Phototherapy Induced Hypocalcemia in Neonates with Unconjugated Hyperbilirubinemia

2021 ◽  
Vol 11 (1) ◽  
pp. 4-8
Author(s):  
Amna Khan ◽  
Anila Farhat ◽  
Hamayun Anwar ◽  
Sajid Shamim ◽  
Mujeeb Ur Rehman ◽  
...  

Objective: To determine the frequency of hypocalcemia in neonates with unconjugated hyperbilirubinemia receivingphototherapy.Study design and setting: Cross sectional study conducted at neonatal intensive care unit, King Abdullah Teaching Hospital,Mansehra for one year from December 2017 to November 2018.Methodology: Total 213 full term stable neonates of either gender with jaundice were studied in this study. Out of which,143 with unconjugated hyperbilirubinemia were exposed to phototherapy while 70 neonates with exaggerated physiologicalhyperbilirubinemia taken as control were not exposed to phototherapy. Serum calcium level was determined through bloodtest before and after 24 hours of phototherapy. SPSS version 22 was used to analyze the data. Frequency and percentageswere used to describe categorical variables like gender and hypocalcemia. Hypocalcemia was stratified by age and genderto see effect modifiers. Post stratified chi-square test was applied in which p value = 0.05 was considered as significancevalue.Results: In study group, 143 neonates who received phototherapy had mean age of 7 days ± 2.62 SD. Total 65% neonateswere male and 35% neonates were female. Mean serum calcium level of neonates before and after provision of phototherapywas 9.28 mg/dl ± 0.23 and 8.54 mg/dl ± 0.68 respectively, which is statistically significant. The frequency of hypocalcemiawas 40% in neonates with unconjugated hyperbilirubinemia after 24 hours of phototherapy.Conclusion: Hypocalcemia is an important complication in neonates with unconjugated hyperbilirubinemia after continuousphototherapy. Hypocalcemia has clinical impact and adds to morbidity, and if left untreated, can lead to mortality.

Author(s):  
Amna Khan ◽  
Anila Farhat ◽  
Hamayun Anwar ◽  
Sajid Shamim ◽  
Mujeeb Ur Rehman ◽  
...  

Objective: To determine the frequency of hypocalcemia in neonates with unconjugated hyperbilirubinemia receivingphototherapy.Study design and setting: Cross sectional study conducted at neonatal intensive care unit, King Abdullah Teaching Hospital,Mansehra for one year from December 2017 to November 2018.Methodology: Total 213 full term stable neonates of either gender with jaundice were studied in this study. Out of which,143 with unconjugated hyperbilirubinemia were exposed to phototherapy while 70 neonates with exaggerated physiologicalhyperbilirubinemia taken as control were not exposed to phototherapy. Serum calcium level was determined through bloodtest before and after 24 hours of phototherapy. SPSS version 22 was used to analyze the data. Frequency and percentageswere used to describe categorical variables like gender and hypocalcemia. Hypocalcemia was stratified by age and genderto see effect modifiers. Post stratified chi-square test was applied in which p value = 0.05 was considered as significancevalue.Results: In study group, 143 neonates who received phototherapy had mean age of 7 days ± 2.62 SD. Total 65% neonateswere male and 35% neonates were female. Mean serum calcium level of neonates before and after provision of phototherapywas 9.28 mg/dl ± 0.23 and 8.54 mg/dl ± 0.68 respectively, which is statistically significant. The frequency of hypocalcemiawas 40% in neonates with unconjugated hyperbilirubinemia after 24 hours of phototherapy.Conclusion: Hypocalcemia is an important complication in neonates with unconjugated hyperbilirubinemia after continuousphototherapy. Hypocalcemia has clinical impact and adds to morbidity, and if left untreated, can lead to mortality.


2021 ◽  
Vol 18 (2) ◽  
pp. 1-3
Author(s):  
Rajesh KC ◽  
Piush Kanodia

Introduction: Neonatal hyperbilirubinemia is seen mainly in the first week of life and in many of the cases it is only in physiological range which requires no intervention. Approximately 5-10% of them have clinically significant jaundice that requires phototherapy and even exchange transfusion. Phototherapy can produce various adverse effects; hypocalcaemia is one of the lesser known effects. So, estimation of calcium levels before and after phototherapy should be done in neonates with jaundice. Aims: The aim of this study is to determine hypocalcaemia, in neonates receiving phototherapy, by measuring serum calcium levels. Methods: This cross sectional study was conducted, from February 2020 to August 2020, on 50 neonates admitted in Neonatal Intensive Care Unit of Nepalgunj Medical College, Kohalpur with unconjugated hyperbilirubinemia requiring phototherapy. Serum calcium levels were evaluated before and after phototherapy. Neonates were assessed for clinical features of hypocalcaemia i.e. jitteriness, irritability/ excitability and convulsions. Data were analyzed using SPSS version 25.P value <0.05 was taken as significant. Results: Frequency of hypocalcaemia after phototherapy was 26%. There was significant change in serum calcium levels before and after phototherapy (p<0.01). Among hypocalcaemic neonates, 56% were symptomatic; 38% developed jitteriness, 18% developed irritability / excitability and none of them developed convulsions. Conclusion: Neonates undergoing phototherapy are at increased risk for hypocalcaemia. Monitoring for hypocalcaemia and its complications should be considered. However, universal recommendation of calcium supplementation is yet to be established but seems reasonable.


2020 ◽  
Vol 7 (8) ◽  
pp. 1772
Author(s):  
Anjali Vasant Kale ◽  
Pranoti Uttam Jadhao ◽  
Aashna Valecha ◽  
Sreelekha Kethepalli

Background: Neonatal Hyperbilirubinemia is one of the leading causes for admission in NICU in the first week of life. This condition if left untreated may lead to irreversible neurological damage hence increasing mortality and morbidity in newborns. Neonatal Hyperbilirubinemia is treated with phototherapy which employs blue wavelengths of light to change unconjugated bilirubin in the skin. The bilirubin is then converted to less toxic water-soluble photo-isomers that are excreted in the bile and urine. There are several toxic effects to the use of this treatment, one of them being hypocalcemia.Methods: This study has been done at Mahatma Gandhi Institute of Medical Sciences in 2016-2018 on 100 new-borns to prove the effect of phototherapy on serum calcium levels in neonates with hyperbilirubinemia. New-born who were admitted in NICU for Hyperbilirubinemia were screened according to inclusion and exclusion criteria, their sample for serum calcium and serum bilirubin levels were taken as pre and post phototherapy samples.Results: It was observed that the mean Serum calcium level before phototherapy in neonates was 9.31 mg/dl with standard deviation of 0.69 mg/dl. Whereas after phototherapy mean serum calcium level in neonates was 8.88 mg/dl with standard deviation of 0.73 mg/dl. There was statistically significant mean difference in serum calcium level at before and after phototherapy in neonates (p<0.0001).Conclusions: This study proves the hypothesis that phototherapy can cause hypocalcemia in neonates with hyperbilirubinemia.


Author(s):  
Laxmi Poonia ◽  
Swati Kochar ◽  
Shweta Chaudhary ◽  
Priyanka Gaur ◽  
Kirti Solanki

Background: Hypertensive disorders of pregnancy, including preeclampsia complicates about 10% of pregnancies worldwide. Preeclampsia is one of the major cause of maternal and perinatal morbidity and mortality worldwide. According to the National Health Portal of India, the incidence of preeclampsia is reported to be about 8-10% among pregnant women. The present study was aimed to compare mean serum calcium levels in preeclamptic and normotensive pregnant women at third trimester of gestation and assess relationship between maternal serum calcium levels, severity of disease and overall maternal and perinatal outcome.Methods: This was a cross sectional study conducted on 200 females divided into two groups (i.e. Study and Control Group) from 1st November 2019 to 31st October 2020. Informed consent was obtained for subjecting. Detailed history and clinical examination were performed. Serum calcium level was measured in both groups by spectrophotometric method.Results: Mean serum calcium level in study group (preeclamptic) was 7.84+0.74mg/dl while in control group (normotensive) mean serum calcium level was 9.68+0.97mg/dl. Serum calcium level was significantly lower in preeclamptic women than normotensive pregnant women (p<0.001).Serum calcium showed significant negative correlation with systolic and diastolic blood pressure.Conclusions: This study concludes that hypocalcaemia may have a role in aetiology of preeclampsia and adverse maternal and perinatal outcome. Thus intake of calcium supplements may help in reduction of incidence of preeclampsia especially in a population of a developing country. 


2018 ◽  
Vol 48 (1) ◽  
pp. 165-176
Author(s):  
Noor Sharifatul Hana Yeop ◽  
Zaleha Md Isa ◽  
Khadijah Shamsuddin ◽  
Khor Geok Lin ◽  
Zaleha Abdullah Mahdy ◽  
...  

Purpose The aim of this study is to determine the prevalence of hypocalcaemia among first-trimester pregnant women and its contributing factors. Design/methodology/approach A cross-sectional study was carried out among first-trimester pregnant women who were recruited during their first antenatal visit. A total of 396 respondents of age 18-40 years completed the self-administered questionnaire (socio-demographic, socio-economic, obstetric information), validated semi-quantitative food frequency questionnaire for calcium (FFQ-calcium), anthropometric measurements (weight and height) and blood test for serum calcium during their first trimester. Findings The prevalence of hypocalcaemia based on serum calcium level of less than 2.11 mmol/L was 26.0 per cent (n = 103). The median serum calcium level was 2.2 mmol/L (IQR, 25th and 75th percentile – 2.1 and 2.3, respectively). Milk intake of less than two glasses per day during pregnancy showed a twofold increase in developing hypocalcaemia (OR, 2.231; 95 per cent CI, 1.399, 3.588). Other than that, underweight (aOR, 2.038; 95 per cent SK, 1.088, 3.820) and obese before pregnancy (aOR, 1.954; 95 per cent SK, 1.007, 3.790) are also predictors of hypocalcaemia. Originality/value The prevalence of hypocalcaemia among first-trimester pregnant women in this study was 26.0 per cent. Intake of two or more glasses of milk per day can help prevent hypocalcaemia at this stage of pregnancy.


2013 ◽  
Vol 2 (1) ◽  
pp. 26-31
Author(s):  
Omid Dalfardi ◽  
Dariush Jahandideh ◽  
Gholam Hossein Ranjbar Omrani

Background: Obesity is caused by several factors while sedentary lifestyle and excessive energy intake are the most important ones. Obesity could be due to abnormal calcium metabolism, and a high calcium intake may prevent obesity. Studying serum calcium level, albumin, and triglyceride concentrations, we searched for probable correlation between serum calcium level and anthropometric data of the participants.Materials and Methods: This cross-sectional study was performed in 2011 in Shiraz Endocrine and Metabolism Research Center on 468 participants. Anthropometrics and serum levels of calcium, albumin, and triglyceride levels were measured, recorded, and analyzed by SPSS statistical software.Results: 329 participants were female (70.3%) and the remaining were male (29.7%) with mean age of 46.08 ±15.22 years old. Corrected plasma concentration of calcium based on albumin level had a significant relation with weight, BMI, and triglyceride levels.Conclusion: It is assumed that obesity induces the production of inflammatory cytokines which stimulates bone absorption by osteoclasts that might subsequently lead to a higher serum calcium level in obese people who have a high level of triglyceride at the same time.


2021 ◽  
Vol 8 ◽  
Author(s):  
Yang Hua ◽  
Heng-li Liu ◽  
Jin-Yu Sun ◽  
Xiang-Qing Kong ◽  
Wei Sun ◽  
...  

Background: Hypertension is a significant risk factor of cardiovascular diseases, posing a serious threat to global health. Calcium plays an important role in regulating body homeostasis. The association of calcium with hypertension remains uncertain in the general population.Methods and Results: Cross-sectional data from the 2007–2018 National Health and Nutrition Examination Survey (NHANES) were analyzed. Adjusted multivariable logistic regression analysis and restricted cubic spline were used to investigate the association of serum calcium with the prevalence of hypertension. A total of 26,778 participants were included. The increase in calcium levels showed a positive association with the prevalence of hypertension in all three models with ORs of 1.347 (1.249–1.454), 1.522 (1.401–1.654), and 1.438 (1.306–1.583). The further subgroup analysis demonstrated a robust trend across all categories by sex, age, race, BMI, and eGFR. The restricted cubic spline plot exhibited an S-curve relationship between calcium and hypertension.Conclusion: Our cross-sectional study demonstrated a positive association between higher serum calcium level and the prevalence of hypertension. Our findings highlighted serum calcium level in hypertensive patients.


2020 ◽  
Author(s):  
Arithi Mutembei ◽  
Festus K. Mutai ◽  
Damaris Mwololo ◽  
John Muriuki ◽  
Mark Obonyo ◽  
...  

AbstractIntroductionLeptospirosis is a neglected bacterial zoonotic infection caused by spirochetes of Leptospira genus. Humans get infected through direct or indirect contact with urine of infected animals or environment. It accounts for more than 300,000 severe cases annually worldwide with case fatality rates of over 30%. Costs of diagnosis and treatment for human and animals, disruption of international trade of animals and products, reduced productivity and reproductivity in animals constitute economic importance. In Kenya, leptospirosis burden is significant but under-diagnosis and under-reporting affects the awareness of the disease. This study aimed to determine and compare the sero-prevalence and factors associated with Leptospira spp. in the two counties.MethodsWe conducted a cross-sectional study that involved apparently healthy people of at least 5 years of age in randomly selected households in Garissa and Tana River Counties. Blood samples were collected and tested for Leptospira spp antibodies using IgM ELISA. Standardized structured questionnaires were administered to collect socio-demographic and exposure information. We calculated frequencies and proportions for categorical variables and odds ratios (OR) and 95% confidence interval (CI) to evaluate association between sero-positivity and exposure factors. We used Wilcoxon test to evaluate statistical difference in sero-positivity for continuous variables and calculated test statistic (H) and p-value.ResultsA total of 952 subjects were recruited into the study – these included 482 persons from Garissa and 470 from Tana River. The overall sero-prevalence was 26% [(244/952); (CI: 23% to 29%)]. Garissa County had significantly higher Leptospira spp. seroprevalence (31%, n = 147; CI: 27% to 35%) compared to Tana River County (21 %, n = 97; CI: 17% to 25%). Being a female (OR=1.6, CI: 1.2-2.2) and engaging in pastoralism (OR=2.7, CI: 1.8-3.9) were significantly associated with higher odds of Leptospira spp. seropositivity compared to being a male or working in irrigated areas. The mean altitude of residence of sero-positive patients was 73m ± 21 SD (standard deviation) above sea level and that for sero-negative was 80m ± 22 SD (H=35, p-value = 0.00).ConclusionThis study determined the seroprevalence and risk factors for Leptospira spp. exposure in Garissa and Tana River Counties, Kenya. Females in pastoral communities experience high burden of the disease. Enhanced surveillance in humans and animals and further research is required to understand the complex and multifactorial drivers of leptospirosis transmission in the two Counties.


2017 ◽  
Vol 8 (1) ◽  
pp. 16-20
Author(s):  
SN Chowdhury ◽  
N Sultana ◽  
AH Chowdhury ◽  
P Mazumder ◽  
N Sharmin ◽  
...  

Acute myocardial infarction (AMI) is a leading cause of morbidity and mortality worldwide. The incidence of AMI is dependent on certain traditional predisposing risk factors. In addition to the traditional risk factors, raised serum calcium level is also being considered as an associated factor for AMI. The aim of the study is to evaluate the association of serum calcium level with acute myocardial infarction in a tertiary level hospital in Bangladesh. This case control study was conducted in the Department of Biochemistry, Dhaka Medical College, Dhaka from January 2013 to December 2013. In this study, 50 diagnosed cases of AMI and 50 age and sex matched apparently healthy subjects were selected from DMCH purposively according to the selection criteria. Blood pressure, height and weight were measured and BMI was calculated. Biochemical parameters- serum calcium and fasting blood glucose in two groups were estimated in mmol/l. Then serum calcium was compared between two groups to observe the association with AMI. Results were analyzed statistically in SPSS version 17.0. Unpaired student's 't'-test and Spearman correlation analysis was done. All the results were expressed as mean ±SD and p value <0.05 was accepted as level of significance. Present study showed that serum calcium level was significantly higher(p=.001) in cases (2.61±.15 mmol/l) when compared with that of controls (2.13±.15mmol/l). Serum calcium also showed a significant positive correlation with AMI (rho=0.858, p=0.001).Findings of study concludes that increased serum calcium is associated with AMI.Bangladesh J Med Biochem 2015; 8(1): 16-20


2021 ◽  
Vol 9 (3) ◽  
pp. 154-159
Author(s):  
Dr. Sanjay Kumar Bharty ◽  
◽  
Dr. Jitendra Kishore Bhargava ◽  
Dr. Brahma Prakash ◽  
Dr. Vikas Patel ◽  
...  

Introduction: Respiratory physiotherapy is one of the therapeutic methods in various respiratoryviral infections. Breathing exercises with other interventions, could enhance the total lung capacityand symptom alleviation in patients with virus-related acute respiratory distress syndrome (ARDS).Aim: To study the clinical evaluation of the role of physiotherapy in hospitalised patients of covid-19diseases. Method: This was an Observational (prospective, cross-sectional) study. 187 patientswere recruited and diagnosed as COVID-19 as per RTPCR at NSCB Medical College, Jabalpur (MP).Patients were randomised into the physiotherapy group and controlled group. Patients in thephysiotherapy group were undergone positional changes, prone ventilation, Breathing exercise,Resistive training, Passive joint motion, Muscle stretching, Bedside standing training, enduranceexercise by a specialized physiotherapist. Mean cough severity index, MMRC grade, respiration rateand peripheral blood saturation were recorded before and after intervention and compared with thecontrolled group. Result: There was significant improvement found in MMRC grade and respirationrate after physical therapy in the physiotherapy group (p-value < 0.05). Exertional dyspnoea andcough severity index significant deceased in physiotherapy group. The positive change was found inperipheral blood saturation. There was decreased in hospitalization stay in the physiotherapy groupas compared to the controlled group. Conclusion: Our study revealed the positive effect ofphysiotherapy on covid-19 disease in terms of symptoms and hospitalization duration among thephysiotherapy group. Physiotherapy exerts a beneficial role in the management of the covid-19disease.


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