Correlation between Neonatal Hyperbilirubinemia and Serum Magnesium and Copper Levels in Dhaka City

Background: Neonatal hyperbilirubinemia is a condition when a newborn has an excessive amount of bilirubin in the blood and is one of the most prevalent problems in neonates. Many studies reported that copper and magnesium play an important role in the pathogenesis and development of neonatal hyperbilirubinemia. Objectives: The aim of this study is to find out the correlation between the level of magnesium and copper with hyperbilirubinemia. Methodology: Serum bilirubin was assayed with colorimetric method by the use of diazotized sulfanilic acid reaction. A photometric automated method was used to determine the levels of magnesium and copper in the serum of neonates in both controls group (162) and cases group (220). Results: In the present study a significantly higher levels of Mg was found in hyperbilirubinemia of newborn infants when compared with control groups (23.67 ±2.33 mg/L versus 19.74 ±2.18 mg/L respectively and p value <0.001 which was significant) and correlation between hyperbilirubinemia and magnesium also significant (p value <0.001). Copper levels was significantly higher in hyperbilirubinemia of newborn infants (0.74 ±0.08 mg/L) compared with control groups (0.41 ±0.12 mg/L), where p value was <0.001, which was significant and correlation between hyperbilirubinemia and copper also significant (p value <0.001). Conclusion: It can be concluded that current study showed the concentrations of magnesium and copper levels were found to be significantly greater than control groups and may have a correlation with neonatal jaundice.

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One-step protocol for assays of total and direct bilirubin with stable combined reagents.

Clinical Chemistry ◽

10.1093/clinchem/35.1.173 ◽

1989 ◽

Vol 35 (1) ◽

pp. 173-176 ◽

Cited By ~ 8

Author(s):

P Fossati ◽

M Ponti ◽

L Prencipe ◽

G Tarenghi

Keyword(s):

Room Temperature ◽

Total Bilirubin ◽

Serum Bilirubin ◽

Colorimetric Method ◽

Sulfanilic Acid ◽

Direct Bilirubin ◽

Azo Compound ◽

Step Procedure ◽

Working Solution ◽

One Step

Abstract We describe an improved colorimetric method for assays of total and direct bilirubin in serum. Bilirubin reacts with diazotized sulfanilic acid in an acidic medium to form a blue azopigment. Total bilirubin is assayed in the presence of reaction accelerators (caffeine, urea, and citric acid), direct bilirubin in their absence. The azo compound so formed is read at the same wavelength (570 nm) in both assays. A sample blank is run in parallel. Standard curves are linear for total and direct bilirubin concentrations up to 513.0 and 256.5 mumol/L, respectively. The method is characterized by (a) use of the same protocol for both assays, i.e., a one-step procedure with short reaction time (5 min at room temperature), and (b) use of a single working solution, which, refrigerated, is stable for one month. The method is reliable, yields results that compare closely with those of the classical Jendrassik--Gróf method, is suitable for routine use, and lends itself to automation.

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PHENOBARBITONE ENHANCEMENT OF BROMSULPHALEIN CLEARANCE IN NEONATAL HYPERBILIRUBINEMIA

PEDIATRICS ◽

10.1542/peds.48.4.556 ◽

1971 ◽

Vol 48 (4) ◽

pp. 556-561

Author(s):

C. Y. Yeung ◽

Victor Y. H. Yu

Keyword(s):

Drug Therapy ◽

Serum Bilirubin ◽

Newborn Infants ◽

Hepatic Uptake ◽

Control Group ◽

Control Groups ◽

Impaired Liver Function ◽

Impaired Liver ◽

Before And After ◽

And Control

Forty jaundiced Chinese newborn infants were randomly assigned to treatment and control groups. Twenty infants in the former group were given phenobarbitone 5 mg 8-hourly; those in the control group received no drug. BSP tests were performed in all infants on admission and repeated 24 hours afterwards. The percentage disappearance of the dye at designated intervals up to 135 minutes of each test before and after drug therapy was compared with that of the controls. Rate constants for the hepatic uptake phase (K1) and the biliary excretory phase (K2) in BSP removal were calculated from the plasma dye disappearance graph. Following phenobarbitone therapy, a significant increase in BSP clearance was observed, with increases in K1 and K2 values, suggesting the corresponding enhanced hepatic uptake and excretion of the dye. These results are consistent with the hypothesis that several mechanisms together are responsible for the phenobarbitone effect on the impaired liver function of newborn infants. It is suggested that the observed reduction of serum bilirubin levels with phenobarbitone therapy results both from enhanced uptake and from increased excretion of bilirubin by the liver.

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The Combined Effect of Phototherapy and Phenobarbital on Serum Bilirubin Levels of Premature Infants

PEDIATRICS ◽

10.1542/peds.49.1.110 ◽

1972 ◽

Vol 49 (1) ◽

pp. 110-112

Author(s):

Michael G. Blackburn ◽

Marcello M. Orzalesi ◽

Penelope Pigram

Keyword(s):

Premature Infants ◽

Serum Bilirubin ◽

Combined Therapy ◽

Newborn Infants ◽

Neonatal Hyperbilirubinemia ◽

Combined Effect ◽

Sufficient Evidence ◽

Monochorionic Twins ◽

Photo Oxidation ◽

Prevention And Treatment

The effectiveness of phototherapy in the prevention and treatment of neonatal hyperbilirubinemia is well established. There is also sufficient evidence to indicate that phenobarbital is effective in decreasing serum bilirubin levels in newborn infants. Since light is thought to break down bilirubin in the skin by photo-oxidation, and phenobarbital is known to induce bilirubin conjugating activity in the liver, the possibility of an additive effect in combined therapy was investigated in the present study. Materials and Methods Six sets of premature identical (monochorionic) twins (33 to 35 weeks' gestation) were studied after obtaining parental permission. Each set of twins was admitted to the study at 12 hours of life if both infants were considered normal with the exception of prematurity.

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A Nanoceutical Agent for Chemoprevention of Bilirubin Encephalopathy

10.1101/2020.12.31.425023 ◽

2021 ◽

Author(s):

Aniruddha Adhikari ◽

Vinod K Bhutani ◽

Susmita Mondal ◽

Monojit Das ◽

Soumendra Darbar ◽

...

Keyword(s):

Serum Bilirubin ◽

Mixed Valence ◽

Newborn Infants ◽

Neonatal Hyperbilirubinemia ◽

Pharmacokinetic Data ◽

List Type ◽

Valence Transition ◽

Bilirubin Encephalopathy ◽

Sustainable Action

ABSTRACTBackgroundTargeted degradation of bilirubin in vivo may enable safer and more effective approach to manage incipient bilirubin encephalopathy consequent to severe neonatal hyperbilirubinemia (SNH). This report builds on the use of a spinel structured mixed-valence transition metal oxide (trimanganese tetroxide) nanoparticle duly functionalized with biocompatible ligand citrate (C-Mn3O4 NP) having the ability to degrade bilirubin without photo-activation.MethodThe efficiency of C-Mn3O4 NP in in vivo degradation of serum bilirubin and amelioration of severe bilirubin encephalopathy and associated neurobehavioral changes was evaluated in C57BL/6j animal model of SNH.ResultsOral single dose (0.25 mg kg-1 body weight) of the NPs efficiently reduced serum bilirubin levels (both conjugated and unconjugated) in study mice. It prevents bilirubin-induced neurotoxicity with reduction of SNH as observed by neurobehavioral and movement studies of SNH-mice. Pharmacokinetic data suggests intestinal reabsorption of the NPs and explain sustainable action. Biodistribution, pharmacokinetics, and biocompatibility of the NPs were tested during sub-chronic exposure.ConclusionThus, we report preliminary studies that explore an affordable chemoprevention mechanism to acutely prevent or minimize bilirubin neurotoxicity in newborn infants.IMPACT STATEMENTDespite several attempts, no pharmaco-therapeutics are available for the treatment of severe neonatal hyperbilirubinemia (SNH) and associated neurotoxicity.Our newly developed nanodrug, citrate functionalized Mn3O4 nanoparticles (C-Mn3O4 NPs), can efficiently ameliorate SNH and associated neurotoxicity as investigated in preclinical rodent model.Chemoprevention effect of the nanodrug is found to be safe and sustainable.If successfully translated into clinical trials, C-Mn3O4 NPs could become the first drug to treat SNH.

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Risk Factors for Serum Bilirubin Rebound After Stopping Phototherapy in Neonatal Hyperbilirubinemia

Journal of Neonatology ◽

10.1177/09732179211048395 ◽

2021 ◽

pp. 097321792110483

Author(s):

Abhishek Yadav ◽

Baljeet Maini ◽

Bablu Kumar Gaur ◽

Rupa R Singh

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Low Birth Weight ◽

Neonatal Sepsis ◽

G6pd Deficiency ◽

Serum Bilirubin ◽

Neonatal Hyperbilirubinemia ◽

P Value ◽

Inclusion Criteria ◽

Abo Incompatibility

Objective: To identify the factors affecting rebound increase in bilirubin levels after stopping phototherapy in neonatal hyperbilirubinemia. Setting: Tertiary-level neonatal unit. Patients: This was a hospital-based cross-sectional observational study. The study was conducted in neonatal division of rural tertiary care hospital. All neonates who were admitted for hyperbilirubinemia treatment and fulfilled the inclusion criteria were included in the study. Inclusion Criteria: All neonates 1.5 kg and above and treated in newborn intensive care unit for hyperbilirubinemia. Exclusion Criteria: (a) Critically ill patients requiring respiratory support any time after delivery, (b) neonates presenting with life-threatening surgical conditions, (c) patient with congenital malformation, (d) conjugated bilirubin elevation, (e) patients with birth asphyxia. Statistical Analysis: All the data were entered into a Microsoft Excel sheet. Appropriate tests of significance were applied. The various variables were sorted and presented as a number or percentage. The categorical variables used in the analysis were evaluated using the chi-square test (Yates’s correction and Fischer exact test were employed where applicable). The continuous data were analyzed by “t” test. The P value of less than 0.05 was taken to be level of statistical significance. Results: One hundred and fifty patients of neonatal hyperbilirubinemia were included in this study. In this study, 81 newborns (54.0%) were male and 78 (52%) of them were born by normal vaginal delivery. One hundred and nine babies (72.6%) were term babies. Fifty babies (33.3%) were low birth weight. Out of 150 neonates, 18(12%) had ABO incompatibility, 13(8.7%) Rh incompatibility, 23(15.7%) neonatal sepsis, and 4 (2.6%) had polycythemia. Out of 150 patients, 15(10%) babies had rebound hyperbilirubinemia at 24 h of life requiring phototherapy prematurity (particularly <34 weeks) ( P value: .03), low birth weight (particularly <2.0 kg) ( P value:.009), onset of jaundice requiring phototherapy before 72 h of life ( P value .04), blood group (both Rh and ABO) incompatibility ( P values: .001 and .002), neonatal sepsis ( P value: .004) were significantly associated with rebound hyperbilirubinemia. Glucose 6 phosphate dehydrogenase (G6PD) deficiency, polycythemia, maturity, mode of feeding, and gender did not show any statistical significant relationship with rebound hyperbilirubinemia. Conclusions: Rebound level of bilirubin need not be checked in all babies. Babies with risk factors like born preterm, low birth weight, having sepsis, requirement of phototherapy before 72 h of life, Rh and ABO group incompatibility, only need to be checked for serum bilirubin rebound. We recommend more studies with larger sample size to evaluate all these factors including polycythemia and G6PD deficiency.

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Light Emitting Diode (LED) Phototherapy versus Conventional Phototherapy in Neonatal Hyperbilirubinemia: A Single Blinded Randomized Control Trial from Coastal India

BioMed Research International ◽

10.1155/2019/6274719 ◽

2019 ◽

Vol 2019 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Sreesravya Gutta ◽

Janardhan Shenoy ◽

Sowmini P. Kamath ◽

Prasanna Mithra ◽

B. Shantharam Baliga ◽

...

Keyword(s):

Side Effects ◽

Randomized Control Trial ◽

Serum Bilirubin ◽

Neonatal Hyperbilirubinemia ◽

Total Serum Bilirubin ◽

Conventional Group ◽

Total Serum ◽

P Value ◽

Significant Difference ◽

Randomized Control

Neonatal hyperbilirubinemia is a common problem with potentiality to cause irreversible brain damage. Reduction of serum bilirubin level is essential to minimize such damage. Compact fluorescent tubes, halogen bulbs, fiber optic blankets, and LEDs are commonly used light sources for phototherapy with varying efficacies. This study aimed at evaluating the effect of LED versus conventional phototherapy on (a) rate of reduction in total serum bilirubin levels, (b) effect on urinary lumirubin excretion, and (c) comparing side effects of phototherapies among neonates with hyperbilirubinemia. In this randomized control trial, 166 neonates ≥ 35 weeks of age requiring phototherapy were recruited and further divided into 2 groups [LED (83) and conventional (83)] by using computer generated random numbers. Serial total serum bilirubin levels and random urinary lumirubin levels were collected and side effects of phototherapy were noted. Rate of fall in total serum bilirubin levels (TSB, μmol/L/hour) and random urinary lumirubin levels were computed. Data were collected using a pretested proforma. Analysis was done with Statistical Package for Social Sciences (SPSS) version 11.5. Independent sample “t” test and Chi-square tests were used with p value of <0.05 being significant. Significant difference was documented in mean rate of decrease of TSB (μmol/L/hour) in LED group (5.3 ± 2.91) when compared to conventional group (3.76 ± 2.39) (p <0.001). A significant increase in mean random urinary lumirubin levels (arbitrary units) was observed in LED group (129.01 ± 33.18) when compared to conventional group (114.44 ± 44.84) (p = 0.021). Side effects were minimal and comparable in both groups. This study concludes the rates of decrease in total serum bilirubin levels and increase in urinary lumirubin levels were significant with LED when compared with conventional phototherapy, implying LED to be more efficacious.

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Effectiveness of short duration phototherapy in government hospital setup

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20214803 ◽

2021 ◽

Author(s):

Revanasiddappa Bhosgi ◽

Kirankumar Harwalkar

Keyword(s):

American Academy ◽

Short Duration ◽

Serum Bilirubin ◽

Effective Means ◽

Neonatal Hyperbilirubinemia ◽

P Value ◽

Government Hospital ◽

Normal Limits ◽

American Academy Of Pediatrics ◽

Set Up

Background: Neonatal hyperbilirubinemia is most common presentation of neonates. Phototherapy remains standard treatment for neonatal hyperbilirubinemia. Overcrowding in government hospital makes it difficult to give phototherapy for more than 1-2 days. The objectives of the study were to determine the effectiveness of short duration of phototherapy in treating hyperbilirubinemia and to determine the risk of rebound hyperbilirubinemia.Methods: Study was hospital based retrospective study. The study place was GIMS kalaburagi. The study was conducted from September 2019 to December 2019. All healthy full-term neonates with serum bilirubin above cut off range according to (American academy of pediatrics) nomogram were included in the study. Requirement of phototherapy was decided on serum bilirubin levels as per AAP (American academy of pediatrics) nomogram. Phototherapy was used as treatment modality.Results: Total 110 neonates were included in the study. Total of 56 neonates (50.9%) required 1 day of phototherapy to fall within normal limits for discharge and 46 neonates (41.8%) required 2 days of phototherapy to fall within normal limits for discharge with a significant p<0.05. Rebound hyperbilirubinemia requiring repeat phototherapy was seen in 6(10%) neonates who were discharged after 1 day of phototherapy and in 5 neonates (10%) who were discharged after 1 day of phototherapy with a p value of 0.05.Conclusions: Short duration phototherapy is the effective means of treatment for most neonates in government hospital set up. Serum bilirubin has to be reviewed during follow up to assess rebound hyperbilirunemia.

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PENGGUNAAN SELAPUT AMNION SEGAR PADA INSISI LUKA OPERASI SEKSIO SESAREA

JOURNAL OBGIN EMAS ◽

10.25077/aoj.1.2.47-55.2017 ◽

2019 ◽

Vol 1 (2) ◽

pp. 47-55

Author(s):

Syahredi Syaiful Adnani ◽

Hafni Bachtiar

Keyword(s):

Wound Healing ◽

Caesarean Section ◽

Amniotic Membrane ◽

Healing Time ◽

Cost Of Care ◽

Control Group ◽

P Value ◽

Control Groups ◽

And Control ◽

Wound Healing Time

In the last few decades, the incidence of caesarean section is increasing in the world, especially in Indonesia. One of the way to treat tissue scar is through biologic and synthetic dressing where nowadays, amnion has been used as biologic dressing frequently. This study was conducted to determine the effect of the use of fresh amniotic membrane on wound incision Caesarean section compared with Caesarean section incision wound covered using regular gauze bandages and fixated with plaster in RS. Dr. Reksodiwiryo Padang. The design of this study is an experimen-tal study with Post test design with control group design. Sampling was done using a formula consecutive sampling two different test samples obtained an average of 72 people for each group. The analysis used include univariate and bivariate analyzes. The average wound healing time the difference was statistically significant (p value <0.05) in the treatment and control groups. There was highly significant difference in the proportion of local infection on day 3 between the treatment and control groups (p value <0.05). There were very significant differences in the proportion of local allergic reactions at day 3, and 5 between the treatment and control group (p <0.05). There are significant differences in terms of the cost of care per day between treatment and control groups (p <0.05). From this study, the average wound healing time has a very significant difference.Keywords: Fresh Amniotic Membrane, Wound Cesarean Section, Wound Healing

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Neonatal hyperbilirubinemia prediction by cord blood and 24-hour serum bilirubin analysis

MedPulse International Journal of Pediatrics ◽

10.26611/10141332 ◽

2020 ◽

Vol 13 (3) ◽

pp. 47-50

Author(s):

Gurajala Chandra Sekhar ◽

◽

Radha Lavanya Kodali ◽

Ramisetty Uma Mahesh ◽

R Kedarnath ◽

...

Keyword(s):

Cord Blood ◽

Serum Bilirubin ◽

Neonatal Hyperbilirubinemia

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Neonatal Hyperbilirubinemia and Physical and Cognitive Performance at 17 Years of Age

PEDIATRICS ◽

10.1542/peds.88.4.828 ◽

1991 ◽

Vol 88 (4) ◽

pp. 828-833

Author(s):

Daniel S. Seidman ◽

Ido Paz ◽

David K. Stevenson ◽

Arie Laor ◽

Yehuda L. Danon ◽

...

Keyword(s):

Test Scores ◽

Serum Bilirubin ◽

School Achievement ◽

Ethnic Origin ◽

Full Term ◽

Neonatal Hyperbilirubinemia ◽

Intelligence Test ◽

Coombs Test ◽

Intelligence Test Scores ◽

The Military

To estimate the effect of neonatal hyperbilirubinemia on long-term cognitive ability in full-term newborns with a negative Coombs test, we performed a 17-year historical prospective study of 1948 subjects. Intelligence tests and medical examinations performed at the military draft board were stratified according to serum bilirubin concentration. A logistic regression analysis was used to adjust for the confounding effects of gestational age, birth weight, Apgar score, ethnic origin, socioeconomic class, paternal education, birth order, and the administration of phototherapy and exchange transfusion. No direct linear association was shown between neonatal bilirubin levels and intelligence test scores or school achievement at 17 years of age. However, the risk for low intelligence test scores (IQ score <85) was found to be significantly higher (P = .014) among full-term male subjects with serum bilirubin levels above 342 µmol/L (20 mg/dL) (odds ratio, 2.96; 95% confidence interval, 1.29-6.79). This association was not observed among female subjects. We conclude that severe neonatal hyperbilirubinemia, among full-term male newborns with a negative Coombs test, could be associated with lower IQ scores at 17 years of age.

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