure is a common disorder in children that occurs in 2.5% of children 6-60 months of age. The study was conducted to ascertain the role of serum sodium as a predictor of seizure recurrence within the same febrile illness.Material and Methods: A retrospective study was conducted in children with febrile seizures who were admitted to Kaengkhro Hospital between 1 January 2014 and 31 December 2017. The data collected from medical records included age, gender, serum sodium level, body temperature, duration of fever, and family history of febrile seizures.Results: Two hundred ten children were diagnosed with febrile seizures; 190 had a single febrile seizure and 20 had recurrent febrile seizures. Mean±standard deviation ages of children with a single febrile seizure and recurrent febrile seizures were 22.95 ± 0.95 and 22.34 ± 0.89 months, respectively. Serum sodium levels in children with recurrent seizures within 24 hours (130.80 mmol/L) were significantly lower than in children with a single febrile seizure (132.37 mmol/L, p-value=0.02). A family history of febrile seizures was significant for predicting recurrent seizures within 24 hours (p−value= 0.006).Conclusion: Serum sodium levels predict the recurrence of febrile seizure within 24 hours.

scholarly journals The role of blood pressures in patients with a headache

2016 ◽  
Vol 5 (2) ◽  
Author(s):  
Mehrdokht Mazdeh ◽  
Mojtaba Khazaei ◽  
Arezou Sayad ◽  
Javad Zebarjadi Bagherpour ◽  
Mohammad Taheri
Keyword(s):  
Blood Pressure ◽  
Cross Sectional Study ◽  
P Value ◽  
Chi Square ◽  
Cross Sectional ◽  
History Of ◽  
Daily Headache ◽  
Blood Pressures ◽  
Stage 1

Background: A headache is the most common cause of patients referred to the doctor. About 40 percent of people are suffering from a headache for at least once a year. Due to it's the high prevalence and its association with cardiovascular diseases, hypertension was considered as a  health problem in industrialized and developing countries. The aim of this study was to investigate the role of blood pressure in patients with a headache referred to the neurological clinic during  2014-2015 in Hamadan.Method: This cross-sectional study was performed to evaluate patients with a headache referred to the neurological clinic. Exclusion criteria included: a headache with a specific cause (a migraine, stroke, chronic daily headache, kidney disease, Diabetes Mellitus, history of heart disease or use of cigarette. The data were entered into the list and then were analyzed by SPSS software through paired T-test and chi-square test.Results: In this study, the 100 patients with a headache (78% females and 22% males) were investigated. The average age of patients was 60.07±13.175 years. The prevalence of stage 1 & 2 hypertension was 85%, and prehypertension prevalence of 7% was reported. Most of the headaches were in the frontal (33 %). Furthermore, the most headaches occur in varied time (70%). There wasn’t a significant correlation between age (P-value=0.698), gender (P-value=0.952), headache and blood pressure.Conclusion: The results obtained from the present study indicated that there was not any significant correlation between a headache and blood pressure, and the prevalence of blood pressure in the patients with a headache was similar to those who do not have headaches.Keywords: Blood Pressure, Hypertension, Headache

scholarly journals Effectiveness of short duration phototherapy in government hospital setup

2021 ◽  
Author(s):  
Revanasiddappa Bhosgi ◽  
Kirankumar Harwalkar
Keyword(s):  
American Academy ◽  
Short Duration ◽  
Serum Bilirubin ◽  
Effective Means ◽  
Neonatal Hyperbilirubinemia ◽  
P Value ◽  
Government Hospital ◽  
Normal Limits ◽  
American Academy Of Pediatrics ◽  
Set Up

Background: Neonatal hyperbilirubinemia is most common presentation of neonates. Phototherapy remains standard treatment for neonatal hyperbilirubinemia. Overcrowding in government hospital makes it difficult to give phototherapy for more than 1-2 days. The objectives of the study were to determine the effectiveness of short duration of phototherapy in treating hyperbilirubinemia and to determine the risk of rebound hyperbilirubinemia.Methods: Study was hospital based retrospective study. The study place was GIMS kalaburagi. The study was conducted from September 2019 to December 2019. All healthy full-term neonates with serum bilirubin above cut off range according to (American academy of pediatrics) nomogram were included in the study. Requirement of phototherapy was decided on serum bilirubin levels as per AAP (American academy of pediatrics) nomogram. Phototherapy was used as treatment modality.Results: Total 110 neonates were included in the study. Total of 56 neonates (50.9%) required 1 day of phototherapy to fall within normal limits for discharge and 46 neonates (41.8%) required 2 days of phototherapy to fall within normal limits for discharge with a significant p<0.05. Rebound hyperbilirubinemia requiring repeat phototherapy was seen in 6(10%) neonates who were discharged after 1 day of phototherapy and in 5 neonates (10%) who were discharged after 1 day of phototherapy with a p value of 0.05.Conclusions: Short duration phototherapy is the effective means of treatment for most neonates in government hospital set up. Serum bilirubin has to be reviewed during follow up to assess rebound hyperbilirunemia.  

scholarly journals Effect of HLA-B27 on Development of Psoriatic Arthropathy

2019 ◽  
Vol 14 (2) ◽  
pp. 71-74
Author(s):  
Galawisah A. Abdullah ◽  
Haider H. Zalzala
Keyword(s):  
Psoriatic Arthritis ◽  
Real Time ◽  
Control Group ◽  
P Value ◽  
Hla B27 ◽  
Cross Sectional ◽  
Psoriatic Arthropathy ◽  
Plaque Type ◽  
History Of

Background: Psoriatic arthritis is a type of arthritis that can often affect some patients who suffer from psoriasis. Approximately 40-50% of individuals with psoriatic arthritis have the HLA-B27 genotype Objective: To investigate whether we could confirm the role of HLA-B27 alleles and psoriatic arthritis in Iraqi Arab Muslims patients. Method: A cross sectional case control comparative study included thirty Iraqi Arab Muslims who had psoriatic arthritis that consulted the Dermatological and Rheumatological Department in AL-Kindy Teaching Hospital from November 2014 to June 2015. HLA-genotyping for HLA-B27 were assessed. A control group consisted of fifty-one healthy volunteers among the staff of Al-Kindy College of Medicine that did not have psoriatic arthritis or family history of psoriasis. HLA-B*27allele was done by using an Exicycler TM 96 Real-time Quantitative Thermal Block (Bioneer, Daejeon, Korea) and Accupower, HLA-B27 real-time PCR kit (Bioneer, Daejeon , Korea) Results: Plaque type psoriasis is more common than other types of psoriasis (66% versus 34%). There is no association between psoriatic arthritis and HLA-B27 with p-value of 0.1197 and Odds ratio (confidence interval) of 2.9375 (0.755-11.415). Conclusions: HLA B*27 is not associated with psoriatic arthritis in Iraqi Arab Muslims patients.

scholarly journals Hubungan Kejadian Laten Tuberkulosis dengan Kontak pada Pasien Tuberkulosis

2020 ◽  
Vol 1 (1) ◽  
pp. 44-50
Author(s):  
Hadiyanto
Keyword(s):  
Latent Tuberculosis ◽  
Total Sample ◽  
P Value ◽  
Tuberculosis Patients ◽  
History Of ◽  
Latent Tb ◽  
In The Beginning ◽  
Age Range ◽  
The Relationship

Introduction: Latent TB is still a problem in Indonesia, the absence of symptoms in patients with latent TB makespatients feel they don't need treatment. Aim of study: The purpose of this study was to analyze the relationship oflatent TB incidence with TB contact patients. Method: This study uses research data on the role of gammainterferon as a marker of the effectiveness of the BCG vaccine, the sample in this study has a complete examinationrecord, especially IGRA examination, then the data are analyzed by the Chi squre method. The total sample was 421respondents. Results and Discussion: Based on the results of the study of female respondents was 265 (62.9%), withan age range of 21-40 were 186 (44.2%) respondents, Positive IGRA 123 (29.2%) respodents, patient contact withTB patients was 105 people, and no contact history with TB patients was 316 people. The prevalence of latent TBwas 29 percent, while respondents who have a history of contact with tuberculosis patients about 33.3 percent andwithout a contact history of 27.8 percent. Conclusion: From the results of the analysis, there was no significantrelationship between latent tuberculosis events and contact history with tuberculosis patients (P value 0.284).Therefore, further research needs to be done to include variables that have not been included in the beginning suchas economic factors, respondent nutrition, and conduct a re-examination to determine the current health status ofrespondents.

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