Cause Of Jaundice Research Articles

Analysis of Ethnopharmaceutical Studies of Traditional Medicine for the Management of Jaundice Due to Hepatic Disorders by the Mandar Tribe of West Sulawesi, Indonesia

Jaundice, or icterus, is a medical condition characterized by yellowing of the skin and whites of the eyes. This is caused by a buildup of bilirubin in the blood, which is a waste product of the breakdown of red blood cells. Liver disorders, such as hepatitis, are the most common cause of jaundice. The Mandar tribe in West Sulawesi Indonesia has a traditional healing tradition that has been passed down from generation to generation. This traditional medicine is often used to treat various diseases, including jaundice. This study aims to analyze the ethnopharmaceutical traditional treatment for jaundice in the Mandar tribe in West Sulawesi. This research used a descriptive observational method with traditional healthcare respondents. Data was collected through interviews and observations of traditional healers and patients who used traditional medicine. The data was analyzed descriptively to determine the type of plant, part of the plant used, processing methods, and how traditional medicines are used. This research found 14 plant species from 13 families that were used as medicine for jaundice. Two types of plants are typically used by the Mandar tribe, namely lapo-lapo (Melanolepis multiglandulosa) and barorang (Blumea balsamifera). The parts of the plant most commonly used as medicine are leaves (43%), followed by fruit (29%), stems (14%), roots (7%), rhizomes (4%), and herbs (3%). Plant processing by pressing and boiling is the most widely used (50% each). The most common method of use is boiling (70%), followed by pounding (20%) and eating directly (10%). This research found 14 plant species from 13 families that were used by the Mandar tribe as medicine for jaundice. Two types of plants are typically used, namely lapo-lapo and barorang. This research provides important information about the Mandar tribe's ethnopharmacology for jaundice and can be a basis for the development of more effective and safer traditional medicines.

Common bile duct polyp: an infrequent cause of jaundice and biliary obstruction.

Common bile duct polyp: an infrequent cause of jaundice and biliary obstruction.

Structural basis for the modulation of MRP2 activity by phosphorylation and drugs

Multidrug resistance-associated protein 2 (MRP2/ABCC2) is a polyspecific efflux transporter of organic anions expressed in hepatocyte canalicular membranes. MRP2 dysfunction, in Dubin-Johnson syndrome or by off-target inhibition, for example by the uricosuric drug probenecid, elevates circulating bilirubin glucuronide and is a cause of jaundice. Here, we determine the cryo-EM structure of rat Mrp2 (rMrp2) in an autoinhibited state and in complex with probenecid. The autoinhibited state exhibits an unusual conformation for this class of transporter in which the regulatory domain is folded within the transmembrane domain cavity. In vitro phosphorylation, mass spectrometry and transport assays show that phosphorylation of the regulatory domain relieves this autoinhibition and enhances rMrp2 transport activity. The in vitro data is confirmed in human hepatocyte-like cells, in which inhibition of endogenous kinases also reduces human MRP2 transport activity. The drug-bound state reveals two probenecid binding sites that suggest a dynamic interplay with autoinhibition. Mapping of the Dubin-Johnson mutations onto the rodent structure indicates that many may interfere with the transition between conformational states.

Vaccination coverage and adverse events following a reactive vaccination campaign against hepatitis E in Bentiu displaced persons camp, South Sudan.

Hepatitis E (HEV) genotypes 1 and 2 are the common cause of jaundice and acute viral hepatitis that can cause large-scale outbreaks. HEV infection is associated with adverse fetal outcomes and case fatality risks up to 31% among pregnant women. An efficacious three-dose recombinant vaccine (Hecolin) has been licensed in China since 2011 but until 2022, had not been used for outbreak response despite a 2015 WHO recommendation. The first ever mass vaccination campaign against hepatitis E in response to an outbreak was implemented in 2022 in Bentiu internally displaced persons camp in South Sudan targeting 27,000 residents 16-40 years old, including pregnant women. We conducted a vaccination coverage survey using simple random sampling from a sampling frame of all camp shelters following the third round of vaccination. For survey participants vaccinated in the third round in October, we asked about the onset of symptoms experienced within 72 hours of vaccination. During each of the three vaccination rounds, passive surveillance of adverse events following immunisation (AEFI) was put in place at vaccination sites and health facilities in Bentiu IDP camp. We surveyed 1,599 individuals and found that self-reported coverage with one or more dose was 86% (95% CI 84-88%), 73% (95% CI 70-75%) with two or more doses and 58% (95% CI 55-61%) with three doses. Vaccination coverage did not differ significantly by sex or age group. We found no significant difference in coverage of at least one dose between pregnant and non-pregnant women, although coverage of at least two and three doses was 8 and 14 percentage points lower in pregnant women. The most common reasons for non-vaccination were temporary absence or unavailability, reported by 60% of unvaccinated people. Passive AEFI surveillance captured few mild AEFI, and through the survey we found that 91 (7.6%) of the 1,195 individuals reporting to have been vaccinated in October 2022 reported new symptoms starting within 72 hours after vaccination, most commonly fever, headache or fatigue. We found a high coverage of at least one dose of the Hecolin vaccine following three rounds of vaccination, and no severe AEFI. The vaccine was well accepted and well tolerated in the Bentiu IDP camp community and should be considered for use in future outbreak response.

Alterations in the Gut Microbiota in Chinese Patients With Intrahepatic Cholestasis of Pregnancy

Intrahepatic cholestasis of pregnancy (ICP) is a pregnancy‐specific liver disease and the second most frequent cause of jaundice in pregnancy, but the etiology of it is poorly understood. By collecting blood and fecal samples from 12 healthy pregnant women (CON group) and 32 ICP patients (ICP group) in China, we performed 16s rRNA gene sequencing and analyzed microbial diversity. The results showed a decrease in species richness of the ICP group compared to that in the CON group, with a significant difference in species diversity between the two groups. Differential analysis revealed the following biomarkers: s__unclassified__Megamonas, g__Megamonas, f__Selenomonadaceae, c__Bacilli, and o__Lactobacillales. Importantly, we found a decrease in species richness of Selenomonadaceae at the family level and decreased bacilli at the class level in ICP patients. Correlation network analysis and functional gene prediction were performed accordingly. Our data provided new information linking microbiota and ICP, and are possibly helpful for further exploration of the disease.

Icterícia em gatos: causas e resultados post-mortem em 44 casos

ABSTRACT: The aim of this study was to describe the pathological findings and causes of jaundice in 44 cats (Felis catus) over a six-year period. The cats were from two Brazilian metropolitan areas: 34.1% were female, 56.8% were male, and 9.1% had no information regarding their sex. Their ages ranged from 6 months to 13 years. Most of the cats examined were of a mixed breed (40/44), whereas the others were Angora (2/44), Oriental Short Hair (1/44) and Persian (1/44). All animals had mild to marked jaundice, and 39 were diagnosed with mild to marked anemia. The classification of icterus types (pre-hepatic, hepatic and post-hepatic) was based on gross and microscopic findings. Of the 44 animals, 10 were classified as pre-hepatic icterus, 33 with hepatic icterus and seven with post-hepatic icterus. In some cats, two types of icterus were found, of which five were classified as pre-hepatic and hepatic icterus, and one case was hepatic and post-hepatic icterus. According to the gross and microscopic findings, the cause of pre-hepatic icterus was idiopathic hemolytic anemia. The most frequent cause of hepatic icterus was hepatic lipidosis (26/44), followed by perihepatitis and hepatitis compatible with feline infectious peritonitis, lymphoma, glycogenic degeneration, cholangiocarcinoma and metastatic myeloid leukemia. In animals with post-hepatic icterus, the causes included cholangitis due to Platynosomum spp. infection, cholangioma of the common hepatic duct, and chronic cholangitis. Understanding the etiopathogenesis of jaundice requires an accurate clinic-pathological study and concomitant causes of the disease in cats should be considered.

Exchange Transfusion in Neonatal Hyperbilirubinemia: Experience of A Tertiary Care Hospital in Dhaka

Background: Hyperbilirubinaemia is a benign condition in newborn babies in some infants may become severe, progressing to kernicterus with substantial risk of neonatal mortality and long-term neurodevelopmental impairments. Among many treatment options exchange transfusion (ET) is the standard method for treatment of severe hyperbilirubinemia.
 Objectives: To investigate the frequency of primary risk factors for neonatal hyperbilirubinemia leading to ET, to evaluate the complications and immediate outcome of ET.
 Methods: This was an observational cross sectional study conducted in Dr. MR Khan Shishu Hospital and ICH, Dhaka. Frequency of primary risk factors for severe neonatal hyperbilirubinemia leading to ET, characteristics of babies undergoing ET, complications and immediate outcome of ET were analyzed among the neonates admitted between January 2017 to February 2021.
 Results: Among 61 neonates 49.18% were male and 50.82% were female, 65.57% of neonates were term and 34.43% pre term. The mean gestational age was 37.00 ± 1.50 weeks and mean birth weight was 2619±50gm. The leading causes of jaundice requiring ET were sepsis 31.17%, ABO incompatibility 24.59%, Rh incompatibility 14.75%, PT LBW with sepsis 14.75%, Infant of diabetic mother (IDM) 6.55%, PT LBW 6.55%, and neonatal sepsis with Down syndrome with congenital hypothyroidism 1.63%. Twenty (32.79%) neonates presented with signs of Kernicterus. Seven neonates (35%) presented with lethargy/poor feeding or hypotonic posture, 4(20%) patients had opisthotonus posture/hypertonia, and 9(45%) had convulsion. Nineteen (31.14%) neonates had complications related to ET. The most frequent complication was bradycardia (16.34%), then Catheter block (9.83%), apnaea (6.55%), cardiac arrest (6.55%), hypothermia (4.92%), NEC after ET (1.64%). Immediate outcome was good in 72.13% patients with smooth recovery, 14.75% had neurological deficit and 1.64% died. Among 20 neonates who presented with signs of Kernicterus 35% patients discharged with good recovery, 45% had neurological deficit.
 Conclusion: The common causes of exchange transfusion in neonatal jaundice were sepsis, ABO incompatibility, PT LBW, and infants of diabetic mothers. Overall outcome was good few developed neurological deficit.
 DS (Child) H J 2022; 38(2): 89-95

Implementasi Metode Tsukamoto Pada Sistem Pakar Diagnosa Kernikterus

Kernicterus is brain damage in infants due to high levels of bilirubin in the blood. Bilirubin is the cause of jaundice, and if left untreated, it can accumulate in the brain. The issue at hand is that the community, especially parents, still struggle to find a solution to determine the diagnosis of Kernicterus in a baby's body. Expert systems are advanced technology that can be used to address diagnostic problems with relevant accuracy. One of the expert system methods that can be employed for diagnosing diseases is Tsukamoto. Therefore, in this research, a expert system is built to obtain a Kernicterus diagnosis with relevant accuracy by implementing the Tsukamoto method to address the issues faced by patients. The results of this research show that testing the Tsukamoto method for diagnosing Kernicterus provides good accuracy. Hence, it can be concluded that implementing the Tsukamoto method in an expert system can be a solution to address the Kernicterus diagnosis problem

Advances in research on the clinical phenotype and genetic etiology of jaundice associated with Hereditary bilirubin metabolic disorders

Hereditary bilirubin metabolic disorder is an important cause for jaundice. For its diverse types and similar clinical manifestations, it has been difficult to make a clear etiological diagnosis. The application of next generation sequencing in recent years has delineated the more and more genetic etiologies for jaundice. This article has reviewed the clinical manifestations and genetic etiology of bilirubin metabolic disorder jaundice, with an aim to enhance the understanding of such diseases and facilitate their clinical diagnosis and treatment, which will provide a reference for genetic counseling and/or prenatal diagnosis for the affected individuals and families.

Brief overview of Jaundice and its Current treatment options

The sickness of jaundice is intricate. The cause of jaundice is a high bilirubin level in the body. Jaundice commonly manifests as skin, mucous membranes, and skin that are yellow. Pre-hepatic jaundice is caused by hemolysis of red blood cells, hepatic jaundice is caused by a problem with the liver's ability to collect, conjugate, and excrete bilirubin, and post-hepatic jaundice is caused by the obstruction of the extra hepatobiliary system.When bilirubin is metabolised, red blood cells (RBCs) go through hemolysis and release haemoglobin as a result. Heme is broken down by the heme oxygenase in the reticuloendothelial system into biliverdin and carbon monoxide. Then, biliverdin is converted into unconjugated bilirubin by the enzyme biliverdin reductase. Jaundice typically manifests as extreme weakness, fever and a headache, decrease in appetite, extremely constipated, Nausea, urine, tongue, skin, and eyes that are all yellow, dull discomfort near the liver.In the entire world, liver disease is one of the leading causes of illness and mortality. The total number of liver disease-related deaths in India reached 2.95%, per W.H.O. data released in 2017. One in five Indians may have a liver disorder.The aetiology, causes, symptoms, and combination therapy of jaundice are covered in this review study.

Hepatobiliary and pancreatic: Tiny pigmented intra-hepatic ducts stones as the cause of jaundice and liver failure.

Hepatobiliary and pancreatic: Tiny pigmented intra-hepatic ducts stones as the cause of jaundice and liver failure.

Exploring the Educational Value of Popular Culture in Web-Based Medical Education: Pre-Post Study on Teaching Jaundice Using "The Simpsons".

The potential of popular culture as a tool for knowledge delivery and enhancing engagement in education is promising but not extensively studied. Furthermore, concerns exist regarding learning fatigue due to increased reliance on videoconferencing platforms following the COVID-19 pandemic. To ensure effective web-based teaching sessions that maintain attention spans and enhance understanding, innovative solutions are necessary. This study aims to evaluate the use of specific popular culture case studies to enhance student engagement in a web-based near-peer teaching session. We delivered a web-based teaching session to undergraduate medical students in the United Kingdom. The session included clinical vignettes and single-best-answer questions using characters from "The Simpsons" television show as patient analogies for various causes of jaundice. A pre-post survey, employing a 7-point Likert scale, was distributed to gather data from participants. A total of 53 survey responses were collected. Participants reported significantly improved understanding of jaundice after the session compared to before the session (median 6, IQR 5-6 vs median 4, IQR 3-4.5; P<.001). The majority of participants agreed that the inclusion of "The Simpsons" characters enhanced their knowledge and made the teaching session more memorable and engaging (memorability: median 6, IQR 5-7; engagement: median 6, IQR 5-7). When appropriately integrated, popular culture can effectively engage students and improve self-perceived knowledge retention. "The Simpsons" characters can be used pedagogically and professionally as patient analogies to deliver teaching on the topic of jaundice.

Reviewing the Compounding Risks for Tuberculosis Drug-Induced Liver Injury in a Patient with Transfusion Dependent Thalassaemia

A patient presents with jaundice three weeks into commencement of anti-tuberculosis therapy (ATT). Tuberculosis drug-induced liver injury (TB-DILI) is a main concern in patients commencing ATT. Studies have reported various risk factors associated with TB-DILI, urging vigilance in monitoring liver enzymes in these patients. We aim to review the causes of jaundice in a patient with transfusion dependent thalassaemia commenced on ATT and highlight the risk factors associated with TB-DILI.

Implementation of neonatal phototherapy with the BiliCocoon Bag® device in the maternity ward and impact on mother–infant separation

BackgroundFree bilirubin jaundice is a frequent pathology in the neonatal period. The major complication is neurological toxicity, the most severe form of which is kernicterus. Overall, 5%–10% of jaundiced neonates require treatment. The first-line treatment is phototherapy, with intensive phototherapy being the gold standard. Other equipment is also available, including the BiliCocoon Bag®. It is a safe and controlled therapy that can be performed in the mother's room in the maternity ward, thereby avoiding separation and allowing for breast- or bottle-feeding during treatment. It is easy to install and does not require protective glasses, thus no scope or hospitalization. In our maternity ward, all neonates requiring intensive phototherapy are hospitalized in the neonatology ward. ObjectiveThe objective of our study was to evaluate the number of avoided hospitalizations in neonatology for free bilirubin jaundice since the introduction, according to a strict protocol, of the BiliCocoon Bag® device. Material and MethodThis was a single-center retrospective cohort study using data of newborns usually collected as part of standard care. Children born in our maternity ward during an 18-month period (August 1, 2020 to January 31, 2022) were included. Causes of jaundice, age at the beginning and mode of treatment, number of sessions for each device, and length of stay were compared. Results are presented as number and percentage with median (25th–75th) or mean (extremes) values for categorical and continuous variables, respectively. A t-test was used to compare the means of the independent groups. ResultsA total of 316 newborns were included. Physiological jaundice was the main cause of jaundice. The median age for the first phototherapy treatment was 54.5 h (30–68). The 316 neonates needed 438 phototherapy sessions: 235 (74%) neonates required only one phototherapy session, 85 (36%) of them were treated with the BiliCocoon Bag®. For the 81 children who needed two or more phototherapy sessions, 19 children (23.5%) were treated by tunnel phototherapy and then the BiliCocoon Bag®, and eight children (10%) by BiliCocoon Bag® alone. The BiliCocoon Bag® enabled a relative reduction in the hospitalization rate of 38% and avoided hospitalization for approximately one third of the newborns treated. The BiliCocoon Bag® failure rate was 3.6% and the average length of stay was comparable between the two types of treatment. ConclusionFollowing a strict protocol of use, the BiliCocoon Bag® is a reliable method and a good alternative to intensive phototherapy for newborns in the maternity ward, as it avoids hospitalization and mother–infant separation.

Clinical Profile, Laboratory Parameters &amp; Complications in Pregnancy with Jaundice: A Study in DMCH, Dhaka, Bangladesh

Background: Pregnancy with jaundice is considered a high-risk pregnancy. It is the most usual health complaint in pregnant women found more often in developing countries than in developed ones. Jaundice can be concurrent with 1st trimester due to pathological infection for instance viral hepatitis or gall stones or due to the drug administered during pregnancy. These patients may feel better if initial diagnosis and suitable management are provided. This present study intended to evaluate the clinical profile &amp; complications of jaundice during pregnancy. Material &amp; Methods: This descriptive cross-sectional study was conducted in the Department of Obstetrics and Gynecology, Dhaka Medical College Hospital, Dhaka, Bangladesh from January 2012 to June 2012. A total (N=50) of pregnant women with symptoms of jaundice were enrolled in the study. Completed data forms were reviewed, edited, and processed for computer data entry. The data analysis was performed using Statistical Package for the Social Sciences (SPSS) Version 16.0. Descriptive inferential statistics were performed to determine the results of this study. Results: Among the study population (N=50), the majority of patients (34, 68.0%) age were between 20 to 24 years. The mean gestational age of patients was 35.3±3.2 weeks and twelve patients (12, 24.0%) underwent caesarean delivery. Based on clinical features, twenty-seven respondents (27, 54.0%) had mild jaundice, fourteen respondents (14, 28.0%) had moderate jaundice &amp; about one-fifth of the patients (9, 18.0%) had severe jaundice. Fifteen pregnant (15, 30.0%) women had a fever, around two-fifth of the patients (19, 38.0%) had vomiting, pruritus in one patient (1, 2.0%), vaginal bleeding in twelve patients (12, 24.05), &amp; more than half of the patients (27, 54.0%) had ruptured membrane. The causes of jaundice during pregnancy were viral hepatitis in forty-three patients (43, 86.0%). The majority of the patients (27,54.0%) had serum bilirubin less than 10mg, fourteen patients (14,28.0%) had 10 to 15mg of serum bilirubin &amp; only one patient (1,2.0%) had serum bilirubin more than 20mg. SGOT &amp; SGPT was found 100-500 IU/ml in twenty-three patients (23,46.0%) &amp; 500-1000 IU/ml in ten patients (10,20.0%). Alkaline was raised in eighteen cases (18, 36.0%) Based on maternal complications, the majority of patients (31, 62.0%) had a postpartum haemorrhage, and ten patients (10, 20.0%) experienced encephalopathy. Thirty-eight babies (38, 76.0%) were born alive, intrauterine death was in seven cases (7, 14.0%), and stillborn in five cases (5, 10.0%). Conclusion: Hepatitis E was the most common cause of viral hepatitis in our study. Major complications were postpartum haemorrhage and encephalopathy. This study also prevailed, jaundice in pregnancy is related to an increase in maternal mortality and morbidity, obstetric complications, and perinatal complications.

Demographic and Clinical Profile Analysis of Acute Viral Hepatitis: An Ultra-Sonographic Evaluation in Bangladesh

Background: Acute viral hepatitis (AVH) is a major public health issue throughout the world which affecting millions of people in every year. Clinical features of AVH may vary from asymptomatic to hepatitis, liver failure, cirrhosis and even cancer. The role of ultrasound in acute viral hepatitis (AVH) is limited to exclude the surgical causes of jaundice. A clear concept on the demographic and clinical profile of acute viral hepatitis may be helpful in the treatment procedure of this disease. Aim of the study: The aim of this study was to analyze the demographic and clinical profile of acute viral hepatitis patients based on sonographic findings. Methods: This was a prospective observational study which was conducted in the Department of Gastroenterology, US-Bangla Medical College &amp; Hospital, Dhaka, Bangladesh during the period from January 2019 to December 2019. Along with other diagnosis, ultrasonography was considered as principal diagnosis for the inclusion of study subjects. As per the exclusion criteria of this study, patients detected to have HBV infection or with gall stone were excluded from the study. Sonographic data were collected and tabulated in an Excel sheet and was analyzed using IBM-SPSS version 22.0 to determine the means and proportions. Chi‑squared test was done to compare the ultrasound findings. P&lt;0.05 were considered to indicate a statistically significant difference. Results: In this study, among majority of our participant’s spleen was found as normal in size which was in 96% cases. In only 4% cases splenomegaly was found. In the final ultrasonogram report of our participants we observed that, among a good number of patients, hepatomegaly, GBW thickening and contracted GB were found which were in 79%, 75% and 56% cases respectively. Besides these, porta nodes, splenomegaly and periportal cuffing were associated in 35%, 15% and 13% cases respectively. Conclusion: The ultrasonographic findings of hepatomegaly, contracted gallbladder, .......

Identification and Quantification of Jaundice by Trans-Conjunctiva Optical Imaging Using a Human Brain-like Algorithm: A Cross-Sectional Study.

Jaundice is caused by excess circulating bilirubin, known as hyperbilirubinemia. This symptom is sometimes caused by a critical hepatobiliary disorder, and is generally identified as yellowish sclera when bilirubin levels increase more than 3 mg/dL. It is difficult to identify jaundice accurately, especially via telemedicine. This study aimed to identify and quantify jaundice by trans-conjunctiva optical imaging. Patients with jaundice (total bilirubin ≥3 mg/dL) and normal control subjects (total bilirubin <3 mg/dL) were prospectively enrolled from June 2021 to July 2022. We took bilateral conjunctiva imaging with a built-in camera on a smartphone (1st generation iPhone SE) under normal white light conditions without any restrictions. We processed the images using an Algorithm Based on Human Brain (ABHB) (Zeta Bridge Corporation, Tokyo, Japan) and converted them into a hue degree of Hue Saturation Lightness (HSL) color space. A total of 26 patients with jaundice (9.57 ± 7.11 mg/dL) and 25 control subjects (0.77 ± 0.35 mg/dL) were enrolled in this study. The causes of jaundice among the 18 male and 8 female subjects (median age 61 yrs.) included hepatobiliary cancer (n = 10), chronic hepatitis or cirrhosis (n = 6), pancreatic cancer (n = 4), acute liver failure (n = 2), cholelithiasis or cholangitis (n = 2), acute pancreatitis (n = 1), and Gilbert's syndrome (n = 1). The maximum hue degree (MHD) optimal cutoff to identify jaundice was 40.8 (sensitivity 81% and specificity 80%), and the AUROC was 0.842. The MHD was moderately correlated to total serum bilirubin (TSB) levels (rS = 0.528, p < 0.001). TSB level (≥5 mg/dL) can be estimated by the formula 21.1603 - 0.7371 × 56.3-MHD2. In conclusion, the ABHB-based MHD of conjunctiva imaging identified jaundice using an ordinary smartphone without any specific attachments and deep learning. This novel technology could be a helpful diagnostic tool in telemedicine or self-medication.

A patient with acute fatty liver of pregnancy (AFLP) with acute pancreatitis manifestations

Background: Liver disease in pregnancy can be related to the process of pregnancy (liver disease of pregnancy) or not associated with pregnancy (liver disease in pregnancy). Acute fatty liver of pregnancy (AFLP) is a rare but life-threatening cause of jaundice in the third trimester of pregnancy and early postpartum period which in most cases no definitive risk factors are found. In this case report, we report a patient with AFLP with acute pancreatitis manifestations. Case presentation: A 33-year-old woman referred to the Dr Soetomo General Academic Hospital, Surabaya, Indonesia with diagnosis of day-4 post-section caesarian (SC) accompanied by ileus paralytic, obstructive jaundice hypoalbuminemia hyperbilirubinemia, acalculi cholecystitis, acute kidney injury (AKI) with dd acute on chronic kidney disease (ACKD), suspect pneumonia, and sepsis. Indications for SC were premature rupture of membrane (PROM). The patient initially complained of yellow body and eyes 10 days before delivery with additional complaints including tea-colored urine and brown feces. Chest x-ray results showed infiltrates on the right paracardial suggesting pulmonary inflammation. Abdominal x-rays showed normal result. Abdominal ultrasound results suggested acalculi cholecystitis, however, liver, lien, pancreas, kidney right and left, urinary bladder, uterus, adnexa right and left showed no abnormality. The patient was treated with intravenous fluids, nasogastric insertion for nutrition, analgesics and antibiotics and other symptomatic therapy. The patient was discharged after 20 days of treatment. Conclusion: This case highlights a potentially fatal complication of AFLP case with acute pancreatitis manifestations and the need of rapid diagnosis and comprehensive management to avoid the complicaton and death.

Computer-Aid System for Automated Jaundice Detection

At the beginning of their lives, newborns may have a widespread condition known as Jaundice or Hyperbilirubinemia. High levels of bilirubin in the blood are the primary cause of jaundice. Severe cases of jaundice may cause acute bilirubin encephalopathy due to the toxicity of bilirubin to the cells of the brain, which may lead to kernicterus. Kernicterus causes several symptoms, including a permanent upward look, loss of hearing, and repetitive and uncontrolled movements. Therefore, diagnosing this condition at the appropriate time helps to prevent chronic effects. In this study, jaundice or hyperbilirubinemia is diagnosed using a computer vision system based on a random forest algorithm. The system comprises a digital HD camera, a computer device with a Matlab application installed to analyze and detect the skin color changes of the infant, and an Arduino Uno microcontroller to control an LED ultraviolet light. A set of neonate images were collected to train the random forest algorithm, including 374 for normal and 137 for jaundiced infants. |The experimental results using the random forest algorithm for classification reached an accuracy of 98.4375%. The results of this study are promising and open doors for new monitoring applications in various medical diseases detection with a high degree of accuracy.

MATERNAL AND FETAL OUTCOMES OF JAUNDICE DURING A COMPLICATED PREGNANCY IN TERTIARY CARE HOSPITAL IN KAKINADA DISTRICT: A PROSPECTIVE OBSERVATIONAL STUDY

Background: Viral hepatitis is one of the most common and potentially serious infections that can occur in pregnant women. Liver disease in pregnancy, although rare, can seriously affect the mother and fetus. Physiological changes of a normal pregnancy can be confounding with the sign and symptoms of liver diseases. But it is an essential medical disorder because it has adverse effects on the mother and fetus like PPH, preterm labour, IUD, fetal distress, etc. This study aims to analyze the incidence, demographics, obstetric prole, and causes of jaundice in pregnancy and to know the maternal and fetal outcomes. This is an observational Materials And Methods: study conducted by the Department of Obstetrics and Gynaecology, Governments General Hospital (tertiary care hospital) Kakinada, East Godavari District, Andhra Pradesh. 54 antenatal patients with clinical/laboratory evidence of jaundice were selected for the study between January 2020 to December 2020. Results: The mean (Standard deviation) age of patients was 25.5 ± 5.4. 54 patients had jaundice during pregnancy were analysed. 77% of the patients were between 21 and 35 years old. Most cases were Primi gravida. The incidence of jaundice was 3.7%. The most common cause of jaundice was hemolysis, elevated liver enzymes, and low platelets (HELLP). The most common maternal complication was disseminated intravascular coagulation. The maternal mortality rate was eight. The majority of perinatal outcomes were preterm births. Jaundice in pregnancy has Conclusions: adverse feto-maternal consequences. Improving health awareness, education, regular prenatal examinations, and early referrals lead to early diagnosis and treatment of jaundice during pregnancy, thereby reducing maternal and fetal mortality and morbidity.