Bilirubin Induced Encephalopathy, a Review Article

Hyperbilirubinemia is one of the most common neonatal disorders. Delayed diagnosis and treatment of the pathologic and progressive indirect hyperbilirubinemia lead to neurological deficits, defined as bilirubin induced encephalopathy . The incidence of this disorder in underdeveloped countries is much more than developed areas. All neonates with  the risk factors for increase the blood level of indirect bilirubin are at risk for bilirubin encephalopathy ,especially preterm neonates which are prone to low bilirubin kernicterus .Bilirubin toxicity can be transient and acute(with early ,intermediate and advanced phases)or be permanent, chronic(kernicterus)and lifelong ( with tetrad of symptoms including visual (upward gaze palsy), auditory (sensory neural hearing loss), dental dysplasia abnormalities, and extrapyramidal disturbances (choreoathetosis cerebral palsy).Beside the abnormal neurologic manifestations of the jaundiced neonates ,brain MRI is the best imaging modality for the confirmation of the diagnosis. Although early treatment of extreme hyperbilirubinemia by phototherapy and exchange transfusion can prevent the BIE, unfortunately the chronic bilirubin encephalopathy does not have definitive treatmen

The prospective epidemiological research studies in IrAN (PERSIAN) birth cohort protocol: Rationale, design and methodology

Background: Birth cohorts are essential for developing evidence-based policies and advancing knowledge on different aspects of the concept of developmental origins of health and diseases (DOHaD). The Prospective Epidemiological Research Studies in IrAN (PERSIAN) is a multicentre cohort in Iran. It is one of the pioneers of DOHaD research in the Middle East and North Africa (MENA) region. This profile provides a brief overview of this birth cohort, focusing on the objectives and design of the study. The main objective of this birth cohort is to evaluate the associations of socio-economic characteristics, lifestyle, diet, environmental exposures and epigenetic factors with outcomes of: pregnancy; mother and child mental and physical health and well-being; child neurodevelopment; and the establishment of chronic disease risk factors. Methods: The enrolment of PERSIAN Birth Cohort participants is currently ongoing in five Iranian cities (Isfahan, Yazd, Semnan, Sari and Rafsanjan). We plan to recruit 15, 000 mother-offspring pairs, and to follow them for at least ten years. Data collection consists of three consecutive phases: (1) periconception until birth; (2) infancy (0-2 years); and (3) childhood (3-11 years). We are collecting data on both ‘determinants of health’ and ‘health outcomes’. In addition to questionnaires and physical examination, various biological samples, including blood, urine, hair, nail, cord blood and breastmilk are being collected. Growth and neurodevelopment of children will be monitored. Appropriate data analysis schemes will be employed to assess the role of early life factors in health and disease that would facilitate international comparisons

The Prospective Epidemiological Research Studies in IrAN (PERSIAN) Birth Cohort protocol: rationale, design and methodology

Background: Birth cohorts are essential for developing evidence-based policies and advancing knowledge on different aspects of the concept of developmental origins of health and diseases (DOHaD). The Prospective Epidemiological Research Studies in IrAN (PERSIAN) is a multicentre cohort in Iran. It is one of the pioneers of DOHaD research in the Middle East and North Africa (MENA) region. This profile provides a brief overview of this birth cohort, focusing on the objectives and design of the study. The main objective of this birth cohort is to evaluate the associations of socio-economic characteristics, lifestyle, diet, environmental exposures and epigenetic factors with outcomes of: pregnancy; mother and child mental and physical health and well-being; child neurodevelopment; and the establishment of chronic disease risk factors. Methods: The enrolment of PERSIAN Birth Cohort participants is currently ongoing in five Iranian cities (Isfahan, Yazd, Semnan, Sari and Rafsanjan). We plan to recruit 15, 000 mother-offspring pairs, and to follow them for at least ten years. Data collection consists of three consecutive phases: (1) periconception until birth; (2) infancy (0-2 years); and (3) childhood (3-11 years). We are collecting data on both ‘determinants of health’ and ‘health outcomes’. In addition to questionnaires and physical examination, various biological samples, including blood, urine, hair, nail, cord blood and breastmilk are being collected. Growth and neurodevelopment of children will be monitored. Appropriate data analysis schemes will be employed to assess the role of early life factors in health and disease that would facilitate international comparisons