Might Bilirubin Serve as a Natural Antioxidant in Response to Neonatal Encephalopathy?

2018 ◽  
Vol 35 (11) ◽  
pp. 1107-1112 ◽  
Author(s):  
Alona Bin-Nun ◽  
Francis Mimouni ◽  
Yair Kasirer ◽  
Irina Schors ◽  
Michael Schimmel ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Hepatic Injury ◽  
Serum Bilirubin ◽  
Area Under The Curve ◽  
Total Serum ◽  
Control Group ◽  
Neonatal Encephalopathy ◽  
Term Neonates ◽  
Serial Serum ◽  
The Mean

Background Neonatal asphyxia is often associated with hepatic injury. We hypothesized that this might lead to increased bilirubin concentrations. Study Design Term neonates admitted between January 2015 and April 2017 who remained hospitalized for ≥ 4 days and who had serial serum bilirubin concentrations recorded were divided into those with neonatal encephalopathy (NE) and controls. Serial serum bilirubin concentrations during the first days of life were compared between groups. Results Twenty-nine neonates with NE and 84 age-matched controls were identified. Mean total serum bilirubin concentrations of NE babies were significantly lower than those controls throughout the first days of life. At 96 hours of age, NE serum bilirubin concentrations were 4.5 (3.2, 5.8) versus controls of 10.5 (9.4, 11.5) mg/dL (p < 0.0001). The mean area under the curve (AUC) for the NE group was 268 (215, 321) versus 663 (608, 718), p < 0.0001, for the control group. All of the NE babies remained below the 40th percentile of the Bhutani curve and none required phototherapy. Conclusion Contrary to our hypothesis, bilirubin concentrations in NE infants are significantly lower than expected during the first 4 days postnatally. We speculate that, under conditions of severe oxidative stress, bilirubin is consumed as an antioxidant.

scholarly journals Effectiveness of phototherapy with reflecting curtains on neonatal jaundice

2011 ◽  
Vol 51 (5) ◽  
pp. 256 ◽  
Author(s):  
Ari Kurniasih ◽  
Guslihan Dasa Tjipta ◽  
Muhammad Ali ◽  
Emil Azlin ◽  
Pertin Sianturi
Keyword(s):  
Neonatal Jaundice ◽  
Serum Bilirubin ◽  
Low Cost ◽  
Total Serum Bilirubin ◽  
Spectral Irradiance ◽  
Total Serum ◽  
Control Group ◽  
Study Group ◽  
Term Newborns ◽  
The Mean

Background Although phototherapy has been used in clinical practice for 40 years, there is still much debate on how to provide the most efficacious phototherapy. Phototherapy with white reflecting curtains may increase the average spectral irradiance provided, as well as decrease serum bilirubin concentrations at a faster rate in neonates with jaundice.Objective To determine if adding low cost, white, reflecting curtains to a standard phototherapy unit can increase the effectiveness of phototherapy for neonatal jaundice.Methods A randomized, controlled, open trial was conducted at H. Adam Malik and Pirngadi Hospitals, Medan, from May to December 2009. The criteria for inclusion in the study were full term newborns with neonatal jaundice presenting in their first week of life. Single phototherapy with white curtains hanging from the sides of the phototherapy unit (study group, n=30) was compared to single phototherapy without curtains (control group, n=30). The primary outcomes measured were the mean difference in total serum bilirubin levels and average spectral irradiation levels measured at baseline, and after 12 hours and 24 hours of phototherapy.Results The sum of average spectral irradiance in the curtained phototherapy unit was significantly higher than that of the standard phototherapy unit without curtains (P < 0.05). The decrease of total serum bilirubin levels after 12 and 24 hours of phototherapy was significantly greater in the study group (3.71 and 9.7 mg/dl, respectively) than in the control group (0.1 and 3.8 mg/dl, respectively), both P <0.05.Conclusion White, reflecting curtains in phototherapy units was significantly more effective than phototherapy without curtains for treatment of neonatal jaundice. [Paediatr Indones. 2011;51:256-61].

scholarly journals Glucose-6-Phosphate Dehydrogenase (G6PD) Status in Neonatal Jaundice and its Relationship with Severity of Hyperbilirubinemia

1970 ◽  
Vol 4 (2) ◽  
pp. 71-76
Author(s):  
Nilufa Akhter ◽  
Noorzahan Begum ◽  
Waqar Ahmed Khan
Keyword(s):  
Bilirubin Level ◽  
G6pd Deficiency ◽  
Serum Bilirubin ◽  
Serum Bilirubin Level ◽  
Total Serum ◽  
Control Group ◽  
Term Neonates ◽  
Group A ◽  
The Difference ◽  
Enzyme Deficient

Background: G6PD deficiency is one of the common inherited enzymatic disorder associated with high incidence of severe neonatal hyperbilirubinemia. Objectives: To observe G6PD status in male, term neonates with jaundice and its correlation with serum level of bilirubin. Methods: This cross sectional study was conducted on 90 male, term neonates with jaundice, age ranged from 3 to 12 days (Group B) in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University (BSMMU) between July 2007 to June 2008. On the basis of total serum bilirubin (TSB) level, study group was further divided into B1(TSB <15mg/dl), B2(TSB 15-20mg/dl) and B3 (TSB>20mg/dl). For comparison age and sex matched 30 apparently healthy neonates (Group A) were also included in the study. Erythrocyte G6PD level was measured by Spectrophotometric method by using kit of Randox. Serum bilirubin level was measured by standard laboratory technique. For statistical analysis ANOVA, independent sample "t" test and Pearson's correlation coefficient test were performed as applicable by using SPSS windows version-12. Results: In this study, erythrocyte G6PD levels were significantly lower in moderate (p<0.01) and severe (p<0.001) hyperbilirubinemic group in comparison to that of control group . However, this enzyme level was lower in mild group compared to that of control but the difference was statistically non significant. Again, this enzyme levels were significantly lower in moderate (p<0.05) and severe (p<0.01) group than that of mild group and also between severe and moderate hyperbilirubinemic group (p<0.05). In this study, G6PD enzyme deficient were found in 1(3.33%) and 6(20%) subjects of group B2 and B3 respectively. Though, percentage of the subjects with enzyme deficiency were higher in severe group ( B3 ) compared to that of moderate group( B2 ) but the difference was statistically not significant. However, no enzyme deficient patient were found in control group (A) and mild hyperbilirubinemic group (B1). Serum bilirubin level showed significant (p<0.05) positive (r=+.429) correlation with erythrocyte G6PD level in control group (A). On the other hand, this level was negatively correlated with G6PD enzyme in groups B1 (r= -.127), B2 (r=-.120) and B3 ( r= -.671) but significant negative correlation in group B3 (p<0.01). Conclusion: The results of the study revealed that severity of hyperbilirubinemia depends on degree of G6PD deficiency. Therefore, early detection of this enzymopathy and close surveillance of the affected neonates may be important in reducing the complications of severe hyperbilirubinemia. Key words: Glucose-6-PD, Hyperbilirubinemia, Neonates DOI: 10.3329/jbsp.v4i2.4176 J Bangladesh Soc Physiol. 2009 Dec;4(2): 71-76  

Efficacy and Safety of Fenofibrate in Uncomplicated Hyperbilirubinemia in Newborn: A Randomized Trial, with a 6-month Follow-up

2020 ◽  
pp. 37-42
Author(s):  
Jayendra R. Gohil ◽  
Vishal S. Rathod ◽  
Bhoomika D. Rathod
Keyword(s):  
Single Dose ◽  
Serum Bilirubin ◽  
Total Serum Bilirubin ◽  
Total Serum ◽  
Control Group ◽  
Term Neonates ◽  
Significant Difference ◽  
Group A ◽  
Group B

Objective: To study the effect and safety of Fenofibrate in uncomplicated hyperbilirubinemia in newborn with 6-month follow-up. Materials and Methods: This is a randomized controlled clinical trial conducted in 60 normal term neonates admitted for uncomplicated hyperbilirubinemia in NICU at Sir T G Hospital, Bhavnagar from January 2012 to December 2012. The data included: age, sex, total serum bilirubin (TSB), weight and duration of phototherapy. All neonates enrolled in the study received phototherapy. They were divided in two groups of 30 each: control group A and group B receiving Fenofibrate (100 mg/kg single dose). There was statistically insignificant difference between the parameters of age, sex, weight and TSB between the two groups at hospitalization. Data was analyzed by using appropriate statistical methods. Results: Mean values for total serum bilirubin in Fenofibrate group B at 24 and 48 hours after admission were significantly lower than those for control group A (p<0.0001,  p=0.0001). There was no significant difference in fall of TSB between 24 and 48 hours. The mean duration of phototherapy in Fenofibrate group (44.8h: 24-72h) was significantly shorter than that in control group (55.2 h: 24‐96 h) (P=0.02). There were no side effects of the drug observed during the study and during 6 months follow up period. Conclusion: Fenofibrate as a single 100 mg/kg dose in healthy full term neonates, is effective and a safe drug (till six-month follow-up) for neonatal hyperbilirubinemia, that can decrease the time needed for phototherapy and hence hospitalization. Effect of a single dose seems to wane after 24 hours.

scholarly journals Effect of Oral Fenofibrate on Serum Bilirubin Level in Term Neonates with Unconjugated Hyperbilirubinaemia: A Randomized Control Trial

2021 ◽  
Vol 16 (1) ◽  
pp. 35-38
Author(s):  
Murshida Mosharref ◽  
Naila Rehnuma ◽  
Nusrat Jahan ◽  
Farzana Zafreen
Keyword(s):  
Bilirubin Level ◽  
Serum Bilirubin ◽  
Serum Bilirubin Level ◽  
Total Serum Bilirubin ◽  
Military Hospital ◽  
Total Serum ◽  
Control Group ◽  
Term Neonates ◽  
Normal Birth ◽  
And Control

Introduction: Hyperbilirubinemia is a common problem in the neonatal period. Phototherapy is the most important proposed treatments for hyperbilirubinemia, but several drugs along with phototherapy are used with recent advances. Aim: To see the effect of oral fenofibrate on serum bilirubin level in term neonates with unconjugated hyperbilirubinaemia. Methods: This prospective study was carried out in Combined Military Hospital Cumilla from July 2018 to June 2019. Total 60 term and normal birth weight neonates with neonatal jaundice were enrolled in this study. Jaundiced newborns presenting with infection, G6PD deficiency, conjugated bilirubin >2 mg/dl or >15% of total serum bilirubin (TSB) and congenital anomalies were excluded from this study. These neonates were randomly allocated to the Fenofibrate group (30 cases) and Control group (30 cases). Total serum bilirubin was measured every 24 hours till the end of phototherapy and at the time of discharge. Statistical analysis was done using SPSS 22.0 and p<0.05 was considered significant. Results: There were no significant differences in gender, age, weight, gestational age and type of delivery between two groups. Mean duration of hospital stay were 4.0±0.7 and 5.5±1.4 days in Fenofibrate group and Control group respectively (p<0.001). In Fenofibrate group, TSB was decreased from 17.2 mg/dl to 15.2 mg/dl after 24 hours, to 13.6 mg/dl after 48 hours, and to 10.1 mg/dl at the time of discharge.  In control group, TSB was decreased from 17.0 mg/dl to 16.3 mg/dl after 24 hours, to 15.9 mg/dl after 48 hours, and to 10.3 mg/dl at the time of discharge. Conclusion: Treatment of neonatal unconjugated hyper- bilirubinemia with fenofibrate reduces neonatal bilirubin levels and decreases the need for phototherapy and hospitalization. JAFMC Bangladesh. Vol 15, No 1 (June) 2020: 35-38

scholarly journals Association between Thyroid Profile and Serum Bilirubin Levels in Term Neonates on Day 3 of Life

2020 ◽  
Vol 8 (2) ◽  
pp. 42-45
Author(s):  
Prahlad Kadambi ◽  
MA Ramprakash ◽  
Gandi Soujanya ◽  
L Sushanth Prabhath Reddy
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Serum Bilirubin ◽  
Positive Association ◽  
Serum Levels ◽  
Total Serum ◽  
Term Neonates ◽  
The Mean ◽  
Thyroid Profile ◽  
Serum Tsh

Background: Neonatal indirect hyperbilirubinemia is a common clinical scenario that manifests as jaundice in the first week of life. Studies have shown that the physiological peak of serum bilirubin (SBR) levels is highest at 72 hours of life as a result of which SBR is measured at  72 hours of life routinely. The American Academy of Pediatricians (AAP) recommends routine screening for congenital hypothyroidism within the first week of life for all neonates. In common practice, both parameters are assessed simultaneously at 72 hours of life. This study aims     to correlate thyroid Profile and serum bilirubin levels assessed in term neonates at 72 hours of life. Subjects and Methods: Our retrospective study included 105 term neonates born through cesarean-section at MMCHRI, Kanchipuram; between August 2018 and August 2019. Pre-term, neonates born to eclamptic, pre-eclamptic, diabetic, hypothyroid, Rh-incompatible mothers were excluded from the study. The data collected included Birth Weight, Gestational Age, Thyroid Profile (T3, T4, TSH), SBR (Total and Direct). Data were analyzed using SPSS v16. Results: The mean gestational age of the study population was 268.05  6.25 days, and mean birth weight was 2.997  0.36 kgs. The mean serum levels  of total bilirubin were 11.36 3.52 mg/dl. The mean serum fT3, fT4, TSH levels were 8.17 23.2 pg/ml, 2.16 1.68 ng/dl and 4.07 3.4 mIU/ml respectively. A positive association was noted between serum TSH and total serum bilirubin (r= 0.176, p = 0.067) but not statistically significant. Conclusion: Our study has not shown a significant association between serum TSH and SBRT in term neonates. However, the simultaneous assessment remains practical in practice.

scholarly journals The Importance of Antioxidant Status in Gastric Intestinal Metaplasia

2021 ◽  
Author(s):  
Nilay Danis ◽  
Aysegul Ertinmaz Ozkan ◽  
Fatih Karatas ◽  
Cagri Cakici ◽  
Turkan Yigitbasi ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Intestinal Metaplasia ◽  
Prognostic Marker ◽  
Smoking Status ◽  
Serum Levels ◽  
Control Group ◽  
Gastric Intestinal Metaplasia ◽  
Oxidative Stress Status ◽  
Cancer Types ◽  
The Mean

Background and Aim: Oxidative stress status in different cancer types was investigated before, but not studied in gastric intestinal metaplasia to the best of our knowledge. Purpose of this study is to examine whether there is a difference between oxidative stress status in patients with intestinal metaplasia (IM) compared to individuals without IM, we compared the serum levels of disulfide (SS), total thiol (TT) and native thiol (NT). Patients and Methods: This was a prospective, non-randomized case-control study including 67 patients with histopathologically confirmed IM and 60 individuals demographically matched in terms of age, gender, BMI, smoking status, and chronic diseases as control group. Results: The mean NT, TT and NT to TT(NT/TT) ratios were statistically significantly higher in IM group compared to controls [(351.71±81.9µmol/L vs. 271.82±54.13µmol/L, p=0.000),(391.5±92.69µmol/L vs. 308.59±55.53 µmol/L, 0.000) and (0.89±0.6 vs. 0.87±0.29,  p=0.022), respectively].The mean SS to TT(SS/TT) ratio was significantly lower in IM group than control group (0.050±0.31 vs. 0.060±0.014, P=0.022). Median SS and mean SS/NT ratio was similar in both groups[16.3 (3.3 – 78) vs. 18.3 (10 – 32.7), p=0.271 and 0.055 ± 0.041 vs. 0.070 ± 0.019, p=0.068, respectively). In ROC analysis, cut off value of SS/NT for IM was found 0.062, in regression analysis, SS/NT<0.062 was found as an independently prognostic marker for IM (OR, 2.38; 95%CI: 1.168 - 4.865, P=0.017). Conclusion: SS /NT ratio lower than 0.062 was found as an independently prognostic marker for IM. This ratio could help to distinguish which patients should be followed closely for gastric cancer.

EFFECT OF PHOTOTHERAPY ON SERUM CALCIUM LEVELS IN NEONATAL JAUNDICE

2021 ◽  
pp. 17-19
Author(s):  
Aradhana Gupta ◽  
Anand Kumar Bhardwaj ◽  
Anisha Aggarwal ◽  
Gauri Chauhan
Keyword(s):  
Serum Calcium ◽  
Neonatal Intensive Care ◽  
Neonatal Jaundice ◽  
Serum Bilirubin ◽  
Calcium Supplementation ◽  
Clinical Signs ◽  
Total Serum ◽  
Medical Sciences ◽  
Term Neonates ◽  
Unconjugated Hyperbilirubinemia

Background :To study the effect of phototherapy on serum calcium levels in neonates with unconjugated hyperbilirubinemia. Methods : This hospital based longitudinal interventional study was conducted on 100 neonates with neonatal hyperbilirubinemia admitted to Neonatal Intensive Care Unit at Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala. Total serum bilirubin and serum calcium levels of each participants were checked before and at the end of phototherapy. Neonates were also checked for the clinical signs of hypocalcemia i.e. jitteriness, irritability, lethargy, and convulsions. Results : Atotal of 100 neonates with neonatal jaundice were included with 55% boys and 45 % girls whose mean age was 3.0 ± 0.95 days. Mean S.Bilirubin level before phototherapy was 13.92 ± 2.32 mg/dl which was reduced to 8.87 ± 2.18 mg/dl. S.Calcium levels pre-phototherapy were 8.66 ± 0.65 mg/dl which were reduced to 7.94 ± 1.05 mg/dl. It was found that 32% of the participants in total exhibited symptoms related to hypocalcemia. More term neonates (56.3%) experienced symptoms related to hypocalcemia compared to pre-terms (43.8%). Conclusion : It can be deduced that phototherapy induced hypocalcemia is a signicant concern and hence, neonates requiring phototherapy may be considered for calcium supplementation.

scholarly journals The Impact of Wood, Cigarette and Marijuana Smoke on the Reproductive Health of Tandoor Occupants

2014 ◽  
Vol 5 (2) ◽  
pp. 95
Author(s):  
Ghulam Nabi ◽  
Muhammad Amin ◽  
Jeena Urooj ◽  
Muhammad Kamil ◽  
Ayaz Ali Khan
Keyword(s):  
Reproductive Health ◽  
Economic Status ◽  
Serum Testosterone ◽  
Total Serum ◽  
Control Group ◽  
Fuel Type ◽  
Blood Samples ◽  
Testosterone Concentration ◽  
The Mean ◽  
The Impact

The objective of this study was to determine the effects of wood, cigarette and marijuana smoke on the reproductive health of tandoor occupants. A total of 100 male individuals were selected (50 control and 50 tandoor occupants). A standard questionnaire was designed regarding their age, economic status, marital status, fuel type, exposure time (per day), use of mask, addiction and reproductive health. Morning blood samples of 5 mL of the size were taken from all participants. Serums were obtained and analyzed for total serum testosterone concentration. Bio-check (USA) kit was used according to the manufacturer protocol and procedures for testosterone analysis. In control group the mean ± SEM of total serum testosterone was 671.9 ± 20.02 ng/dl where as in tandoor occupants it was 542.7 ± 16.40 ng/dl. There was a significant reduction (P**** < 0.0001) in total serum testosterone concentration in tandoor occupants as compared to control group. Reproductive health problems like, low libido, erection problems, infertility, decreased frequency for shaving and absent morning and nocturnal erection were common in tandoor occupants as compared to control group. Wood, cigarette and marijuana smoke negatively affects testosterone concentration and lowers it significantly. This reduced testosterone concentration then produces ill effects like low libido, erection problems, infertility and absent morning and nocturnal erection. 

Diagnostic Value of Neutrophil to Lymphocyte Ratio and Mean Platelet Volume on Early Onset Neonatal Sepsis on Term Neonate

2020 ◽  
Author(s):  
Birol Karabulut ◽  
Silem Ozdem Alatas
Keyword(s):  
Neonatal Sepsis ◽  
Predictive Value ◽  
Mean Platelet Volume ◽  
Early Onset ◽  
Area Under The Curve ◽  
Neutrophil To Lymphocyte Ratio ◽  
Control Group ◽  
Platelet Volume ◽  
Term Neonates ◽  
Lymphocyte Ratio

AbstractBy setting out from increased neutrophil count, decreased lymphocyte count, and increased mean platelet volume (MPV), which is a result of the effect of inflammation on blood cells, we aimed to investigate whether neutrophil to lymphocyte ratio (NLP) and MPV can be used as an auxiliary parameter for the diagnosis of early-onset neonatal sepsis (EOS). This study was conducted by analyzing term neonates with EOS and physiological jaundice who were admitted to the neonatal intensive care unit of Izmir Katip Celebi University Ataturk Training and Research Hospital. A total of 63 neonate files were examined to include 30 term neonates with EOS, and 77 neonate files were examined to include 30 term neonates with physiological jaundice as a control group. NLR had an area under the curve (AUC) of 0.891 for prediction of EOS. At a cut-off level of 1.42, NLR had a likelihood ratio (LR) of 5.5, sensitivity of 88%, a specificity of 84%, a positive predictive value (PPV) of 84.6%, and a negative predictive value (NPV) of 87.5%. MPV had an AUC of 0.666 for the prediction of EOS and at a cut-off level of 9.3 fL, MPV had an LR of 1.23, sensitivity of 84%, a specificity of 32%, a PPV of 55.2%, and an NPV of 66.6%. In conclusion, this study provides evidence that NLR and MPV can be used in addition to conventional parameters in the diagnosis of EOS.

scholarly journals Can Apelin play a role in the etiology of tinnitus?

2019 ◽  
Author(s):  
Nuray ENSARİ ◽  
Özer Erdem GÜR ◽  
Nilgün GÜR ◽  
Ömer Tarık SELÇUK ◽  
Levent RENDA ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Inflammatory Diseases ◽  
Significant Negative Correlation ◽  
Control Group ◽  
Tinnitus Severity ◽  
The Mean ◽  
General Populations ◽  
Plasma Apelin

Background and Aims: Tinnitus, which affects 15% of general populations and in 1-6%, the quality-of-life is seriously affected by a chronic condition. Chemical, oxidative, and emotional stressors are important in terms of the clinical course of tinnitus. Apelin mediates oxidative stress. We measured apelin levels in patients with tinnitus affecting both ears, but without hearing loss. Material and Methods: We enrolled patients diagnosed with bilateral idiopathic tinnitus. Tinnitus severity was determined using the Tinnitus Handicap Inventory. We recorded the levels of plasma apelin-13 and biochemical parameters. Results: The mean apelin level of the control group was higher than that of the patient group (p = 0.002). A significant negative correlation was evident between the apelin level and the THI (r = 0.460, p = 0.003). The TG level was significantly higher in the patient than the control group (p < 0.001). Conclusions: As tinnitus severity increased, the apelin level fell. Thus, apelin may play a role in the pathophysiology of idiopathic tinnitus, and may be prescribed during follow-up to reduce oxidative stress in the future. Further clinical studies on the effects of the apelin/APJ system and the effects of antioxidants in patients with inflammatory diseases, are required. Key words: apelin, oxidative stress, tinnitus

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