Blood Bilirubin Levels Research Articles

The Assessment of the Relationship among Bilirubin in Cord Blood and Venous Blood during the Intensive Care Unit Stay of Infants with Jaundice

Aim: Newborn babies who are released from the hospital at a younger postnatal age are more likely to be hospitalized to the nursery due to neonatal jaundice. This readmission is undoubtedly a significant source of strain in the nurseries, but it may be addressed by adequate assessment prior dismissing the newborn. The purpose of this study was to see if there was a link among cord blood bilirubin and vein bilirubin on the third day of life.
 Methods: On 120 healthy term newborns, a cross-sectional description research was conducted. Blood was drawn from the child's cord right after birth, whether vaginally or through caesarean surgery, for total serum bilirubin, unconjugated serum bilirubin levels, and conjugated serum bilirubin levels. On the third day (72 hours), a second serum blood sample is obtained from peripheral venous blood, and total serum bilirubin, unconjugated serum bilirubin, and conjugated serum bilirubin levels are measured again. The research was carried out over a one-year period, from March 2020 to February 2021.
 Results: The babies were divided into two groups: those with hyperbilirubinemia and those without. The findings acquired from aggregate and stratified samples demonstrate a significant association 0.542 and P-value 0.001 among serum cord blood bilirubin and peripheral venous blood bilirubin.
 Conclusion: There is a link among elevated bilirubin levels in normal infants born and serum cord blood bilirubin levels. The increase in serum cord blood bilirubin levels correlates with both the increase in peripheral venous blood bilirubin on the third day of life.

(Invited) Low Cost Paper Based Bilirubin Sensor Integrated with Smartphone APP for Point-of-Care Neonatal and Adult Jaundice Diagnostics

Accumulation of excessive bilirubin induces hyperbilirubinemia and neonatal jaundice, and is a signal of adult liver diseases. Currently, the mainstream bilirubin detection is conducted in hospital pathological laboratories, which is expensive and time-consuming. To release the heavy burden of laboratory-based tests and to provide point-of-care testing and feedback to patients, recently some handheld optical devices have been developed for blood bilirubin measurement; however, they still require professional operation and uneconomical for home use. In this regard, a lower-cost and non-powered paper-based analytical device is developed for fast and point-of-care quantitative measurement of blood bilirubin levels in jaundiced neonates and hepatopathy adults. The design achieves plasma separation from whole blood and optical quantification of the chromogenic results by a specially designed smartphone APP. Especially, for jaundiced neonates, the APP not only calculates the bilirubin levels but also suggests the essential therapy if the detected bilirubin level versus the age of the baby is at risk. It is believed that this low-cost design provides a home-use solution for parents/patients to monitor the health conditions of newborn babies/themselves.

A Brief Review on Kernicterus

Kernicterus is a rare neurological condition which occurs when the unconjugated bilirubin levels rises above 25 mg/dL in the blood leading to decreased elimination and increased production of bilirubin. Most commonly, it affects newborns and infants of age three to four years, in that the premature infants are more prone to this condition. Accumulation of toxic levels of bilirubin in blood as well as in brain leads to life threatening complications. However, early diagnosis and management of this condition helps in preventing brain damage and also developmental abnormalities in an infant. In this article, we mainly reviewed about the epidemiology, etiology, pathophysiology, clinical manifestations, diagnosis and the treatment of kernicterus. It is necessary for the health care team and professionals to detect the early signs of kernicterus by close monitoring of infant at the time of birth to prevent it from getting worsen. However, there are various effective and advanced techniques available to treat the condition as soon as it is diagnosed and thus it is a preventable condition if managed with utmost care.

A Comparison Between Transcutaneous Bilirubin and Total Serum Bilirubin Levels for the Management of Jaundice in Preterm Neonates by Bland-Altman Plot.

ObjectiveTo compare the bilirubin levels measured by transcutaneous bilirubinometer and serum samples for the management of jaundice in preterm neonates.MethodsThe study was a prospective comparative observational study conducted in a tertiary care neonatal unit of Odisha from January 2019 to June 2020. All inborn and outborn neonates with a gestational age of 280/7 weeks to 366/7 weeks with the clinical diagnosis of neonatal jaundice were included in the study. Transcutaneous bilirubin (TcB) was estimated by Dragger jaundice meter JM-105 and simultaneously venous blood and total serum bilirubin levels (TSB) were measured by diazonium method. The comparison between TcB and TSB values was analyzed by direct linear correlation in scatter plot and Bland-Altman plot.ResultsA total of 167 preterm neonates (66, 28-336/7 and 111, 34-366/7), with a mean gestational age 33.55 ±2.36 weeks and a mean birth weight of 1960 ± 613 grams, were analyzed. The mean TSB and TcB levels were 12.99 ± 3.47 mg/dl (min-max 4.9-18.3 mg/dl) and 14.156 ± 4.71 mg/dl (min-max 4-20.1 mg/dL), respectively. The TcB is excellently correlated with TSB with a correlation coefficient of r =0.948, p ≤0.001. The bias difference between TcB and TSB is -1.16 (95% CI: 2.35, -4.6) mg/dl. The correlation coefficients between 28-336/7 weeks gestational age groups (r = 0.944) and 34-366/7gestational age (r = 0.950) were similar.ConclusionTcB is well correlated with TSB level in preterm neonates. Hence, TcB can be used for the guidance of management in these neonates.

Betaine supplementation to rats alleviates disturbances induced by high-fat diet: pleiotropic effects in model of type 2 diabetes.

Betaine is a biologically active compound exerting beneficial effects in the organism, however, the exact mechanisms underlying its action are not fully elucidated. The present study aimed to explore, whether betaine alleviates disorders induced by feeding rats a high-fat diet (HFD). Rats were divided into 3 groups: control, fed an HFD and fed an HFD and receiving betaine (2% water solution for 8 weeks). Betaine improved glucose tolerance, decreased blood levels of non-esterified fatty acids and prevented lipid accumulation in the skeletal muscle of rats on an HFD. Betaine reduced activities of blood alanine aminotransferase, blood levels of bilirubin and hepatic lipid content. Expression of fatty acid synthase in the liver and the skeletal muscle was decreased in response to feeding an HFD, and this effect was deepened by betaine in the muscle tissue. Hepatic and muscular expression of genes related to insulin signaling were unchanged in HFD-fed rats. Lipolysis stimulated by epinephrine (an adrenergic receptor agonist), forskolin (an activator of adenylate cyclase), dibutyryl-cAMP (an activator of protein kinase A) and DPCPX (an adenosine A1 receptor antagonist) was diminished in the adipocytes of rats fed an HFD, however, this effect was alleviated by betaine. Moreover, blood leptin levels in HFD-fed rats were elevated, whereas leptinemia have normalized by betaine supplementation. Betaine prevented the increase in expression of N-methyl D-aspartate receptors in the hippocampus and in the cerebral cortex. These results indicate that betaine positively affects the insulin-sensitive tissues: liver (hepatoprotective effects), skeletal muscle (reduced lipid accumulation) and adipose tissue (a rise in lipolysis), which is associated with improved insulin sensitivity. Betaine-induced prevention of hyperleptinemia indicates restoration of leptin action, and changes in the brain reveal neuroprotective properties. Our results show that betaine induces positive changes in HFD-fed rats, its action is pleiotropic and involves different tissues.

Effect of Stevia rebaudiana and exercise on fatty liver in type 2 diabetic rats

Introduction: Nonalcoholic fatty liver disease (NAFLD) is a prevalent chronic liver disease, which threatens the health of both adults and children. It is strongly associated with type 2 diabetes mellitus, obesity and insulin resistance. In the present study, we evaluate the effect of Stevia rebaudiana and exercise on fatty liver in T2DM. Methods: Thirty two male Sprague Dawely rats were divided into normal control, diabetic, Stevia treated diabetic, and exercise treated diabetic rats. Biochemical parameters, oxidative stress markers, and histopathological examination for liver tissue were done. Results: in diabetic group, blood glucose level, HOMA index, cholesterol level, triglycerides level, bilirubin level, liver enzymes (ALT& AST), and MDA were significantly increased. While insulin level, GSH, and CAT activity were significantly decreased when compared to normal control group. Biochemical parameters and Oxidative stress markers were improved in the treated groups, the improvement was more significant in exercise treated group than Stevia treated group. Histopathological examination confirmed our results. Conclusion: Stevia rebaudiana and exercise could protect against liver injury induced by T2DM, as they improve glycemic state, liver enzymes, and oxidative stress markers. Key words: NAFLD, T2DM, Stevia, Exercise.

Laboratory and demographic findings among patients with coronavirus disease 2019: a review.

Coronavirus disease 2019 (COVID-19) is the third known animal coronavirus, after severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome coronavirus (MERS-CoV). The mean age of the infected patients was estimated to be between 50 and 69 years old. Accordingly, the COVID-19 mortality rate was calculated as 15%. In this regard, the essential component of prevention and planning is knowledge of laboratory and demographic findings among COVID-19 patients; therefore, the present study was conducted to investigate laboratory and demographic findings among these patients worldwide. This systematic review was performed on the articles published in English between January 1, 2019 and May 4, 2020, using MeSH-compliant keywords such as "COVID-19", "Laboratory, coronavirus disease-19 testing", and " demography " in international databases (PubMed, and web of science Scopus). Thereafter, the articles relevant to laboratory and demographic findings among COVID-19 patients were included in the final review. Reviewing the included articles showed changes in the mean lymphocytes count ranged from 0.7 to 39 in hospital or severe cases. Moreover, Leukopenia was not observed in patients with thrombocytopenia. In addition, C-reactive protein (CRP), leukocytes, D-dimer, FDP, FIB, neutrophils, AST, serum creatinine, t-troponin, troponin I, and blood bilirubin levels showed increasing trends in most studies conducted on COVID-19 patients. Notably, the elevated LDH level was more common among children than adults. According to the results of the present study, and by considering the clinical characteristics of COVID-19 patients on the one hand, and considering the changes in laboratory samples such as lymphocytes and other blood markers due to the damaged myocardial, hepatic, and renal tissues on the other hand, it is recommended to confirm the diagnosis of this infection by evaluating the patients' blood samples using other diagnostic methods like lung scan.

Neutrophils’ functional activity in patients with mechanical jaundice and different levels of bilirubin

Introduction: Mechanical jaundice (MJ) or bile duct blockage occurs when the bile ducts' patency is impaired, and the bile flow has stopped. One of the main pathogenetic factors developing complications with MJ is immune system imbalance, particularly its phagocytic link. The purpose of the study was to understand neutrophils' functional activity dependence with different blood bilirubin levels in men with mechanical jaundice.
 Methods: Forty-seven middle-aged men with mechanical jaundice were divided into three groups depending on the bilirubin levels in their blood: less than 60 μmol/L (n = 10), 60 – 200 μmol/L (n = 20), and more than 200 μmol/L (n = 17). The control group consisted of 50 practically healthy men of the same age. The neutrophils' functional state was assessed using the methods of spontaneous and induced luminol-dependent chemiluminescence of neutrophils.
 Results: In the group of patients with mechanical jaundice and a bilirubin level of less than 60 μmol/L, there was an increase in the values of T max spontaneous by 96%, I max spontaneous by 44.81%, S spontaneous by 224.6%, T max induced by 19.9%, I max induced by 13.5%, and S induced by 140.3%. In the group with bilirubin levels from 60 – 200 μmol/L, there was an increase in the values of T max spontaneous by 86.8%, I max spontaneous at 47.7%, S spontaneous at 204.6%, I max induced at 28.3%, S induced at 445%, and activation index at 70%. The group with bilirubin levels more than 200 μmol/L showed an increase in the level of T max spontaneous by 85.9%, I max spontaneous by 53.4%, S spontaneous by 927.3%, I max induced by 28.6%, S induced by 1045%, and activation index by 92.3% compared with the control values. The intergroup differences were found in S spontaneous levels, which were higher in the group with more than 200 μmol/L bilirubin levels compared with the 60 – 200 μmol/L group and less than the 60 μmol/L groups by 216.9% and 237.3% respectively.
 Conclusion: The revealed changes characterize the functional activity of neutrophils' increase with an increase in the bilirubin levels in patients with mechanical jaundice.

To Study the Predictive Value of Umbilical Cord Blood Bilirubin Levels Term Neonates as Marker of Neonatal Hyperbilirubinemia

Background: Infants who are clinically jaundiced in the first few days are more likely to develop hyperbilirubinemia. Hyperbilirubinemia is the most common medical problem in newborn infants. It is the most important cause for hospital readmissions during the early neonatal period and also the cause for neonatal morbidity. Objective: In this prospective study we are going to evaluate the predictive value of cord bilirubin level for identifying term neonates for subsequent hyperbilirubinemia. Materials and Methods: Cord bilirubin levels at birth and subsequently serum bilirubin levels at 72 h were assessed in 291 neonates. The cutoff value was estimated beyond which there was significant hyperbilirubinemia. Statistics employed include quantitative data which is expressed in terms of mean and SD and qualitative in terms of proportions and receiver operator characteristic curve used to find cut-off value and to find sensitivity and specificity. Results: The cutoff value of cord bilirubin >2 mg/dl had sensitivity and specificity of 77.97 and 56.90%, respectively, with positive predictive value of 31.51 and negative predictive value of 91.03% for subsequent hyperbilirubinemia. Conclusion: To decreases the significant burden of untreated severe neonatal jaundice, cord serum bilirubin can be used as a screening tool to identify the neonatal jaundice in term and this prediction of neonatal hyperbilirubinemia has widespread implication especially in our country where there are limited resources. Keywords: Hyperbilirubinemia, Neonatal morbidity, cord serum bilirubin.

Aspects of transition cow metabolomics—Part I: Effects of a metaphylactic butaphosphan and cyanocobalamin treatment on the metabolome in liver, blood, and urine in cows with different liver metabotypes

Dairy cows in modern production systems are at risk to develop metabolic disorders during the transition period. Reasons for individual differences in susceptibility, as well as the underlying pathomechanisms, are still only partially understood. The development of metaphylactic treatment protocols is needed. In this context, an on-farm prospective 3-fold blinded randomized study involving 80 German Holstein cows was performed throughout 1 yr. The trial involved a thorough recording of the production and clinical traits, clinical chemistry, and liver biopsies and blood and urine sampling at d 14 (mean: 12 d, range: 1-26 d) antepartum (AP), and d 7 (7, 4-13) and 28 (28, 23-34) postpartum (PP) for metabolomics analyses. Two groups received a treatment with butaphosphan and cyanocobalamin (BCC) at either the dosage recommended by the manufacturer or the double dosage (5 or 10 mL/100 kg of body weight 10% butaphosphan and 0.005% cyanocobalamin (Catosal, Bayer Animal Health), n = 20 in each group, parity: 4.2 ± 2.0 and 3.4 ± 1.3, respectively (mean ± SD)] and one group a placebo treatment (NaCl 0.9%, n = 40, parity: 4.0 ± 1.9). The animals were treated at 6 time points (7, 6, and 5 d AP, and 1, 2, and 3 d PP) via intravenous injection. Mass spectroscopy-based targeted metabolomics analysis of blood plasma and liver samples were performed using the AbsoluteIDQ p180 kit (Biocrates Life Sciences), whereas the urine samples were analyzed by nuclear magnetic resonance spectroscopy. Statistical analysis was performed using multivariate [partial least squares discriminant analysis (PLS-DA)] and univariate methods (linear mixed model). Multivariate data analysis (PLS-DA plots) of the liver metabolome revealed 3 different metabotypes (A = medium, B = minor, C = large alterations in liver metabolome profile between AP and PP status). Metabotype B animals were characterized by higher PP lipomobilization (stronger PP body condition decrease and higher blood bilirubin, fatty acids, gamma-glutamyltransferase, and triglyceride levels) and a higher occurrence of transition cow diseases, compared with the animals in metabotype C. Analysis of the feeding data showed that the period of metabotype B animals (calving in a distinct time frame) was characterized by a decreased grass silage quality. The PP liver metabolome of the metabotype C animals was characterized by higher concentrations of AA, acylcarnitines, lysoPC and sphingomyelins compared with metabotype B. For the metaphylactic treatment with BCC a dose-dependent effect was confirmed, differing between the metabotypes. In all matrices and metabotypes at various time points significant treatment effects were observed, with different profiles in clinical chemistry and as well in metabolomics data. The most clear-cut treatment effect was observed in metabotype B in the liver at 7 d PP, characterized by an increase in several acylcarnitines and phosphatidylcholines, indicating a more efficient influx and oxidation of fatty acids in mitochondria and thereby an increase in energy supply and more efficient triglyceride export in the liver. The results from the liver metabolomics analysis support the application of an indication-based metaphylactic treatment with BCC.

METHOD OF TELEPORTATION BASED ON NATURE-LIKE USING OF BIOLOGICAL OBJECTS

SEFER hA MINAGIM, p. 574 (photo 1), on behalf of an older book, writes that according to Jewish tradition, the navel does not close completely after childbirth, but remains partially open to extract various infections from the body. "From the "greenness" called "gable- zaht" (דזשאָנדַאַס איז קרענק די – disease jaundice), he will take a male pigeon for a man, and a dove for a woman; and put it on the navel, and the pigeon (dove), having drained all the infection from it (the patient), will die. Well-known veterinarian, Dr. Yekutiel Sharabi, owner of an elite veterinary clinic in Northern Tel Aviv, studied the causes of pigeon death after such a session. He found that immediately after treatment with pigeons, the patient's blood bilirubin level decreases by 25%, and recovery lasts an average of 3 days (as opposed to 28 days with conventional treatment). Autopsies of pigeons that died after the session showed liver enlargement and dysfunction. If the session was applied to a healthy person, not a single pigeon died. [1]
 In this paper, we consider a heuristic method for using quantum teleportation protocols in convergent dualuse biotechnologies based on new physical principles of operation [1-80]. The features of these biotechnologies will be considered within the framework of the possibilities of convalescence of pathological conditions (for example, nosological form: liver damage (lat. jecur, jecor, hepar, etc. - Greek ἧπαρ) by the hepatitis "C" virus (non-A, non-B hepatitis, or NANBH, or HCV infection). A hypothetical convalescence technology can be implemented by preparing cascades of entangled states of biological objects. In fact, this paper implies a certain information exchange in the planet's biogeosphere, hypotheses, protocols, and schemes for implementing these mechanisms based on new physical principles of action (NFP) [1-80].

Outcomes and limitations of endoscopic ultrasound-guided hepaticogastrostomy in malignant biliary obstruction

BackgroundTranspapillary biliary drainage in ERCP is an established method for symptomatic treatment of patients with unresectable malignant biliary obstruction. Percutaneous transhepatic biliary drainage frequently remains the treatment of choice when the transpapillary approach proves ineffective. Recently, EUS-guided extra-anatomical anastomoses of bile ducts to the gastrointestinal tract have been reported as an alternative to percutaneous biliary drainage. To assess the usefulness of extra-anatomical intrahepatic biliary duct anastomoses to the gastrointestinal tract as endotherapy for unresectable malignant biliary obstruction and to determine factors affecting the efficacy of treatment.MethodsA prospective analysis of the treatment results of all patients with unresectable biliary obstruction treated with EUS-guided hepaticogastrostomy at our institution in the years 2016–2019.ResultsTransmural intrahepatic biliary drainage (EUS-guided hepaticogastrostomy) was performed due to the ineffectiveness of ERCP in 53 patients (38 males, 15 females; mean age 74.66 [56–89] years) with unresectable biliary obstruction. Technical success of EUS-guided hepaticogastrostomy was achieved in 52/53 (98.11%) patients. Complications of endoscopic treatment were observed in 10/53 (18.87%) patients. Clinical success of EUS-guided hepaticogastrostomy was achieved in 46/53 (86.79%) patients. Bismuth type II–IV cholangiocarcinoma, hepatic metastases, ascites, suppurative cholangitis, and high blood bilirubin levels exceeding 30 mg/dL were independent factors for increased complications and inefficacy of EUS-guided hepaticogastrostomy.ConclusionsIn the event of transpapillary biliary drainage proving ineffective, extra-anatomical anastomoses of intrahepatic bile ducts to the gastrointestinal tract provide an effective method for the treatment of patients with malignant biliary obstruction.

Association between elevated serum bilirubin levels with preserved lung function under conditions of exposure to air pollution

BackgroundHigh serum bilirubin levels have been shown to be associated with an improved pulmonary function test results. Their potential ability to similarly benefit pulmonary function in an environment of polluted air has not been tested. We retrospectively analyzed data of 15,605 apparently healthy individuals in order to evaluate the effect of serum bilirubin levels on forced expiratory volume in 1 s (FEV1).MethodsIndividuals attended the Tel-Aviv Medical Center Inflammatory Survey for a routine annual health check between February, 2002 and June, 2009 and were divided into low, medium and high serum bilirubin levels. Their FEV1 results were compared under various levels of air pollution. Air pollution and weather data were obtained from air pollution monitoring stations of the Israeli Ministry of Environmental Protection.ResultsThe elevated serum bilirubin concentrations on FEV1 were evaluated under moderate and high pollution levels FEV1 and were significantly higher in participants with high blood bilirubin levels compared to medium or low levels (p < 0.001 and p = 0.018, respectively). Participants with high levels of bilirubin had preserved FEV1 under exposure to high and medium pollution levels of both Nitrogen Oxide (NOx) and Carbon Monoxide (CO) pollutants (p = 0.003 and p = 0.022, respectively). The multivariate regression analysis revealed that the influence of bilirubin under conditions of air pollution remained significant even after adjustment for FEV1 confounders, but the interaction was not significant.ConclusionsElevated serum bilirubin concentrations are associated with preserved lung function in healthy individuals in Israel exposed to high levels of air pollution.

Prediction of Neonatal hyperbilirubinemia by The Cord Blood Alkaline ‎Phosphatase

Background: Owing to early discharge of neonates from the hospital, the readmission rate has been increased. Therefore, early detection of jaundice and prompt measures are important. Measurements of bilirubin and alkaline phosphatase levels in cord blood have been used for this function. The aim of the work: To assess the cord blood alkaline phosphatase value in predicting neonatal jaundice. Patients and Methods: This study carried out during the period from August 2019 to January 2020 in pediatric department [Al-Azher University Hospital in Damietta]. This study included a total of 101 term infants with gestational age between 37 and 42 weeks, weighing more than 2500g born to healthy mothers. We performed an assessment of the complete medical history [maternal history and neonatal history]. Cord blood samples were collected for measurement of alkaline phosphatase. Neonates were followed-up for the emergence of jaundice. Infants with clinical jaundice were recalled and serum bilirubin level was measured. Significant indirect neonatal hyperbilirubinemia was considered. Results: The study showed that patients with neonatal jaundice had statistically significant higher reticulocyte count, alkaline phosphate level and total bilirubin than patients without neonatal jaundice. However, the study shows the best cut-off points of regarding ALP to predict neonatal jaundice in neonates. A value of 200 or more IU/L was the best cut-off point to predict occurrence with a sensitivity of 98.3%, a specificity of 97.6%. Conclusion: Increased alkaline phosphatase level in cord blood act as an indicator to neonatal jaundice, and may be used as a marker for early diagnosis.

Comparison of the effect of foot reflexology and body massage on physiological indicators and bilirubin levels in neonates under phototherapy

BackgroundHyperbilirubinemia is one of the most common problems in infancy in the world. The aim of this study was to compare the effect of foot therapy and body massage on physiological indicators and bilirubin levels in infants under phototherapy. MethodsThis study was a randomized clinical trial that conducted on 51 infants with jaundice at Imam Hussein Pediatrics’ Medical Center, Goldis Hospital in Isfahan (Iran). The samples randomly assigned to first intervention (reflexology), second intervention (body massage) and control groups using the block randomization. In the reflexology group, the relevant area on each foot was massaged for 15 min in a relaxed position. In the massage body group, the limbs were massaged with circular motion. The massage was performed once a day for 15 min and the control group did not receive any intervention. Physiological indicators were monitored using vital sign monitoring tools, and blood bilirubin levels were measured photo metrically (intravenous blood samples from the wrist). Finally, the data were analyzed using descriptive and inferential statistics and SPSS software version 18. ResultsThe results showed that before the intervention there was no significant difference in the mean of physiological indicators and bilirubin level between the three groups (p > 0.05), but after the intervention the average percentage of arterial oxygen saturation and bilirubin levels were significantly improved in the intervention groups compared to the control group (p < 0.05), while the mean of heart rate and respiration rate between the three groups were not significant (p > 0.05). ConclusionThe results showed that reflexology and massage therapy can be effective in improving the condition of physiological indicators and blood bilirubin levels.

Evaluation of immunoglobulins IgG, IgM, IgA and Complement Components C3 and C4 Levels in Iraqi full term Neonates with Severe Hyperbilirubinemia

Background and aim: Hyperbilirubinemia is an elevation of the bilirubin levels in blood of newborn babiesthat presented as jaundice. This study aimed to evaluate the levels of important of immunological systemproteins (IgG, IgM, IgA, C3 and C4) in both newborn babies with severe hyperbilirubinemia and healthycontrols.Methods: Thirty (30) full-term neonates with severe hyperbilirubinemia (serum bilirubin &gt;20 mg/dl) andtwenty five (25) healthy control full-term neonates were included in the study. Blood samples taken and Hb,total serum bilirubin, total protein measured immediately by spectrophotometer. IgG, IgM, IgA, C3 and C4measured by immune-nephelometric method.Results: In hyperbilirubinemia group (Male/ Female percentages) were (63% / 37%), (IgG 373.4±218 mg/dl),( IgM 20.5 ± 24.03 mg/dl), and (C3 209.4±17.81 mg/d)l values were significantly lower than controlgroup ( 588.2±298.5 mg/dl IgG, 26.44 ± 2.92 mg/dl IgM and 627.5±221.1 mg/dl for C3). Correlationanalysis revealed that in control group IgG, IgM, and C3 shown to be significantly (P value &lt;0.05) andpositively correlated (r-value &gt; 3) with both age and weight.Conclusions: jaundice is a risk factor for sepsis that could be due to lower levels of immunoglobulins andcomplements components. The normal development of immune system that observed with increasing ageand weight was impaired in patients with neonatal hyperbilirubinemia.

Study of Cord Blood Levels of Erythropoietin, Bilirubin and Reticulocyte Count as Early Predictors of Neonatal Hyperbilirubinemia.

Neonatal hyperbilirubinemia is a serious neonatal problem which has hazardous effects on the neonates when the level of indirect bilirubin is increased to the levels that could cause kernicterus. The aim of this research is to study the cord blood levels of erythropoietin (EPO), bilirubin and reticulocyte count (RC) as early predictors of neonatal hyperbilirubinemia. This is a case-control study, which was conducted at Tanta University Hospital (TUH) from July 2016 to March 2018 on 90 neonates. The studied neonates were divided into 2 groups: Group 1 (45 neonates) who developed pathological hyperbilirubinemia and required treatment and group 2(45 neonates) who did not develop pathological hyperbilirubinemia and did not require treatment. Cord blood levels of EPO, bilirubin and RC were measured in all the studied neonates in both groups. There was a significant difference between both groups with regard to cord blood bilirubin (CBB), hemoglobin, EPO and RC levels where the P. value is 0.001*,0.027, *0.001*&0.001*respectively. There was a significant positive correlation between cord blood EPO levels and both CBB and cord blood RC with r=0.610 and 0.579, respectively and P. value is 0.001* & 0.001* respectively. With regard to ROC curve, there were high cord blood EPO levels where the cut off value was 22.5 mIU/ml while the sensitivity and specificity were 96 and89, respectively. In the cord blood RC, the cut off value was 5.7% while the sensitivity and specificity were 93 and 85, respectively, and lastly, CBB where the cut off value was 1.8 mg/dl while the sensitivity and specificity were 89 and 78 respectively. Cord blood levels of EPO, bilirubin and RC were increased in cases of pathological neonatal hyperbilirubinemia. Cord blood levels of EPO, bilirubin and RC could be used for early prediction of pathological neonatal hyperbilirubinemia.

PENYULUHAN PENANGANAN BAYI KUNING (IKTERIK) DI DESA LUBUK SUKON KECAMATAN INGIN JAYA KABUPATEN ACEH BESAR

The condition of jaundice is very common in newborns, especially in LBW (Low Birth Weight Babies). There are many causes for this yellow baby. What often happens is because the baby's liver function is immature to process erythrocytes (red blood cells). In infants the age of red blood cells is approximately 90 days. The result of the breakdown, erythrocytes must be processed by the baby's liver. At birth the baby's heart is not yet good enough to do its job. The rest of the breakdown of erythrocytes is called bilirubin, this bilirubin is what causes jaundice in babies. Neonatal jaundice is a clinical condition in infants characterized by icterus staining of the skin and sclera due to excessive accumulation of unconjugated bilirubin. Clinical jaundice will begin to appear in newborns when blood bilirubin levels are 5-7 mg/dL. Jaundice during the first week of life is present in about 60% of term infants and 80% of preterm infants. The method used is Pre Test and Post Test using a questionnaire. Based on the results of the counseling there was an increase in respondents' knowledge about handling jaundice (icteric) babies, which were in the good category as much as 47 (88.68%). The conclusion is that there is a significant increase in respondents' knowledge after being given counseling.

Can Phototherapy Requirements Be Predicted through Cord Blood Test Results in Newborns?

Objective: Hyperbilirubinemia is one of the common problems in newborns. If not diagnosed and treated in time, high bilirubin levels can cause kernicterus and permanent brain damage. Therefore, early detection of hyperbilirubinemia development risk in newborns is important. Our aim is to determine whether the cord blood bilirubin level and the direct coombs test can be used as determinant parameters in order to predict babies with a high risk of developing hyperbilirubinemia requiring treatment. Material and Method: During the process of creating a hyperbilirubinemia follow-up protocol at Ordu University Training and Research Hospital, 300 babies born between January -June 2014with a birth weight ≥ 2500 g and gestational week ≥ 37 weeks were included in the study. The results of the cord blood bilirubin in of these babies, direct coombs test, maternal and infant blood groups and serum bilirubin levels of those who were hospitalized for phototherapy treatment within the first 24 hours were analyzed retrospectively. Results: Phototherapy was given to 35 of 300 (11.7%) newborns included in the study within the first 24 hours after birth. Direct coombs test was positive in 25 of them (8.3%). Phototherapy was given to 80% (n: 20) of the cases whose direct coombs test was positive. ABO incompatibility was found in the etiology of 51.5% of the cases with hyperbilirubinemia. It has been observed that patients with positive direct coombs test have a high rate of hospitalization (p&lt;0.001). Cord blood bilirubin levels were found to be statistically higher in cases who received phototherapy (2.7±1.0 and 1.8±0.6, respectively, p&lt;0.01). In determining the need for phototherapy, sensitivity was 77.1%, specificity was 77.0%, and negative predictive value was 96% for the cut off value of 2.0 mg/dl of cord blood bilirubin. Conclusion: Cord blood bilirubin level and direct coombs test are useful in predicting the possibility of pathological hyperbilirubinemia and hospitalization in newborns. Thus, detection of risky newborns with a noninvasive method within a few hours after birth will prevent early discharge and provide close follow-up and early treatment.

INSIGHT OF METHANOLIC EXTRACT OF VENTILAGO MADERASPATANA LEAVES ON HEPATOPROTECTIVE ACTIVITY UNDER STREPTOZOTOCIN-INDUCED DIABETIC RATS

Objective: The methanolic leaf extract of Ventilago maderaspatana (MEVML, 200 mg/kg body weight [b.w.]) was investigate to hepatoprotective activity under streptozotocin-induced (45 mg/kg b.w.) diabetic (Di) rats.&#x0D; Methods: In the present study, we determined the blood glucose levels, b.w., insulin, creatinine, and bilirubin levels in normal, Di, Di treated with MEVML and positive control rats.&#x0D; Results: The Di rats shown adverse changes in blood glucose levels, b.w., insulin, creatinine, and bilirubin levels when compared to other group rats. Reverse the adverse changes in the above parameters when treated the Di rats with MEVML&#x0D; Conclusion: The MEVML shown anti-diabetic activity and reverse the adverse changes in the above parameters in liver so that the MEVML supported the traditional claim of the hepatoprotective activity under Di condition.