Background: The gene 211G>A variants, that underlie complex disorders, are characteristically common in the neonatal hyperbilirubinemia. However, it is the contribution of multiple different co-expressed susceptibility genes that individually confer a small increase in risk coupled with environmental factors that generate complex disorder phenotypes.Objective: This study aimed to understand the relation of 211G>A promoter polymorphism in UGT1A1 gene and the risk of hyperbilirubinemia in newborns. Patients and Methods:The study included 50 newborns with hyperbilirubinemia with gestation age of ≥ 37weeks and postnatal age of ≤ 2 weeks with normal birth weight. 34 were males and 16 were females. They were divided into two groups; case group consisting of 30 neonates with the peak of total serum bilirubin (TSB) levels ≥ 16 mg /dl and control group consisting of 20 neonates with the peak total serum bilirubin (TSB) levels <12 mg/dl. Variation status of UGT1A1 genes in our study was determined by direct sequencing or genotype assays. Results: This study showed that UGT1A1 promoter gene polymorphism 211G>A genotype can be used as a novel method to detect susceptibility to indirect hyperbilirubinemia in neonates. Conclusion:Our findings added to the understanding of the significance of UGT1A1 in association with neonatal hyperbilirubinemia in East Delta of Egyptian population. Additionally we are in need for other studies to investigate the protective mechanisms.

Background: Invasive respiratory support is associated with risk and complications including mortality and neurological impairments. Consequently, extubation of a ventilated infant should be as early as possible.Objective: This study aimed to assess the efficacy of spontaneous breathing trial as indicator for the success of extubation in mechanically ventilated preterm infants. Patients and methods: A prospective cohort study included 62 preterm born infants who were maintained on mechanical ventilation. They were divided into: (32 infants) group for whom a spontaneous breathing trial was carried out for 5 minutes. Second (30 infants) group for whom a spontaneous breathing test was carried out for 3 minutes. Then, rapid Shallow Breathing Index (RSBI) was calculated for each patient. At the end of the test, the newborns were extubated and placed on continued positive airway pressure (CPAP) or just oxygen, as needed, according to the unit's routine protocol. Results: On multivariate logistic regression of factors associated with failure of weaning, APGAR at 5 minutes was > 6, absence of maternal PIH, birth weight > 400 gm. Pre-extubation MAP < 5.5 and preextubation PO2 > 28 were protective against failure of weaning. On the other hand, lower preextubation PCO2 was a predictor of weaning failure (increase risk of failure by about 63 times). Failure of weaning forecated in RSBI trial can predict actual failure of weaning with sensitivity of 97.9%, specificity of 73.3%, positive predictive value of 92%, negative predictive value of 91.7% and accuracy of 91.9%. Conclusion: Failure of weaning associated with lower birth weight, PO2, PCO2 and higher pre-extubation MAP. 3 minutes and 5 minutes spontaneous breathing trial (SBT) can predict actual failure of weaning with sensitivity 97.9%, specificity 73.3%.