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AKUH 'Signs, Symptoms and Care' Programme
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Management of Jaundice Essential to Prevent Complications
"Jaundice is the yellow discoloration of the skin due to the accumulation
of a substance called bilirubin. This substance, normally cleared
from the body by the liver, accumulates under different circumstances
and conditions vary amongst different age groups."
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This was stated by Dr Uzma Shah, Associate Professor and Consultant
Paediatrician, Department of Paediatrics, Aga Khan University (AKU),
while giving a presentation on 'Jaundice in Children'. Dr Shah was
speaking at 'Signs, Symptoms and Care', a public health awareness
programme recently organised by Aga Khan University Hospital (AKUH)
at the University Auditorium in Karachi.
Dr Shah explained that in the newborn, jaundice may become apparent
in the first few days of life. "This jaundice is usually 'physiological'
or a normal occurrence as the liver of the newborn is immature and
takes a little time to start functioning at full capacity," she said.
"This physiological jaundice lasts for a few days and is usually mild,
requiring no treatment. However in certain circumstances, such as
prematurity, bruising during delivery or dehydration, jaundice may
become exaggerated. Phototherapy with special lights may then be required
for a short period of time," added Dr Shah.
'Pathological jaundice', on the other hand, indicates a problem. "Infections,
anatomical abnormalities and metabolic disorders may lead to liver
damage which is manifested as jaundice," elaborated Dr Shah. "An important
entity to exclude in the early newborn period is obstruction of bile
flow in biliary atresia. This disease requires timely surgical correction
and removal of the obstruction."
In older children, common causes of jaundice include hepatitis that
may be viral or bacterial in origin. "The most common viruses that
infect the liver are hepatitis A, B, C, D and E. The hepatitis A and
E viruses are spread via contaminated food and water. These are usually
self-limited illnesses that present with jaundice, fever, nausea and
vomiting. In a few cases these viruses may produce a serious life-threatening
illness," said Dr Shah.
Hepatitis, B, C and D viruses are spread via contaminated blood, blood
products and secretions. As such transmission can occur through contaminated
blood transfusions, needles used for vaccination, and dental and surgical
equipment. Dr Shah stressed that it is vital to ensure the use of
safe, screened blood and completely sterile dental and surgical equipment.
Vaccination against hepatitis B is also critically important. At the
moment, no vaccines are available for protection against hepatitis
C or D.
All children require appropriate follow-up with their paediatricians
throughout infancy and childhood. Physician order laboratory investigations
for jaundiced children as well as imaging studies where required,
and treatment is provided once a diagnosis is established. It is important
to note that jaundice should never be taken lightly, concluded Dr
Shah.
Drs Sohail Salat, Khadija Humayoun and Sohail Thobani, Consultant
Paediatricians at AKUH, also participated in the question-and-answer
session that followed.
As part of its outreach programme and societal commitment of creating
awareness of early diagnosis and timely treatment, AKUH has organised
over 160 'Signs, Symptoms and Care' programmes in Karachi, Hyderabad
and the UAE, reaching out to more than 35,000 people.
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