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2- Assistant Professor
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4- Ex head of department of pediatrics
Abstract: (418 Views)
ABSTRACT
Objective: The aim of the work is to study the effect of phototherapy on serum calcium level in neonates with hyperbilirubinemia .
Methods: It was an observational study, conducted in the NICU of BYL & T.N. Medical college, Mumbai over a period of 12 months after obtaining permission from institutional ethics committee . This study was performed on 100 neonates (>34 weeks of gestational age) with hyperbilirubinemia managed with phototherapy. A sample of blood was sent to the laboratory for serum calcium level before initiating phototherapy and after completion of phototherapy. All the neonates were clinically assessed for clinical features of hypocalcemia . All the data were recorded in the preformed proforma. Data was analysed using SPSS version 27. P value <0.05 was taken as significant.
Results: The mean age of the neonates was 3±1.2 days .Mean gestational age at the time of birth was 37±1.2 weeks. Mean duration of jaundice was 2.8±1.10 days. The median serum calcium (mg/dL) level before phototherapy was 8.6 (8.49–8.61). After phototherapy, the median serum calcium (mg/dL) levels were reduced to 7.35 (7.33–7.50), which was significant (p<0.001). Hypocalcemia was defined as a serum calcium level of 8 mg/dL, and the incidence of hypocalcemia in the study population was 16%. 60% of new-borns with hypocalcemia experienced mild symptoms like jitteriness or irritability.
Conclusion: The Incidence of hypocalcemia is significant in the jaundiced neonates treated with phototherapy. One needs to be watchful in dealing neonates in NICU while serial monitoring for hypocalcemia and its complications.
Objective: The aim of the work is to study the effect of phototherapy on serum calcium level in neonates with hyperbilirubinemia .
Methods: It was an observational study, conducted in the NICU of BYL & T.N. Medical college, Mumbai over a period of 12 months after obtaining permission from institutional ethics committee . This study was performed on 100 neonates (>34 weeks of gestational age) with hyperbilirubinemia managed with phototherapy. A sample of blood was sent to the laboratory for serum calcium level before initiating phototherapy and after completion of phototherapy. All the neonates were clinically assessed for clinical features of hypocalcemia . All the data were recorded in the preformed proforma. Data was analysed using SPSS version 27. P value <0.05 was taken as significant.
Results: The mean age of the neonates was 3±1.2 days .Mean gestational age at the time of birth was 37±1.2 weeks. Mean duration of jaundice was 2.8±1.10 days. The median serum calcium (mg/dL) level before phototherapy was 8.6 (8.49–8.61). After phototherapy, the median serum calcium (mg/dL) levels were reduced to 7.35 (7.33–7.50), which was significant (p<0.001). Hypocalcemia was defined as a serum calcium level of 8 mg/dL, and the incidence of hypocalcemia in the study population was 16%. 60% of new-borns with hypocalcemia experienced mild symptoms like jitteriness or irritability.
Conclusion: The Incidence of hypocalcemia is significant in the jaundiced neonates treated with phototherapy. One needs to be watchful in dealing neonates in NICU while serial monitoring for hypocalcemia and its complications.
Research Article: Research Article |
Subject:
Biochemistry
Received: 2024/04/7 | Accepted: 2024/10/6
Received: 2024/04/7 | Accepted: 2024/10/6
References
1. Sinha R, Sachendra B, Syed Vs, Nair L, John BM. To study the prevalence of glucose 6 phosphate dehydrogenase(G6PD) deficiency in neonates with neonatal hyperbilirubinemia and to compare the course of the neonatal jaundice in deficient versus non deficient neonates. J Clin Neonatol. 2017;6(2):71-4. [View at Publisher] [DOI] [Google Scholar]
2. Gamaleldin R, Iskander I, Seoud I, Aboraya H, Aravkin A, Sampson PD, et al. Risk factors for neurotoxicity in newborns with severe neonatal hyperbilirubinemia. Pediatrics. 2011;128(4)):e925-31. [View at Publisher] [DOI] [PMID] [Google Scholar]
3. Hamza A. Kernicterus. Autops case reports. Brazil. 2019;9(1):e2018057. [View at Publisher] [DOI] [PMID] [Google Scholar]
4. Singh DPK, Chaudhuri DPK, Chaudhary DAK. Phototherapy Induced Hypocalcemia in Neonatal Hyperbilirubinemia. IOSR J Dent Med Sci. 2017;16(4):35-8. [View at Publisher] [DOI] [Google Scholar]
5. Eichenwald EC, Hansen AR, Martin CR, Stark AR, Martin CR. Cloherty and Starks Manual of neonatal care. Wolters Kluwer. (2016) [View at Publisher] [Google Scholar]
6. Linarelli LG. Newborn urinary cyclic AMP and developmental renal responsiveness to parathyroid hormone. Pediatrics. 1972;50(1):14-23. [View at Publisher] [DOI] [PMID] [Google Scholar]
7. Salle BL, Delvin EE, Lapillonne A, Bishop NJ, Glorieux FH. Perinatal metabolism of vitamin D. Am J Clin Nutr. 2000;71(5):1317S-24S. [View at Publisher] [DOI] [PMID] [Google Scholar]
8. Hakanson DO, penny R, bergstrom WH. Calcemic responses to photic and pharmacologic manipulation of serum melatonin. Pediatr Res. 1987;22(4):414-6. [View at Publisher] [DOI] [PMID] [Google Scholar]
9. Canalis E, Delany AM. Mechanisms of glucocorticoid action in bone. Ann N Y Acad Sci. 2002;966:73-81. [View at Publisher] [DOI] [PMID] [Google Scholar]
10. Vigneshwar NKV, Basu S, Naithani M, Vivekanand N, Chacham S, Singh P. Serum Calcium and Melatonin Levels in Neonates Undergoing Phototherapy. Indian J Pediatr. 2021;88(8):805-8. [View at Publisher] [DOI] [PMID] [Google Scholar]
11. Manoj G M, Anupama D. Comparative study of incidence of phototherapy induced hypocalcemia in preterm vs term neonates. Int J Sci Res. 2016;5(7):341-4. [View at Publisher]
12. Jain BK, Singh H, Singh D, Toor NS. Phototherapy induced hypocalcemia. Indian pediatrics.1998;35(6):566-7. [View at Publisher] [PMID] [Google Scholar]
13. Ehsanipour F., Khosravi N., Jalali S. The Effect of Hat on Phototherapy-Induced Hypocalcemia in Icteric Newborns. RJMS . 2008;15(0):25-9. [View at Publisher] [Google Scholar]
14. Karamifar H, Pishva N, Amirhakimi GH. Prevalence of phototherapy-induced hypocalcemia. Iran J Med Sci. 2002;27(4):166-8. [View at Publisher] [Google Scholar]
15. Panneerselvam K, Mani S, Vasudevan N, S P, Krishnamoorthy N, Rk P, et al. Effect of Light-Emitting Diode Phototherapy on Serum Calcium Levels in Neonates With Jaundice. Cureus. 2022;14(4):e23938. [View at Publisher] [DOI] [PMID] [Google Scholar]
16. Goyal M, Sharma R, Dabi D. Phototherapy induced hypocalcemia in neonates: A case-control prospective study. Indian J Child Heal. 2018;5(3):208-12. [View at Publisher] [DOI] [Google Scholar]
17. Sethi H, Saili A, Dutta AK. Phototherapy induced hypocalcemia. Indian Pediatr. 1993;30(12):1403-6. [View at Publisher] [PMID]
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.