Care Bundle Application Decreases The Frequency and Severity of Intraventricular Hemorrhage in Preterm Neonates: Single Center Study

Background: Intraventricular hemorrhage (IVH) is a severe complication in preterm babies admitted to Neonatal Intensive Care Units (NICU). Advanced stages of IVH predispose to neurological deficits such as cerebral palsy and hydrocephalus. There are numerous strategies and policies implemented in NICUs around the world to decrease the incidence of IVH in preterm babies and prevent its ensuing neurodevelopmental complications. Aim of the Work: To study the effect of implementing a bundle of care on incidence and severity of IVH among preterm neonates. Materials and Methods: Retrospective analysis of patient records for incidence and severity of IVH between May and August 2018 was done. This was followed by an educational interim period where NICU staff received training of pre-natal, natal, and postnatal care bundle guidelines to reduce IVH. The guidelines were then implemented on all preterm babies (28-34 weeks gestational age (GA)) born and admitted to Kasr Al Ainy Teaching Hospital NICU, Cairo University between October 2018 and January 2019 (n=58). Cranial ultrasonography was performed at week 1 and week 2-3 of life. Frequency and severity of IVH were compared among studied groups. Risk factors for IVH were analyzed and recorded. Results: The frequency of IVH was significantly lower in the post-bundle group (44-46% pre-bundle, and 27% post-bundle) especially evidenced by the ultrasonography in week two of life. Severity of IVH also improved post bundle since there were no grade III IVH patients in that group. Exposure to hypocapnia, blood pressure fluctuations, IV fluid boluses and administration of sodium bicarbonate were significantly correlated with development of IVH in preterm babies (p = 0.001). Conclusion: Implementation of an IVH care bundle that includes perinatal measures can positively affect the neurological outcome by decreasing incidence and severity of IVH in preterm babies

Interaction of a novel inorganic nickel complex with tyrosinase as potential inhibitor: Synthesis, spectroscopic, DFT, NBO, docking and ADMET properties

The obtained Ni(II) complex has been synthesized and characterized by elemental analysis (EA), spectroscopic studies such as FT-IR, UV-Vis. and MS. Also, thermal analysis (TG and DTG) analysis, X-ray powder diffractometry (PXRD) and morphological (SEM/EDXS) measurements were as well performed. By using cyclic voltammetry (CV), the redox properties of Ni(L) complex was found to be a quasi-reversible Ni(II)/Ni(I) redox system. The structure of Ni(L) complex was investigated by utilizing density functional theory (DFT) calculations with the Becke 3-Lee-Yang-Parr (B3LYP) method employing the LANL2DZ basis set. Frontier molecular orbitals (FMOs), important parameters of reactivity, Mulliken charge and Natural bond orbitals (NBOs) computational studies on Ni(L) complex were carried out in the ground state using DFT theory at B3LYP/ LANL2DZ level. This complex was found to exhibit, in vitro, a strong tyrosinase inhibitory activity with an IC value of 5.7 μM approximately 6.5-fold better than kojic acid as positive control IC = 37.86 µM). The binding energy of the best pose, in silico, is – 8.7 kcal/mol. Thus, these results showed a good agreement with the experimental data obtained from the enzyme-inhibiting assay.The authors thank the Algerian Ministry of Higher Education and Scientific Research (MESRS) and the General Directorate for Scientific Research and Technological Development (DGRSDT) for the financial support

Comparison between Bilistick System and transcutaneous bilirubin in assessing total bilirubin serum concentration in jaundiced newborns

Objective:To compare the performance and accuracy of the JM-103 transcutaneous bilirubinometer and Bilistick System in measuring total serum bilirubin for the early identification of neonatal hyperbilirubinemia.Study Design:The study was performed on 126 consecutive term and near-term (â(c) 3/436 weeks' gestational age) jaundiced newborns in Cairo University Children Hospital NICU, Egypt. Total serum bilirubin was assayed concurrently by the clinical laboratory and Bilistick System and estimated using the JM-103 transcutaneous bilirubin instrument. Bland-Altman analysis was used to evaluate the agreement between determinations.Result:The limits of agreement of the Bilistick System (â '5.8 to 3.3 mg dl-1) and JM-103 system (-5.4 to 6.0 mg dl â '1) versus the clinical laboratory results were similar.Conclusion:The Bilistick System is an accurate alternative to transcutaneous (TcB) determination for early diagnosis and proper management of the neonatal jaundice

Design, structural and theoretical characterizations of novel Schiff base compounds: Enzymes inhibitory potential using in vitro and in silico methods

105-124The aim of this paper is to further explore the enzymatic properties of two synthetic Schiff base compounds. The corresponding copper complex (CuII(L)2), with its Schiff base ligand (HL) have been synthesized and their spectroscopic (IR, UV-visible., NMR (1H, 13C, Dept-135) and MS), thermogravimetric (TG/DTG), electrochemical (CV) and theoretical (Density Functional Theory) using the hybrid B3LYP/6–31 G(d,p) method) properties have been studied and well discussed. The electrochemical behaviour of CuII(L)2 displays the Cu(III)/Cu(II) and Cu(lI)/Cu(I) redox processes. The molecular structure of HL is confirmed by X-ray diffraction analysis. HL crystalized in the triclinic system with the space group of P-1. The morphological structures are also analyzed by X-ray powder diffraction, scanning electron microscopy with energy-dispersive X-ray spectroscopy. To improve their biological activities, inhibition of the target proteins, acetylcholinesterase (AChE), butyrylcholinesterase (BChE), Tyrosinase (TYR), and Urease enzymes are tested in vitro and in silico using molecular docking. Furthermore, their ADMET parameters are analyzed. The drug-likeness results indicate that HL followed to Lipinski’s, Ghose’s, Veber’s, Egan’s and Muegge’s rules contrary to its copper complex which followed only to Veber’s rule. Due to the importance of cytochrome P450s proteins for detoxification, five major CYP isoforms (CYP1A2, CYP2C19, CYP2C9, CYP2D6, and CYP3A4) are also considered during in silico prediction

Diagnostic Performance Analysis of the Point-of-Care Bilistick System in Identifying Severe Neonatal Hyperbilirubinemia by a Multi-Country Approach

Importance: The real prevalence and clinical burden of severe neonatal jaundice are undefined due to difficulties in measuring total serum bilirubin (TSB) outside secondary and tertiary clinical centers. Objective: To assess the diagnostic performance of the point-of care Bilistick System (BS) in identifying neonatal jaundice patients requiring treatment. Design: Between April 2015 and November 2016, 1911 neonates, were recruited to participate in the study. Blood samples were simultaneously collected for the TSB determination by BS and by hospital laboratory (Lab). Data were collected and sent to the Bilimetrix headquarter in Trieste where statistical analysis was performed. Newborns with neonatal jaundice were treated with phototherapy according to each center's guidelines. Setting: 17 hospitals from Nigeria, Egypt, Indonesia, and Viet Nam. Participants: 1911 newborns were included, of which 1458 (76·3%) fulfilled the inclusion criteria. Results: TSB level measured by BS agreed (p < .0001) with the lab result in all four countries. The diagnostic performance of BS showed a positive predictive value (PPV) of 92·5% and a negative predictive value (NPV) of 92·8%. Conclusions and Relevance: BS is a reliable system to detect neonatal jaundice over a wide range of bilirubin levels. Since Bilistick is a point-of-care test, its use may provide appropriate and timely identification of jaundiced newborns requiring treatment