scholarly journals Severe Perinatal Asphyxia and Risk of Neonatal Jaundice at a Tertiary Hospital in Northern Nigeria

2021 ◽  
pp. 17-22
Author(s):  
I. A. Imoudu ◽  
M. O. Yusuf ◽  
A. T. Aro ◽  
P. E. Akpabio ◽  
Z. M. Waziri
Keyword(s):  
Medical Records ◽  
Neonatal Jaundice ◽  
Serum Bilirubin ◽  
Perinatal Asphyxia ◽  
Tertiary Hospital ◽  
P Value ◽  
Community Based ◽  
Special Care Baby Unit ◽  
The Mean ◽  
The Relationship

Background: The risk factors of neonatal jaundice are largely known, yet there is little agreement on the association between it and perinatal asphyxia. Aim: To investigate the association between severe perinatal asphyxia (SPA) and the risk of clinical jaundice (NNJ) among neonates managed at the Federal Medical Centre, Azare, Nigeria. Methodology: Case control design was employed. Medical records of 315 babies managed at the special care baby unit from 1st January, 2011 to 31st December, 2018 were analysed. The exposure of interest was SPA and the outcome was jaundice. Logistic regression was applied to demonstrate the relationship between neonatal jaundice and SPA. Relative risk was provided as odds ratio and 95% confidence interval. Results: Sixty-three cases and 252 controls were enrolled in the study. The mean age of the cases (4.39) and that of the controls (4.95 ) did not differ significantly (t= -0.52, P= 0.30). One hundred and fifty-six (61.9%) of the controls were males while 34 (54.0%) of the cases were females. For 59 (93.7%) of the cases treatment for jaundice was done with phototherapy and 1.6% required exchange blood transfusion. SPA significantly reduced the risk of developing NNJ (adjusted OR = 0.27, P-value ˂ 0.01).                                                                           Conclusion: We demonstrated a significantly reduced risk of developing neonatal jaundice with prior exposure to severe perinatal asphyxia. Prospective multicenter and community based studies correlated with serum bilirubin levels are recommended.   

scholarly journals Factors associated with clinical outcomes among neonates admitted with acute bilirubin and hypoxic-ischaemic encephalopathies at a tertiary hospital in south-west Nigeria

2019 ◽  
Vol 61 (5) ◽  
pp. 30
Author(s):  
Olusoga Babatunde Ogunfowora ◽  
Tinuade Adetutu Ogunlesi ◽  
Victor Ayodeji Ayeni
Keyword(s):  
Serum Bilirubin ◽  
Social Issues ◽  
Perinatal Asphyxia ◽  
Tertiary Hospital ◽  
Social Challenges ◽  
Factors Associated ◽  
Bilirubin Encephalopathy ◽  
Retrospective Design ◽  
South West ◽  
The Relationship

Background: Babies who are delivered outside hospital are most at risk of serious illnesses such as perinatal asphyxia and severe hyperbilirubinaemia. These conditions are major contributors to neonatal mortalities in resource-poor settings.Objective: To explore the relationship between pre-admission and intra-facility care and immediate outcomes among neonates with acute bilirubin and hypoxic-ischaemic encephalopathies.Methods: Using a retrospective design, the outcome of outborn babies with acute bilirubin encephalopathy (ABE) and hypoxic-ischaemic encephalopathy (HIE) were studied in a Nigerian hospital between 2012 and 2016.Results: A total of 40 and 80 babies with ABE and HIE were studied. Among babies with ABE, 67.5% arrived at the hospital on self-referral and of the babies with official referral, only 61.5% had had a serum bilirubin check prior to referral. Among the babies with ABE, 25.0% had both social and facility-related challenges, 45.0% had only facility-related challenges and 20.0% had only social challenges. All the babies with ABE who died had either social or facility-related challenges. For the babies with HIE, 56.2% came on self-referral while 70% received no care prior to presentation at the hospital. Some 40% of babies with HIE had both social and facility-related challenges while 12.5% had only facility-related challenges. None of the babies who died presented early. Comparable proportions of babies who died or survived had social challenges and facility-related challenges.Conclusion: Most of the outborn babies with HIE and ABE who arrived at the hospital on self-referral and facility-based care were hindered by social issues and facility-related challenges.

Abstract P014: Lower eGFR and Proteinuria Were Independently Associated With Lower Cognitive Abilities in Community-dwelling Men in Japan: SESSA study

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Akira Fujiyoshi ◽  
Takayoshi Ohkubo ◽  
Katsuyuki Miura ◽  
Akihiko Shiino ◽  
Naoko Miyagawa ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Cognitive Abilities ◽  
Estimated Glomerular Filtration Rate ◽  
Subclinical Atherosclerosis ◽  
Community Dwelling ◽  
Community Based ◽  
Lower Egfr ◽  
The Mean ◽  
The Relationship

Introduction: The relationship between chronic kidney disease (CKD) and cognitive function remains to be determined. Existing studies focused primarily on estimated glomerular filtration rate (eGFR) but not proteinuria in relation to cognitive function. Hypothesis: In a community-based sample, lower eGFR and presence of proteinuria are cross-sectionally independently associated with lower cognition. Methods: The Shiga Epidemiological Study of Subclinical Atherosclerosis (SESSA) randomly recruited and examined participants from Shiga, Japan in 2006-08 at baseline. Among 824 male participants in the follow-up exam (2010-12), we restricted our analyses to those who underwent the Cognitive Abilities Screening Instrument (CASI), age ≥65 years-old, free of stroke, with no missing pertinent covariates. We calculated eGFR (creatinine-based) according to the 2012-guideline by the Japanese Society of Nephrology. We then divided the participants into three groups by eGFR of ≥60, 59-40, and <40 (mL/min/1.73m 2 ), and separately divided into three groups according to proteinuria using urine dipstick: (-), (-/+), and ≥(1+). We defined CKD as either eGFR <60 or proteinuria ≥ (-/+). In linear regression with CASI score being a dependent variable, we computed the score adjusted for age, highest education attained, smoking, drinking, body mass index, hypertension, diabetes, and dyslipidemia. Results: We analyzed 541 men. The mean [standard deviation] of age and unadjusted score were 72.6 [4.3] years and 89.7 [6.0]. Prevalence of CKD was 56%. The score was significantly lower in participants with CKD than those without it (P=0.03). eGFR and proteinuria categories were separately and jointly associated with lower CASI score in a graded fashion (Ps for trend <0.05 in all the models tested. Table 1 ). Conclusions: Lower eGFR and higher degree of proteinuria were independently associated with lower cognitive function in the community-based men. CKD even in its early phase may predispose to lower cognitive function.

scholarly journals A biochemical profile of cardiac involvement in perinatal asphyxia

2018 ◽  
Vol 5 (2) ◽  
pp. 328 ◽  
Author(s):  
Senthil Kumar P. ◽  
Durai Arasan G.
Keyword(s):  
Creatine Kinase ◽  
Cardiac Involvement ◽  
Predictive Accuracy ◽  
Perinatal Asphyxia ◽  
P Value ◽  
Perinatal Hypoxia ◽  
Specific Enzyme ◽  
Mortality And Morbidity ◽  
Significant Difference ◽  
The Mean

Background: Perinatal hypoxia is one of the leading causes of mortality and morbidity in developing countries like India, and even in developed countries. Perinatal hypoxia can result in Transient myocardial ischemia, tricuspid and mitral regurgitation, myocardial infarction, cardiac failure. The measurement of Creatine kinase -MB isoenzyme a cardiac specific enzyme helps in assessing the degree of myocardial involvement in asphyxiated infants.Methods: A Prospective case-control study was done in a Tertiary care centre serving rural areas predominantly, to determine the cardiac involvement by measuring serum MB isoenzyme of creatine kinase in perinatally asphyxiated inborn term babies for a period of six months.Results: There was a significant difference in the CK-MB values with regard to weight in both cases and controls. The mean CK-MB levels were higher in babies who had assisted delivery (forceps and breech) than those delivered by labour natural and LSCS. Mean CK-MB values of asphyxiated and controls were 133.8u/l and 27.12 u/l respectively with a p value of < 0.01. There was a significant difference between HIE1 and 3 with a p value of<0.02. Out of 60 cases 28 had abnormal ECG findings (46.6%). Statistically significant difference was found in the mean CK-MB between the normal and Grade4 ECG changes group. The overall predictive accuracy of CK-MB is high in Perinatal asphyxia (88%), Cardiac involvement (83%), Mortality (83%) and a moderate predictive accuracy for HIE (75%).Conclusions: Cardiac abnormalities in asphyxiated neonates are often underdiagnosed and requires high index of suspicion. Cardiac specific enzyme CK-MB helps in early recognition of myocardial damage and better management of cases, would reduce the neonatal mortality and morbidity. An expectant eye can be kept for complications in babies with markedly elevated CK-MB enzyme. 

A Comparison of Fluorescent and Nonfluorescent Light Sources for Phototherapy

PEDIATRICS ◽  
1980 ◽  
Vol 65 (4) ◽  
pp. 795-798 ◽  
Author(s):  
Joseph B. Warshaw ◽  
Jeryl Gagliardi ◽  
Anil Patel
Keyword(s):  
Serum Bilirubin ◽  
Newborn Infants ◽  
Radiant Flux ◽  
Light Sources ◽  
Halogen Lamp ◽  
The Mean ◽  
Additional Support ◽  
The Relationship ◽  
Tungsten Halogen Lamp ◽  
Practical Measure

We have compared fluorescent and nonfluorescent light sources for phototherapy for newborn infants with hyperbilirubinemia. Phototherapy was provided by a tungsten halogen lamp and conventional fluorescent lights with identical radiant flux of 6 µW/sq cm. For 22 infants treated with the nonfluorescent lamp the mean duration of phototherapy was 33.77 hours and the mean reduction of bilirubin was 3.84 mg/100 ml/day. This did not differ significantly from infants treated with conventional fluorescent lights. The nonfluorescent light can be utilized for infants in incubators or on radiant warmers. These results provide additional support for the relationship between radiant flux as a practical measure of phototherapy dose and the clinical response of a reduction in serum bilirubin.

95 Evaluating The Rate, The Predictors And The Outcomes Of Patients With Negative Appendectomy(NAR)

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
K Noureldin ◽  
A Ayantunde ◽  
M Elkholy ◽  
H S Shah Heer Shah ◽  
A Hatim
Keyword(s):  
Serum Bilirubin ◽  
Lower Abdominal Pain ◽  
Inflammatory Cells ◽  
Female Gender ◽  
P Value ◽  
Negative Appendectomy ◽  
Duration Of Symptoms ◽  
The Mean ◽  
Negative Appendicectomy ◽  
Definition Of

Abstract Introduction Appendectomy is associated with complications and negative appendicectomy. We evaluated the rate and predictors of NAR in a cohort. Method Patients' data who underwent emergency appendicectomies over a year was analysed. A definition of NA; absence of inflammatory cells in the appendix. The NAR was calculated using (NAR-SDC) and (NAR-STC). Leucocytosis was a total WBC &gt;11000/mm3, elevated CPR &gt;5 mg/L. Results 372 patients were included. Median durations of symptoms 2 days. The mean admission WBC, CRP and serum bilirubin levels were 12,600 (3000-38000)/mm3, 66.9 (1-323) mg/L and 12.7 (4-38) µmol/L respectively. Laparoscopic appendectomy was performed in 93.5% with a conversion rate of 4.6%.NAR-SDC was 10.2% and NAR-STC was 25.8%. NAR was higher in females than males (39.4% versus 11.1%; p-value 0.0001). Patients with NA were younger (p-value 0.0001), had lower WBC (p-value 0.014), CRP (p-value 0.0001) levels on admission. Female gender, duration of symptoms more than 3 days, lower WBC were found to be predictors of NAR. Conclusions NA is a problem in management of patients with acute right lower abdominal pain. Our NAR compared favourably with reported rates. Female gender, symptoms more than 3 days, lower WBC were predictors of NA.

Effect of Addition of Probiotics to Standard Treatment on Neonatal Jaundice

2021 ◽  
Vol 17 (2) ◽  
pp. 199-203
Author(s):  
Tehreem Afzal ◽  
Naveed Butt ◽  
Shahzad Munir ◽  
Nazish Zia
Keyword(s):  
Bilirubin Level ◽  
Neonatal Jaundice ◽  
Standard Treatment ◽  
Serum Bilirubin ◽  
Serum Bilirubin Level ◽  
Combination Group ◽  
Medical Institute ◽  
Significant Difference ◽  
The Mean ◽  
Time Required

Objective: To compare the mean change in the bilirubin levels with addition of probiotics to standard treatment for the management of neonatal jaundice. Methodology: The randomized controlled trial was undertaken at the Neonatal Intensive Care Unit of the Paediatrics Department, Federal Government Polyclinic (Post Graduate Medical Institute), Islamabad from 1st April to 30th September 2019.  Neonates with hyperbilirubinemia requiring phototherapy were randomly divided into two groups, each having 30 patients. Group A received probiotics along with phototherapy while group B received phototherapy alone. Primary outcome was serum total bilirubin, which was calculated on 0, 1 and 3 days of treatment. Duration of phototherapy and patient's outcome was also recorded. Data was analyzed statistically using SPSS v. 23. Results: The mean serum bilirubin level after 24 hours was 14.27 ± 4.35 mg/dl in combination group while 16.43 ± 4.36 mg/dl in phototherapy group (p > 0.05). After 48 hours, the mean serum bilirubin level was 12.37 ± 3.33 mg/dl in combination group while 14.09 ± 3.60 mg/dl in phototherapy group (p > 0.05). After 72 hours, the mean serum bilirubin level was 11.09 ± 2.87 mg/dl in combination group while 11.72 ± 2.96 mg/dl in phototherapy group (p > 0.05). The mean time required of blue light phototherapy was 43.47 ± 20.71 hours in combination group while 61.53 ±28.27 hours in phototherapy group (p < 0.05). All neonates were discharged. Conclusion: Addition of probiotics to standard treatment decreased the time required for the phototherapy in neonatal jaundice. However no statistically significant difference was seen in the bilirubin levels between the two groups.

Transcutaneous Bilirubin Measurements: Variation in Meter Response

PEDIATRICS ◽  
1983 ◽  
Vol 71 (3) ◽  
pp. 457-459
Author(s):  
M. JEFFREY MAISELS ◽  
CHERYL LEE
Keyword(s):  
Neonatal Jaundice ◽  
Serum Bilirubin ◽  
Full Term ◽  
Term Infants ◽  
Transcutaneous Bilirubin ◽  
Potential Variation ◽  
Screening Device ◽  
The Relationship

The transcutaneous bilirubin meter has been shown to be a useful screening device for the identification of significant neonatal jaundice in full-term infants.1-3 Investigators have, nevertheless, emphasized the necessity for each institution to establish the relationship between the transcutaneous bilirubin index, as measured with a particular instrument, and the serum bilirubin determination obtained from the institution's laboratory. 3 This is important, because of the known variation between laboratories in the measurement of serum bilirubin concentration4 and because no information has been published regarding the potential variation in the response of different transcutaneous bilirubin meters.

Effect of Backrest Elevation on the Development of Ventilator-Associated Pneumonia

2005 ◽  
Vol 14 (4) ◽  
pp. 325-332 ◽  
Author(s):  
Mary Jo Grap ◽  
Cindy L. Munro ◽  
Russell S. Hummel ◽  
R.K. Elswick ◽  
Jessica L. McKinney ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Medical Records ◽  
Pulmonary Infection ◽  
Severity Of Illness ◽  
Clinical Pulmonary Infection Score ◽  
Ventilator Associated Pneumonia ◽  
Entire Study ◽  
System Data ◽  
The Mean ◽  
The Relationship

• Background Ventilator-associated pneumonia is a common complication of mechanical ventilation. Backrest position and time spent supine are critical risk factors for aspiration, increasing the risk for pneumonia. Empirical evidence of the effect of backrest positions on the incidence of ventilator-associated pneumonia, especially during mechanical ventilation over time, is limited. • Objective To describe the relationship between backrest elevation and development of ventilator-associated pneumonia. • Methods A nonexperimental, longitudinal, descriptive design was used. The Clinical Pulmonary Infection Score was used to determine ventilator-associated pneumonia. Backrest elevation was measured continuously with a transducer system. Data were obtained from laboratory results and medical records from the start of mechanical ventilation up to 7 days. • Results Sixty-six subjects were monitored (276 patient days). Mean backrest elevation for the entire study period was 21.7°. Backrest elevations were less than 30° 72% of the time and less than 10° 39% of the time. The mean Clinical Pulmonary Infection Score increased but not significantly, and backrest elevation had no direct effect on mean scores. A model for predicting the Clinical Pulmonary Infection Score at day 4 included baseline score, percentage of time spent at less than 30° on study day 1, and score on the Acute Physiology and Chronic Health Evaluation II, explaining 81% of the variability (F=7.31, P=.003). • Conclusions Subjects spent the majority of the time at backrest elevations less than 30°. Only the combination of early, low backrest elevation and severity of illness affected the incidence of ventilator-associated pneumonia.

scholarly journals An unresolved issue: The relationship between spot urine protein-to-creatinine ratio and 24-hour proteinuria

2019 ◽  
Vol 47 (3) ◽  
pp. 1179-1184 ◽  
Author(s):  
Davut Akin ◽  
Sehmus Ozmen
Keyword(s):  
Medical Records ◽  
Urine Protein ◽  
Entire Study ◽  
Spot Urine ◽  
Protein Excretion ◽  
Ratio Data ◽  
Study Population ◽  
The Mean ◽  
The Relationship ◽  
H Protein

Objective To investigate the relationship between spot urine protein-to-creatinine (sP/Cr) ratio and 24-h protein excretion in patients with different diagnoses. Methods This retrospective study analysed data from the medical records of patients admitted for24-h proteinuria determination who also had sP/Cr ratio data for the same day. Results A total of 1222 urine samples obtained from 694 adult outpatients were analysed. The mean ± SD age of the patients was 53.6 ± 15.9 years. The mean ± SD 24-h proteinuria and sP/Cr were 1.7 ± 2.4 g/day and 1.8 ± 2.4, respectively. The correlation between the sP/Cr and 24-h protein excretion was high (R2 = 0.89). The sP/Cr ratio accounted for 72% of the variability in 24-h proteinuria in the entire study population. Areas under the curve for 24-h proteinuria at 0.3 g/day, 1.0 g/day and 3.0 g/day were 0.940, 0.966, and 0.949, respectively. The mean + 2SD limits of agreement were between +2.99 and –2.73 g/day according to the Bland Altman analysis. Conclusion This current study found a clinically unacceptable deviation between 24-h proteinuria and sP/Cr ratio. Therefore, the sP/Cr ratio cannot replace 24-h proteinuria. A new method using spot urine protein and creatinine values that is able to minimize under or over estimation is still warranted.

Rapid rituximab infusion is safe and well tolerated in malignant and benign disease

2020 ◽  
pp. 107815522097845
Author(s):  
Sorana G Ursu ◽  
Derek L Rinchuse ◽  
John Lister
Keyword(s):  
Medical Records ◽  
Malignant Disease ◽  
Benign Disease ◽  
P Value ◽  
Infusion Time ◽  
Benign Diseases ◽  
Secondary Objective ◽  
The Mean ◽  
The One ◽  
Related Reaction

Introduction Although the safety and feasibility of rapid rituximab administration has been demonstrated for B-cell malignancies, there is scant data in the literature to support its use in patients with benign diseases. Objective To identify the incidence of infusion-related reaction with rapid rituximab administration in malignant and benign disease. Secondary objective was to determine the infusion time saved between standard administration and rapid rituximab administration. Methods A retrospective cohort study was conducted by reviewing electronic medical records from December 2018 to April 2020. Adult patients who received at least one dose of rapid rituximab were included. Results A total of 63 patents were included. The incidence of an infusion-related reaction with rapid rituximab was 1.6%. The one patient who reacted had a diagnosis of neuromyelitis optica. The mean infusion time saved was 2.9 hours (95% CI: 2.7-3.1; P-value <0.001). Conclusion The use of the rapid rituximab administration is safe and well tolerated in both benign and malignant disease.

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