Novel or new method for the treatment of jaundice in paediatrics

Shabbeer and Sham prasad

Neonatal jaundice or neonatal hyperbilirubinemia, or neonatal icterus, attributive adjective: icteric, is a yellowing of the skin and other tissues of a newborn infant. A bilirubin level of more than 85 μmol/l (5mg/dL) leads to a jaundiced appearance in neonates whereas in adults a level of 34 μmol/l (2 mg/dL) is needed for this to occur. In newborns, jaundice is detected by blanching the skin with pressure applied by a finger so that it reveals underlying skin and subcutaneous tissue. Jaundiced newborns have yellow discoloration of the white part of the eye, and yellowing of the face, extending down onto the chest. Neonatal jaundice can make the newborn sleepy and interfere with feeding. Extreme jaundice can cause permanent brain damage from kernicterus. In neonates, the yellow discoloration of the skin is first noted in the face and as the bilirubin level rises proceeds caudal to the trunk and then to the extremities. This condition is common in newborns affecting over half (50–60%) of all babies in the first week of life.[3] Infants whose palms and soles are yellow, have serum bilirubin level over 255 μmol/l (15 mg/dL) (more serious level). Studies have shown that trained examiners assessment of levels of jaundice show moderate agreement with icterometer bilirubin measurements as the new or novel method to determine.[2] In infants, jaundice can be measured using invasive or non-invasive methods. This research article focuses on a brief introduction to jaundice, its types and causes, measuring the bilirubin level, clinical approaches towards hyperbilirubinemia, different precautionary measures for the parents of babies suffering from hyperbilirubinemia and different remedial therapeutic measures for its treatment. Qualitative response regression models was proposed to obtain the precise estimates of the probabilities of a neonatal having neonatal jaundice. Binary Logistic regression analysis which model neonatal jaundice as a response variable while Neonate age, neonate sex, birth weight, mode of delivery, place of delivery, settlement, G6PD, Mothers’ Rhesus factor, mother illness during pregnancy, mother level education, parity of the mother and gestational age were the risk factors. The result showed that gestational age, place of delivery, Rhesus incompatibility, and G6PD were statistically significant risk factors for neonatal jaundice. The model converges at the 4th iteration with -2log-likelihood of 267.712, and Cox & Snell R2 is .206 with probability of 0.0000 at 5% ∝ level of significance, this indicated that the model fitted for the study is adequate at that level of significance.

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