European Journal of Molecular & Clinical Medicine

Introduction: Neonatal hyperbilirubinemia is the most common clinical finding noted during
the first seven days following birth. Amongst all the modalities available for management of
neonatal hyperbilirubinemia, phototherapy is proven to be the safest. However, like any other
intervention, phototherapy too has some of its own side effects.
Aim & objectives: To estimate and compare alterations in serum electrolytes of healthy term
neonates before and after phototherapy.
Material & methods: A hospital based prospective observational comparative study was
conducted over a period of 18 months in the department of Pediatrics on 110 healthy term
neonates with unconjugated hyperbilirubinemia who were subjected to phototherapy as per
American Academy Pediatrics guidelines. Electrolytes including sodium, potassium, chloride
and calcium were analyzed from serum using standard laboratory techniques.
Results: The mean sodium, chloride, potassium and calcium levels before phototherapy was
141.3±2.69 meq/L, 102.2±2.98 meq/L, 4.43±0.52 meq/L, 9.14±0.46 mg/dl and after
phototherapy was 140.5±2.70 meq/L, 102.0±2.93 meq/L, 4.23±0.48 meq/L and 8.09±0.55
mg/dl respectively. All were found to be statistically significant (p-value <0.05); although none
were clinically significant and conveyed no symptom of dyselectrolytemia in this study.
Conclusion: This study shows that neonates exposed to phototherapy are at a risk of
developing electrolyte imbalances and consequently their complications. Hence, close
monitoring of such babies are needed to prevent imbalances and their untoward consequences.

Background: Cholestasis is a known complication of gram-negative bacterial infection,
especially in infants. This syndrome is more frequent in the neonatal period and may
account for as much as a third of the cases of neonatal jaundice. Objectives: to
determine the prevalence of neonatal cholestasis in neonatal sepsis and to determine the
prevalence of Gram negative septicemia in neonatal sepsis.
Materials and Methods: This retrospective, observational study was conducted among
267 neonates attending in neonatal ward department of pediatrics at Dr. B.R.A.M.
Hospital, Raipur, Chhattisgarh.
Results: Only 47 infants out of 267 cases were having Cholestasis jaundice.
Overwhelming majority of infection in our study were caused by gram negative
organism Klebsiella pneumoniae (78.72%), E.coli (17.02%), Acinobacter (2.13%) and
S.aureus (2.1%). Association of Cholestasis with infecting organism in subjects with
neonatal sepsis was assessed using Chi square test. No significant association was found
to exist between two parameters (p=0.07).
Conclusion: It was concluded that majority of infection in our study were caused by
gram negative organism Klebsiella pneumonia, E.coli, Acinobacter and S.aureus.

Background: Aim & Objectives: To study the ABG and electrolyte disturbances in
severe malaria. To assess the prognostic significance of these parameters.
Materials and Methods: The present study is a prospective study of 50 patients above
the age of 12 yrs. The patients were selected from those who were admitted with severe
malaria in Acute Medical Care Unit, Ganndhi Hospital, Secunderabad. Patients who
came with symptoms or signs of severe malaria like coma, convulsions, hypotension,
decreased urine output, anemia, jaundice, respiratory distress are assessed. Out of them
who fit the exclusion criteria are excluded.
Results: Acidosis is commonly seen with malaria and this most often high anion gap
metabolic acidosis contributed by lactic acidosis, renal failure and other anions.
Electrolyte abnormalities are common in malaria with hyponatremia, eukalemia,
hypochloremia, hypocalcemia and hypophosphatemia being the commonest.
Conclusion: Finally, we conclude, Strong predictors of mortality include acidosis, high
anion gap, hyperlactatemia and hyperkalemia

Background: Cholestasis is a known complication of gram-negative bacterial infection,
especially in infants. This syndrome is more frequent in the neonatal period and may
account for as much as a third of the cases of neonatal jaundice. Objectives: to
determine the prevalence of neonatal cholestasis in neonatal sepsis and to determine the
prevalence of Gram negative septicemia in neonatal sepsis.
Materials and Methods: This retrospective, observational study was conducted among
267 neonates attending in neonatal ward department of pediatrics at Dr. B.R.A.M.
Hospital, Raipur, Chhattisgarh.
Results: Only 47 infants out of 267 cases were having Cholestasis jaundice.
Overwhelming majority of infection in our study were caused by gram negative
organism Klebsiella pneumoniae (78.72%), E.coli (17.02%), Acinobacter (2.13%) and
S.aureus (2.1%). Association of Cholestasis with infecting organism in subjects with
neonatal sepsis was assessed using Chi square test. No significant association was found
to exist between two parameters (p=0.07).
Conclusion: It was concluded that majority of infection in our study were caused by
gram negative organism Klebsiella pneumonia, E.coli, Acinobacter and S.aureus.

Background:Humans have long known about jaundice. Obstructive jaundice is
common in general surgery. Intrahepatic or extrahepatic blockage can cause
obstructive jaundice. Most patients with suspected biliary blockage start with an
abdominal ultrasound. This study aims to determine the prevalence of obstructive
jaundice owing to choledocholithiasis in my hospital, the role of ultrasound in detecting
such cases, and the treatment options available at Princes Dusra Hospital Hyderabad.
Materials and Methods: Between June 2019 and June 2021, 24 patients with obstructive
jaundice due to choledocholithiasis were studied at Princes Esra Hospital in Hyderabad.
These patients received surgery. The proforma was used to assess these patients both
pre- and post-operatively.
Results: Obstructive jaundice due to choledocholithiasis was 0.14 percent in hospitals.
The patients were mostly female (16:4).Symptoms presented in decreasing order of
frequency. 100% jaundice, 95% abdominal pain, 50% nausea/vomiting, 50% itching
(35 percent),Fever with chills and rigours (25%) Steatorrhea (10%) and abdominal
mass (5%).Ultrasound showed stones in 16 (80%) and dilated CBD in all 24 (100%)
instances (100 percent ). 11 patients had choledocholithiasis. Four instances had
choledocholithiasis and cholelithiasis. The investigation found one incidence of
choledocholithiasis with CBD stricture. The most common surgical technique was
choledochoduodenostomy (50%) followed by choledochotomy with T-tube drainage
(40%) One case each of choledocho-jejunostomy and transduodenal sphincter. All
twenty instances had cholecystectomy. All cases were monitored for 1-6 months with no
complaints.
Conclusion:Patients with obstructive jaundice are more susceptible to infections due to
impaired liver function. It's also critical to identify specific risk factors in biliary tract
surgery patients. Our study shows that ultrasound is the cheapest, safest, and most
reliable diagnostic technique for postoperative jaundice. Despite the advent of
laparoscopic CBD exploration, open, internal, and external biliary drainage procedures
are still used successfully in areas lacking technology and experience.