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Background: Drawing blood to measure total serum bilirubin is painful & time consuming. Transcutaneous bilirubinometer working by multiwavelength spectral reflectance from the skin surface on forehead or upper sternum is a quick & painless technique. Objectives: to compare the effectiveness of transcutaneous (over the upper sternum and forehead) and serum bilirubin measurement of neonate with jaundice. Subjects and Methods: This is a cross sectional prospective study. It enrolled 175 jaundiced neonates & excluded those exposed to phototherapy. It was conducted at Child Central Teaching Hospital in Baghdad, Iraq from the 1st of August to the 30th of October 2018. Transcutaneous bilirubin measurement on forehead and upper sternum was done by JM 103 Minolta Air shields bilirubinometer. Total serum bilirubin was measured by APEL BR 501 BILIRUBIN METER. Data entered & analyzed using SPSS 20 computer software. Means, frequencies, cutoff values, sensitivity & specificity were calculated. Results: The mean age, gestational age & birth weight were (6.3±4.3 days), (36.9±2.1 weeks) and (2.7±0.6 Kg) respectively. Mean total serum bilirubin, transcutaneous chest & forehead bilirubin levels were 12.6±4.2 mg/dl, 11.8±3.8 mg/dl & 11.2±3.9 mg/dl respectively. Mean total serum bilirubin was significantly higher than transcutaneous chest and forehead bilirubin. Cutoff values of transcutaneous chest & forehead bilirubin levels were [(9 mg/dl) with sensitivity (95.4%) & specificity (86.4%)] and [(8.2 mg/dl) with sensitivity (94.7%) & specificity (86.4%)] respectively. |
In this paper, customers’ expectations are continually shifting due to the business environment’s growing competition and substantial changes. As a result, organisations no longer viewed it as a static objective but as an ever-evolving aim. From this vantage point, the research has explored the accounting literature in search of novel approaches to addressing the strategic dimensions of quality, cost and time. Getting them to respond positively to the customer’s requests also requires recognising their needs and controlling their impact on these dimensions. With the removal of operations that do not contribute any value to the product’s value chain and a reduction in manufacturing costs through continuous improvement, the ou
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