Background: Early prediction and identification of severe hyperbilirubinemia for that age and appropriate treatment are must to prevent kernicterus. Objective: The objective is to study the predictive value of bilirubin albumin ratio (BAR) and to compare it with cord bilirubin alone for early identification of significant neonatal hyperbilirubinemia in healthy term neonates. Materials and Methods: This prospective cross-sectional study was done in a tertiary care center located in Central India on 543 healthy term neonates. Cord blood of 2 ml was collected during the delivery from the placental end and sent for BAR and cord bilirubin analysis. All the neonates had undergone total serum bilirubin estimation and neonates with serum bilirubin ≥17 mg/dl at ≥72 h of age were defined to have significant hyperbilirubinemia. Results: Among the study population, 44 neonates developed significant hyperbilirubinemia. Sensitivity and specificity of cord BAR were 95.45% and 89.78%. Sensitivity and specificity of cord blood bilirubin were 95.65% and 95.57%. Positive predictive value (PPV) and negative predictive value (NPV) of cord BAR were 45.16% and 99.55%. PPV and NPV of cord blood bilirubin were 64.70% and 99.58%. Considering mean as the cutoff value, cutoff value for cord BAR was 0.89 and it was 2.95 for cord blood bilirubin. Diagnostic accuracy of cord BAR and cord blood bilirubin in predicting the hyperbilirubinemia was 90.79% and 96.31%, respectively. Conclusion: Both cord BAR and cord blood bilirubin are the early predictors of neonatal significant hyperbilirubinemia, but cord blood bilirubin is the better diagnostic tool than the former in early detection of neonatal jaundice.

Background: Nearly all smokers show some evidence of lung and systemic cellular and/or humoral inflammation, only a few will experience an amplified response and develop chronic obstructive pulmonary disease (COPD). Several studies have shown systemic inflammation in COPD patients with increased neutrophil, macrophage and T lymphocyte numbers, and high concentrations of inflammatory mediators in peripheral blood (C-reactive protein, interleukin (IL)-6, IL-8, and tumor necrosis factor- (TNF-)). Aims and Objective: To study oxidative stress, antioxidant status, and TNF- levels in patients with COPD. Materials and Methods: Forty-four COPD patients along with an equal number of age-and sex-matched controls were included in study. The levels of malondialdehyde (MDA; by thiobarbituric acid assay), assay of TNF- (by TNF-), and total antioxidant were measured. Results: Malondialdehyde level was found to be significantly higher in all cases, and it was statistically significant in COPD patients with Global Initiative on Obstructive Lung Disease (GOLD) classification grades 2 and 3. Total antioxidant level was significantly lower in all the patients with COPD and was statistically significant in GOLD grades 2 and 3. Like MDA, TNF level was also significantly higher in all the cases with statistically significant increase in GOLD grades 2 and 3. Conclusion: To better understand the role of these trace elements and oxidative stress in the pathogenesis and complications of COPD, it is recommended to carry out further clinical studies.

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