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      Demystifying non-invasive approaches for screening jaundice in low resource settings: a review

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          Abstract

          All national and international pediatric guidelines universally prescribe meticulous bilirubin screening for neonates as a critical measure to mitigate the incidence of acute bilirubin encephalopathy (ABE) and Kernicterus. The prevailing gold standard for jaundice detection in neonates necessitates invasive blood collection, followed by subsequent biochemical testing. While the invasive procedure provides dependable bilirubin measurements and continues to be the sole gold standard diagnostic method for assessing bilirubin concentration. There exists a pressing need to innovate non-invasive screening tools that alleviate the sampling stress endured by newborns, mitigate iatrogenic anemia, and expedite the turnaround time for obtaining results. The exploration of non-invasive modalities for bilirubin measurements is gaining momentum, driven by the overarching goal of minimizing the number of pricks inflicted upon neonates, thereby rendering screening a swift, efficient, comfortable, and dependable process. This comprehensive review article delves extensively into the array of non-invasive approaches and digital solutions that have been proposed, implemented, and utilized for neonatal bilirubin screening, with a particular emphasis on their application in low-resource settings. Within this context, the review sheds light on the existing methodologies and their practical applications, with a specific focus on transcutaneous bilirubin meters. Moreover, it underscores the prevailing open challenges in this domain and outlines potential directions for future research endeavors. Notably, the review underscores the imperative need for robust educational programs targeted at both families and healthcare personnel to expedite the process of seeking timely care for neonatal jaundice. Additionally, it underscores the necessity for the development of enhanced screening and diagnostic tools that can offer greater accuracy in clinical practice.

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          The Optics of Human Skin

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            Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation.

            (2004)
            Jaundice occurs in most newborn infants. Most jaundice is benign, but because of the potential toxicity of bilirubin, newborn infants must be monitored to identify those who might develop severe hyperbilirubinemia and, in rare cases, acute bilirubin encephalopathy or kernicterus. The focus of this guideline is to reduce the incidence of severe hyperbilirubinemia and bilirubin encephalopathy while minimizing the risks of unintended harm such as maternal anxiety, decreased breastfeeding, and unnecessary costs or treatment. Although kernicterus should almost always be preventable, cases continue to occur. These guidelines provide a framework for the prevention and management of hyperbilirubinemia in newborn infants of 35 or more weeks of gestation. In every infant, we recommend that clinicians 1) promote and support successful breastfeeding; 2) perform a systematic assessment before discharge for the risk of severe hyperbilirubinemia; 3) provide early and focused follow-up based on the risk assessment; and 4) when indicated, treat newborns with phototherapy or exchange transfusion to prevent the development of severe hyperbilirubinemia and, possibly, bilirubin encephalopathy (kernicterus).
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              Hyperbilirubinemia in the newborn infant > or =35 weeks' gestation: an update with clarifications.

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                Author and article information

                Contributors
                URI : https://loop.frontiersin.org/people/2468284/overviewRole: Role: Role:
                Role: Role: Role:
                Role: Role: Role:
                Journal
                Front Pediatr
                Front Pediatr
                Front. Pediatr.
                Frontiers in Pediatrics
                Frontiers Media S.A.
                2296-2360
                20 November 2023
                2023
                : 11
                : 1292678
                Affiliations
                [ 1 ]Department of Smart Healthcare, Indian Institute of Technology , Jodhpur, India
                [ 2 ]All India Institute of Medical Science , Jodhpur, India
                [ 3 ]Computer Science and Engineering, Indian Institute of Technology , Jodhpur, India
                [ 4 ]Transfusion Medicine and Blood Bank, All India Institute of Medical Science , Jodhpur, India
                Author notes

                Edited by: Amuchou S. Soraisham, University of Calgary, Canada

                Reviewed by: Adhisivam Bethou, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), India Yao Mun Choo, University of Malaya, Malaysia

                [* ] Correspondence: Umme Abiha abiha.1@ 123456iitj.ac.in
                Article
                10.3389/fped.2023.1292678
                10694303
                38054187
                97e84130-fc9f-4db9-b2c0-b9eee6f6183e
                © 2023 Abiha, Banerjee and Mandal.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 12 September 2023
                : 18 October 2023
                Page count
                Figures: 11, Tables: 3, Equations: 0, References: 252, Pages: 0, Words: 0
                Funding
                The author(s) declare that no financial support was received for the research, authorship, and/or publication of this article.
                Categories
                Pediatrics
                Review
                Custom metadata
                Neonatology

                physiological jaundice,kernicterus,bilirubin,icterometry,visual inspection,transcutaneous bilirubinometers

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