Author(s): Laxmipati G H, Shreedhara Avabratha K, Bhagyalakshmi K

Email(s): shreedharkdr@fathermuller.in

DOI: 10.52711/0974-360X.2022.00359   

Address: Laxmipati G H1, Shreedhara Avabratha K2*, Bhagyalakshmi K3
1Department of Pediatrics, Taluka Hospital Mundargi, Gadag District, Karnataka, India.
2Department of Pediatrics, Father Muller Medical College, Mangalore, Karnataka, India.
3Department of Physiology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India.
*Corresponding Author

Published In:   Volume - 15,      Issue - 5,     Year - 2022


ABSTRACT:
The present study was aimed to assess the effect of head covering on phototherapy induced hypocalcaemia in jaundiced term newborns. This study was conducted in a medical college hospital in South India. All enrolled term neonates were randomly allotted to either the group using a cap (cases) or the group not using a cap (controls) by using closed envelope method. Conventional phototherapy equipment was used and the American Academy of Pediatrics (AAP) guidelines for phototherapy were followed. Serum calcium levels were measured before and after 24 hours and after 48 hours of phototherapy in case phototherapy was continued for a longer period. Results were tabulated and analyzed using student t-test and Chi square test. Out of 110 newborns studied, 58(53%) were boys and 52(47%) were girls. The average age of onset of jaundice was between 25- 48 hours. The mean weight of the neonates was 2993±241g. Mean total serum bilirubin level before phototherapy was 13.43±3.27mg/dl. Mean total serum calcium level before phototherapy was 9.92±0.84mg/dl. Mean total serum calcium levels after 24 hours of phototherapy were 9.37±0.67mg/dl and 9.21±0.71mg/dl in cases and controls respectively (p =0.000). Mean total serum calcium levels after 48 hours of phototherapy were 8.87±0.80 mg/dl and 8.52±0.54mg/dl in cases and controls respectively (p=0.022). Only 3 babies in control group developed hypocalcaemia (Serum calcium <8 mg/dl) and none were symptomatic. There is a reduction in the total serum calcium level after phototherapy which is more as the duration of phototherapy is increased. The reduction in the total serum calcium level after phototherapy is significantly less when the head is covered with a cap during phototherapy than when it is not.


Cite this article:
Laxmipati G H, Shreedhara Avabratha K, Bhagyalakshmi K. Effect of head covering on Phototherapy Induced Hypocalcemia in Jaundiced term neonates. Research Journal of Pharmacy and Technology. 2022; 15(5):2163-7. doi: 10.52711/0974-360X.2022.00359

Cite(Electronic):
Laxmipati G H, Shreedhara Avabratha K, Bhagyalakshmi K. Effect of head covering on Phototherapy Induced Hypocalcemia in Jaundiced term neonates. Research Journal of Pharmacy and Technology. 2022; 15(5):2163-7. doi: 10.52711/0974-360X.2022.00359   Available on: https://www.rjptonline.org/AbstractView.aspx?PID=2022-15-5-41


REFERENCES:
1.    Shaughnessy EE, Goyal NK. Jaundice and hyperbilirubinaemia in the newborn. In: Kliegman, St Geme, Blum, Shah, Tasker, Wilson (editors.) Nelson Textbook of Paediatrics. 21st ed. Elsevier; Philadelphia; 2020: 953-7.
2.    Maisels MJ. Neonatal Jaundice. Pediatrics in Review 2006; 27(12): 443-54. https://doi.org/10.1542/pir.27-12-443
3.    Harsha. L, Jothi Priya, Khushali. K. Shah, Reshmi. B. Harsha. L, Jothi Priya, Khushali. K. Shah, Reshmi. B. Systemic Approach to Management of Neonatal Jaundice and Prevention of Kernicterus, Research J. Pharm. and Tech. 2015; 8(6): 1087-92. https://doi.org/10.5958/0974-360X.2015.00189.4
4.    Stokowski LA. Fundamentals of phototherapy for neonatal jaundice. Advances in Neonatal Care 2006; 6(6): 303-12. https://doi.org/10.1016/j.adnc.2006.08.004
5.    Cloherty JP, Eichenwald EC, Stark AR. Neonatal hyperbilirubinaemia. In: Manual of Neonatal Care. 7th ed.; Philadelphia: Lippincott Williams and Wilkins; 2012: 304-39.
6.    Omprakash Bhargava, Suresh Kumar Sutrakar, Pawan Ghanghoria, Arvind Verma. Incidence of thrombocytopenia in hyperbilirubinemic neonates following Phototherapy. Asian J. Research Chem. 2015; 8(4): 221-30. https://doi.org/10.5958/0974-4150.2015.00039.5
7.    Shelar Sangita, V. Radha, Vaibhav Bhosale. Assess the Effectiveness of Increased Breast feeding on Temperature Stability and Hydration among the Newborns with Hyperbilirubinemia Receiving Phototherapy at Pravara Rural Hospital. Int. J. Nur. Edu. and Research. 2018; 6(1): 122-5. https://doi.org/10.5958/2454-2660.2018.00029.7
8.    Eghbalian F, Monsef A. Phototherapy induced hypocalcemia in icteric newborns. International Journal of Medical Students 2002; 27(4): 162-71.
9.    Romagnoli C, Polidori G, CataldiL,Tortorlo SG, Segni G. Phototherapy induced hypocalcaemia. Journal of Pediatrics. 1979; 94(5): 813-6. https://doi.org/10.1016/S0022-3476(79)80166-3
10.    Maha AN, Wafaa FE, Amaal ES, Sanaa MM. Impact of covering the heads of icteric neonates during  phototherapy on the prevalence of hypocalcaemia. Medical Journal of Cairo University 2013; 81(2): 219-22.
11.    Hakanson DO, Bergstorm WH. Phototherapy induced hypocalcaemia in rats. Prevention by melatonin. Science. 1981; 214(4522): 807-09. https://doi.org/10.1126/science.6895262
12.    Ezzeldin Z, Mansi Y, Abdelhamid TA, SabryM. The effect of hat on phototherapy induced hypocalcemia in jaundiced full term neonates; A randomized controlled trial. Research and Reports in Neonatology 2015;5: 73-8.https://doi.org/10.2147/RRN.S83393
13.    Wiese G. Prediction of the Effect of Phototherapy in Newborns. Neonatal Jaundice [Internet]. Springer US; 1984;245–55. http://dx.doi.org/10.1007/978-1-4684-7517-3_23
14.    Mansi Y, Ezzeldin Z, el Hamid T, Sabry M. The effect of hat on phototherapy-induced hypocalcemia in jaundiced full-term neonates. Research and Reports in Neonatology [Internet]. Informa UK Limited; 2015 Aug;73. http://dx.doi.org/10.2147/rrn.s83393
15.    Gheshmi, A. N., Naderi, S., Homayrani, E., & Safari, B. (2015). Prevalence of hypocalcemia after phototherapy among neonates who underwent phototherapy in Koodakan Hospital in Bandar Abbas in 2013. Electronic physician, 7(6), 1387–1390. https://doi.org/10.14661/1387
16.    Manoj GM, Anupama D. Comparative study of incidence of phototherapy induced hypocalcaemia in preterm v/s term neonates. International Journal of Scientific Research 2016; 5(7): 341-4.
17.    Yadav RK, Sethi RS, Sethi AS, Lalitkumar, Chaurasia O. The evaluation of effect of phototherapy on serum calcium level. People’s Journal of Scientific Research 2012; 5(2):1-4.
18.    Tandon M, Nayar D, Ramachandran S and Kapil U. Phototherapy induced hypocalcaemia. Indian Pediatrics 1998; 35: 566-9.
19.    Taheri AP, Sajjadian N, Eivazzadeh B. Prevalence of phototherapy induced hypocalcaemia in term neonate; Iranian Journal of Pediatrics 2013; 23(6): 710–1.
20.    Karamifar H, Pishva N, Amirhakimi GH. Prevalence of phototherapy induced hypocalcemia. International Journal of Medical Students 2002; 27(4): 166-8.
21.    Aryan R, Patil N. The effect of phototherapy on serum ionised calcium levels in neonates with unconjugated hyperbilirubinaemia; Indian Journal of Applied Research 2015; 5(3):320-2
22.    Durga T, Ravikumar M. The effect of phototherapy on serum ionized calcium in neonates with unconjugated hyperbilirubinemia; Journal of Evidence Based Medicine and Healthcare 2017; 17(2): 2388-92.
23.    Tejas Pandya, Ravindra H.N. Effectiveness of planned teaching program on knowledge regarding care of the neonate under phototherapy among diploma internship nursing students in selected nursing schools at Gujarat state. Int. J. Adv. Nur. Management 2015;3(2): 75-80.
24.    Nisha Abraham, Jijil. B.. A Study to Evaluate the Effectiveness of Structured Teaching Programme (STP) on Knowledge regarding the Management of Neonatal Jaundice among Primipara mothers in selected Hospitals at Gonda, UP. Int. J. of Advances in Nur. Management. 2020; 8(1):29-34. https://doi.org/10.5958/2454-2652.2020.00009.8
25.    Chandrasekhar M, Vishakantamurthy D G, Sheela Williams. A Study to Assess the Knowledge Regarding Neonatal Jaundice and its Management among staff Nurses in selected Hospital at Mysuru. Int. J. Nur. Edu. and Research. 2017; 5(3): 327-30. https://doi.org/10.5958/2454-2660.2017.00067.9


REFERENCES:
1.    Shaughnessy EE, Goyal NK. Jaundice and hyperbilirubinaemia in the newborn. In: Kliegman, St Geme, Blum, Shah, Tasker, Wilson (editors.) Nelson Textbook of Paediatrics. 21st ed. Elsevier; Philadelphia; 2020: 953-7.
2.    Maisels MJ. Neonatal Jaundice. Pediatrics in Review 2006; 27(12): 443-54. https://doi.org/10.1542/pir.27-12-443
3.    Harsha. L, Jothi Priya, Khushali. K. Shah, Reshmi. B. Harsha. L, Jothi Priya, Khushali. K. Shah, Reshmi. B. Systemic Approach to Management of Neonatal Jaundice and Prevention of Kernicterus, Research J. Pharm. and Tech. 2015; 8(6): 1087-92. https://doi.org/10.5958/0974-360X.2015.00189.4
4.    Stokowski LA. Fundamentals of phototherapy for neonatal jaundice. Advances in Neonatal Care 2006; 6(6): 303-12. https://doi.org/10.1016/j.adnc.2006.08.004
5.    Cloherty JP, Eichenwald EC, Stark AR. Neonatal hyperbilirubinaemia. In: Manual of Neonatal Care. 7th ed.; Philadelphia: Lippincott Williams and Wilkins; 2012: 304-39.
6.    Omprakash Bhargava, Suresh Kumar Sutrakar, Pawan Ghanghoria, Arvind Verma. Incidence of thrombocytopenia in hyperbilirubinemic neonates following Phototherapy. Asian J. Research Chem. 2015; 8(4): 221-30. https://doi.org/10.5958/0974-4150.2015.00039.5
7.    Shelar Sangita, V. Radha, Vaibhav Bhosale. Assess the Effectiveness of Increased Breast feeding on Temperature Stability and Hydration among the Newborns with Hyperbilirubinemia Receiving Phototherapy at Pravara Rural Hospital. Int. J. Nur. Edu. and Research. 2018; 6(1): 122-5. https://doi.org/10.5958/2454-2660.2018.00029.7
8.    Eghbalian F, Monsef A. Phototherapy induced hypocalcemia in icteric newborns. International Journal of Medical Students 2002; 27(4): 162-71.
9.    Romagnoli C, Polidori G, CataldiL,Tortorlo SG, Segni G. Phototherapy induced hypocalcaemia. Journal of Pediatrics. 1979; 94(5): 813-6. https://doi.org/10.1016/S0022-3476(79)80166-3
10.    Maha AN, Wafaa FE, Amaal ES, Sanaa MM. Impact of covering the heads of icteric neonates during  phototherapy on the prevalence of hypocalcaemia. Medical Journal of Cairo University 2013; 81(2): 219-22.
11.    Hakanson DO, Bergstorm WH. Phototherapy induced hypocalcaemia in rats. Prevention by melatonin. Science. 1981; 214(4522): 807-09. https://doi.org/10.1126/science.6895262
12.    Ezzeldin Z, Mansi Y, Abdelhamid TA, SabryM. The effect of hat on phototherapy induced hypocalcemia in jaundiced full term neonates; A randomized controlled trial. Research and Reports in Neonatology 2015;5: 73-8.https://doi.org/10.2147/RRN.S83393
13.    Wiese G. Prediction of the Effect of Phototherapy in Newborns. Neonatal Jaundice [Internet]. Springer US; 1984;245–55. http://dx.doi.org/10.1007/978-1-4684-7517-3_23
14.    Mansi Y, Ezzeldin Z, el Hamid T, Sabry M. The effect of hat on phototherapy-induced hypocalcemia in jaundiced full-term neonates. Research and Reports in Neonatology [Internet]. Informa UK Limited; 2015 Aug;73. http://dx.doi.org/10.2147/rrn.s83393
15.    Gheshmi, A. N., Naderi, S., Homayrani, E., & Safari, B. (2015). Prevalence of hypocalcemia after phototherapy among neonates who underwent phototherapy in Koodakan Hospital in Bandar Abbas in 2013. Electronic physician, 7(6), 1387–1390. https://doi.org/10.14661/1387
16.    Manoj GM, Anupama D. Comparative study of incidence of phototherapy induced hypocalcaemia in preterm v/s term neonates. International Journal of Scientific Research 2016; 5(7): 341-4.
17.    Yadav RK, Sethi RS, Sethi AS, Lalitkumar, Chaurasia O. The evaluation of effect of phototherapy on serum calcium level. People’s Journal of Scientific Research 2012; 5(2):1-4.
18.    Tandon M, Nayar D, Ramachandran S and Kapil U. Phototherapy induced hypocalcaemia. Indian Pediatrics 1998; 35: 566-9.
19.    Taheri AP, Sajjadian N, Eivazzadeh B. Prevalence of phototherapy induced hypocalcaemia in term neonate; Iranian Journal of Pediatrics 2013; 23(6): 710–1.
20.    Karamifar H, Pishva N, Amirhakimi GH. Prevalence of phototherapy induced hypocalcemia. International Journal of Medical Students 2002; 27(4): 166-8.
21.    Aryan R, Patil N. The effect of phototherapy on serum ionised calcium levels in neonates with unconjugated hyperbilirubinaemia; Indian Journal of Applied Research 2015; 5(3):320-2
22.    Durga T, Ravikumar M. The effect of phototherapy on serum ionized calcium in neonates with unconjugated hyperbilirubinemia; Journal of Evidence Based Medicine and Healthcare 2017; 17(2): 2388-92.
23.    Tejas Pandya, Ravindra H.N. Effectiveness of planned teaching program on knowledge regarding care of the neonate under phototherapy among diploma internship nursing students in selected nursing schools at Gujarat state. Int. J. Adv. Nur. Management 2015;3(2): 75-80.
24.    Nisha Abraham, Jijil. B.. A Study to Evaluate the Effectiveness of Structured Teaching Programme (STP) on Knowledge regarding the Management of Neonatal Jaundice among Primipara mothers in selected Hospitals at Gonda, UP. Int. J. of Advances in Nur. Management. 2020; 8(1):29-34. https://doi.org/10.5958/2454-2652.2020.00009.8
25.    Chandrasekhar M, Vishakantamurthy D G, Sheela Williams. A Study to Assess the Knowledge Regarding Neonatal Jaundice and its Management among staff Nurses in selected Hospital at Mysuru. Int. J. Nur. Edu. and Research. 2017; 5(3): 327-30. https://doi.org/10.5958/2454-2660.2017.00067.9

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