Treatment Of Neonatal Jaundice Research Articles

Correlation of Clinical Assessment of Jaundice with Total Serum Bilirubin in Neonates: Hospital-Based Cross-Sectional Study

Introduction: Neonatal jaundice is a common cause of admission in the neonatal period. Early diagnosis and treatment of neonatal jaundice prevent the bilirubin encephalopathy. There are various methods for the estimation of neonatal jaundice. Clinical assessment of neonatal jaundice can aid in the diagnosis of neonatal jaundice in low-resource settings and refer to the higher center for those who require treatment. This study aims to understand the relation between clinical assessment of jaundice and total serum bilirubin in neonates and to know the risk factors of neonatal jaundice.  Methods: The Clinical assessment of jaundice by Kramers scale can be used to assess the level of jaundice and know the progression of jaundice.  Results: This shows a significant positive relation between clinical assessment of jaundice and serum bilirubin level.  Conclusions: The study findings showed that clinical assessment of jaundice was comparable with the serum bilirubin. Clinical assessment of jaundice by Kramer‟ 's scale can be used to assess the level of jaundice and know the progression of jaundice.

Continuous versus intermittent phototherapy in treatment of neonatal jaundice: a randomized controlled trial.

In this study, IPT was found to be at least as effective as CPT in reducing total serum bilirubin. Even though the duration of PT is shorter in IPT, the slower rate of rebound bilirubin, shorter hospital stays and lower incidence of side effects indicated that intermittent phototherapy is superior to continuous phototherapy. Choosing IPT over CPT is a more rational approach in neonatal jaundice. gov Identifier: NCT06386731 (registered retrospectively on 23/04/2024) What is Known: • PT is common used in the treatment of neonatal jaundice. • There is no standard model of application for PT. • The IPT model is as effective as CPT. • Newborns are discharged faster with IPT.

Research and Discussion on Flipped Classroom Combined with Case-Based Learning in Pharmacoeconomics Teaching

Objective: To explore the application effect of flipped classroom combined with case-based learning teaching methods in pharmacoeconomics teaching. Methods: The students majoring in clinical pharmacy in 2019 were selected as the study subjects, and the cost-effectiveness analysis of different dosage forms of Yinzhihuang in the treatment of neonatal jaundice was selected as the teaching case. The flipped classroom combined with case-based learning teaching method was used to carry out theoretical teaching to the students. After the course, questionnaires were distributed through the Sojump platform to evaluate the teaching effect. Results: The results of the questionnaire showed that 85.71% of the students believed that the flipped classroom combined with case-based learning teaching method was helpful in mobilizing the learning enthusiasm and initiative, and improving the comprehensive application ability of the knowledge of pharmacoeconomics. 92.86% of the students think that it is conducive to the understanding and memorization of learning content, as well as the cultivation of teamwork, communication, etc. Conclusion: Flipped classroom combined with case-based learning teaching method can improve students’ knowledge mastery, thinking skills, and practical application skills, as well as optimize and improve teachers’ teaching levels.

Effectiveness of phototherapy with and without probiotics for the treatment of indirect hyperbilirubinaemia in preterm neonates: a randomised controlled trial

ABSTRACT Introduction Raised serum bilirubin levels can cause kernicterus, and premature infants are at increased risk owing to metabolic immaturity. The standard treatment for neonatal jaundice is phototherapy, but probiotics alone can reduce the duration of phototherapy and hospitalisation. Objectives To determine the effectiveness of phototherapy with and without probiotics for the treatment of indirect hyperbilirubinaemia in preterm neonates. Patients and methods The open-labelled randomised controlled trial was conducted from January 2022 to January 2023 in the neonatal unit of the University of Lahore Teaching Hospital, Pakistan. A total of 76 preterm neonates who fulfilled the selection criteria were included and divided into two groups. Both groups received standard phototherapy. In Group B, a probiotic (Saccharomyces boulardii) 125 mg, twice daily, orally (in 5 cc of whichever milk the infant was receiving) was given until discharge from hospital. The primary outcome measurements were the duration of phototherapy and the length of hospitalisation. Results The mean (SD) duration of phototherapy was 36.55 (14.25) hours in Group A and 24.61 (9.25) hours in Group B (p <0.05). The mean (SD) duration of hospital stay was 47.36 (16.51) hours in Group A and 33.13 (8.93) hours in Group B (p <0.05). Conclusion Oral probiotics (Saccharomyces boulardii) have a significant effect on the duration of phototherapy for neonatal hyperbilirubinaemia, and they decrease the chances of nosocomial infection. Exploration of clinical outcomes by investigating faecal flora and undertaking large randomised controlled trials of various probiotics are needed. Abbreviations ABE: acute bilirubin encephalopathy; CNS: central nervous system;GA: gestational age; IVIG: intravenous immunoglobulin; KSD: kernicterus;NNU: neonatal unit; RCT: randomised controlled trial; S. boulardii: Saccharomyces boulardii.

Magnitude and its associated factors of neonatal jaundice among neonates admitted to the neonatal intensive care unit of Dessie Town public hospitals, Amhara region, Ethiopia, 2020: a multicenter cross-sectional study.

Neonatal jaundice is a prevalent illness affecting approximately 60%-80% of newborns. In severe cases, it can result in severe neurological distress. Approximately 1.1 million neonates are affected annually on a global scale, with the vast majority living in sub-Saharan Africa and southern Asia. It is common in newborns in the first week of life. This study aims to assess the magnitude and determinants of jaundice in newborns admitted to the neonatal intensive care unit (NICU) of public hospitals in the city of Dessie in northern Ethiopia. An institutional cross-sectional study was conducted at the NICU at Dessie town public hospitals from 30 March to 30 April 2020. A systematic random sampling procedure was used to select the study participants. Data were collected through face-to-face interviews with mothers using a structured questionnaire and by reviewing neonatal medical records using a checklist. Binary logistic regression analysis was used to identify the determinants of neonatal jaundice. A significance level of less than 0.05 was used to declare the statistical significance in the final model. A total of 218 neonates with their mothers were included in the study. The prevalence rate of neonatal jaundice was found to be 28.4%. The major associated factors for neonatal jaundice were sepsis [adjusted odds ratio (AOR): 10.13, 95% confidence interval (CI) = 2.36, 43.56], preterm < 37 weeks (AOR: 6.03, 95% CI = 1.41, 25.79) low APGAR score < 7 (AOR: 7.34, 95% CI = 1.34, 39.65), ABO incompatibility (AOR: 24.55 95% CI = 1.58, 68.83), prolonged labor (AOR 9.03, 95% CI = 1.67, 48.33), and Rh incompatibility (AOR = 30.40, 95% CI = 2.01, 66.20). The magnitude of neonatal jaundice among neonates was determined to be high. Therefore, both maternal and neonatal factors contributed significantly to the management of neonatal jaundice and also influenced the use of phototherapy treatment. Proper consideration of these factors is crucial for the prevention and treatment of neonatal jaundice.

The Effect of Vitamin D Supplementation as Adjuvant to Phototherapy versus Phototherapy Alone on Neonatal Jaundice: A Randomised Controlled Trial

Introduction: Neonatal jaundice, or neonatal hyperbilirubinaemia, is a common and significant concern among newborns globally. Given that phototherapy is the primary treatment for neonatal jaundice, exploring alternative adjunctive treatments is beneficial. Aim: To observe the impact of vitamin D supplementation as an adjuvant therapy alongside phototherapy in managing neonatal jaundice. Materials and Methods: A hospital-based double-blinded randomised controlled trial was conducted at the Special Newborn Care Unit (SNCU) in Department of Paediatrics, G.R. Medical College, Gwalior, Madhya Pradesh, a tertiary care neonatal centre in North India, over a two-year period (April 2020 to March 2022). The study included 70 newborns with neonatal jaundice, divided into two groups: one receiving phototherapy and vitamin D (Group 1), and the other receiving phototherapy alone (Group 2). The average levels of bilirubin were compared at baseline, 48 hours, 96 hours, and 120 hours in the two groups. Statistical analysis was performed using Statistical Package for Social Sciences (SPSS) 22.0, calculating frequency, percentage, mean, Standard Deviation (SD), and applying the independent t-test for comparison. A p-value less than 0.05 was considered statistically significant. Results: The mean total serum bilirubin at admission in Group 1 was 18.58±1.76 mg/dL, and in Group 2 was 17.77±2.01 mg/ dL, with a p-value of 0.077. At 48 hours, the levels in Group 1 were 15.11±1.99 mg/dL, and in Group 2 were 14.69±1.53 mg/ dL, with a p-value of 0.339. At 96 hours, the levels in Group 1 were 14.75±5.62 mg/dL, and in Group 2 were 13.16±1.49 mg/ dL, with a p-value of 0.237. At 120 hours, the levels in Group 1 were 8.90±4.66 mg/dL, and no patients were observed in Group 2. The study found that vitamin D as an adjuvant to phototherapy did not significantly impact the rate of decline of serum bilirubin, and the duration of phototherapy was not affected significantly. Conclusion: The study concludes that vitamin D, as an adjuvant to phototherapy, does not significantly affect the rate of decline of serum bilirubin, and it does not alter the duration of phototherapy when comparing both groups.

The Mechanism of Action of Cotoneaster Manna, an Iranian Herbal Medicine, in the Treatment of Neonatal Jaundice

Background: Neonatal jaundice is a common clinical problem caused by the deposition of bilirubin in the tissue. Natural products have long been used to treat jaundice, and Iranian medicine can be a good source of natural treatments for this purpose. In this study, we investigate the mechanism of the effect of Cotoneaster, an Iranian herbal medicine, in the treatment of jaundice in neonates.&#x0D; Methods: We investigated every article that evaluated Purgative manna, Cotoneaster manna, or Cotoneaster in the treatment of neonatal jaundice. We searched the databases of PubMed, Scopus, Web of Sciences, SciELO, CNKI, and Google Scholar for English articles, and a search was also done in Persian in Magiran and Scientific Information Database (SID) published until August 2023.&#x0D; Results: The exact mechanism of Cotoneaster in reducing jaundice is not known, but the following mechanisms have been suggested. The most common mechanisms include increased urination, increased bile excretion from the liver, and increased defecation, as well as neutralizing the effects of oxidative agents and free radicals.&#x0D; Conclusion: Considering that most studies have stated that Cotoneaster combined with phototherapy is effective in treating jaundice and herbal medicines alone cannot treat jaundice. Therefore, identifying the mechanism of Cotoneaster in reducing jaundice can lead to the creation of methods to strengthen its effect. More detailed biochemical and pharmacological studies are needed to understand the mechanism of action of Cotoneaster in reducing neonatal jaundice.

Impact of Light Emitting Diode Phototherapy in Full-Term Neonates with Hyperbilirubinemia

Abstract Background: To study the difference in serum total calcium levels during phototherapy with light-emitting diodes (LEDs) in full-term neonates with hyperbilirubinemia. Materials and Methods: In this prospective observational study, 74 term neonates with hyperbilirubinemia who were admitted for phototherapy using LEDs devices were examined. The research was carried out in a tertiary care facility. Before and after the phototherapy treatment, total serum bilirubin levels as well as total serum calcium levels were measured and compared. The symptoms observed with hypocalcemia, such as drowsiness irritability/excitability, lethargy, and convulsions, were also evaluated in full-term neonates during this study. Results: After treatment, the total serum calcium level decreased significantly (P &lt; 0.001) compared to the pretreatment level. Around 5% of the term neonates who participated in the study had hypocalcemia, where the serum calcium level is defined that is lower than 8 mg/dL in term neonates. Conclusions: In the context of the treatment of neonatal jaundice in full-term neonates, LED phototherapy, which is analogous to traditional blue and white light phototherapy, also has hypocalcemia as one of its potential side effects. During their treatment with light-emitting diode phototherapy, we advise checking up on these full-term neonates for signs of hypocalcemia.

Efficacy and safety of fenofibrate in combination with phototherapy for the treatment of neonatal hyperbilirubinemia: a systematic review and meta-analyses.

Phototherapy is the standard treatment for neonatal jaundice. We aimed to review the efficacy and safety of fenofibrate as an adjunct therapy. Twelve databases were searched and a systematic review and meta-analysis were conducted. Mean change (MC), mean difference (MD), and risk ratios (RR) with a 95% confidence interval (CI) were calculated using a random effects model. The GRADE approach was used to evaluate the evidence's certainty. Nine randomized trials were included. The MC of total serum bilirubin (mg/dL) was significant at 12, 24, 36, 48, and 72 h with respective MC (95% CI) values of -0.46 (-0.61, -0.310), -1.10 (-1.68, -0.52), -2.06 (-2.20, -1.91), -2.15 (-2.74, -1.56), and -1.13 (-1.71, -0.55). The FEN+PT group had a shorter duration of phototherapy (MD: -14.36 h; 95% CI: -23.67, -5.06) and a shorter hospital stay (MD: -1.40 days; 95% CI: -2.14, -0.66). There was no significant difference in the risk of complications (RR: 0.89; 95% CI: 0.54, 1.46) or the need for exchange transfusion (RR: 0.58; 95% CI: 0.12, 2.81). The certainty of the evidence was very low for all outcomes. In conclusion, fenofibrate might be a safe adjunct to neonatal phototherapy. Larger randomized controlled trials are needed for the confirmation of these results.

Intramolecular hydrogen bonds interactions in the isomers of the bilirubin molecule: DFT and QTAIM analysis.

Bilirubin is an important molecule, used as a marker of some liver diseases, and it can also be toxic and cause jaundice, especially in newborns. The main treatment for neonatal jaundice is phototherapy with blue light, which is still widely studied because the photophysical processes involved are not fully understood. Calculations based on the density functional theory (DFT) at M062X/6-31G(d,p) level were performed in order to evaluate the structural, electronic, and topological properties of bilirubin isomers. It was found that the ZZ conformation can form a greater number of hydrogen bonds, which gives the isomer greater energy stabilization compared to the other ZE, EZ, and EE isomers, and that the EE isomer is the conformer with the lowest energy of stabilization. The hydrogen bonds were characterized by the quantum theory of atoms in molecules (QTAIM) and for the ZZ isomer four hydrogen bonds (HBs) were found classified as intermediate, ∇2ρ(r) > 0, H(r) > 0. The ZE, EZ, and EE isomers show weak HBs, ∇2ρ(r) > 0, H(r) > 0.

A wireless physiological parameter monitoring system with a treatment feedback function during neonatal phototherapy

Objective. Neonatal jaundice is a common condition in the early stages of newborns, and phototherapy is a fast, safe and effective method that is used to treat it. However, recent studies have shown that phototherapy may elicit side effects in infants, such as hypothermia, hyperthermia and dehydration. To improve the quality of phototherapy and the prognosis of patients, the changes in neonatal physiological parameters during phototherapy should be monitored to give better feedback to pediatricians or the phototherapy system. However, the current standard of clinical care during neonatal phototherapy with hard-wired devices limits this realization. Approach. Here, we developed a prototype of a neonatal wearable device, which can wirelessly potentially monitor the jaundice value, transepidermal water loss, skin wettedness factor and body orientation during phototherapy, and conducted prototype validation experiments. We also set up user-friendly interfaces and an analysis system on custom software, all designed to make the future addition of data interfaces for treatment feedback functions easier. Main results. The preliminary in vitro experiment demonstrated the effectiveness of simultaneous monitoring of the required physiological parameters. And further suggestions and specific operations are discussed in terms of optimization of the treatment of neonatal jaundice. Significance. It is believed that the established system has the potential to provide a basis for future phototherapy nursing guidelines and physiological monitoring standards.

The Effect of Tunnel versus Conventional Phototherapy on the T Lymphocytes in Full Term Neonates with Hyperbilirubinemia

Background Neonatal jaundice is one of the most common conditions. Phototherapy has been accepted as the standard treatment for neonatal jaundice and the decline in the number of exchange transfusions in recent years is, at least in part, likely a direct reflection of the effectiveness of phototherapy at treating hyperbilirubinemia. However, this treatment modality also has some complications. One possible harmful consequence is potential immunotoxic effects by affection of lymphocytes subtypes which can affect the immune system functions in infants. Aim of the Work current study was performed to compare the effect of both conventional and tunnel phototherapy on lymphocytes subsets in term neonates (≥37weeks) with unconjugated hyperbilirubinemia. Patients and Methods The present study was conducted on 60 term neonates (≥37weeks) 40 of them with unconjugated hyperbilirubinemia admitted to NICUs in Ain-Shams University hospital during the period from January 2019 to July 2019. They were randomly assigned to 3 groups: 20 patients were exposed to conventional phototherapy and 20 patients were exposed to tunnel phototherapy and the other 20 healthy full term were assigned as control group. Total serum bilirubin (TSB), direct serum bilirubin (DSB), CBC, CD4 and CD8 percentages and absolute count were measured before and 48 h after phototherapy in the phototherapy groups. Baseline lab was done in the control group at once. Results significant decrease in total and direct bilirubin post-phototherapy in both phototherapy groups proved that tunnel phototherapy is as effective as conventional phototherapy as both provided rapid decrease in bilirubin levels. As regards the effect of phototherapy on lymphocytic count, we found that lymphocytic count significantly decreased post-phototherapy in both phototherapy groups. As regards the effect of phototherapy on CD4+ and CD8+ percentages, we found that CD4+ % significantly decreased postphototherapy in conventional phototherapy group. Moreover, when we measured CD4+ and CD8+ absolute counts, we found that CD4+ and CD8+ absolute counts significantly decreased post-phototherapy in both phototherapy groups. In the view of the effect of phototherapy on CD4/CD8 ratio, we found that the ratio significantly increased in tunnel phototherapy group. Conclusion Conventional and tunnel phototherapy which are used in the treatment of neonatal hyperbilirubinemia, affects the function of the immune system in newborns via alterations in CD4+ and CD8+ absolute counts.

Comparative study of continuous versus intermittent phototherapy in the neonatal jaundice treatment

Aim: The goal of this study is the comparison of the mean reduction in serum bilirubin after intermittent and continuous phototherapy for neonatal jaundice treatment. Study Design: A randomized controlled study. Place and Duration: In the Pediatric department of Mardan Medical Complex (MMC), Mardan for one-year duration from July 2021 to June 2022. Methodology: Total 200 children were registered after meeting the exclusion and inclusion criteria to compare the reduction in serum bilirubin following intermittent/ continuous phototherapy for neonatal jaundice treatment. There were 100 children in both Group A and B. The continuous phototherapy was given in Group A children while intermittent phototherapy was given in group B. The children in Group A were given continuous phototherapy (2 hrs with 20 mints break), and intermittent phototherapy was given in group B children (1 hr therapy and 30 Mints break).

Recent Advances in Adjuvant Pharmacotherapy for Neonatal Indirect Hyperbilirubinemia: A Narrative Review

Context: Hyperbilirubinemia is a common cause for diagnostic work-up and therapeutic intervention in neonates and needs a convenient, quick, and safe treatment modality. Phototherapy is the most common treatment for neonatal jaundice; however, complementary treatment is still needed. Despite the identification of the enzymatic pathways of bilirubin catabolism, few pharmacological interventions have been found to be effective in reducing bilirubin, along with traditional phototherapy. This review was conducted to evaluate recent pharmacotherapies as adjuvants to phototherapy for the treatment of neonatal indirect hyperbilirubinemia (IHB). Evidence Acquisition: This study was carried out through a literature search with the keywords of Infant, Newborn, and Indirect Hyperbilirubinemia, combined with Drug Therapy, in PubMed, Scopus, International Statistical Institute, Web of Science, Cochrane, and Embase databases. This study included relevant articles (i.e., randomized controlled trials, observational studies, guidelines, and reviews) written in English and published between 2012 - 2022. Results: This narrative review first assessed the relevant articles to define IHB and its etiology. Then, the efficacy and side effects of recent pharmacologic agents as adjuvants to phototherapy were discussed. Additionally, this study reviewed the efficacy and safety of drugs prescribed to neonates to prevent jaundice. Conclusions: The best drug for adjuvant pharmacotherapy, in addition to phototherapy, for neonatal jaundice has not still been identified. The use of probiotics, prebiotics, synbiotics, and ursodeoxycholic acid (UDCA) in adjuvant to phototherapy has been recently increasing, and beneficial results were observed in most studies. The use of agar, charcoal, fibrate, and phenobarbital had a minor therapeutic role in recent years. There were conflicting results about the efficacy of herbal agents in neonatal jaundice. The use of intravenous immunoglobulin (IVIG), metalloporphyrin, and albumin is also limited to severe or immune-related IHB cases. The prescription of the aforementioned drugs sometimes had different results. Therefore, further research in this regard is necessary.

Study on the value of KMC combined with blue light irradiation in improving the therapeutic effect of neonatal jaundice

ABSTRACT Neonatal jaundice is a common problem that affects newborns. We aim to investigate the effect of Kangaroo Mother Care (KMC) combined with blue-light irradiation on enhancing the therapeutic effect in the treatment of neonatal jaundice. From May 2020 to August 2022, 89 neonates with pathological jaundice and their mothers were selected as participants. All neonates received blue-light irradiation. The participants were divided into two groups: 46 neonates cared for by KMC as the research group (RG) and 43 neonates receiving routine nursing as the control group (CG). The first lactation time, first breastfeeding duration, and scores of Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) before and after nursing were recorded and compared between the groups. Pre- and post-interventional total bilirubin (TBIL), direct bilirubin (DBIL), and indirect bilirubin (IBIL) levels of both groups of newborns were measured, and the time of jaundice resolution, first defecation, and meconium yellowing were recorded. Neonatal adverse reactions (ARs) during treatment were counted, and a nursing satisfaction survey was conducted at discharge. KMC group mothers had earlier lactation and longer first breastfeeding durations (P < 0.05). Both groups’ SAS and SDS scores decreased post-nursing, with greater improvement in the KMC group (P < 0.05). KMC group newborns had lower bilirubin levels and faster resolution of jaundice and meconium yellowing, with fewer adverse reactions and higher nursing satisfaction (P < 0.05). KMC can effectively improve the efficacy of blue light irradiation in the treatment of neonatal jaundice, and promote the healthy development of newborns and the efficiency of maternal breastfeeding.

Phototherapy Effects on Zinc Level of Neonates With Hyperbilirubinemia: A Systematic Review and Meta-analysis

Background: Phototherapy is the most common treatment of neonatal jaundice that affects the zinc level as well as the bilirubin level. Objectives: The purpose of this study is to investigate the effect of phototherapy on the zinc level of infants with jaundice by a systematic review and meta-analysis. Methods: In this systematic review and meta-analysis a comprehensive literature search of the databases, including Cochrane Library, Web of Science, PubMed, Scopus, and Google Scholar web browser was conducted using standard keywords. Data analysis of this meta-analysis was performed using STATA software, version 14 and P&lt;0.05 was considered a significant level for tests. Results: In the five studies reviewed in this article with a sample size of 398 individuals, phototherapy increased the level of zinc [Standardized mean difference (SMD): 0.88 (95% CI: 0.38, 1.38), P&lt;0.001] and decreased bilirubin level [SMD: -7.67 (95% CI: -9.11, -6.23), P&lt;0.001] in infants with jaundice. The effect of phototherapy was on the zinc level of these groups: infants with a birth weight of 3000 to 3300 grams (gr) [SMD: 1.07 (95% CI: 0.42, 1.71), P&lt;0.001] and 3301 to 3600 gr [SMD: 0.40 (95% CI: -0.32, 1.12), P=0.028], three-day-old infants [SMD: 1.05 (95% CI: 0.35, 1.74), P&lt;0.001], four-day-old [SMD: 0.76 (95% CI: 0.26, 1.32)], and 5-day-old ones [SMD: 0.23 (95% CI: -0.01, 0.48)]. In addition, phototherapy affected on zinc level of those whose gestational age (GA) was 37 [SMD: 1.12 (95% CI: 0.06, 2.17), P&lt;0.001] and 38 [SMD: 0.61 (95% CI: 0.15, 1.06), P=0.001] weeks. Conclusions: Phototherapy by reducing the level of bilirubin increases the level of zinc in infants with jaundice. So, the standardized mean difference of “phototherapy effects on the zinc level of infants with jaundice” decreases with increasing infants’ weight, increasing infants’ age, and increasing gestational age.

Current status of neonatal jaundice management in Japan.

This nationwide survey aimed to determine the status of jaundice management in Japan. A questionnaire about bilirubin level measurements and neonatal jaundice treatment was sent to 330 institutions providing neonatal care. The responses were analyzed according to institution level. Of 330 institutions, 172 responded (52.1% response rate). Total bilirubin levels were measured in the central laboratory using spectrophotometry at 134 institutions and a blood gas analyzer at 81 institutions. Unbound bilirubin (UB) levels were measured by 79 institutions, while transcutaneous bilirubin measurements were taken at 63 institutions. There was no association between institution level and UB or transcutaneous bilirubin measurement. For phototherapy criteria, the Murata-Imura criteria were adopted by 67 institutions, Nakamura criteria by 36, and Morioka criteria by 39. Light-emitting diodes (LED) were used by 160 institutions versus fluorescent lights by 31. When a blue LED was used, 119 institutions used the high mode. There is no standard for increasing light intensity. No association was found between institution level and phototherapy criteria. UB was measured in 14 of 63 institutions using the Murata-Imura criteria. There is a large variation in the management and treatment of neonatal jaundice among institutes in Japan.

基于CiteSpace中医治疗新生儿黄疸的可视化分析

基于CiteSpace中医治疗新生儿黄疸的可视化分析

Effects of comfort care combined with blue-light phototherapy on neonatal jaundice and total bilirubin and high-sensitivity C-reactive protein levels

In order to explore the effects of comfort care combined with blue-light phototherapy on neonatal jaundice and total bilirubin (TBIL) and high-sensitivity C-reactive protein (hsCRP) levels, this study selected 100 neonates as research objects. Those 100 neonates were diagnosed with neonatal jaundice in a designated hospital of this study from December 2020 to December 2021, and randomly divided into observation group and control group with 50 cases in each group. The neonates in control group were given blue-light phototherapy, while the neonates in observation group were given comfort care combined with blue-light phototherapy. Before and after the treatment, the neonates in the two groups were evaluated for their quiet sleep time, the number of crying, decrease in jaundice, weight gain, and TBIL and hs-CRP levels, and compared those indicators for follow-up analysis. The results of this study show that the total effective rate was 96.0 % (48/50) in the observation group and 82.0 % (41/50) in the control group, with statistically significant difference between the two groups (P < 0.05); the indexes of the neonates’ jaundice decline [(4.41 ± 0.71) μmol/l] of the observation group were significantly better than the neonates’ jaundice decline [(3.32 ± 0.68) μmol/l] of the control group (P < 0.05); before treatment, there was no statistically significant difference in the levels of TBIL [(304.12 ± 27.63) μmol/l] and Hs-CRP [(8.01 ± 2.29) mg/L] of the observation group between the levels of TBIL [(304.08 ± 27.58) μmol/l] and Hs-CRP [(8.03 ± 2.41) mg/L] of the control group (P > 0.05); after treatment, the TBIL level [(99.27 ± 11.35) μmol/l] and hs-CRP level [(1.18 ± 0.32) μmol/l] of the observation group and the TBIL level [(123.25 ± 19.43) μmol/l] and hs-CRP level [(1.62 ± 0.45) μmol/l] of the control group were both lower than those before treatment, while the reduction degree of those in the observation group was better than that of the control group with statistically significant difference (P < 0.05). Therefore, the comfort care combined with blue-light phototherapy can achieve more ideal treatment effects than that of single use of blue-light phototherapy, which proves that the two treatment methods have certain synergy and provides a new potential technology for the prevention and treatment of neonatal jaundice.

Neonatal Jaundice: Knowledge, Practice, And Attitudes Among Primigravida Women

ABSTRACT Objective: Neonatal jaundice is characterized by a yellowish coloration of the skin and sclera of newborn infants and elevated serum bilirubin levels. In this study, it was aimed to evaluate the knowledge, practices and attitudes of primigravidas in Diyala province of Iraq regarding neonatal jaundice. Material and Methods: A questionnaire was applied to 165 women who were primigravidas between January 1, 2022 and March 31, 2022 in hospitals and health centers to evaluate their knowledge, practices and attitudes about neonatal jaundice. Results: Although 71.4% of the women knew the two signs of neonatal jaundice, 78.8% of them did not know any of the dangerous signs of neonatal jaundice. 28.4% of women knew that there are two effective treatment methods for the treatment of neonatal jaundice. 57.6% of the women were not aware of any of the severe complications of neonatal jaundice. Conclusion: Most of the primigravida in this study decided to visit physicians when their babies have jaundice without using traditional treatment.