Haematological Performances of Jaundice Catfish (Clarias gariepinus, Burch)

The research was aimed to study hematological performances of jaundice and healthy catfish (Clarias gariepinus, Burch.). Fifty fish (i.e. twenty five of jaundice and twenty five of healthy catfish) were collected and analyzed for their hematological parameters. The blood samples were taken from caudal vein of the fish by using 2.5 ml-spuit, and then were collected into bottle samples with no or containing anticoagulant of 1% EDTA. Blood samples in the bottles with anticoagulant were used for blood cell counting and blood glucose analysis. Total billirubin, direct and indirect billirubin, and transaminase-enzymes were measured from serum of the blood samples without anticoagulant. Results showed that the blood cells (i.e. leucocytes, erythrocytes, hemoglobin, and haematocrit) of the jaundice catfish were lower than the healthy catfish. On the other hand, the blood glucose concentration) of the jaundice fish was higher. The direct and indirect billirubin concentration of the jaundice catfish was also higher, which indicated that the jaundice catfish was hiperbillirubin. However, both jaundice and heathty catfish performed high concentration of the transaminase enzymes in their blood serum. It was suggested that the hiperbillirubin-jaundice fish was mal function of their hepar and showing a stress symptoms. Keywords: Billirubin, Blood glucose, Clarias gariepinus, Hematology, Jaundice catfish, Transaminase enzym

Panhypopituitarism : a rare cause of neonatal cholestatic jaundice

Although not uncommon, neonatal cholestatic jaundice is usually caused by congenital anatomical defects of the biliary tree or intrinsic liver pathology. We describe a case of persistent cholestatic jaundice in a six week old female infant caused by panhypopituitarism. To our knowledge this is the first report of hypopituitarism presenting with cholestatic jaundice in Malta. Prolonged obstructive jaundice in the neonatal period should be urgently investigated until a cause is found.peer-reviewe

A case of intraplacental twin transfusion

There have been several reports of polycythaemia in one of uniovular twins with anaemia in the other twin. This syndrome has been recently fully recorded and reviewed by Corney and Aherne (1965). We describe here a severe example of this condition, with jaundice in the polycythaemic twin necessitating exchange transfusion. The severe anaemia in the other twin caused death in utero, and the birth of a macerated foetus. The twins showing intraplacental transfusion are described. Successful treatment of the polycythaemia and hyperbilirubinaemia is described. Bilirubin estimation should be performed routinely in such cases because polycythaemia may mask severe jaundice. Furthermore, previous reports of the condition and its management are briefly discussed.peer-reviewe

Jaundice: a basic review

Jaundice is a complex disease. Jaundice is actually the high bilirubin level in the body. Yellowing of skin, mucous membranes and skin are common presentations of jaundice. Jaundice has various variants including pre-hepatic jaundice (due to hemolysis of red blood cells), hepatic jaundice (due to defect in capture, conjugation and excretion of bilirubin by liver) and post hepatic jaundice (due to the obstruction of extra hepatobiliary system). The causes of various variants of Jaundice is either acquired or congenital. High plasma bilirubin level can cause various manifestations involving satiety, gastrointestinal bleeding, diarrhea, anemia, edema, weight-loss and can be fatal because it can cause psychosis, lethargy, seizures, coma or even death. High bilirubin level can help in the diagnosis of Jaundice. Differential diagnosis of various variants of Jaundice can be carried out on the basis of bilirubin level (conjugated and unconjugated), ultrasonography and other radiological techniques. The proper management of Jaundice is high water intake and low fat diet. The primary effective treatment for pre-hepatic jaundice and neonatal physiological jaundice is phototherapy. Infusion of immunoglobulins is also used for treatment of pre-hepatic jaundice. Proper nutrition, steroids and immunosuppressant are used for treatment of hepatic jaundice. The treatment for post hepatic jaundice is decompression and surgery

Epstein-Barr Virus-induced Jaundice

Infectious mononucleosis is primarily caused by Epstein-Barr virus (EBV) and is a common di-agnosis made in emergency departments worldwide. Subclinical and transient transaminase ele-vations are a well-established sequela of EBV. However, acute cholestatic hepatitis is a rare complication. EBV infection should be considered as part of the differential diagnosis in patients with an obstructive pattern on liver function tests without evidence of biliary obstruction demon-strated on advanced imaging

Management of late-preterm and term infants with hyperbilirubinaemia in resource-constrained settings.

Hyperbilirubinaemia is a ubiquitous transitional morbidity in the vast majority of newborns and a leading cause of hospitalisation in the first week of life worldwide. While timely and effective phototherapy and exchange transfusion are well proven treatments for severe neonatal hyperbilirubinaemia, inappropriate or ineffective treatment of hyperbilirubinaemia, at secondary and tertiary hospitals, still prevails in many poorly-resourced countries accounting for a disproportionately high burden of bilirubin-induced mortality and long-term morbidity. As part of the efforts to curtail the widely reported risks of frequent but avoidable bilirubin-induced neurologic dysfunction (acute bilirubin encephalopathy (ABE) and kernicterus) in low and middle-income countries (LMICs) with significant resource constraints, this article presents a practical framework for the management of late-preterm and term infants (≥ 35 weeks of gestation) with clinically significant hyperbilirubinaemia in these countries particularly where local practice guidelines are lacking. Standard and validated protocols were followed in adapting available evidence-based national guidelines on the management of hyperbilirubinaemia through a collaboration among clinicians and experts on newborn jaundice from different world regions. Tasks and resources required for the comprehensive management of infants with or at risk of severe hyperbilirubinaemia at all levels of healthcare delivery are proposed, covering primary prevention, early detection, diagnosis, monitoring, treatment, and follow-up. Additionally, actionable treatment or referral levels for phototherapy and exchange transfusion are proposed within the context of several confounding factors such as widespread exclusive breastfeeding, infections, blood group incompatibilities and G6PD deficiency, which place infants at high risk of severe hyperbilirubinaemia and bilirubin-induced neurologic dysfunction in LMICs, as well as the limited facilities for clinical investigations and inconsistent functionality of available phototherapy devices. The need to adjust these levels as appropriate depending on the available facilities in each clinical setting and the risk profile of the infant is emphasised with a view to avoiding over-treatment or under-treatment. These recommendations should serve as a valuable reference material for health workers, guide the development of contextually-relevant national guidelines in each LMIC, as well as facilitate effective advocacy and mobilisation of requisite resources for the optimal care of infants with hyperbilirubinaemia at all levels

Flexural strength of concrete prism strengthened using CFRP with modified mortar

Reinforced concrete (RC) is a good durable material that commonly used in construction compared to others. However, reinforced concrete structures may be damaged and are suffering from various deteriorations because of overloading and an inadequacy of design which may be attributed to cracks, spalling, large deflection, and more. Hence, it is essential to find repair and strengthening techniques of deteriorated concrete structures not only suitable in terms of the economy, but also to use them for their intended service life

Acute Jaundice in a Six-year-old: An Unusual Presentation of Atypical Kawasaki Disease

Kawasaki disease (KD) is a rare vasculitis of childhood that is critical to recognize and treat due to associated morbidity and mortality. A six-year-old male presented to our emergency department (ED) afebrile but with reported recent fevers. Exam revealed jaundice and erythematous tongue with papules, and laboratory studies indicated a direct hyperbilirubinemia. Admitted for evaluation, he developed continuous fever, increasing maculopapular rash, and subsequent desquamation of hands and feet. He ultimately met criteria for incomplete KD, was treated with intravenous immunoglobulin, and avoided cardiac complications. This presentation of incomplete KD with hyperbilirubinemia is rare because the patient was afebrile at ED presentation

A Large Outbreak of Hepatitis E Among a Displaced Population in Darfur, Sudan, 2004: The Role of Water Treatment Methods.

BACKGROUND: The conflict in Darfur, Sudan, was responsible for the displacement of 1.8 million civilians. We investigated a large outbreak of hepatitis E virus (HEV) infection in Mornay camp (78,800 inhabitants) in western Darfur. METHODS: To describe the outbreak, we used clinical and demographic information from cases recorded at the camp between 26 July and 31 December 2004. We conducted a case-cohort study and a retrospective cohort study to identify risk factors for clinical and asymptomatic hepatitis E, respectively. We collected stool and serum samples from animals and performed a bacteriological analysis of water samples. Human samples were tested for immunoglobulin G and immunoglobulin M antibody to HEV (for serum samples) and for amplification of the HEV genome (for serum and stool samples). RESULTS: In 6 months, 2621 hepatitis E cases were recorded (attack rate, 3.3%), with a case-fatality rate of 1.7% (45 deaths, 19 of which involved were pregnant women). Risk factors for clinical HEV infection included age of 15-45 years (odds ratio, 2.13; 95% confidence interval, 1.02-4.46) and drinking chlorinated surface water (odds ratio, 2.49; 95% confidence interval, 1.22-5.08). Both factors were also suggestive of increased risk for asymptomatic HEV infection, although this was not found to be statistically significant. HEV RNA was positively identified in serum samples obtained from 2 donkeys. No bacteria were identified from any sample of chlorinated water tested. CONCLUSIONS: Current recommendations to ensure a safe water supply may have been insufficient to inactivate HEV and control this epidemic. This research highlights the need to evaluate current water treatment methods and to identify alternative solutions adapted to complex emergencies

Benign recurrent intrahepatic cholestasis : report of two local cases

Benign Recurrent Intrahepatic Cholestasis (BRIC) is a rare disorder characterized by recurrent episodes of cholestasis without permanent liver damage. Familial and sporadic cases have been reported and both autosomal recessive and autosomal dominant inheritance described. We report two children with BRIC without any previous family history.peer-reviewe