Baby Shareen Ashfak Aurora
Infant Clinical Course, Investigation Summary & Consultant Review Points
01Patient Profile & Birth History
Birth Profile02Chronological Timeline & Clinical Course
Birth → DOL 20Delivered by LUCS at 36w6d with birth weight 2.70 kg (AGA). Hypoglycemia was noted during the early neonatal period.
Fluctuating neonatal jaundice, weak suck, two reported deep-sleep episodes (D5 and D7), and intermittent bicycling-type leg movements were observed.
Admitted to OGSB Hospital (Mirpur) for hyperbilirubinemia and IDM. Intensive phototherapy was given for approximately 40 hours. A rebound bilirubin rise occurred and phototherapy was restarted. The infant was subsequently discharged stable.
Discharged clinically stable following treatment. Medications started: V-Plex, Folison, D-Vine and Compiron.
Follow-up period was clinically stable with TSB 7.30 mg/dL documented on D16. Mild progressive abdominal distension and increased yellow-stool frequency were reported.
Reviewed by Dr. Sharmin Afroze at Shishu Hospital. Digital EEG and Echo were advised. Today's TSB is 5.88 mg/dL; serum electrolytes: Na 142.6 mmol/L and K 5.40 mmol/L (flagged high). Digital EEG was performed at Popular and the report is pending.
03Master Investigation Summary
Key Results| Date / DOL | Investigation | Result | Clinical Context / Note | |
|---|---|---|---|---|
| 27 Aug · D10 | TSB | 20.94 mg/dL | Pre-treatment baseline; NICU admission for phototherapy. | |
| 27 Aug · D10 | CBC | Hb 13.0; Platelets 6.39 lakh | Documented baseline CBC. | |
| 27 Aug · D10 | TSH / FT4 | TSH 2.27; FT4 28.96 | Documented thyroid profile. | |
| 29 Aug · D12 | TSB | 9.85 mg/dL | Post-phototherapy follow-up. | |
| 30 Aug · D13 | TSB | 12.25 mg/dL | Rebound rise; phototherapy restarted. | |
| 31 Aug · D14 | TSB | 7.30 mg/dL | Improved; discharged stable. | |
| 02 Sep · D16 | TSB | 7.30 mg/dL | Stable follow-up value. | |
| 08 Sep · D20 | TSB | 5.88 mg/dL | Current value; continued downward trend. | |
| 08 Sep · D20 | Serum Na | 142.6 mmol/L | Current electrolyte result. | |
| 08 Sep · D20 | Serum K | 5.40 mmol/L · HIGH | Requires clinical interpretation; consider sample hemolysis versus true elevation in the clinical context. | |
| 08 Sep · D20 | Digital EEG | Pending | Performed at Popular; report not yet available. | |
| 08 Sep · D20 | Echo | Advised | Recommended at pediatric review; completion not documented here. |
04Current Medications
As Documented4 drops daily × 3 months
¼ tablet on alternate days × 3 months
5 drops BD × 1 year
Step-up dose
05Key Clinical Questions for Consultant Review
Review PointsDigital EEG: How should the EEG be interpreted in light of the reported past hypoglycemia, deep-sleep episodes and intermittent abnormal-appearing movements?
IDM follow-up: What ongoing monitoring and precautions are appropriate for an infant of a diabetic mother?
Abdominal / stool changes: What is the clinical significance of the recent mild abdominal distension and increased yellow-stool frequency, and when should further assessment be considered?
Potassium 5.40 mmol/L: Does the mildly elevated value warrant repeat testing, particularly to assess possible sample hemolysis versus a true elevation?
Travel fitness: Is the infant clinically fit for the planned Narail trip in 2 days, and are any travel-specific precautions required?