European Journal of Molecular & Clinical Medicine

The advancement of modern Neonatology has led to more and more survival of babies at lower gestation age. Late preterm babies (born between 33 completed weeks of gestation and before beginning of 38 week of gestation) are the largest growing set of babies among premature babies. They look developmentally and physically more mature and hence often overlooked. They constitute one of the largest subsets of babies requiring hospitalization. This study was conducted to look at the readmission rates of late and early preterm babies in the first month of life with aim to look at various determinants of readmissions.
Aim: A study on readmission of late-preterm and early-term neonates in the first month of life following normal hospital discharge
Materials: Hospital based prospective observational study from Apr 2016 to Oct 2017 in a tertiary care hospital in western India to study the readmission rate of late-preterm and early-term neonates in the first month of life following normal hospital discharge.
Result: There were total 22 (7.1%) admissions among the study population, of which 13 (9.3%) were late preterm neonates and 9 (5.3%) early term neonates. Common causes of readmission were Neonatal hyperbilirubinemia in 12(55%) followed by feeding issues in 8 (36%), hypernatremic dehydration in 5 (23%) and late onset sepsis in 2 (9%) neonates.
Conclusion: Late preterm babies are vulnerable group of population as highlighted by their high rates of readmission. Jaundice and feeding problems were the most common diagnoses associated with readmission.

Introduction: Hyperbilirubinemia is the most common morbidity in normal term healthy
newborn. There is evidence that cord blood albumin (CBA) level can act as a potential marker
for the prediction of hyperbilirubinemia in neonates. The present study was therefore designed
to establish a correlation between the level of cord blood albumin (CBA) and total serum
bilirubin (TSB) so that albumin level could be standardized as a prediction marker for the
neonatal hyperbilirubinemia.
Methods: CBA and TSB levels were analysed in 500 normal term healthy newborns with birth
weight ≥2500 grams and APGAR score ≥ 7/10 at 1 min and 5 mins, after obtaining consent
from their parents. Albumin levels were analysed from the cord blood at the time of birth and
TSB levels were analysed from venous blood. Pearson’s correlation coefficient was used to
analyse the correlation between CBA and TSB levels.
Results: The mean CBA was 2.94 ± 0.34 g/dl and mean TSB was 11.17 ± 2.52 mg/dl. The
relationship between CBA and TSB values was statistically significant on further analysis of
CBA with the modality of treatment, the results were again statistically significant. The
correlation between CBA and TSB was also observed with negative correlation of r = - 0.43
with p value of <0.0001 which was highly significant.
Conclusion: Newborns with high CBA levels have low risk of developing neonatal
hyperbilirubinemia and can be discharged early from hospital. Whereas low CBA is an
indicator for developing neonatal hyperbilirubinemia in the first week of life.

Background:Recently, a number of publications have raised concern about the rising
prevalence of diabetes mellitus in Telangana. The International Diabetes Federation has
named Saudi Arabia among the top 10 countries with the highest prevalence of diabetes
Objective of the Study: To observe and evaluate the incidence and complications seen in
infants of diabetic mothers.
Materials and Methods: It is a prospective observational time bound study conducted
Yashoda Hospital, Telangana, India from December 2019 to November 2020. All live
babies born to mothers with GDM or pregestational DM were enrolled in study.
Maternal history and complications during labour were recorded. APGAR scores
assessed. Investigation for glucose estimation, PCV, serum calcium, serum bilirubin was
sent. Chest X ray was done in babies with respiratory distress. 2D ECHO, USG
abdomen, USG cranium were done in all babies after stablisation.
Results: 70 neonates were born to diabetic mothers. 2 IUD and 6 still born were
excluded from study and 62 neonates were evaluated. 2 neonates died.70.96% were
term babies and 29 % preterm. 40 infants (64.5%) were born to GDM mothers, 20
(32.3%) to mothers with type 2 DM and 2(3.2%) to type 1 DM. 16.2% were LGA while
12.9% were SGA. Hypocalcemia was seen in 4 neonates (6.7%). Hyperbilirubinemia
was seen in 4 (13.3%). Sepsis was seen in 8 neonates. CHDs were seen in 42.9%, most
common being ASD/PFO 21.3%. VSD was seen in 10.7%, PDA in 7.1% and septal
hypertrophy in 3.5%. One case had pyloric atresia and one had RDS. Association
between HbA1c levels and complications like macrosomia, hypoglycemia, congenital
anomalies was not significant in our study.
Conclusion: Neonates born to diabetic mother are at a high risk of developing
complications like hypoglycemia, hypocalcemia and cardiac defects.

Aim: The aim of this study to determine the value of pre-operative hyperbilirubinemia as a predictor of complicated appendicitis.
Material and methods: The study was a prospective observational study conducted in the Department of General Surgery……, India for the period of 1 year. Total 60 patients who were diagnosed to have appendicitis and admitted in surgery department and who underwent appendicectomy were included in the study. Clinical examination, blood routine examination, Alvarado score, ultrasound abdomen, histopathology examination, pre and post-operative values of total bilirubin, direct bilirubin and indirect bilirubin were studied.
Results: In our study 35 (58.33%) were males and 25 (41.67%) were females. Out of the 60 cases 26 were complicated. 37 cases had elevated bilirubin preoperatively in which 21 cases were having complications like gangrene, suppuration and perforation. Out of the 37 cases that had elevated bilirubin pre-operatively 19 (51.35%), the bilirubin level came down to normal limits after 72 hours of appendicectomy. On histopathology, 34 were acute appendicitis, 8 were perforated appendicitis, 6 were gangrenous appendicitis, 12 were suppurative appendicitis. From the study of sensitivity and specificity of pre-operative total bilirubin values in predicting perforated appendicitis, it was found that preoperative total bilirubin value of 1.59 mg/dl had the best sensitivity and specificity. Taking preoperative total bilirubin value 1.59 mg/dl as cut off in predicting perforated appendicitis the sensitivity was 68.8, specificity was 95.1 with an accuracy of 90.2.
Conclusion: Patients with appendicitis with elevated bilirubin levels have more chance for complications like perforation, gangrene and suppuration.

Abstract: Background- Neonatal jaundice is commonly seen in preterm new born and
phototherapy treatment of choice when indicate. Phototherapy is an efficient treatment
although there is some side effect present. These side effect may be on behavioural and
physiological in some organ and there is also changes in stages of sleep cycle and
circadian rhythm during and after phototherapy for few days. These changes in sleep cycle
due to the neurotransmitter tryptophan and there is also changes is hormones like
decreased in the growth hormones and there is changes in the melatonin which may affect
with sleep cycle. there is some study done which suggestive that phototherapy will affect the
stages of sleep but there is solid information available whether there is any effect of
phototherapy on cardiorespiratory activity. Some old study is suggestive of there is
increased in heart rate and decreased in the SBP systolic blood pressure during
phototherapy. Phototherapy cause to increase the respiratory rate and heart rate during
phototherapy. Objectives: To determine the outcome of phototherapy after 24hrs, 48hrs,
72hrs, and >72hrs on cardiac function in term neonates with hyperbilirubinemia. Results-
After completion of the study we will come to know the effect of phototherapy on cardiac
function and also get the idea for how many hours ( <24hrs / 48hrs. 72hrs or > 72hrs) we
can give safe phototherapy to the neonate with hyperbilirubinemia without affecting the
cardiac function. Or is there any need for cardiac shielding during phototherapy.
Conclusion- After completion of the study we will come to know the effect of phototherapy
on cardiac function in term neonate who is having neonatal hyperbilirubinemia.