Background: Neonatal hyperbilirubinemia is one of the common entities that lead to frequent hospital admission of newborn. There are many risk factors that, when present, can lead to increased chances of neonatal hyperbilirubinemia. It is essential to identify these risk factors that are involved in the increased incidence of neonatal hyperbilirubinemia because its incidence can be decreased by modifying them. Objective: To compare and determine any correlation of 25-hydroxy vitamin D levels of newborn and their mothers with the serum bilirubin level of newborn. Methodology: This was a case–control study conducted in a tertiary care hospital on 100 newborn who were divided into two groups (50 in each group) on the basis of their serum bilirubin level on the 5th day of life. Newborns having serum bilirubin levels in the physiological range were included in the control group, and newborns having serum bilirubin levels out of the physiological range and who needed treatment were included in the case group. The blood samples of both newborns and their mothers were collected on the 5th day and sent to the laboratory for serum bilirubin and 25-hydroxy vitamin D estimation. Results: The mean serum vitamin D level of cases was found to be lower than that of controls in both newborn and their mothers. A statistically significant difference was noted only between the vitamin D level of newborn but not in mothers when cases and controls were compared. Negative, statistically insignificant correlation was seen between vitamin D level and serum bilirubin in cases and controls. However, correlation of the vitamin D level of cases and their serum bilirubin was statistically significant, with a correlation coefficient of −0.335 and a p value of 0.0172. Conclusion: Term healthy newborn having hyperbilirubinemia, with serum bilirubin levels out of the physiological range, have significantly low vitamin D levels and show a statistically negatively correlation with neonatal hyperbilirubinemia (which is out of the physiological range). Thus, decreased vitamin D can be included in the list of risk factors for neonatal jaundice.
Background : Febrile seizures are associated with a lot of modifiable and nonmodifiable risk factors. Extensive research is currently going on to discover more and more risk factors of febrile seizures, so that they can be modified to decrease their incidence and recurrence. Aims and Objectives : The aim of this study was to determine the status of 25-hydroxy vitamin D in children presented with simple febrile seizures and to find its correlation with recurrence of seizures. Materials and Methods : This prospective observational study was conducted on 223 children of age group 7–59 months who presented with simple febrile seizures. 25-hydroxy vitamin D were sent to laboratory for quantitative estimation. All data were recorded, status of vitamin D in these children was analyzed, and statistical significance of correlation of vitamin D with the number of recurrent seizure episodes was derived. Statistical Analysis : The comparison among groups was carried out by analysis of variance and correlation was conducted by Pearson’s correlation analysis. A value of P < 0.05 was considered statistically significant. Results : 25-hydroxy vitamin D insufficiency was present in 43.5% of the children, deficiency in 30.85 %, and normal level in 25.56% of children who had simple febrile seizures. Majority of the children presented with recurrent episodes of seizures had vitamin D deficiency followed by insufficiency and normal level. Comparison of Vitamin D showed significant negative correlation (As vitamin D level increases frequency of seizure febrile seizure recurrence decreases and vice versa) with recurrence of simple febrile seizures. Conclusion : Deficiency of vitamin D is associated significantly with simple febrile seizures and their recurrence is negatively correlated with it.
Background Early discharge of healthy term newborns after delivery has become a common practice, because of medical and social reasons, as well as economic constraints. Thus, the recognition, follow-up, and early treatment of jaundice has become more difficult as a result of early discharge from the hospital. Since the dreaded complication of neonatal hyperbilirubinemia is kernicterus, an investigation which can predict the future onset of neonatal pathological jaundice is needed. Objective To investigate the predictability of neonatal hyperbilirubinemia by using cord blood bilirubin, albumin and bilirubin/albumin ratio. Methods This study was conducted on 300 healthy newborns. Umbilical cord blood was used to measure albumin and bilirubin. All infants were regularly followed up to 5th day of life. Neonates were divided into two groups: group A was consisted of neonates who developed jaundice which was in physiological range, while group B was consisted of neonates who developed neonatal hyperbilirubinemia (requiring phototherapy or other modality of treatment). Babies suspected to have bilirubin level which cross physiological limit on any day after birth were subjected to serum bilirubin measurement. Infants whose serum bilirubin level measurement revealed bilirubin levels crossing physiological values were sent to nursery for phototherapy. Results The incidence of neonatal hyperbilirubinemia was 11%. Statistically significant correlations between cord blood bilirubin, albumin, and bilirubin/albumin ratio to the development of neonatal hyperbilirubinemia were observed. On ROC analysis, cut-off points to predict significant hyperbilirubinemia in newborn were cord blood bilirubin >3 mg/dL (sensitivity 60.61%, specificity 97.63%), albumin <2.4 mg/dL (sensitivity 78.79%, specificity 98.13%), cord blood bilirubin/albumin ratio >0.98 (sensitivity 78.79%, specificity 95.51%). Conclusion Cord blood total bilirubin, albumin. and bilirubin/albumin ratio are excellent parameters to predict the occurrence of neonatal hyperbilirubinemia. However, cord blood albumin is better compared to cord blood bilirubin and bilirubin/albumin ratio.
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