Introduction: Bilirubin is a frequently ordered investigation in neonatal intensive care units and out-patient practice during follow- up. The gold standard for its estimation is serum bilirubin which is invasive resulting in parenteral apprehension, pain, discomfort and iatrogenic anaemia in a neonate, while the non-invasive measurement by transcutaneous bilirubinometer is not available in all the centres because of its cost. Biliscan is a smartphone application that uses a phone’s inbuilt camera and a colour calibration card to detect neonatal jaundice. We compared bilirubin measured by Biliscan with reference to serum bilirubin among neonates admitted to a tertiary care centre. Methods: We conducted an observational study from June-2019 to September-2019 at a tertiary care centre in Hyderabad, India. Inborn neonates (greater than > 35 weeks gestational age at birth, and less than a week old) who required bilirubin estimation, underwent both invasive serum sampling and non-invasive estimation by Biliscan. Photograph of the baby’s chest was captured using the colour calibration card of the Biliscan application. Bilirubin values derived from the Biliscan application were compared to those derived from blood samples. Results: A total of 143 neonates were enrolled. The mean bilirubin value estimated by serum sampling was 11.9 g/dl against 13.1 g/dl of that derived from smartphone application. Biliscan and serum bilirubin showed moderate agreement with a correlation coefficient of 0.6. Bland- Altman plot constructed showed bias of 1.1 with the limits of agreement ranging from -3 to +5.3. Biliscan had a good sensitivity of 90% in identifying high levels of serum bilirubin (> 95th percentile on Bhutani nomogram). Conclusion: Biliscan application is a non-invasive, real-time, inexpensive and an easily available method that cannot replace serum bilirubin, however can complement and has the potential to help in screening neonates thus facilitating recognition of jaundice early and minimising the number of invasive pricks.

Dengue is a Flavivirus, affecting about 100 million people annually and mainly in the tropical and subtropical countries. Neonatal dengue is uncommon and usually by vertical transmission or, in the postnatal period, by horizontal transmission. We describe the clinical profile, management and outcome of neonates with dengue infection. Ten patients were prospectively recruited from August to November 2019 during dengue epidemic season at Niloufer Hospital, Hyderabad, India. Four babies had vertical mode of transmission while 6 had horizontal mode of transmission. All babies were positive for Ns1 antigen and IgM dengue serology, confirming dengue infection. Fever, flushing and thrombocytopenia were observed in all the babies while 2 babies had hypotension requiring inotropes. Oxygen supplementation was required in 8 babies. There was no recorded mortality. We conclude that neonatal dengue should be considered as a differential diagnosis in a neonate with sepsis and thrombocytopenia especially in endemic regions. Judicious use of fluids (avoid excessive) and inotropes (dopamine) form the cornerstone of dengue management in neonates.