Background: Kernicterus occurs in infants around the world. This study examined the outcomes of various treatments for neonatal hyperbilirubinemia (NH) used in the Khulna Medical College Hospital in Bangladesh. Methods: All of the jaundiced newborns in the neonatal ward between 2005 and 2008 were included in the study. Total serum bilirubin and fractional levels were measured in all cases, regardless of the degree of jaundice. NH was classified as mild, moderate or severe depending on the bilirubin level; mild NH was treated with a sunbath, moderate NH was treated with phototherapy, and severe NH was treated with exchange transfusion. Results: Of 1981 neonates, 426 (22%) were diagnosed with NH. Physiological jaundice (26.7%) was most common, followed by the jaundice of prematurity (20.9%). Haemolytic jaundice was primarily caused by ABO incompatibility (11.3%) and Rh incompatibility (5.4%). Exchange transfusion (ET) was performed in 22 patients; four (18.2%) died as a result of hazards that could have been avoided with skilled monitoring. Twelve (2.8%) individuals with jaundice died. Kernicterus developed in nine (2.1%) children, four of whom survived with neurological sequelae. Conclusion: ABO incompatibility is twice as common as Rh incompatibility. The majority of kernicterus patients died in the acute phase.

Objective To explore a common B- and T-cell epitope-based vaccine that can elicit an immune response against encephalitis causing genus Henipaviruses, Hendra virus (HeV) and Nipah virus (NiV). Methods Membrane proteins F, G and M of HeV and NiV were retrieved from the protein database and subjected to different bioinformatics tools to predict antigenic B-cell epitopes. Best B-cell epitopes were then analyzed to predict their T-cell antigenic potentiality. Antigenic B- and T-cell epitopes that shared maximum identity with HeV and NiV were selected. Stability of the selected epitopes was predicted. Finally, the selected epitopes were subjected to molecular docking simulation with HLA-DR to confirm their antigenic potentiality in silico. Results One epitope from G proteins, one from M proteins and none from F proteins were selected based on their antigenic potentiality. The epitope from the G proteins was stable whereas that from M was unstable. The M-epitope was made stable by adding flanking dipeptides. The 15-mer G-epitope (VDPLRVQWRNNSVIS) showed at least 66% identity with all NiV and HeV G protein sequences, while the 15-mer M-epitope (GKLEFRRNNAIAFKG) with the dipeptide flanking residues showed 73% identity with all NiV and HeV M protein sequences available in the database. Molecular docking simulation with most frequent MHC class-II (MHC II) and class-I (MHC I) molecules showed that these epitopes could bind within HLA binding grooves to elicit an immune response. Conclusions Data in our present study revealed the notion that the epitopes from G and M proteins might be the target for peptide-based subunit vaccine design against HeV and NiV. However, the biochemical analysis is necessary to experimentally validate the interaction of epitopes individually with the MHC molecules through elucidation of immunity induction.