Evaluation Of Some Blood Biomarkers As Predictors Of Neonatal Necrotizing Enterocolitis

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Nehal M El-Raggal ◽  
Yasser W Darweesh ◽  
Azza M Hassan ◽  
Esraa R Zaki ◽  
Dina E Rabie
Keyword(s):  
Early Diagnosis ◽  
Necrotizing Enterocolitis ◽  
Metabolic Diseases ◽  
Serum Bilirubin ◽  
Perinatal Asphyxia ◽  
Total Serum Bilirubin ◽  
Predictive Score ◽  
Preterm Neonates ◽  
Total Serum ◽  
Control Group

Abstract Background Necrotizing enterocolitis is a leading cause of mortality and morbidity in preterm neonates; however the lack of a reliable biomarker makes definite diagnosis difficult. Therefore, its early suspicion and proper management are important. Objective To evaluate the value of NLR, serum levels GGT, total serum bilirubin and serum Ca2+ concentrations for early diagnosis and prediction of NEC severity; and to make a predictive score for early diagnosis of NEC. Patients and methods A case control study which was conducted on neonates admitted to NICU, Children Hospital, Ain Shams University over a period of 6 months, fifty neonates were classified into two groups: the patients group included 25 neonates with NEC with a gestational age 28-36 weeks regardless of birth weight matched with control group which included 25 healthy preterm neonates, however we excluded neonates with congenital infectious diseases, perinatal asphyxia, severe birth defects, congenital digestive tract malformations, inherited metabolic diseases or parental refusal of enrollment. Results ROC curve of NEC diagnosis by NLR, serum GGT, total serum bilirubin and serum Ca2+ showed cut off: > 1.13, > 40 U/L, > 0.95 mg/dl, < 8.85 mg/dl respectively, Sensitivity 84, 92%, 84%, 84% respectively and Specificity 80%, 92%, 92%, 84% respectively; also beta-weighted score for prediction of NEC disease showed that NLR (Best cut off > 1.13) or GGT (Best cut off > 40 U/L could be helpful with sensitivity 92% and specificity 92%. Conclusion NLR, GGT, T.Bil and calcium levels could be good non-invasive markers for NEC disease prediction and also for its diagnosis.

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].

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 Efficacy of prophylactic phototherapy for prevention of hyperbilirubinemia in very low birth weight newborns

2016 ◽  
Vol 6 (2) ◽  
pp. 151
Author(s):  
M. A. Mannan ◽  
Ismat Jahan ◽  
Sadeka Choudhury Moni ◽  
Zahidul Hasan ◽  
Arjun Chandra Dey ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Birth Weight ◽  
Exchange Transfusion ◽  
Serum Bilirubin ◽  
Serum Bilirubin Level ◽  
Total Serum Bilirubin ◽  
Total Serum ◽  
Control Group ◽  
P Value ◽  
Unconjugated Hyperbilirubinemia

<p><strong>Background:</strong> Jaundice is a common clinical condition in newborn occurring in approximately 60% of term and 80% of preterm infants. Unconjugated hyperbilirubinemia is universally common in all preterm infants especially in newborns with very low biLth weight. Low birth weight and premature infants are at major risk for exaggerated hyperbilirubinemia that can lead to bilirubin encephalopathy. Significant heterogeneity in the approach to the treatment of jaundiced neonates exists throughout the world. Phototherapy is the most common treatment for neonatal hyperbilirubinemia and could be most effective in preventing the sequelae of hyperbilirubinemia if initiated prophylactically. This randomized clinical trial has been proposed with the objective of assessing the efficacy of prophylactic photo therapy in preventing significant rise of unconjugated hyperbilirubinemia in premature neonates weighing less than 1500 gram and therefore to decrease the need for exchange transfusion and finally to reduce hospital stay due to hyperbilirubinemia. <strong></strong></p><p><strong>Methods:</strong> This randomized controlled clinical trial enrolled sixty newborns with birth weight less than 1500 gram. They were divided into two groups: 1) Prophylactic group, in whom phototherapy was started within 24 hours of birth and continued for 7 days and 2) Control group in whom therapeutic phototherapy was started considering serum bilirubin level and other clinical condi­tions as per institutional guidelines. Mean value of total serum bilirubin (TSB), duration of phototherapy, the need for exchange transfusion and duration of hospital stay in both groups were analyzed.</p><p><strong>Results:</strong> The maximum mean TSB level in prophylactic group was observed on 7th day and in control group it was observed on 3rd day of life. The total serum bilirubin levels were significantly lower in the 3rd and 5th days of life in the prophylactic group in comparison to control group (P value 0.001). Total serum bilirubin level exceeded therapeutic range in 6 (21 %) and 14 (50 %) newborns of the prophylactic group and control groups respectively (P value 0.026). No documented side effects of prophylactic photo­therapy was observed.<strong> </strong></p><p><strong>Conclusion:</strong> The use of prophylactic photo therapy for infants weighing less than 1500 grn is effec­tive and sate when compared to the control group, considering satisfactory maintenance of low total serum bilimbin levels during first 7 days of life.</p>

scholarly journals Evaluation of Jaundice meter in the assessment of jaundice among Nigerian preterm neonates

1970 ◽  
Vol 42 (3) ◽  
pp. 194-198
Author(s):  
BO Kayode-Adedeji ◽  
JA Owa ◽  
GO Akpede ◽  
SO Alikah
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Serum Bilirubin ◽  
Objective Assessment ◽  
Total Serum Bilirubin ◽  
Preterm Neonates ◽  
Total Serum ◽  
Transcutaneous Bilirubin ◽  
The Mean ◽  
Transcutaneous Bilirubinometry

Background: The objective assessment of the severity of neonatal jaundice is Total Serum Bilirubin (TSB) determination, which requires multiple blood sampling. This has inherent problems, including risks of anaemia and infection. Transcutaneous Bilirubinometry (TcB) is a reliable, non-invasive alternative, however there is paucity of data on its performance in black preterm neonates.Objectives: To evaluate the correlation between transcutaneous bilirubin (TcB) and total serum bilirubin (TSB) among Nigerian preterm neonates, and to determine the parameters affecting the relationship.Method: Jaundiced preterm neonates delivered between 28 and 36 weeks of gestation admitted at the Irrua Specialist Teaching Hospital (ISTH), Nigeria were recruited . The TSB levels were determined by spectrophotometry while the corresponding TcB levels were obtained using Jaundice Meter (JM-103). The neonates were stratified into gestational age and birth weight groups.Results: A total of 189 paired TcB and TSB levels were obtained from 60 neonates. The Mean (sd) TcB level of 11.4 (3.1) mg/dl was significantly higher than the mean TSB level of 10.2 (2.8)mg/dl (p= 0.028). The overall correlation coefficient between TcB and TSB was 0.98 and it was not significantly affected by the gestational age, birth weight and bilirubin levels.Conc lusion: Transcutneous bilirubin strongly correlates with total serum bilirubin levels among Nigerian preterm neonates, irrespective of gestational age, birth weight and the degree of jaundice.Keywords: hyperbiliruinaemia, jaundice meter, Nigerian, preterm, neonates, transcutaneous bilirubinometry

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 Efficacy of Transcutaneous Bilirubinometry as Compared to Serum Bilirubin in Preterm Newborn During Phototherapy

2021 ◽  
Author(s):  
Sunil Gothwal ◽  
Neelam Singh ◽  
Sadasivam Sitaraman ◽  
Ramesh Choudhary ◽  
Kailash Kumar Meena ◽  
...  
Keyword(s):  
Neonatal Intensive Care ◽  
Serum Bilirubin ◽  
Tertiary Care ◽  
Total Serum Bilirubin ◽  
Preterm Neonates ◽  
Total Serum ◽  
Skin Area ◽  
Care Hospital ◽  
Transcutaneous Bilirubin ◽  
The Difference

Abstract Transcutaneous measurement of bilirubin is being used for neonatal jaundice. Its utility during phototherapy in preterm babies is not established. Objective of our study was to assess the efficacy of transcutaneous bilirubin (TcB) measurement in comparison to total serum bilirubin in preterm newborns at admission and during phototherapy at covered skin area (glabella). It was a prospective observational study and conducted at neonatal intensive care unit of a tertiary care hospital from January 2017 to January 2019. One hundred eligible preterm neonates were enrolled. Babies who were very sick, with poor peripheral circulation, edematous, having conjugated hyperbilirubinemia, with major congenital malformations, already received phototherapy or exchange transfusion were excluded. Paired total serum bilirubin and transcutaneous bilirubin were measured at admission, at 6 hours and 24 hours during phototherapy. TcB was measured from area (glabella) covered by eye protector during phototherapy. Sample for TsB was taken within 10 minutes of TcB measurement. The mean difference between TsB and TcB values at admission, 6 hours and 24 hours of phototherapy were -0.005 (0.353), --0.350 (0.611), and -0.592 (0.353) respectively. At admission or before starting of phototherapy the difference (TsB-TcB) was statistically not significant (p=.125), while the difference in these values were statistically significant at 6 hours and 24 hours of phototherapy. Conclusion: TcB measurements from covered skin area in jaundiced preterm infants during phototherapy were not correlated with TsB and cannot be used as an alternate of serum bilirubin levels.

scholarly journals Urinary N-Acetyl-beta-D-glucosaminidase as an Early Marker for Acute Kidney Injury in Full-Term Newborns with Neonatal Hyperbilirubinemia

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Bangning Cheng ◽  
Yulian Jin ◽  
Guanghui Liu ◽  
Zhiheng Chen ◽  
Hongmei Dai ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Serum Bilirubin ◽  
Kidney Injury ◽  
Full Term ◽  
Total Serum Bilirubin ◽  
Total Serum ◽  
Control Group ◽  
Term Newborns ◽  
Group 3 ◽  
Group 2

Purpose. To investigate renal function estimated by markers in full-term newborns with hyperbilirubinemia.Methods. A total of 332 full-term newborns with hyperbilirubinemia and 60 healthy full-term newborns were enrolled. Total serum bilirubin, serum creatinine (Cr), serum blood urea nitrogen (BUN), serum cystatin C (Cys-C), urinary beta-2-microglobulin (β2MG) index, and urinary N-acetyl-beta-D-glucosaminidase (NAG) index were measured before and after treatment. All newborns were divided into three groups according to total serum bilirubin levels: group 1 (221-256), group 2 (256-342), and group 3 (>342).Results. The control group and group 1 did not differ significantly in regard to serum Cr, serum BUN, serum Cys-C, urinaryβ2MG index, and urinary NAG index. Urinary NAG index in group 2 was significantly higher than that in control group (P<0.001). Between control group and group 3, serum Cys-C, urinaryβ2MG index, and urinary NAG index differed significantly. The significant positive correlation between total serum bilirubin and urinary NAG index was found in newborns when total serum bilirubin level was more than 272 μmol/L.Conclusions. High unconjugated bilirubin could result in acute kidney injury in full-term newborns. Urinary NAG might be the suitable marker for predicting acute kidney injury in full-term newborns with hyperbilirubinemia.

scholarly journals The Protective Role of crude Polyphenolic Compounds Extracted from black Olive fruit (Oleaeuropae ) on Liver Functions in Males Rats Treated with Hydrogen Peroxide

2012 ◽  
Vol 36 (0E) ◽  
pp. 164-171
Author(s):  
Layla Hashim Alol
Keyword(s):  
Serum Bilirubin ◽  
Inflammatory Cells ◽  
Treated Group ◽  
Protective Role ◽  
Polyphenolic Compounds ◽  
Total Serum Bilirubin ◽  
Male Rats ◽  
Total Serum ◽  
Control Group ◽  
Black Olive

This study was conducted to investigate the protective role of polyphenolic compounds extracted from olive (Oleaeuropae) to contrast the damaging effects of 1% hydrogen peroxide on liver functions in male rats. Crude polyphenolic compounds were extracted from fruits of black olive by 95% methanolic extraction method. Twenty adult male rats (200-220gm.) were randomly divided into four equals groups and treated daily for 30 days. Rats in the first group received tap water (orally)and considered as control group, animals of second group received 1% H2O2 in drinking water . The rats in the third group received 1% H2O2 in drinking water plus 200mg/kgB.W. of crude polyphenolic compounds while animals in the fourth group received 200mg/kg B.W. of crude polyphenoliccompounds. At the end of the experiment, blood samples were taken to investigate the activity of liver enzymes (Aspartate aminotransferase (AST) and Alanine aminotransferase (ALT), concentration of total serum bilirubin, as well as protein picture of blood serum by using agarose gel electrophoresis. Ultimately, animals of all groups were sacrified to examine the histopathological changes in liver. The results illustrated significant increase (P<0.05) in liver enzymes activity (AST,ALT) and total serum bilirubin in H2O2 treated group as compared with control. Although rats treated polyphenolic compounds of olive plus H2O2 showed significant decrement (P<0.05) in ALT activity and total serum bilirubin, while no significant alteration in (AST) activity was recorded in H2O2 treated group. The result also demonstrated significant decrease (P<0.05) in authority of ALT, total serum bilirubin in animals treated with polyphenolic compounds. Serum proteins showed a significant (P<0.05) decreament of albumin percentage and increment of globulins in H2O2 treated group as well as polyphenolic compounds treated group as compared with control group (G1) . However, no significant different in group treated with polyphenolic compounds as compared with control. Histological sections of liver illustrated clear impact of group treated with H2O2, manifested by necrosis of hepatic cells with infiltration of inflammatory cells while animals treated with polyphenolic compounds plus H2O2 revealed slight infiltration of inflammatory cells with proliferation of kupffer cells in liver. In infereance, the autcomes of this study documented the advantageous effect of crude polyphenolic compounds of olive apposite the noxious effect of H2o2 on liver function of adult males rats.

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