TO STUDY THE CORRELATION OF URINARY URIC ACID AND CREATININE RATIO IN BIRTH ASPHYXIA

2021 ◽  
pp. 53-54
Author(s):  
B Revanth Reddy ◽  
Gauri Chauhan ◽  
Anand Kumar Bhardwaj ◽  
Sasanka Chakrabarti

Introduction: Perinatal asphyxia is one of the leading causes of perinatal morbidity and mortality. Feasible and early biochemical markers to diagnose and predict the neurologic outcome is a great need of time as APGAR score alone is inuenced by various factors. The present study was performed to determine the urinary uric acid to creatinine ratio in perinatal asphyxia and its correlation with APGAR score and compare urinary uric acid to creatinine ratio with Sarnat and Sarnat staging. Materials and Methods: This study was carried out on 100 term neonates with an equal number of cases and control 50 each, control group being the neonates with Apgar score ≥ 7 at 1 minute of life and cases being the neonates who suffered from perinatal asphyxia with Apgar < 7 at 1 minute of life. The spot urine sample was collected within 24 hours of birth and their uric acid and creatinine levels were measured and the ratio calculated. Asphyxiated neonates were classied according to Sarnat and Sarnat staging. We Compare UA/Cr ratio with Apgar score and HIE staging using Sarnat and Sarnat staging.Results: On comparison of UUA/Cr among cases and controls we found that ratio was signicantly higher in asphyxiated neonates as compared to non asphyxiate neonates. (Control vs. Cases Group: 2.4 ± 1 vs. 3.6 ± 1.5; p –value < 0.0001). On comparison of UUA/Cr among cases with Sarnat and Sarnat staging of HIE, there is a signicant difference observed in mean UA/Cr ratio across Sarnat and Sarnat staging of HIE (F – Value = 68.760; p – value = 0.0001). Conclusion: Urinary uric acid and creatinine ratio can be used as markers for perinatal asphyxia for screening in centers where other markers for assessing perinatal asphyxia are not available. Urinary uric acid and creatinine ratio is a non-invasive, cheap and easily available marker for assessing the severity perinatal asphyxia.

2018 ◽  
Vol 5 (4) ◽  
pp. 1485
Author(s):  
Yathiraj Sreekrishna ◽  
Adarsh Eregowda ◽  
Aarti Sharma H. L.

Background: Perinatal asphyxia is a common neonatal problem and contributes significantly to neonatal morbidity and mortality. Every hour, 104 children die as a result of asphyxia. In India; between 250,000 to 350,000 infants die each year secondary to birth asphyxia and mostly within the first three days of life. The present study was performed to determine the Urinary Uric Acid to Creatinine Ratio in perinatal asphyxia and its correlation between APGAR score and urinary uric acid to creatinine ratio in perinatal asphyxia.Methods: A randomized case control hospital-based study was conducted on 50 asphyxiated and 50 normal newborn. Urinary uric acid and creatinine were estimated in spot urine within 24 hours after birth in both cases and controls. A ratio between the concentrations of uric acid to creatinine was estimated and comparison done between cases and controls.Results: Urinary uric acid to creatinine ratio can be used as an additional non-invasive, easy and early biochemical marker of birth asphyxia which biochemically supports the clinical diagnosis and the severity grading of asphyxia by APGAR score.Conclusions: Urinary uric acid to creatinine ratio can be used as an additional non-invasive, easy and early biochemical marker of birth asphyxia which biochemically supports the clinical diagnosis and the severity grading of asphyxia by APGAR score.


2020 ◽  
Vol 7 (6) ◽  
pp. 1378
Author(s):  
Siddharth . ◽  
Preeti Lata Rai ◽  
P. L. Prasad

Background: Perinatal asphyxia is amongst the common problem of neonates and there exists a significant contribution to the neonatal morbidity and mortality. It is observed as a common and a vital cause of the preventable cerebral injury. The prediction of the perinatal asphyxial outcome is very important but dreadful. There is a limited role for APGAR score to predict the immediate outcome, like HIE and the long-term neurological sequelae observational error may happen in APGAR. But the biochemical parameters can truly be relied upon. This study was done to assess urinary uric acid/urinary creatinine ratio (UA/Cr) as a non-invasive marker for perinatal asphyxia and co-relate its absolute value to the degree of the perinatal asphyxia.Methods: In this prospective case control study conducted in the Pediatrics Department of Shri Ram Murti Smarak Institute of Medical Sciences between Nov 2017 to May 2019, 42 asphyxiated and 42 non-asphyxiated newborns were included. Detailed history and assessment were for all the enrolled newborns. Spot urine samples were sent for the uric acid and creatinine estimation. Results were documented, and statistical analysis was performed.Results: Urinary uric acid to creatinine ratio used as additional non-invasive, early and easy biochemical marker of the birth asphyxia that biochemically supports severity grading and clinical diagnosis of the asphyxia by APGAR score.Conclusions: The ratio of the urinary uric acid and creatinine enables rapid and early recognition of asphyxial injury and also the evaluation of its severity and potential for short-term morbidity or death.


Author(s):  
Dr. Pradeep Kumar Jena ◽  
◽  
Dr. Himansu Parida ◽  
Dr. Banashree Swain ◽  
Dr. Mangal Charan Murmu ◽  
...  

Introduction: Perinatal asphyxia is a serious problem globally and is one of the common causes ofneonatal mortality. Worldwide each year four million infants suffer from birth asphyxia. Of these onemillion die and an equal number develop serious sequelae. Perinatal asphyxia ranks as the secondmost important cause of neonatal death after infections accounting for about 23% of mortalityworldwide. Aim & objective: To establish the level of nucleated red blood cells as an indicator ofpoor immediate outcome in perinatal asphyxia. Method: It was a case-control study done in thedepartment of pediatrics, S C B Medical College & S V P PG I P, Cuttack. Observation: The NRBCcount was significantly higher in neonates with adverse outcomes than in those with favourableoutcomes (p-value <0.001). NRBC count cut-off of >27/100 WBC had a sensitivity of 75% andspecificity of 95.2% in predicting adverse outcome defined as death, hemiplegia, hypertonia orsignificant hypotonia, unreliable sucking and seizures resistant to Phenobarbital. Conclusion:Nucleated red blood cell count can be used as a surrogate marker for birth asphyxia. It has asignificant negative correlation with Apgar score at one minute and Apgar score at 5minutes &significant positive correlation with severity of hypoxic ischemic-encephalopathy, time is taken forrecovery of neurological impairment following birth asphyxia and duration of NICU stay.


Author(s):  
Elango Krishnana ◽  
Venmugil Ponnusamy ◽  
Sathiya Priya Sekar

Background: Perinatal asphyxia is a common neonatal problem and there is significant contribution to neonatal morbidity and mortality. It is regarded as an important and common cause of preventable cerebral injury. The prediction of perinatal asphyxial outcome is important but formidable. There is only a limited role for the Apgar score for predicting the immediate outcome, such as HIE and the long-term neurological sequelae observational error can happen in APGAR. But biochemical parameters can be truly relied upon. This study was to evaluate the utility of urinary uric acid to creatinine ratio (UA/CR ratio) as non-invasive, easy, cheap and at the same time early biochemical means of asphyxia diagnosis.Methods: In this prospective case control study conducted in KAPV Government medical college between Feb 2017 to Sept 2017, 100 asphyxiated and 100 non-asphyxiated newborns were included. Detailed history and assessment were for all the enrolled newborns. Spot urine samples were sent for uric acid and creatinine estimation. Results were recorded, and statistical analysis was done.Results: The mean Uric acid/Creatinine ratio in the cases and controls groups were 2.58±1.09 and 0.86±0.17 respectively. The ratio also correlated well with the stage of HIE.Conclusions: The ratio of UA/Cr enables early and rapid recognition of asphyxial injury and also the assessment of its severity and the potential for short term morbidity or death.


2020 ◽  
Vol 7 (8) ◽  
pp. 425-429
Author(s):  
Dr. Nikhil Gupta ◽  
◽  
Dr. Alka Bhambri ◽  
Dr. Vedika A Bhat ◽  
Dr. Rashmi Katyal ◽  
...  

Objective: The value of urinary uric acid and creatinine ratio in neonatal asphyxia. Method: This was a prospective observational study conducted over one year, on 45 newborns admitted in NICU with perinatal asphyxia. Cord blood from the umbilical artery was sent for pH analysis and urinary uric acid and creatinine levels were estimated in spot urine samples. Results: The urinary uric acid and creatinine ratio had a positive correlation with low APGAR scores at the 1st and 5th minute. Also, urinary uric acid to creatinine ratios was significantly higher in infants with severe HIE (3.18±0.61) when compared with infants of moderate HIE (2.19±0.32). It showed a significant negative correlation with pH of cord blood in neonates with perinatal asphyxia. Conclusion: The urinary uric acid and creatinine ratio can be used as a supportive diagnostic test for early diagnosis of perinatal asphyxia.


2017 ◽  
Vol 3 (6) ◽  
pp. 697-701
Author(s):  
Fara Imelda Theresia Patty ◽  
Suhartono Suhartono ◽  
Ngadiyono Ngadiyono ◽  
Mardiyono Mardiyono

Background: The prolonged partus is one of the causes of maternal deaths marked by the slow progress of labor. Induction of labor and caesarean section is a common procedure performed on long-term partus events to end pregnancy. The birth acupressure technique is a complementary method to activate the hormone oxytocin at a certain point to use to soften the cervix and increase contraction.Objective: To examine the effect of acupressure point LI4, SP6 and BL60 on the duration of the first stage of labor and APGAR Score of newborn in primigravida.Methods: This research employed a Quasy experimental study with posttest control group design. It was conducted at the Public Health Center of Trauma and Public Health Center of Palaran Samarinda, East Kalimantan. There were 40 respondents selected using purposive sampling, which 20 respondents assigned in the experiment and control group. The duration of the first stage of labor was assessed using partograph and APGAR Score was assessed using APGAR Score assessment sheets. Mann Whitney test was used for data analysisResults: Findings showed that the duration of the first stage of labor in the experiment group was 187 minutes and in the control group was 307 minutes. Mann Whitney test obtained p-value 0.001 (<0.05), which indicated that there was a statistically significant difference of the duration of the first stage of labor between both groups. However, Mann Whitney test for APGAR score showed p-value 0.114 (>0.05), which indicated that there was no significant difference of APGAR score in the experiment and control group.Conclusion: There was a significant effect of acupressure on the duration of the first stage of labor, but no effect of the APGAR score. Therefore, acupressure may be recommended to shorten the duration of the first stage of delivery in primigravida.


2020 ◽  
Vol 5 (1) ◽  
pp. 287-293
Author(s):  
Savinaz Abubakir Mohammed ◽  
Ariana Khalis Jawad ◽  
Srwa Jamal Murad

Enhanced recovery program (ERP) for cesarean section (C/S) is improving patient health and is cost-effective for healthcare providers. We aimed to assess how ERP improves patient satisfaction, ambulation time, severity of pain, decrease hospital stay among patients attending Sulaimani Maternity Teaching Hospital and fetal outcome. A quasi-experimental study was performed on 200 patients in Sulaimani from June 2019 to December 2019. The participants divided into two equal groups. The intervention group was 100 women who underwent elective C/S in Sulaimani Maternity Teaching Hospital and subjected to ERP. While the control group was the other 100 women who were not subjected to the ERP, and they were from the Emergency Department of the same hospital. The women in the intervention group were supervised by anesthetists from preoperatively, intraoperatively, through postoperatively. The intervention group showed significantly better outcome regarding time to ambulate; all patients were able to ambulate 4-5 hours postoperatively. Also, the duration of hospital stay was better in the intervention group; all the patients discharged before 24 hours, but five patients in the control group discharged after 24 hours. Besides, fetal Apgar score after five minutes was also better in the intervention group; at the first minute, the mean±SD (standard deviation) of Apgar score was 8.36±1.38 and 8.08±1.69 for the intervention, and control groups, respectively (P-value = 0.2). While at five minutes, the mean±SD of Apgar score was 9.59±064, and 8.96±1.12 for the intervention, and control groups, respectively (P-value = <0.001). This intervention had favorable outcomes regarding pain, time of ambulation, and fetal Apgar score. We recommend implementing ERP at a broader scale as it gives better outcomes.


2008 ◽  
Vol 23 (4) ◽  
pp. 361-364 ◽  
Author(s):  
Pallab Basu ◽  
Sabyasachi Som ◽  
Nabendu Choudhuri ◽  
Harendranath Das

2020 ◽  
Vol 7 (5) ◽  
pp. 993
Author(s):  
Trinadh Gubbala ◽  
Shree Krishna G. N.

Background: Perinatal asphyxia refers to an impairment of the normal oxygenation during parturition and the ensuing adverse effects on the fetus/neonate.  In India, due to birth asphyxia, between 250,000 to 350,000 infants die each year, mostly within the first three days of life. Low APGAR score is commonly used to as a indicator of asphyxia in infants, but it may often be not available and may be reduced in premature infants. In present study we evaluated urinary uric acid and creatinine ratio as a marker for perinatal asphyxia, at our tertiary care hospital.Methods: Present study was a observational, case-control study, conducted in department of paediatrics, in case group consisted of 40 full-term neonates who were hospitalized with the diagnosis of perinatal asphyxia. The control group consisted of 40 healthy full-term newborns.Results: Male to female ratio was 1.5:1 in case group as compared to 1.22:1 in control group. Mean gestational age in case group was 286±10.32 days, while in control group it was 274±7.310 days. Mean birth weight was 2.72±0.51 kg & 2.88±0.49 kg in case & control group respectively. In 52.5 % neonates from case group, signs of intrapartum fetal distress were noted. A statistically significant difference (p<0.005) was noted in Apgar 5 min, Arterial blood pH, pO2 (mm Hg), pCO2 (mm Hg), Urinary uric acid (mg/dl) and Urinary uric acid/ creatinine ratio. Authors did not noted any significant difference in Urinary creatinine (mg/dl) values of cases and control group. Urinary UA/CR ratio is significantly higher in case group when compared with control group with t=11.19; P<0.001.Conclusions: The ratio of urinary uric acid to creatinine helps in rapidly recognizing asphyxia and assessing its severity, so it can be a good, simple screening test for early assessment of neonatal asphyxia.


2020 ◽  
Vol 3 (11) ◽  
pp. 1100-1104
Author(s):  
Hussein Naeem Aldhaheri ◽  
Ihsan Edan AlSaimary ◽  
Murtadha Mohammed ALMusafer

      The Aim of this study was to determine Immunogenetic expression of  Toll-like receptor gene clusters related to prostatitis, to give acknowledge about Role of TLR in prostatitis immunity in men from Basrah and Maysan provinces. A case–control study included 135 confirmed prostatitis patients And 50 persons as a control group. Data about age, marital status, working, infertility, family history and personal information like (Infection, Allergy, Steroid therapy, Residency, Smoking, Alcohol Drinking, Blood group, Body max index (BMI) and the clinical finding for all patients of Prostatitis were collected. This study shows the effect of PSA level in patients with prostatitis and control group, with P-value <0.0001 therefore the study shows a positive significant between elevated PSA levels and Prostatitis.


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