scholarly journals Increased serum total bilirubin-albumin ratio was associated with bilirubin encephalopathy in neonates

2020 ◽  
Vol 40 (1) ◽  
Author(s):  
Yan Wang ◽  
Guangyao Sheng ◽  
Lina Shi ◽  
Xiuyong Cheng
Keyword(s):  
Total Bilirubin ◽  
Direct Bilirubin ◽  
Control Group ◽  
Case Group ◽  
Serum Total Bilirubin ◽  
Natural Childbirth ◽  
Albumin Ratio ◽  
Indirect Bilirubin ◽  
Bilirubin Encephalopathy ◽  
Epidemiological Characteristics

Abstract We performed the present study to summarize the recent epidemiological characteristics of bilirubin encephalopathy and assess the role of total bilirubin-albumin ratio in the bilirubin encephalopathy. We retrospectively collected clinical data of 669 neonates with hyperbilirubinemia from the First Affiliated Hospital of Zhengzhou University between January 2015 and July 2018, including 153 neonates belonged to bilirubin encephalopathy and 516 ones were treated as control group. Compared with the control group, those with bilirubin encephalopathy have higher bilirubin-albumin ratio (13.8 ± 3.6 vs. 10.6 ± 2.5, P=0.000). The direct bilirubin and indirect bilirubin level were higher in the case group than that in the control group (P=0.000). On the contrary, the hemoglobin level was lower in the case group than that in the control group (P=0.004). There were no significant differences in gestational age (P=0.510), gender rate (P=0.313), maternal gestational diabetes ratio (P=0.071), natural childbirth ratio (P=0.686), and meconium delay (P=0.091). The results from univariate regression indicated the total bilirubin/albumin ratio was positively associated with bilirubin encephalopathy (odds ratio (OR) = 1.67, 95% confidence interval (CI): 1.59–3.14). The total bilirubin, direct bilirubin, and indirect bilirubin were also related to encephalopathy. After adjusting some potential cofounding factors, the total bilirubin-albumin was still associated with bilirubin encephalopathy. The higher total bilirubin-albumin ratio increased the risk of bilirubin encephalopathy by 23% (OR = 1.23, 95% CI: 1.16–2.48). Our results indicated that the bilirubin-albumin ratio is associated with bilirubin encephalopathy in neonates, and could be a potential predictor.

Higher Level of Serum Heme Oxygenase-1 in Patients With Intracerebral Hemorrhage

2015 ◽  
Vol 100 (7-8) ◽  
pp. 1220-1224 ◽  
Author(s):  
Xin Li ◽  
Changqing Li ◽  
Lichun Hou ◽  
Mei He ◽  
Guangfu Song ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Serum Level ◽  
Intracerebral Hemorrhage ◽  
Heme Oxygenase ◽  
Total Bilirubin ◽  
Direct Bilirubin ◽  
Control Group ◽  
Heme Oxygenase 1 ◽  
Serum Total Bilirubin ◽  
Significant Difference

The objective of this paper was to investigate the association of the serum level of heme oxygenase-1 in patients with intracerebral hemorrhage (ICH) with the risk of ICH. Heme oxygenase-1(HO-1) metabolizes heme into biliverdin, bilirubin, carbon monoxide, and iron, our recent study showed that serum level of HO-1 was increased in stroke patients, yet the association of HO-1 level with risk of intracerebral hemorrhage (ICH) is poorly known. Forty patients with ICH and another 40 patients without ICH were recruited. The serum level of HO-1, total, and direct bilirubin were measured. The level of HO-1, serum total bilirubin, and direct bilirubin, as well as blood pressure were increased in ICH group than in control group (P < 0.001). The level of HO-1, both systolic and diastolic blood pressure had a significant difference between subgroups (P < 0.05). Multivariate regression analysis showed that poor compliance to medicine for hypertension, the serum level of HO-1, and systolic blood pressure were associated with the prevalence of ICH. Blood pressure, serum HO-1, serum total bilirubin, and direct bilirubin were raised in patients with ICH who did not take medicine for hypertension compared with those who did, and increased in ICH patients in comparison with control group. Further investigation in multiple medical centers with large number of cohorts is warranted to verify these results.

scholarly journals A mini review on the Lactic Acidosis in goats and its remedial approaches

2020 ◽  
Vol 5 (2) ◽  
pp. 98-103
Author(s):  
Asad Ali Khaskheli ◽  
Muhammad Ibrahim Khaskheli ◽  
Allah Jurio Khaskheli ◽  
Arshad Ali Khaskheli
Keyword(s):  
Alkaline Phosphatase ◽  
Lactic Acidosis ◽  
Sodium Bicarbonate ◽  
Glucose Level ◽  
Magnesium Hydroxide ◽  
Total Bilirubin ◽  
Direct Bilirubin ◽  
Cassia Fistula ◽  
Indirect Bilirubin ◽  
Rumen Ph

The current study was performed in order to investigate the threat of lactic acidosis in goats worldwide and explore the curative strategies. In this regards a detailed review was performed, however obtained facts were found to be much interesting and valuable. It was indicated by researchers that lactic acidosis is the most common problem in goats throughout the worlds. It represents significant economic loss due to direct and indirect effects. It was further stated that goats with lactic acidosis show decreased body temperature up to 98.1±0.89 °F, rumen and intestinal movement 0.23±0.48/m, rumen pH 4.8±0.07, blood pH 7.1±0.08, increased respiration rate 56.14±7.15/m and heart rate, 136.28±4.71/m. Affected goats also show signs of dyspnea, anorexia, inactivity, incoordination and recumbancy. The glucose level remains 190.14±36.49 mg/dl, total bilirubin 0.75±0.04 mg/dl, direct bilirubin 0.27±0.03mg/dl, indirect bilirubin 0.40±0.03 mg/dl, alanine aminotransferase ALT 36.42±3.04 U/l and alkaline phosphatase 420±3.65 U/l. Furthermore, Glucose level, total bilirubin, direct bilirubin, indirect bilirubin, ALT (SGPT) and alkaline phosphatase increase with treatment of Cassia Fistula, serum biochemical changes rapidly return to normal compared to treatment with Sodium bicarbonate or Magnesium hydroxide. The ruminal juices changes are also significantly improved with the treatment. The changes in the ingesta color, odor and consistency and rumen pH return to normal with the use of Cassia Fistula, Sodium bicarbonate and Magnesium hydroxide. In conclusion, Cassia fistula, Sodium bicarbonate and Magnesium hydroxide could be used as valuable strategies against lactic acidosis in goats. These therapies have been proved to be effective for treating the acidosis in goats. 

In Vitro Effects of Light on Serum Bilirubin Subfractions Measured by High-Performance Liquid Chromatography: Comparison with Four Routine Methods

1992 ◽  
Vol 38 (10) ◽  
pp. 2124-2129 ◽  
Author(s):  
H Ihara ◽  
H Nakamura ◽  
Y Aoki ◽  
T Aoki ◽  
M Yoshida
Keyword(s):  
High Performance ◽  
Total Bilirubin ◽  
Serum Bilirubin ◽  
Accurate Determination ◽  
Hplc Method ◽  
Direct Bilirubin ◽  
Spectrometric Method ◽  
Indirect Bilirubin ◽  
In Vitro Effects

Abstract The effects of light on serum bilirubin subfractions in vitro were investigated by HPLC and four routine methods for bilirubin analysis. By HPLC, the rate of photodegradation of unconjugated bilirubin (Bu) was nearly twice that of monoconjugated bilirubin (mBc) and threefold that of diconjugated bilirubin (dBc); delta bilirubin (Bd) was most stable against photoirradiation. In the diazo method, the rate of photodegradation of direct bilirubin was almost the same as that of the sum of mBc, dBc, and Bd determined by the HPLC method. However, the rate of photodegradation of indirect bilirubin was significantly lower (P < 0.001) than that obtained by HPLC, because approximately 30% of the bilirubin photoproducts reacted with the diazo reagent as indirect bilirubin. The rate of photodegradation of total bilirubin determined by the direct spectrometric method was lower than that determined by the diazo method, but equal to that of the total peak areas of HPLC. In the Ektachem method, bilirubin photoproducts affected total bilirubin negligibly, and Bc and Bu positively, so that the value of Bd decreased. In the bilirubin oxidase method, bilirubin photoproducts were oxidized enzymatically by both the total and direct bilirubin reagents. We re-emphasize the importance of shielding serum from light to avoid generating bilirubin photoproducts that interfere with the accurate determination of serum bilirubin subfractions. We also recommend HPLC analysis as a standard method for bilirubin measurement.

scholarly journals Baseline Serum Bilirubin and Risk of First Stroke in Hypertensive Patients

2020 ◽  
Vol 9 (12) ◽  
Author(s):  
Jiancheng Wang ◽  
Xianglin Zhang ◽  
Zhuxian Zhang ◽  
Yuanyuan Zhang ◽  
Jingping Zhang ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Proportional Hazards ◽  
Total Bilirubin ◽  
Serum Bilirubin ◽  
Cox Proportional Hazards ◽  
Direct Bilirubin ◽  
Serum Total Bilirubin ◽  
Inverse Association ◽  
Baseline Serum ◽  
Hypertensive Patients

Background Data on the association between serum bilirubin and the risk of stroke are limited and inconclusive. We aimed to evaluate the association between serum bilirubin and the risk of first stroke and to examine any possible effect modifiers in hypertensive patients. Methods and Results Our study was a post hoc analysis of the CSPPT (China Stroke Primary Prevention Trial). A total of 19 906 hypertensive patients were included in the final analysis. Cox proportional hazards models were used to estimate the hazard ratios (HRs) and 95% CIs for the risk of first stroke associated with serum bilirubin levels. The median follow‐up period was 4.5 years. When serum total bilirubin was assessed as tertiles, the adjusted HR of first ischemic stroke for participants in tertile 3 (12.9–34.1 μmol/L) was 0.75 (95% CI, 0.59–0.96), compared with participants in tertile 1 (<9.3 μmol/L). When direct bilirubin was assessed as tertiles, a significantly lower risk of first ischemic stroke was also found in participants in tertile 3 (2.5–24.8 μmol/L) (adjusted HR, 0.77; 95% CI, 0.60–0.98), compared with those in tertile 1 (<1.6 μmol/L). However, there was no significant association between serum total bilirubin (tertile 3 versus 1: adjusted HR, 1.45; 95% CI, 0.89–2.35) or direct bilirubin (tertile 3 versus 1: adjusted HR, 1.27; 95% CI, 0.76–2.11) and first hemorrhagic stroke. Conclusions In this sample of Chinese hypertensive patients, there was a significant inverse association between serum total bilirubin or direct bilirubin and the risk of first ischemic stroke.

scholarly journals Preliminary phytochemical screening and hepatoprotective activity of methanol extract of Artocarpus hirsutus leaves.

2016 ◽  
Vol 8 (3) ◽  
pp. 379
Author(s):  
Jitendra Patel ◽  
Venkateshwar Reddy ◽  
GS Kumar
Keyword(s):  
Total Bilirubin ◽  
Methanol Extract ◽  
Hepatoprotective Activity ◽  
Direct Bilirubin ◽  
Control Group ◽  
Phytochemical Screening ◽  
Methanolic Extracts ◽  
Group I ◽  
Hepatic Protection

<p>The objective of the present work was investigating the preliminary phytochemical screening and hepatoprotective activity of methanol extract of the leaves of <em>Artocarpus hirsutus</em>.<strong></strong></p><p>Group I served as vehicle control, Group II served CCL<sub>4 </sub>(2ml/kg, s.c.), Group III served as standard Silymarin (50 mg/kg, p.o.)  Group IV and V served as methanolic extracts of <em>Artocarpus hirsutus</em><strong> </strong>(MEAH) at the dose level (250 and 500 mg/kg, p.o.). The degree of protection was determined by measuring level biochemical marker like alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), direct bilirubin, total bilirubin and Cholesterol. The histopathology study also showed the hepatic protection of extracts. The preliminary phytochemical screening was performed to find out the phytoconstituents responsible for the activity.<strong></strong></p><p>The marker biochemical level such as ALT, AST, ALP, Direct bilirubin, Total bilirubin and Cholesterol were significantly raised in CCL<sub>4 </sub>treated rats when compared with the normal group (p&lt;0.05), but the MEAH (500 mg/kg, bw) treated rats exhibited maximum depletion. The histopathology study also showed the hepatic protection of extracts. Preliminary phytochemical screening showed the presence of glycosides, flavonoids, Tannins, triterpenoids, carbohydrates and steroids.</p><p>The results of <em>in vivo</em> hepatoprotective activity showed that the methanol extract of <em>Artocarpus hirsutus</em><strong> </strong>exhibit significant hepatoprotective activity. This might be due to flavonoids and tannins; which was confirmed their presence in phytochemical tests.  </p>

scholarly journals Direct Bilirubin Levels and Risk of Metabolic Syndrome in Healthy Chinese Men

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Xiao-Hong Li ◽  
Hai-Yan Lin ◽  
Li-Ying Guan ◽  
Hui Peng ◽  
Meng-Meng Wen ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Heart Association ◽  
Direct Bilirubin ◽  
Serum Total Bilirubin ◽  
Study Cohort ◽  
Cross Sectional ◽  
Chinese Men ◽  
Blood Institute ◽  
Indirect Bilirubin ◽  
Healthy Chinese

Background. Serum bilirubin is a potent endogenous antioxidant with anti-inflammatory properties. Several cross-sectional studies have reported that bilirubin was negatively associated with metabolic syndrome. However, in recent longitudinal studies, the relations between bilirubin and metabolic syndrome are inconsistent. Moreover, previous studies mainly focused on serum total bilirubin which is the sum of direct bilirubin and indirect bilirubin. For these reasons, the longitudinal effect of bilirubin subtypes on incident metabolic syndrome was evaluated in Chinese men. Methods. The study cohort involved 1339 Chinese men without metabolic syndrome. Metabolic syndrome was defined by the American Heart Association/National Heart, Lung and Blood Institute (AHA/NHLBI) criteria, using BMI for the replacement of waist circumference. Results. There are 117 incident metabolic syndrome cases (8.7%) during 5 years of follow-up among 1339 metabolic syndrome-free participants at baseline. After adjusting for age, drinking, smoking, physical activity, TG, and LDL-C, the odd ratios (ORs) and 95% confidence intervals (CIs) for MetS incidence in the second, third, and fourth quartiles versus the first quartile of DBil concentration were 1.00 (0.61–1.63), 0.57 (0.32–1.02), and 0.51 (0.28–0.92) (Ptrend=0.031), respectively. Conclusions. Our findings support the negative association between direct bilirubin and incident metabolic syndrome in healthy Chinese men over 5-year period.

scholarly journals Prediction of Hyperbilirubinemia in Preterm Newborns Admitted in a Tertiary Care Teaching Hospital

2013 ◽  
Vol 37 (2) ◽  
pp. 85-89
Author(s):  
Farhana Rahat ◽  
Mahfuza Shirin ◽  
Md M Monir Hossain
Keyword(s):  
Negative Predictive Value ◽  
Gestational Age ◽  
Predictive Value ◽  
Total Bilirubin ◽  
Tertiary Care ◽  
Serum Total Bilirubin ◽  
Indirect Bilirubin ◽  
Study Population ◽  
Safe Limit ◽  
Preterm Newborns

Introduction: Neonatal hyperbilirubinemia is a cause of major concern for the parents as well as the pediatricians due to chance of neurotoxicity. Early prediction of development of significant hyperbilirubinemia can reduce anxiety and duration of hospital stay. Objective: To find out the risk of development of significant hyperbilirubinemia among preterm newborn within first seven days of life. Methodology: This prospective study was carried out in Dhaka Shishu Hospital during the period of January to June, 2007. One hundred & eleven preterm newborns of 30-37 weeks gestational age were enrolled in first day of their life and their serum total and indirect bilirubin were estimated on the 1st, 2nd, 5th & 7th day. Neonates with evidence of hemolysis, direct hyperbilirubinemia, sepsis & major congenital malformation were excluded. Their 1st and 2nd day serum total bilirubin values were analyzed statistically at different cut off points from which significant hyperbilirubinemia can develop on 5th & 7th day of life. Results: The study included 111 premature neonates of 30-37 weeks gestation who were enrolled on first day of their life. Their mean gestational age was 33.7(±2) weeks and mean birth weight was 1754(±341) gm. Of them, 38 (34%) neonates developed significant hyperbilirubinemia within first seven days of life. Among the study population, 40 (36%) neonates had serum total bilirubin value of <2 mg/dL on first day of life. None of them developed significant hyperbilirubinemia (100% negative predictive value). Again 65 (58.5%) neonates had serum total bilirubin value of <5 mg/dL on second day of life. Among them only 7.6% developed significant hyperbilirubinemia (92.3% negative predictive value). Conclusion: The first and second day serum total bilirubin values can predict subsequent hyperbilirubinemia within seven days of life. First day serum total bilirubin value of 2 mg/dL can be taken as a safe limit from which chance of significant hyperbilirubinemia is less. DOI: http://dx.doi.org/10.3329/bjch.v37i2.17265 BANGLADESH J CHILD HEALTH 2013; VOL 37 (2) : 85-89

Is there any relationship between serum levels of total bilirubin and the severity of erectile dysfunction?

2018 ◽  
Vol 85 (3) ◽  
pp. 106-110 ◽  
Author(s):  
Ercüment Keskin ◽  
Mehmet Karabakan ◽  
Aliseydi Bozkurt ◽  
Erkan Hirik ◽  
İbrahim Karabulut ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Erectile Dysfunction ◽  
High Density Lipoprotein ◽  
Total Bilirubin ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Control Group ◽  
Total Testosterone ◽  
Serum Total Bilirubin ◽  
Low Density

Objective: Recent studies have shown that atherosclerosis is associated with erectile dysfunction and the serum bilirubin level. In this study, the serum total bilirubin levels of patients with erectile dysfunction were measured to investigate the relationship between the levels of erectile dysfunction and total bilirubin. Methods: A total of 94 patients with erectile dysfunction were divided into three groups; severe erectile dysfunction (33 patients), moderate erectile dysfunction (31 patients), and mild erectile dysfunction (30 patients). In addition, a control group was formed with 31 healthy men. The International Index of Erectile Function-5 Questionnaire was used to measure the quality of erection in all the groups. The body mass index was calculated for all the participants. The serum glucose, low-density lipoprotein and high-density lipoprotein, cholesterol, triglyceride, total bilirubin, and total testosterone levels were also determined. Results: No statistically significant difference was observed between the groups in terms of the mean age, hypertension, smoking status, alcohol use, cardiovascular diseases, hepatobiliary disease, diabetes mellitus, and levels of total testosterone, low-density lipoprotein–cholesterol, and triglyceride. However, high-density lipoprotein, body mass index, and total bilirubin were significantly lower compared to the control group (p < 0.001). The serum total bilirubin level was found to be 0.41 ± 0.21 ng/dL in the severe erectile dysfunction, 0.43 ± 0.19 ng/dL in the moderate erectile dysfunction, and 0.48 ± 0.11 ng/dL in the mild erectile dysfunction groups (p < 0.001). Conclusion: Considering the significant differences between the erectile dysfunction and control groups in terms of serum total bilirubin levels, a low level of bilirubin may have a role in the etiology of erectile dysfunction.

scholarly journals Ursodeoxycholic acid in neonatal sepsis-associated cholestasis

2014 ◽  
Vol 54 (4) ◽  
pp. 206
Author(s):  
Rita Mey Rina ◽  
Hanifah Oswari ◽  
Pustika Amalia
Keyword(s):  
Liver Function ◽  
Ursodeoxycholic Acid ◽  
Total Bilirubin ◽  
Controlled Trial ◽  
Intervention Group ◽  
Direct Bilirubin ◽  
Function Parameter ◽  
Control Group ◽  
Gamma Glutamyl Transpeptidase ◽  
Double Blind

Background Sepsis-associated cholestasis (SAC) is an intrahepatic cholestasis caused by inflammatory cytokines. Patients with this condition have poor prognoses. Antibiotics are the mainstay of therapy, however, other adjuvant therapies, such as ursodeoxycholic acid (UDCA), have not been well established.Objective To assess the effect ofUDCA for treatment ofneonatal sepsis-associated cholestasis.Methods We performed a randomized, double-blind, controlled trial in 3 7 neonates who were diagnosed with sepsis-associated cholestasis in the Neonatal Care Unit of Cipto Mangunkusumo Hospital. Subjects were divided into two groups, with 19 neonates randomly allocated to the intervention group (received UDCA at 30 tngikg/day divided into 3 doses for 7 days) and 18 neonates to the control group (received placebo) . After 7 days of treatment, we evaluated the subjects' liver function parameters and performed asurvival analysis.Results Liver function parameter improvements at day 7 were not significantly different between the UDCA group and the control group, including for mean decrease of total bilirubin (TB) levels [2.2 (SD 2.9) mg/dL vs 1.7 (SD 4.6) mg/dL; P=0.080), mean decrease of direct bilirubin (DB) levels [1.1 (SD 2.3) mg/dL vs 0.6 (SD 3.6) mg/dL; P=0.080), median indirect bilirubin (lB) levels [0.4 (range 0.1- 5.6) mg/dL vs 0.9 (range 0.1-4.1) mg/dL; P=0.358) , mean decrease of alanine aminotransferase (ALT) levels [0.5 (-80.0 -21.0) U/L vs -2.0 (ranged -167 .0 - 85.0) U/L; P= 0.730), median aspartate aminotransferase (AST) levels [ 43 .0 (range 14.0-297 .0) U/L vs 150.0 (range 24.0-840.0) U/L; P=0.081), and median gamma-glutamyl transpeptidase (GGf) levels [125.0 (48.0-481.0) U/L vs 235.0 (56.0-456.0) U/L; P=0.108)). Five neonates in control group died compared to two in the UDCA group (P=0.232). In addition, UDCA did not significantly lengthen the survival time (hazard ratio/HR 3.62; 95%CI 0.69 to 18.77) .Conclusion Ursodeoxycholic acid tends to improve total bilirubin, direct bilirubin, and AST levels in sepsis associated cholestasis .

scholarly journals Use of serum bilirubin/albumin ratio for early prediction of bilirubin induced neurological dysfunction

2019 ◽  
Vol 67 (1) ◽  
Author(s):  
Dalia Mosallam ◽  
Reem N. Said ◽  
Marwa A. Abd Elsamad ◽  
Nada M. Abdelfatah
Keyword(s):  
Total Bilirubin ◽  
Age Of Onset ◽  
Neurological Dysfunction ◽  
Early Management ◽  
Unconjugated Hyperbilirubinemia ◽  
Albumin Ratio ◽  
Cutoff Value ◽  
Bilirubin Encephalopathy ◽  
The Mean

Abstract Background Kernicterus or bilirubin encephalopathy is a preventable cause of handicap, still occurs in our country. The aim of the current study was to assess the role of bilirubin/albumin ratio in improving the morbidity of the cases with unconjugated hyperbilirubinemia and to estimate of the cutoff value for B/A ratio for prevention and early management of bilirubin-induced neurological dysfunction. Results The mean gestational age was 37.1 ± 2.11 weeks; the mean age of onset of jaundice was 2.36 ± 1.04 days; the mean level of total bilirubin was 26.14 ± 7.36 mg/dl. At chosen cutoff value of bilirubin albumin ratio (B/A) 6.68, sensitivity was 82% while specificity was 64% and accuracy was 95%. Conclusion Bilirubin encephalopathy still occurs in significant number in our country though it is a preventable cause of handicapping. TSB is a sensitive but not a specific indicator of ABE, B/A ratio is more specific indicator of the neurologic outcome and should be utilized in the decision of early intervention.

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