Hi I have a 7 days old neonate admitted with me with complaint of neonatal icterus. This male baby was delivered by C-section(indicated for prolonged labour and leaking membranes) at full term. He cried and gasped after about 1 1/2minute and had an Apgar score of 10/10 at 3minutes. Mother's blood group is O-positive and baby is B-positive.The baby developed jaundice after 24 hours. DCT was negative and se Bil was T-11.2 and direct- 1.8 mg.G 6PD normal,Retic count 1.8% and HB -12.8gm.C.B.C is normal. There was no sign of sepsis as baby was active and accepting feed well. The baby was started on Omnatax and mikacin for PRM and put under Phototherapy. subseq . Bilirubin reports are as follows. Age in hrs. Total Direct 36 12.6 1.6 48 19.2 1.8 54 18.2 1.6 60 17.7 1.7 72 17.4 1.6 96 17.6 1.7 120 17.2 1.5 After this inspite of double surface continous Phototherapy ,the total Bil is persisting at 17.6 and direct 1.8 even on day 7. Should we do an Exchange transfusion or continue with Phototherapy?In case if we want to do an exchange which vein will be available as by this time the Umblical vein must be obliterated? Dr. JS Chugh     Check out the answer

What is the incidence of Neonatal Hyperbilirubinemia in India and in the World?.......I'm doing a project on Utility of Nomogram in NNH and need this information     Check out the answer

19 days mch presented with lethargy ,poor feeding.o/e;2.5kg.afebrile.jaundice+.s.bill.total 10.8,conjugated:3.6.child put in taximax,amplus,genta.there is history of constipation for 8days,gc of child improved,pased stools,accepting feeds.but icterus is same.breast feeding stopped for 48hrs,no regression of jaundice.please guide what all further management i should do,as BMJ,septicaemia is ruled out. thanx.     Check out the answer

What is the pathophysiology of jaundice in hypothyroidism?     Check out the answer

My child was born on 11 Seop 05. He was admitted in hospital on 16 Sept 05 for hyperbilirubinemia with count as 16.Double phototherapy for 24 hours brought the count down to 11.6. After 30 hours of observation the count rose to 15.Single phototherapy was again initiated for 24 hours bringing the count to 12.8. Another 24 hours of observation saw the count rise to 14.8 The baby was then discharged on 21 Sept 05.Follow up after nine days ie on 30 Sept witnessed the count at 14.0 , 0.3 The jaundice is not seeming to subside even after three weeks. I am worried . Please advise.     Check out the answer

Why skin pigmentation starts from head to extremities in neonatal hyperbilirubinemia in relation to the severity of jaundice?     Check out the answer

What is the current treatment modalities for the management of breast milk jaudice     Check out the answer

Respected sir/ Madam, recently we came across a case of intrahepatic biliary atresia with marked fibrosis and hepatic dysfunction in a two month old child. A Kasai operation is being planned for him. i want to know what is the treatment of choice in this case. because according to the literature he has a very bad prognosis and liver transplant is the only answer in this case. please clear my doubt in the above case. thanking you . Dr. Sangeeta     Check out the answer

Thanks you have shown interest in case history i have sent*(hepatospenomegaly withhh anaemia). Ihave sent the case with examination point view only. So the discussion is restricted only to case history and approach.My q is whether thev h/o and clinical exam is suggestive of hemolytic anaemia. OF COURSE THE POSSIBILITY OF CHRONIC LILVER DISEASE and hiv u told is very likely but i want to concentate on anaemia . 2)PROPHYLACTIC PHOTOTHERAPY has been mentioned in fstandard books .Is it practised? because i have not seen in practise. kindly give detail about it. 3)One leading company has somewhere advertised rotavirus and malaria vaccine as forthcoming vaccine. ROTA vaccine was banned due to intussuseption and malaria still experimental. kindly tell latest update. Iap book also mention these as vaccine of mill;enium     Check out the answer

What is the role of fresh frozen plasma in treatment of hyperbilirubinemia in neonates ........ any references     Check out the answer

17yr.old girl;1st.episode of jaundice age 7yrs.back;from July/04 icteric eyes/urine bilefree/LFT I/R; Sr.bilirubin repeatedly Total around 1.8/UC Bil.1.5; ultrasound mild hepato-splenmegaly only; Totally symptomfree but for the eyes; possibilities? further investigations please .     Check out the answer