Introduction: Most neonatal hyperbilirubinemia is benign, but because of the potential toxicity of bilirubin, neonates should be monitored to identity those who might develop severe hyperbilirubinemia. Objective: To determine if the cord blood hydrogen peroxide level can be used as an early predictor of neonatal hyperbilirubinemia or not and if there is a correlation between its levels and the severity of hyperbilirubinemia. Methods: This is a prospective comparative study included 59 full term neonates. Forty-one neonates developed jaundice (group I) and 18 neonates did not develop jaundice (group II) as controls. For all studied groups, we measured the cord blood bilirubin using modified diazo method and hydrogen peroxide levels using ELISA Kits and we measured their levels at 5 th and 7 th days of life for patients. Results: The cord blood H 2 O 2 levels as well as the bilirubin levels were higher in patients than controls. Significant positive correlations between cord blood H 2 O 2 and cord blood bilirubin levels were present (r=0.81& p<0.001), bilirubin levels at the 5 th day of life (r=0.46& p<0.001) and bilirubin levels at the 7 th day (r=0.60 & p<0.001). Moreover, there was a significant positive correlation between the 5 th day H 2 O 2 and the 5 th day bilirubin levels (r=0.75& p<0.001) and a strong significant correlation between 7 th day H 2 O 2 and 7 th day bilirubin (r=0.94 & p= 0.001). The sensitivity of the cord blood H 2 O 2 in cases as a predictor to neonatal hyperbilirubinemia was 92.6% and the specificity was100% with a cutoff point >35 (p-value 0.001). Conclusion: Cord blood hydrogen peroxide (H 2 O 2) levels can be used as an early predictor of neonatal indirect hyperbilirubinemia and can determine which neonates should be followed after discharge from the hospital.

Introduction: Neonatal sepsis represents a major health problem with high mortality and morbidity rates. Although early diagnosis of neonatal sepsis is very important for proper management yet it remains a difficult task. Neutrophil CD64 (nCD64) is used as a marker for the diagnosis of sepsis, requiring a small sample volume, short turnaround time. Objectives: In this study we aimed to study the diagnostic performance of nCD64 against routine markers in low birth weight neonates (LBWN) with sepsis. Patients and methods: A case control study was conducted on 40 LBWN suspected clinically to have early onset neonatal sepsis against 20 neonates clinically free of sepsis as control. Investigations included CBC, CRP, blood culture andnCD64 expression. Results: among the studied markers of sepsis; immature neutrophil count, immature /mature ratio, immature/total ratio, CRP and nCD64 were significantly higher in suspected group than control (p value 0.007, 0.001, 0.002, 0.001, and 0.001 respectively). Among the group of neonates with suspected sepsis, blood culture of 11 cases (27.5%) did not show growth. nCD64 showed the highest sensitivity and specificity; 100% each. Immature neutrophil count and total leucocytic count showed the lowest sensitivity 40% and mature neutrophil showed the lowest specificity 45%. The expression of nCD64 in those neonates who died as a complication of sepsis was significantly higher than those who survived (p value 0.001). Conclusion: nCD64 is a reliable marker for the diagnosis of early onset neonatal sepsis in LBWN with a significant predictive value for disease course.