Objective: To determine accuracy of cord blood bilirubin in identifying significant neonatal hyperbilirubinemia. Methodology: A Cross sectional study was conducted in Pediatric department of Fauji Foundation Hospital Rawalpindi from Jan.2019 to June 2019. Cord blood samples were sent for the blood group and bilirubin levels. Neonates with cord bilirubin level > 2mg/dl and < 5 mg/dl were enrolled and admitted for 3 days and serum bilirubin level were done on 3rd day. Those developing significant hyperbilirubinemia were further investigated for hemoglobin, reticulocyte count, Coomb’s test and other causes. Results: Total 74 newborns at >35 weeks of gestation were included in the study of which 35 (47.3%) were male and 39 (52.7%) were female (male: female: 1:1.1). The data was analyzed using SPSS 17. At 3rd day of life mean ± SD cord blood bilirubin was 8.4 ± 2.7 mg/dl, mean direct bilirubin was 1.6 ± 0.9 mg/dl and mean indirect bilirubin was 6.8 ± 2.3mg/dl. Significant hyperbilirubinemia developed in 16 (21.6%) newborns at >35 weeks of gestation, who had a cord blood bilirubin level of > 2 mg/dl, so that the accuracy of cord blood bilirubin level (true positives) in determining significant hyperbilirubinemia was 21.6%. Conclusion: Cord blood bilirubin level >2mg/dl in all healthy term newborns predicts significant hyperbilirubinemia.
<p><strong>Background and Objective</strong>: The contagious and invasive nature has made coronavirus disease-19 (COVID-19) a critical health issue for the community. The lower respiratory tract is the major site of inflammation seen in COVID-19-positive individuals. Vitamin D (Vit D) has been proposed to have a positive role in immunomodulation, hence, this study aimed to determine the association between Vit D levels and the severity of COVID-19 in infected pediatric patients presenting at a secondary healthcare hospital in Pakistan.</p> <p><strong>Methods:</strong> This cross-sectional analytical study was conducted on 100 pediatric patients of the age range 1-18 years from March to December 2021. These patients were hospitalized and diagnosed with coronavirus disease with confirmed results on a real‐time reverse transcription-polymerase chain reaction. Blood samples of the patients were taken to monitor the baseline levels of markers of acute infection and Vit D levels. Patients with serum Vit D levels ≤ 20ng/ml were labeled with deficiency, those with levels 21-29ng/ml were presumed to have Vit D insufficiency whereas levels ≥30 ng/ml were considered normal.</p> <p><strong>Results:</strong> There were 57 (57%) males and 43 (43%) female pediatric patients. The mean age of the patients was 10.46 ± 4.25 years (1-18 years). The deficient Vit D level group had a greater frequency of pyrexia, weakness, cough, anosmia, headache, myalgia, and diarrhea. The levels of Vit D and severity of the disease were significantly associated (p-value = 0.027).</p> <p><strong>Conclusion: </strong>Pediatric patients with COVID-19 having optimum levels of Vit D were less likely to develop complications associated with the severity of the disease.</p>
Objective: To study the frequency of hypocalcemia in neonates receiving phototherapy with indirect hyperbilirubinemia Materials and Methods: Descriptive case series study was conducted from September 5, 2018, to March 5, 2019, in the NICU of the Paediatric Department Benazir Bhutto Hospital, Rawalpindi. Approval was sought from the hospital’s ethical committee. Neonates fulfilling inclusion criteria were enrolled in the study after obtaining informed consent from the parents. Before giving phototherapy, serum calcium levels were checked. Phototherapy was given for 48 hours. Serum calcium levels were reassessed after 48 hours of phototherapy. Data was entered on a structured proforma and statistical analysis of data was performed. Results: Out of 150 patients enrolled in the study 83(55.33%) were male and 67(44.67%) were female. The mean age of patients was 52.52 hours with minimum and maximum ages of 26 hours and 80 hours. The mean Indirect serum bilirubin level was 15.59 ± 2.36. A total of 50(33.33%) cases had hypocalcemia after 48 hours of phototherapy, all of these neonates had normal calcium levels before phototherapy. When hypocalcaemia was stratified for gestational age, birth weight and serum bilirubin levels at baseline, there was no significant difference in the frequency of hypocalcaemia concerning these effect modifiers. Conclusion: It is concluded that the frequency of hypocalcemia is higher in neonates with indirect hyperbilirubinemia after receiving phototherapy. One needs to be vigilant in dealing with neonates in this context, while serial measurements of calcium levels and monitoring for complications of hypocalcaemia should be included in every institution’s policy
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