Icteric Neonates Research Articles

Effect of phototherapy on eosinophils count in neonatal hyperbilirubinemia (cross-sectional study)

BackgroundNeonatal jaundice is a common disorder in neonates. Phototherapy is associated with various side effects despite being safe. This research aimed to determine the impact of phototherapy (PT) on eosinophil levels in neonates treated for unconjugated hyperbilirubinemia.MethodsIn this cross-sectional prospective study, icteric neonates admitted to the Neonatal Intensive Care Unit (NICU) of Abo-Elreesh Child Hospital, Cairo University, from July 2020 to June 2021 were assessed. Laboratory data, including serum bilirubin and blood cell differentiation for eosinophils before and after phototherapy, were collected, and demographic data like age, gender, gestational age, and duration of phototherapy were taken.ResultsTwo hundred neonates were included in this study. Hyperbilirubinemia was most frequently related to ABO group incompatibility (44.5%). After phototherapy, total serum bilirubin and neutrophil levels were significantly decreased, and platelet levels were significantly increased. Eosinophil count and percent were significantly increased (p < 0.001) following phototherapy. A statistically significant positive correlation was found between eosinophil count before and after PT (r = 0.583, p < 0.001) and between eosinophil percent before and after PT (r = 0.617, p < 0.001).ConclusionSerum eosinophils were increased after phototherapy in icteric neonates with hyperbilirubinemia.

Glucose-6-Phosphate Dehydrogenase Deficiency in Icteric Newborns at the Essos-Yaound&amp;#233;-Cameroon Hospital

Background: Glucose-6-phosphate dehydrogenase deficiency is an enzymopathy characterized by insufficient production of reduced glutathione (GSH), a molecule known for its antioxidant role. This lack of GSH leads to a deficit in the elimination of peroxide ions from the red blood cells, causing thereby hemolytic accidents, which can be fatal if not properly managed. In neonates, the clinical picture is most often that of neonatal jaundice. Objectives: This study aimed to determine the place of G6PD deficiency as a cause of neonatal jaundice at Essos Hospital Centre. Methods: We conducted a prospective descriptive study over three months. Blood samples taken from newborns aged 0 to 28 days were analyzed in the medical analysis laboratory of the Essos Hospital Centre in Yaoundé. We carried out a determination of the enzymatic activity of G6PD, a blood count and the determination of the bilirubin level. The results obtained were analysed using R statistical software version 4.1.1. Linear regression analyses were used to assess correlations between the variables of interest. Results: Sixty-nine icteric neonates constituted our study population, with a total of 40 boys (58%) and 29 girls (42%) with a sex ratio of 1.37 in favour of boys. The prevalence of G6PD deficiency in icteric children was 50.72%. The mean hemoglobin was 15.3 ± 3.08 g/dL and the mean red blood cell count was 4.52 ± 1.01 × 106/mm3. The mean total bilirubin was 122 ± 48.3 mg/L with a maximum of 308 mg/L and the mean free bilirubin was 104 ± 46.6 mg/L with a maximum of 292 mg/L. Furthermore, after linear regression analysis, we obtained a positive and significant correlation between G6PD enzymatic activity and hemoglobin level (r = 0.33; p ≤ 0.001), G6PD red blood cell level (r = 0.26; p Conclusion: Neonatal jaundice in G6PD-deficient children is a real public health problem and the prevention of hemolysis in children requires an early diagnosis of the enzyme disorder and good follow-up of the children.

Effects of Phototherapy on the Serum Magnesium Level in Neonates with Indirect Hyperbilirubinemia: A Prospective Cohort Study.

Objectives Neonatal jaundice or hyperbilirubinemia is one of the common findings in neonatal medicine. Severe disease can cause neurological damage and even Kernicterus. Magnesium ion is the most important N-methyl-D-aspartate receptor antagonist. The most commonly used treatment for jaundice is phototherapy, but the effect of phototherapy on serum magnesium is less investigated. In this study, we aim to investigate the effects of phototherapy on total serum magnesium levels in icteric neonates. Methods This prospective cohort study was carried out on 160 neonates with jaundice referring to the Besat Hospital of Hamadan. Based on the bilirubin level, newborns were divided into three subgroups of mild, moderate, and severe disease which were subjected to single, double, and intensive phototherapy, respectively. Serum bilirubin and magnesium levels were measured before and after phototherapy and compared using parametric tests. Results Subjects have a mean intrauterine age of 38.8 weeks and a jaundice onset age of 3.8 days. In all groups, serum magnesium levels were within the normal range before phototherapy. After phototherapy, on the other hand, the most reduction of total serum magnesium was in the double phototherapy group, which was −0.13 ± 0.42 mg/dl (P = 0.018). The change in serum magnesium level was not significant in the single phototherapy (−0.02 ± 0.25) and intensive phototherapy (−13.55 ± 2.73) groups (P > 0.05). Conclusion In the present study, serum magnesium did not increase significantly before the treatment in three groups. After treatment, a significant reduction was seen in the double phototherapy group.

STUDY OF CORRELATION OF ABO AND RH INCOMPATIBILITY WITH RISK OF NEONATAL HYPERBILIRUBINEMIA IN A TERTIARY CARE HOSPITAL

Background: Hyperbilirubinemia in a neonate is one of the most common problems that may occur in 60-70 % of term and 80% of preterm babies. It is known to be associated with signicant morbidity like neonatal bilirubin encephalopathy and even death. Clinically, and almost exclusively ABO incompatibility occurs in 'A' and 'B' blood group babies of O '+ve' mothers. These babies are reported to be at high risk of severe hyperbilirubinemia. So early intervention, at proper time, is mandatory to prevent these sequelae Methods: The aim is to determine the frequency of ABO and Rh blood group incompatibilities and associated incidence of hyperbilirubinemia for the purpose of instituting intervention for better neonatal outcomes. It was a descriptive cross-sectional study that includes 102 neonates born to mother with O or Rh-negative blood group admitted in the post-natal ward for routine newborn care. Serum bilirubin was documented in icteric neonates. Results: The incidence of ABO incompatibility in our study was 33.33% and of Rh incompatibility was 4.9%. In ABO and Rh incompatibility group, 41.17% and 20% new born respectively developed clinical jaundice. In ABO incompatibility group, majority, 64.28% did not require treatment, whereas in Rh incompatibility group 100% required treatment. In both ABO and Rh incompatibility exchange transfusion was not required. In ABO and Rh incompatibility, all new-born treated well and no kernicterus was seen. Conclusions: In ABO incompatibility, if jaundice develops, it remains in physiological limits. In presence of some aggravating conditions may present as pathological jaundice. It results in signicant morbidity but no mortality, so prevention of aggravating factors is very important, in case of ABO and Rh incompatibility.

Phototherapy Induced Hypocalcemia in Icteric Newborns Attending Birat Medical College Teaching Hospital, Morang, Nepal

INTRODUCTION: Neonatal jaundice is the single most common abnormal physical finding and the cause of morbidity in first week of life. It is commonly managed by phototherapy with its inherent complications. A lesser known side effect, but a potential complication of phototherapy is hypocalcemia. This study was done to determine the prevalence of phototherapy induced hypocalcemia in icteric newborns and to compare it between preterm and term babies.&#x0D; MATERIALS AND METHODS: This was a hospital based cross sectional study carried out in the Department of Paediatrics, Birat Medical College Teaching Hospital from 1st September 2020 to 1st March 2021. This study was performed on 201 icteric newborns (121 term and 80 preterm) who were managed with phototherapy. Serum calcium level was estimated both before initiating phototherapy and after 24 hours of continued phototherapy. All the data were recorded in a structured proforma. Data was analysed using SPSS version 16 and p -value &lt;0.05 was considered statistically significant.&#x0D; RESULTS: Male newborns (n=133; 66.2%) outnumbered the female newborns (n=68; 33.8%). Majority of neonates were in the age group of 1-5 days (n=156; 77.6%), with mean age of 4.50± 3.39 days. 7.9% (16 out of 201) of the neonates exhibited phototherapy induced hypocalcemia. The prevalence of hypocalcemia in preterm was 10% and term neonates was 6.6%.&#x0D; CONCLUSIONS: Hypocalcemia is a significant problem in icteric newborns treated with phototherapy. Hence there is a need for close monitoring of serum calcium levels in the icteric neonates. Also the risk is greater in preterm neonates as compared to the term neonates.

Impact of a Head Covering on Photo-Therapy Induced Hypo-calcaemia in Full-term Neonates with Hyper-bilirubinemia

Background: Hyper-bilirubinemia causes yellowish discoloration of the sclera and skin in newborns and is one of the most common disorders that neonatologists face daily. In the first week of life, 60 percent of term and 80 percent of preterm babies have jaundice. In neonates with unconjugated hyper-bilirubinemia, phototherapy is the most common treatment.&#x0D; Objective: To compare the occurrence of hypocalcemia in full-term icteric neonates with and without head covering during phototherapy.&#x0D; Materials and Methodology: Two hundred and eight full-term neonates were split into two groups for photo-therapy for hyper-bilirubinemia. The heads of the participants in the study group were covered with a hat. Before beginning photo-therapy, serum bilirubin and serum calcium levels were assessed, as well as after 48 hours of photo-therapy. SPSS software was used to tabulate and analyze the data.&#x0D; Results: Ninety-four (45%) of the 208 neonates in the sample were males, while 114 (55%) were females. The average age was 5.56 +2.78 days, and the average weight was 3.04 +0.58 kilograms. Out of 208 neonates, 44 (21%) had hypocalcemia. Hypocalcemia occurred in 28 neonates in the control group and 16 neonates in the study group. There was no symptomatic hypocalcemia in any of the newborns. The p-value for the Chi square test was 0.2. Since this value is greater than 0.05, it is not statistically important.&#x0D; Conclusion: In comparison to neonates whose heads were not covered, fewer neonates with covered heads experienced hypocalcemia in our research. However, these findings were not statistically important. However, Research in other countries found that neonatal head cover at phototherapy had a substantial impact. As a result, we propose that a major multicenter study be performed in our country to determine the exact significance.

Unexpected Neonatal Jaundice as an Early Diagnostic sign of Urinary Tract Infection

Background: Determination of contributing factors for jaundice would result in better programming for prevention. This study was performed to determine the prevalence rate of Urinary Tract Infection (UTI) among neonates with jaundice admitted in Arash Hospital from October 2013 to October 2014. Methods: In this descriptive cross-sectional study, term neonates with non-hemolytic jaundice admitted in Arash Hospital from October 2013 to October 2014 were evaluated for UTI by urine culture and the data were recorded by checklist using medical documents. Results: A total of 436 term infants were enrolled in the study. Mean age at the time of admission was 6.03±3.355 days with age range of 3-18 days including 291(0.66%) males and 145(0.33%) females. Urine culture was positive in 32 neonates (7.3%).The most common germs were Klebsiella in 37.5%, Escherichia coli (E. coli) in 21.9%, Staphylococcus in 9.4%, Pseudomonas in 3.1%, Enterococcus in 15.6%, Enterobacter in 9.4%, and Group B Streptococcus (GBS) in 3.1%. Conclusion: Urine culture should be a part of routine clinical evaluation for all icteric neonates at the age of 5-6 days or more who have no risk factors to exclude the possibility of coincidental UTI.

Post-Exchange Transfusion Sodium Change Within a Laboratory Reference Range of Serum in Hospitalized Severe Neonatal Jaundice Cases

Background: Blood exchange transfusion (ECT) therapy is an essential part of the modern health care for high-risk icteric neonates. Objectives: Therefore, this study sought to examine the effectiveness of monitoring sodium disorders and the required interventions indicating the overall state of health of hospitalized jaundiced neonates. Methods: This prospective analytic study was performed on 49 neonates diagnosed with severe jaundice undergoing screened exchange blood transfusion from November 2018 to May 2019. Serum sodium ion concentrations testing was performed before the exchange, then 1 - 3 hours later, and again 24 hours after receiving ECT, using a sensitive ELISA kit in a laboratory. Using the newest version of SPSS 24 software program, the association between different numerical variables was calculated by a repeated-measure ANOVA test. P &lt; 0.05 criterion was set as the threshold of significance. Results: Out of the total 49 neonates, 24 (48.5%) were girls and 25 (51.5%) were boys, of which 93.9% and 6.1% were term and preterm-born neonates, respectively. The average birth weight was 2843 ± 267/510 g and the mean period of hospital stay was 4.55 ± 2.399 days. The various causes of severe neonatal jaundice of all the hospitalized cases were 45% unknown, 43% combined ABO and Rh incompatibility, 10% breastfeeding pattern, and 2% G6PD deficiency. A continual fall in serum sodium was observed following banked blood exchange (P &lt; 0.05). However, these reversible changes were outside the expected normal range. Despite a diminished sodium concentration, the mean sodium levels were within the laboratory reference range of serum (137 - 142 mEq/L) in all the three measured duration times. Moreover, variation in the amount of serum sodium was associated with an unknown underlying cause that led to neonatal jaundice (P = 0.04) and this difference did not reach statistical significance in terms of birth weight, gestational age, and other causes accounting for high bilirubin (P &gt; 0.05). Conclusions: Given these facts, it was concluded that neonatal jaundice was significantly associated with post-exchange serum sodium changes within the laboratory reference range of serum.

Relationship between Transcutaneous and Serum Bilirubin in Preterm and Term Neonates before and during Phototherapy

Background Neonatal jaundice is a common condition. Total serum bilirubin (TSB) measuring is standard for bilirubin testing, while transcutaneous bilirubin (TcB) is an alternative method. We aimed to evaluate the correlation between TSB and TcB in term and preterm neonates. Materials and Methods This prospective cross-sectional study was conducted to on 93 term and preterm neonates in Fatemieh Hospital in 2018, Hamadan, Iran. The samples were categorized into two groups, including term and preterm icteric neonates. Neonates were evaluated to determine the necessity of bilirubin estimation with TSB measurement. After the confirmation of jaundice, the blood samples obtained were sent to the laboratory for bilirubin estimation, and at the same time, the TcB measurement was performed by the bilirubinometer. Selectra X-L was utilized by which the blood samples were analyzed through the dichloroanilin method. The Pearson correlation coefficient was used to evaluate the relationship and stringency of the correlation between the approaches. Results In general,61% and 38% of neonates were boys and girls, respectively. Before phototherapy, the TSB values were lower than TcB estimations in term and preterm neonates. The estimated Pearson correlation coefficients were obtained at r=0.729 (p <0.001), and r=0.802 (p <0.001) in term and preterm neonates, respectively. After phototherapy, contrary to the obtained results before phototherapy, the TSB concentration was higher than TcB concentrations. The difference between the measured values of the two approaches was more significant in term neonates. The Pearson correlation coefficient estimations were r=0.804 (p <0.001), and r=0.901 (p <0.001) in term and preterm neonates, respectively. Conclusion Based on the results, there was a significant correlation between the values of TSB and TcB in term and preterm neonates.

Evaluation of Changes in the Number of Eosinophils Before and After Phototherapy in Neonatal Hyperbilirubinemia

Background: The prevalence of asthma is higher in icteric babies. It is thought that eosinophilia and asthma are complications of phototherapy rather than hyperbilirubinemia. Objectives: Since there is little data in this regard, we evaluated the relationship between phototherapy and the level of eosinophils in this study. Methods: In this cross-sectional prospective study, we assessed icteric neonates admitted to the neonatal and intensive care unit of Children’s Medical Center of Tehran during 2017 - 2018. Laboratory data including serum bilirubin and count of blood cell differentiation for eosinophils, before, during, and after phototherapy besides demographic data like age, gender, gestational age, and duration of phototherapy were collected. Results: Totally, 163 neonates (52.1% male and 47.9% female) with a mean age of 5.49 ± 4.01 days, enrolled in the study. The prevalence of term neonates was 81% and 19% were preterm. The mean of serum total bilirubin was 17.91 ± 3.37 mg/dL. Compared to the mean value of eosinophils before phototherapy, this value in the first (P = 0.001) and second (P &lt; 0.001) days were significantly higher. In female neonates, there was a significant increase in eosinophils in the first (P = 0.001) and second (P &lt; 0.001) day of the post-treatment period. However, in male subjects, this increase was significant only in the second day after phototherapy (P = 0.001). In neonates less than one week of age, this count was significantly increased on the first (P = 0.003) and second (P &lt; 0.001) day after phototherapy. In cases with hemolytic hyperbilirubinemia, eosinophils count before phototherapy and the second day was significant (P = 0.006). The mean of eosinophils in first and second days after phototherapy was not correlated with the severity of hyperbilirubinemia but there is a significant negative correlation between the mean total bilirubin of patients with mean eosinophils before phototherapy. Conclusions: Our findings showed that there was a significant relationship between hyperbilirubinemia and its therapeutic phototherapy with an increasing level of peripheral eosinophils count in neonates.

Glucose-6-phosphate dehydrogenase deficiency in Tunisian jaundiced neonates.

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common human enzymopathy worldwide associated with hemolysis as well as neonatal jaundice, kernicterus, and even death. The goal of this study is to determinate the prevalence of G6PD deficiency in icteric neonates and to investigate its biochemical, hematological and molecular characteristics. This cross sectional study was carried out on 154 icteric newborns admitted to the Bechir Hamza Children's Hospital in Tunisia. Laboratory evaluations included complete blood count, total serum bilirubin level (TSB), and erythrocyte G6PD activity. The G6PD activity was determined using a quantitative assay, which allowed us to divide the total population into two groups: normal and deficient population. The common G6PD Tunisian mutations (GdA - and GdMed) were determined using the amplification refractory mutation system (ARMS-PCR) method. The prevalence of G6PD deficiency among total population (154 icteric newborns) was 18.83%. Male neonates showed a higher incidence of G6PD deficiency of 11.03% compared to females (7.79%). There was no statistical difference between the two groups (normal and deficient), in relation to the sex, peak TSB level, age at peak TSB, hemoglobin level, and hematocrit. However, there was a significant difference in gestational age. In the deficient group, 48.28% neonates presented the peak TSB level between 3 to 7 days and 55% of the cases show a peak TSB level greater than 250 μmol/L. The G6PD G202A variant was found in 41.37% of cases. This study shows a higher prevalence of G6PD deficiency in icteric newborns of Tunisia (18.83%). This emphasizes the necessity of neonatal screening for G6PD deficiency to prevent the exposure of these newborns to known hemolytic agents and, subsequently, to prevent kernicterus or other serious complications.

ABO and Rh blood group incompatibility among icteric neonates and their mothers in Jos, Nigeria

Context: ABO and Rh blood groups play significant roles in health and diseases, one of which is blood group incompatibility, a common cause of neonatal hyperbilirubinemia. Aims: The aim of the study is to determine the frequency of ABO and Rh blood group incompatibilities among icteric neonates and their mothers for the purpose of instituting intervention for better neonatal outcomes. Settings and Design: This study was conducted at the Special Care Baby Units (SCBUs) of the Jos University Teaching Hospital (JUTH), Bingham University Teaching Hospital (BHUTH), and Plateau State Specialist Hospital (PSSH), Jos, Nigeria, from March 2013 to February 2014. It was a descriptive cross-sectional study that includes all jaundiced neonates admitted into the SCBUs and neonates who developed jaundice on admission in the neonatal wards. Subjects and Methods: A total of 150 icteric neonates admitted into the SCBUs of the JUTH, PSSH, and the BHUTH were recruited for this study with their parent's consent. Blood samples were collected from the neonates and their mothers in ethylene diaminetetra-acetic acid and plain bottles for ABO and Rh blood grouping, direct antihuman globulin test, and serum bilirubin (SB) assays. Statistical Analysis Used: Data obtained were analyzed using Epi Info Version 6 software. The results were reported in tables and frequencies, categorical variables were expressed as proportions, whereas continuous variables were expressed as mean ± standard deviation and were analyzed using Student's “t”-test. The level of statistically significant relationship was set at P ≤ 5% (P ≤ 0.05). Results: Thirty-four (22.7%) mother–neonate pair had ABO incompatibility with 14 mothers (9.3%) with blood group O, having neonates with blood group A and a mean SB of 249.5 ± 131.4 μmol/L. Three (2.0%) mothers were Rh D negative while their neonates were Rh D positive and showed a positive direct antihuman globulin test with a mean SB of 322.1 ± 246.7 μmol/L. Conclusions: Blood group O and Rh D-positive blood groups predominate while ABO and Rh incompatibilities present a risk for hyperbilirubinemia among icteric neonates in Jos, Nigeria.

Glucose-6- Phosphate Dehydrogenase Activity in Newborn in Jos: A Necessary Evaluation for Icteric Neonates

Red blood cell glucose-6-phosphate dehydrogenase (G6PD) is a key regulatory enzyme with the major role of meeting the cellular need for reductive biosynthesis and maintenance of redox status. G6PD deficiency is a common inherited enzyme defect associated with severe neonatal hyperbilirubinaemia that can result in permanent neurologic damage or death. This study was aimed at estimating the level of G6PD activity among icteric neonates to assess its usefulness in the evaluation of icteric neonates in Jos. One hundred and fifty icteric neonates (92 males and 58 females) whose parents consented were consecutively enrolled as they presented at the Special Care Baby Units (SCBU) of the Jos University Teaching Hospital (JUTH), Bingham University Teaching Hospital (BhUTH), and the Plateau State Specialist Hospital (PSSH), Jos. These subjects had their G6PD activity levels assayed using the Pointe Quantitative Diagnostic Kit (USA) while other relevant clinical information was obtained using a questionnaire. G6PD activity of the icteric neonates ranged between 0.54 and 24.18 IU/gHb with a mean of 8.02 ± 4.87 IU/gHb. Sixty-one (40.7 %), comprising 45 males and 16 female neonates were G6PD deficient with mean G6PD activity of 3.79 ± 1.37 IU/gHb while eighty-nine (59.3%) were G6PD normal with a mean G6PD activity of 10.92 ± 4.24 IU/gHb. G6PD activity in icteric neonates in Jos varies widely with a relatively high proportion of these neonates being G6PD deficient. Determination of G6PD activity in icteric neonates should therefore form an important evaluation tool for identification and intervention in those with the deficiency.

Glucose-6- Phosphate Dehydrogenase Activity in Newborn in Jos: A Necessary Evaluation for Icteric Neonates

Red blood cell glucose-6-phosphate dehydrogenase (G6PD) is a key regulatory enzyme with the major role of meeting the cellular need for reductive biosynthesis and maintenance of redox status. G6PD deficiency is a common inherited enzyme defect associated with severe neonatal hyperbilirubinaemia that can result in permanent neurologic damage or death. This study was aimed at estimating the level of G6PD activity among icteric neonates to assess its usefulness in the evaluation of icteric neonates in Jos. One hundred and fifty icteric neonates (92 males and 58 females) whose parents consented were consecutively enrolled as they presented at the Special Care Baby Units (SCBU) of the Jos University Teaching Hospital (JUTH), Bingham University Teaching Hospital (BhUTH), and the Plateau State Specialist Hospital (PSSH), Jos. These subjects had their G6PD activity levels assayed using the Pointe Quantitative Diagnostic Kit (USA) while other relevant clinical information was obtained using a questionnaire. G6PD activity of the icteric neonates ranged between 0.54 and 24.18 IU/gHb with a mean of 8.02 ± 4.87 IU/gHb. Sixty-one (40.7 %), comprising 45 males and 16 female neonates were G6PD deficient with mean G6PD activity of 3.79 ± 1.37 IU/gHb while eighty-nine (59.3%) were G6PD normal with a mean G6PD activity of 10.92 ± 4.24 IU/gHb. G6PD activity in icteric neonates in Jos varies widely with a relatively high proportion of these neonates being G6PD deficient. Determination of G6PD activity in icteric neonates should therefore form an important evaluation tool for identification and intervention in those with the deficiency.

Glucose-6- Phosphate Dehydrogenase Activity in Newborn in Jos: A Necessary Evaluation for Icteric Neonates

Red blood cell glucose-6-phosphate dehydrogenase (G6PD) is a key regulatory enzyme with the major role of meeting the cellular need for reductive biosynthesis and maintenance of redox status. G6PD deficiency is a common inherited enzyme defect associated with severe neonatal hyperbilirubinaemia that can result in permanent neurologic damage or death. This study was aimed at estimating the level of G6PD activity among icteric neonates to assess its usefulness in the evaluation of icteric neonates in Jos. One hundred and fifty icteric neonates (92 males and 58 females) whose parents consented were consecutively enrolled as they presented at the Special Care Baby Units (SCBU) of the Jos University Teaching Hospital (JUTH), Bingham University Teaching Hospital (BhUTH), and the Plateau State Specialist Hospital (PSSH), Jos. These subjects had their G6PD activity levels assayed using the Pointe Quantitative Diagnostic Kit (USA) while other relevant clinical information was obtained using a questionnaire. G6PD activity of the icteric neonates ranged between 0.54 and 24.18 IU/gHb with a mean of 8.02 ± 4.87 IU/gHb. Sixty-one (40.7 %), comprising 45 males and 16 female neonates were G6PD deficient with mean G6PD activity of 3.79 ± 1.37 IU/gHb while eighty-nine (59.3%) were G6PD normal with a mean G6PD activity of 10.92 ± 4.24 IU/gHb. G6PD activity in icteric neonates in Jos varies widely with a relatively high proportion of these neonates being G6PD deficient. Determination of G6PD activity in icteric neonates should therefore form an important evaluation tool for identification and intervention in those with the deficiency.

Glucose-6- Phosphate Dehydrogenase Activity in Newborn in Jos: A Necessary Evaluation for Icteric Neonates

Red blood cell glucose-6-phosphate dehydrogenase (G6PD) is a key regulatory enzyme with the major role of meeting the cellular need for reductive biosynthesis and maintenance of redox status. G6PD deficiency is a common inherited enzyme defect associated with severe neonatal hyperbilirubinaemia that can result in permanent neurologic damage or death. This study was aimed at estimating the level of G6PD activity among icteric neonates to assess its usefulness in the evaluation of icteric neonates in Jos. One hundred and fifty icteric neonates (92 males and 58 females) whose parents consented were consecutively enrolled as they presented at the Special Care Baby Units (SCBU) of the Jos University Teaching Hospital (JUTH), Bingham University Teaching Hospital (BhUTH), and the Plateau State Specialist Hospital (PSSH), Jos. These subjects had their G6PD activity levels assayed using the Pointe Quantitative Diagnostic Kit (USA) while other relevant clinical information was obtained using a questionnaire. G6PD activity of the icteric neonates ranged between 0.54 and 24.18 IU/gHb with a mean of 8.02 ± 4.87 IU/gHb. Sixty-one (40.7 %), comprising 45 males and 16 female neonates were G6PD deficient with mean G6PD activity of 3.79 ± 1.37 IU/gHb while eighty-nine (59.3%) were G6PD normal with a mean G6PD activity of 10.92 ± 4.24 IU/gHb. G6PD activity in icteric neonates in Jos varies widely with a relatively high proportion of these neonates being G6PD deficient. Determination of G6PD activity in icteric neonates should therefore form an important evaluation tool for identification and intervention in those with the deficiency.

Glucose-6- Phosphate Dehydrogenase Activity in Newborn in Jos: A Necessary Evaluation for Icteric Neonates

Red blood cell glucose-6-phosphate dehydrogenase (G6PD) is a key regulatory enzyme with the major role of meeting the cellular need for reductive biosynthesis and maintenance of redox status. G6PD deficiency is a common inherited enzyme defect associated with severe neonatal hyperbilirubinaemia that can result in permanent neurologic damage or death. This study was aimed at estimating the level of G6PD activity among icteric neonates to assess its usefulness in the evaluation of icteric neonates in Jos. One hundred and fifty icteric neonates (92 males and 58 females) whose parents consented were consecutively enrolled as they presented at the Special Care Baby Units (SCBU) of the Jos University Teaching Hospital (JUTH), Bingham University Teaching Hospital (BhUTH), and the Plateau State Specialist Hospital (PSSH), Jos. These subjects had their G6PD activity levels assayed using the Pointe Quantitative Diagnostic Kit (USA) while other relevant clinical information was obtained using a questionnaire. G6PD activity of the icteric neonates ranged between 0.54 and 24.18 IU/gHb with a mean of 8.02 ± 4.87 IU/gHb. Sixty-one (40.7 %), comprising 45 males and 16 female neonates were G6PD deficient with mean G6PD activity of 3.79 ± 1.37 IU/gHb while eighty-nine (59.3%) were G6PD normal with a mean G6PD activity of 10.92 ± 4.24 IU/gHb. G6PD activity in icteric neonates in Jos varies widely with a relatively high proportion of these neonates being G6PD deficient. Determination of G6PD activity in icteric neonates should therefore form an important evaluation tool for identification and intervention in those with the deficiency.

Clofibrate for Non-Hemolytic Icterus in Term Newborns: Randomized-Controlled Trial, Iran

Objectives: To compare the effects of a single dose of clofibrate on the serum bilirubin level in full-term non-hemolytic icteric neonates when it is administered in addition to phototherapy, and to evaluate its possible side effects. Methods: In a randomized-controlled clinical trial in 2016, 90 term icteric neonates were divided into groups of 30. One group took a single dose of 50 mg/kg while another group took a single dose of 100 mg/kg of clofibrate. All neonates were under phototherapy and were compared to a control group who took a placebo. Serum bilirubin levels were measured at admission and then after 6, 12, 24, and 48 hours of treatment. Clofibrate’s side effects were assessed by measuring hepatic enzymes (AST/ALT) and lipid profiles (TG/Chol) at admission and after 48 hours. Results: In neonates with jaundice who were under phototherapy, a single dose of 100 mg/kg of clofibrate decreased the level of serum bilirubin more rapidly compared to the control group (t (58) = -2.73, P = 0.043), or even the group who took a single dose of 50 mg/kg clofibrate (t (58) = -4.261, P = 0.000). A single dose of 50 mg/kg clofibrate did not decrease the serum bilirubin levels more rapidly compared to the control group. Compared to the control group, in the group who took a single dose of 50 mg/kg clofibrate, after 48 hours, a higher number of neonates showed an increase in serum triglyceride (30% versus 63%) and/or cholesterol levels (27% versus 57%). Conclusions: A single dose of 100 (not 50) mg/kg clofibrate better decreased the serum bilirubin.

The Effect of Phototherapy on Serum Levels of 25-Hydroxyvitamin D in Neonatal Hyperbilirubinemia

Background: Hyperbilirubinemia is one of the common problems in neonates; the most effective and commonly used treatment method is phototherapy. The aim of this study was to investigate the effect of phototherapy on the calcium to urine creatinine ratio and serum level of 25-hydroxyvitamin D in icteric neonates hospitalized in term neonates treated with phototherapy at Amirkola Hospital in Babol in year 2018. Method: This study was performed on 60 term neonates (36 boys and 24 girls) with mean age of 1.24±4.88 who underwent phototherapy. The ratio of calcium to urine creatinine and serum levels of 25-hydroxyvitamin D was determined before and 72 hours after phototherapy. Findings: The results of this study showed that the mean serum level of 25-hydroxyvitamin D in icteric neonates before phototherapy was 28.12 ng/dl and after 72 hours of phototherapy was 26.17 ng/dl, which was significantly decreased (P=0.03). Also, the calcium to urinary creatinine ratio in the icteric neonates before phototherapy was 0.16 and after 72 hours phototherapy was 0.17 which significantly increased (P=0.03). Conclusion: Phototherapy reduces serum levels of 25-hydroxyvitamin D and increases urinary excretion of calcium in term neonates.&#x0D;

Expression of neutrophil surface markers in icteric neonates before and after phototherapy

Jaundice due to indirect hyperbilirubinemia affects more than 60% of neonates and phototherapy is the treatment for severe types. There are no previous studies evaluating the effect of phototherapy on the function of neonates neutrophils. The aim of this study was to assess and compare the function of neutrophils by measuring the expression of neutrophils main surface markers in icteric neonates before and after phototherapy. Neonates at a gestational age ≥35 weeks and birth weight ≥2,000 g who met the American Academy of Pediatrics criteria for phototherapy were included. Flow cytometry evaluation of the mean fluorescence intensities of CD10, CD11b, CD11c, CD15, CD16, CD18, CD62L, CD64, and CD66acde was performed before and 24 h after the initiation of phototherapy. Twenty-five neonates at a mean age of 53 h of life were included in the study with a mean bilirubin level of 13.60 ± 2.85 mg/dL. There was no statistical difference in the expression of CD11b, CD15, CD18, CD62L, and CD64 or in the percentage of neutrophils before and after 24 h of phototherapy. There was an increase in the expression of CD10 and CD16 and a decrease in the expression of CD11c and CD66acde after 24 h of phototherapy. Newborns submitted to phototherapy had an increase in the expression of CD10 and CD16 and a decreased in the expression of CD11c and CD66acde after 24 h of treatment, which may be related to an anti-inflammatory effect of phototherapy. © 2018 International Clinical Cytometry Society.