Assessment of Hematological Parameters in Pulmonary Tuberculosis Patients

The aim of the study was the assessment of hematological parameters in pulmonary tuberculosis patients. Forty patients diagnosed with tuberculosis were recruited from the Institute of Thoracic Medicine on the basis of history, clinical examination, chest radiography, sputum examination and related laboratory parameters and were compared with age and sex matched healthy volunteers (n = 40). Hematological parameters and CRP in tuberculosis patients were determined. The mean values for serum hemoglobin level, RBC count and platelet count in PTB was found to be less (p < 0.001). Erythrocyte sedimentation rate (ESR), plasma C-reactive protein, WBC count in PTB subjects was increased (p < 0.001 for ESR & CRP, p < 0.05 for WBCs) and all were statistically significant. This study demonstrated that serum hemoglobin level, RBC count and platelet count was decreased in tuberculosis patients whereas ESR, CRP and WBC count was increased when compared with healthy controls.     

Biochemical effects of various pesticides on sprayers of grape gardens

A total of 85 healthy male pesticide sprayers in grape garden exposed to different class of pesticides for 3 to 10 years were compared with 75 controls matched for age with respect to serum cholinesterase, serum total protein, albumin, AST, ALT, hematological parameters such as Hb, Hct, RBC and serum lipid peroxidation. Serum lipid peroxidation was estimated in the form of thiobarbituric acid reactive substances (TBARS) produced. Significant decrease was observed in serum cholinesterase, serum total proteins, albumin and hematological parameters viz. Hb, Hct and RBC. Significant increase in lipid peroxidation, AST, ALT, was observed in exposed group when compared with control. These results suggest that the long term exposure of various pesticides on sprayers of grape garden affect liver, heme biosynthesis and decrease serum cholinesterase.     

Thiamine Deficiency Induced Dietary Disparity Promotes Oxidative Stress and Neurodegeneration

Thiamine or vitamin B1 is a well known coenzyme and nutrient necessary for the assembly and right functioning of several enzymes involved in the energy metabolism. The present study evaluates oxidative stress and prevalence of neurodegenerative conditions in the brain following TD. The study was carried out on mice (Musmusculus) in three groups, namely control and thiamine-deficient group for 8 (TD 8) and 10 (TD 10) days. Lipid peroxidation was determined in terms of reduced glutathione (GSH) and thiobarbituric acid reactive substance (TBARS). The level of antioxidant enzymes such as catalase (CAT), glutathione reductase, glutathione peroxidase (GPx), superoxide dismutase (SOD) and glutathione transferase (GST) were measured along with histopathological studies in all the groups. There was significant increase in the TBARS levels in group II (TD 8) and group III (TD 10) animals in comparison to controls (Group I). The GSH levels were found to be lower in both the treated groups. The level of antioxidant enzymes CAT (p < 0.001), glutathione reductase (p < 0.001), GPx (p < 0.001), SOD (p < 0.0001) were found to be significantly reduced in group III (TD 10) in comparison to controls. Histopathological studies showed moderated to extensive neuronal loss in group II and group III in comparison to control group. The increase in LPO and reduction in enzymes CAT, glutathione reductase, GPx, SOD, and GST following TD suggests mitochondrial dysfunction, neuronal loss acute oxidative stress that may impair the functioning of the brain along with the rise of neurodegenerative conditions in the affected animals.     

Chronic Exposure to Lead: A Cause of Oxidative Stress and Altered Liver Function in Plastic Industry Workers in Kolkata,India

It is well known that chronic exposure of lead leads to adverse health effects. Workers for plastic industry are generally exposed to high concentration of lead as fume, dust, and additive that protect PVC. This study was done on them to find out the detrimental effects of chronic lead exposure on hepatic and hematological toxicity. Blood and 24 h urine sample was collected from 47 plastic industry workers and matched against 42 controls for various parameters. The study group shows significant increase in blood (p < 0.0001) and urinary level of lead (p < 0.0001). Hemoglobin levels were significantly decreased (p < 0.0001), and the liver enzymes like ALP, ALT, AST and y-GT were significantly increased (p < 0.0001) in all cases exposed for >10 years. Serum lipid peroxide by quantitative assay of thiobarbituric acid reactive substances was also found increased in the study group (p < 0.0001). The observations point towards the acute health risk faced by plastic industry workers, in whom chronic exposure to lead increases the absorption and accumulation, over a period of time, of this highly toxic element in their body. This increases oxidative stress, causes metabolic damage to RBC and cell membranes, and also suggests necrosis of liver cell, hepatocellular injury and presence of space occupying lesions. Considering the data immediate health and hygiene monitoring and proper rehabilitation for the suffering population seem to be of paramount need in plastic industry to minimize occupational hazards.     

Altered Erythrocyte Glycolytic Enzyme Activities in Type-II Diabetes

The activity of enzymes of glycolysis has been studied in erythrocytes from type-II diabetic patients in comparison with control. RBC lysate was the source of enzymes. In the diabetics the hexokinase (HK) activity increased 50 % while activities of phosphoglucoisomerase (PGI), phosphofructokinase (PFK) and aldolase (ALD) decreased by 37, 75 and 64 % respectively but were still several folds higher than that of HK. Hence, it is possible that in the diabetic erythrocytes the process of glycolysis could proceed in an unimpaired or in fact may be augmented due to increased levels of G6P. The lactate dehydrogenase (LDH) activity was comparatively high in both the groups; the diabetic group showed 85 % increase. In control group the HK, PFK and ALD activities showed strong positive correlation with blood sugar level while PGI activity did not show any correlation. In the diabetic group only PFK activity showed positive correlation. The LDH activity only in the control group showed positive correlation with marginal increase with increasing concentrations of glucose.     

Prophylactic Effects of Garlic Oil and Onion Oil Fractions as Compared to Vitamin E on Rats Orally Fed with Lead Acetate Solution

Heavy metal pollution is a global public health challenge due to its stable and persistent environmental contamination. Of these lead is considered to be one of the most common ubiquitous and industrial pollutants and at low concentration it exerts extensive damages to the tissues. Daily feeding of lead acetate solution (Dose: 10 mg/kg/day) to normal rats for a month adversely altered the parameters of blood, serum and tissues, viz; RBC, WBC, Hb, ?- ALAD (Delta amino levulinic acid dehydratase), Pb content, lipids, oxidized lipids (TBARS), vitamins C and E and GSH levels and activities of AST, ALT and antioxidant enzymes viz; catalase, GR, Gpx and SOD. In order to study whether antioxidants have any effect to counteract the toxicity of lead we have selected comparatively better active allium fractions for the study viz: polar fraction of garlic (PFG) and polar fraction of onion (PFO). On feeding of these active fractions of garlic and onion oils i.e. their polar fractions and vitamin E (Dose 100 mg/kg/day) separately for a month along with or without lead acetate to rats each nutraceutical and vitamin E counteracted the adverse effects of Pb significantly (p ≤ 0.05). Their effects are in the order of PFG > PFO > Vitamin E. All these results point out that garlic and onion oils contain natural disulfoxide compounds which act as antioxidant and anti toxic to lead compounds. Their comparative differences in action may be due to the presence and position of double bonds and disulfide oxide bonds in their molecules. i.e., in PFG the allyl disulfide oxide group is present and in PFO saturated methyl and propyl groups and unsaturated propenyl group are present in place of allyl groups. The former group confers a better antioxidant activity on PFG, while the latter groups confer a lesser activity on PFO.     

Correlation of Red Blood Cell Acetylcholinesterase Enzyme Activity with Various RBC Indices

Cholinesterases belongs to class hydrolases. There are two types acetylcholinesterase and butyryl cholinesterase. Acetylcholinesterase present in nerve endings and also in the RBC membrane. It helps to maintain the shape and size of RBCs. Any change in shape and size of RBCs may affect the activity of Acetylcholinesterase. Thus this study aimed to estimate RBCs Acetylcholinesterase enzyme activity in various types of anemias and correlate the RBCs Acetylcholinesterase enzyme activity with various hematological indices such as Erythrocyte Sedimentation Rate (ESR), Mean Corpuscular Hemoglobin (MCH), Mean Corpuscular Hemoglobin Concentration (MCHC), Mean Corpuscular Volume (MCV), Red cell Distribution Width (RDW) etc. After obtaining ethical approval from Institutional ethics committee total of 100 samples were collected from Clinical Biochemistry laboratory, Kasturba Medical College, Manipal, Manipal University. 25 were having normal RBC indices, 12 with hemolytic anemia, 26 with microcytic anemia and 26 with macrocytic anemia based on peripheral smear report and RBC indices. Acetylcholinesterase were measured using Ellman’s method. RBC acetylcholinesterase activity was significantly increased in microcytic anemia (58.13 ± 5.4) and macrocytic anemia (76.87 ± 6.7) than normal group (37.62 ± 2.71). Also increased RBC acetylcholinesterase was seen in hemolytic anemia (48.11 ± 5.18) but the increase is not statistically significant. RBC acetylcholinesterase correlated negatively with hemoglobin (r = ?0.356, p = 0.001) and positively with RDW (r = 0.31, p = 0.003). To conclude RBC acetylcholinesterase activity can be used as one of the potential marker for various types of anemia.     

Vitamin E supplementation on biochemical changes observed in agricultural field workers exposed to different classes of pesticides

A total of 41 healthy male pesticide sprayers exposed to different clases of pesticides for 3-5 years were compared with 21 controls matched for age and economic status with respect to free radical generation, lipid peroxidation, antioxidant status, cholesterol, lipoprotein status and haematological profile. Plasma lipid peroxidation was estimated in the form of thiobarbituric acid reactive substances (TBARS) produced. Significant increase in TBARS was observed in sprayers population when compared with control subjects and the level of TBARS increased with increase in the duration of exposure. The levels of antioxidants such as glutathione (GSH) were significantly depleted, whereas those of superoxide dismutase (SOD) were remarkably increased than control population. Significant reduction in total cholesetrol, alteration in lipoprotein fractions and nonsignificant changes in hematological parameters were observed. These results suggested that exposure to pesticidal residual drift augments the free radical generation, and lipid peroxidation. Decline in non-enzymatic antioxidant and elevation of enzymatic antioxidant were observed. Supplementation of α-tocopherol for 45 days resulted in the partial restoration of these biochemical changes produced by pesticides.     

The Correlative Study of Serum Pseudo-cholinesterase, Biological Parameters and Symptoms Among Occupational Workers

Cholinesterase is one of many important enzymes needed for acetylcholine hydrolysis. This study aimed to evaluate the serum pseudo-cholinesterase (BuChE) level and its relation to biological parameters (hematological and biochemical parameters) and symptoms among occupational workers, gasoline station worker in Bangkok, Thailand. Our results revealed that the average BuChE level was in normal range, but it had strong relation to hemoglobin (Hb), hematocrit (Hct), blood urea nitrogen (BUN), creatinine (Cr) and serum glutamic pyruvic trans-aminase (SGPT) (Linear regression analysis, p < 0.05, p < 0.05, p < 0.01, p = 0.001 and p < 0.01 respectively). Although, BuChE was not related to white blood cell parameters, but it may exhibit the skin irritation (p = 0.058) of the workers as it showed significant correlation to conjunctivitis and nausea (Pearson’s correlation, p < 0.01 and p < 0.05). In conclusion, this finding may explain that BuChE was significantly related to red blood cells (RBC), liver and kidney functions.     

Lipid Parameters, Doses and Blood Levels of Calcineurin Inhibitors in Renal Transplant Patients

The calcineurin inhibitors (CNIs) [cyclosporin A (CsA) and tacrolimus (Tac)] are currently the most widely prescribed drugs for maintenance of immunosuppression after renal transplantation. These immunosuppressants are associated with side effects such as hyperlipidemia. We evaluated the differential effects of different CNIs on serum lipid parameters in renal transplant patients. Moreover, the aim of this study is to investigate the relationships between doses and blood levels of CNIs, and blood levels of CNIs and lipid parameters retrospectively. Two groups of 98 non-diabetic renal transplant patients, each treated with different CNIs, were studied: group A (n = 50, mean age: 31 ± 10 years), CsA, mycophenolate mofetil/azathioprin, steroid; group B (I = 48, mean age: 34 ± 12 years), Tac, mycophenolate mofetil/azathioprin, steroid. In renal transplant patients, CNIs blood levels and doses were examined at 1, 3, 6, 9, and 12 months after transplantation. Biochemical laboratory parameters including plasma lipids [total-cholesterol (CHOL), low-density lipoprotein (LDL)–CHOL, high-density lipoprotein (HDL)–CHOL, and triglycerides (TG)], CNI levels and doses were examined at 1, 3, 6, 9, and 12 months after transplantation. None of the patients received anti-lipidemic drugs during the study period. Blood levels of CNIs were detectable in all whole-blood samples by Cloned- Enzyme-Donor Immunoassay (CEDIA). The relationship between CNIs blood levels and CHOL, (LDL)–CHOL, HDL–CHOL, TG were evaluated. The mean serum CHOL levels and LDL–CHOL levels of patients in group A were found significantly higher than the patients in group B during the 12 month of follow up (p < 0.05). There was no significant difference in TG and HDL–CHOL plasma levels between group A and group B (p > 0.005). In group A the daily dose of CsA was significantly correlated with the mean blood levels of CsA at the 1st and 3rd months (r = 0.387, p = 0.005; r = 0.386, p = 0.006), respectively. In group A, the daily dose of CsA was significantly correlated with the mean serum TG levels during the 12 month of follow up (r = 0.420, p = 0.003). In group B, the daily dose of Tac was significantly correlated with the mean blood level of Tac (r = 0.335, p = 0.020) at the 1st month. No correlation was found between mean Tac blood levels and lipid parameters during the 12-month of follow up (p > 0.05). Significant positive correlation was observed between the CsA blood levels and LDL–CHOL levels (r = 0.338, p = 0.027) at the 3rd month. In the renal transplant patients with well functioning grafts, CsA therapy is associated with increased CHOL and LDL–CHOL ratio which represents an increased atherogenic risk tended to be associated with CsA. Serum LDL–CHOL levels may be effected by blood CsA levels.     

Congenital Lead Poisoning: An Unusual Presentation

Lead poisoning presents a common acquired as well as congenital environmental threat to children’s health today. An unusual case of severe lead poisoning in breast fed male infant is presented here. The objective of the study is to describe a patient who developed clinical lead intoxication with an uncommon source of poisoning. A 6 months old male baby presented with gradual loss of weight, not feeding well and persistent vomiting. Laboratory investigation revealed that he was having anemia (Hb level 5.4 gm/dl), abnormal liver enzymes (including elevated transaminase activity) and high blood lead value (83 μg/dl). RBC morphology showed basophilic stippling with cabot ring, suggestive of a case of lead poisoning. A course of chelation treatment using calcium versenate (EDTACaNa2) was prescribed following which a radical solution for mobilization of lead from his systems was observed.     

Attempting to maintain normoglycemia during cardiopulmonary bypass with insulin may initiate post-operative hypoglycemia

Cardiopulmonary bypass is known to cause alterations in insulin secretion and resistance, resulting in profound hyperglycemia. Aggressive treatment of the resulting hyperglycemia intra-operatively could result in a severe degree of post-operative hypoglycemia. We undertook this prospective non-randomized clinical study to compare the alterations in glucose homeostasis in diabetic (group A, n=50) and non-diabetic (Group B, n=50) patients undergoing moderate hypothermic (30°C) cardiopulmonary bypass for coronary artery bypass grafting (CABG). All patients had a fasting blood sugar level done on the morning of surgery. Blood sugars were monitored intra-operatively and post-operatively at fixed time intervals. Intra-operative hyperglycemia was treated aggressively by a continuous, infusion of injecting plain insulin. Both the groups experienced similar significant increase in blood glucose levels during bypass (‘p’=0.00003). However, the mean blood glucose level upon arrival in the intensive care unit was significantly decreased in group B compared to group A (p=0.0002). 60% of group B and 10% of group A patients required treatment for post-operative hypoglycemia (blood glucose level <60mg/dl). This clinical study reveals that attempting to maintain normoglycemia in this setting with Insulin may initiate post-operative hypoglycemia.     

Circadian Time Structure of Circulating Plasma Lipid Components in Healthy Indians of Different Age Groups

The circadian rhythm of human circulating lipid components was studied under nearnormal tropical conditions in 162 healthy volunteers (103 males and 59 females; 7 to 75 years of age). They followed a diurnal activity from about 06:00 to about 22:00 and nocturnal rest. These volunteers were divided into four groups: Group A (7–20 years), Group B (21–40 years), Group C (41–60 years) and Group D (61–75 years), comprising 42, 60, 35 and 25 participants, respectively. A marked circadian rhythm was demonstrated for each studied variable in each group by population-mean cosinor analysis (almost invariably p < 0.001). Furthermore, circadian rhythm characteristics were compared among the 4 groups by parameter tests and regressed as a function of age, separately for males and females. A second-order polynomial characterized the MESOR of HDL cholesterol, phospholipids and total lipids, as well as the 24-h amplitude of total cholesterol and phospholipids. The 24-h amplitude of total lipids decreased linearly with age. The 24-h acrophase of the oldest age group (Group D) was advanced in the case of total cholesterol, HDL cholesterol, and total lipids, whereas that of phospholipids was delayed. Mapping the circadian rhythm (an important component of the broader time structure or chronome, which includes a. o., trends with age and extra-circadian components) of lipid components is needed to explore their role in the aging process in health.     

Association of the 12669G&gt;A Apolipoprotein B Gene Polymorphism with Apo-B Serum Level and Lipid Profile in Patients with Coronary Artery Disease Comparing with Individuals Without Coronary Artery Disease in Zanjan Population of Iran

Atherosclerosis is a pathologic disorder which has an important role in the occurrence of coronary heart disease. It is determined as a focal, inflammatory proliferative response to several types of endothelial damage. Apolipoprotein B which is a requirement in the sustenance of cholesterol homeostasis, and is the major protein component of low density lipoprotein, characterized by multitude polymorphic sites, one of which (12669G>A) is related to the levels of serum lipid profiles, coronary artery disease and/or myocardial infarction. One Common polymorphism which is more important in this process is 12669G>A that is appraised in this research. We recruited 80 patients from the Mousavi hospital, Zanjan, Iran, diagnosed with coronary artery disease by the clinician on the basis of clinical symptoms, echocardiogram result, and angiography. Seventy-seven healthy individuals without any evident symptoms of Coronary stenosis and any past history of the disease were taken as controls from the general population. We carried out PCR using specific primers. Then, we digested PCR product by RFLP. Lipid parameters by biochemical methods and Apolipoprotein B serum level by immunoturbidometry method were done. Genotype frequencies for 12669G>A polymorphism were determined: 55 % R+R+, 45 % R+R? in case group, and 55.8 R+R+, 44.2 % R+R? in controls. The R?R? genotype was not seen. There was no significant relationship between this polymorphism and the risk of Coronary stenosis (P = 0.6). In the present study, higher plasma levels of cholesterol and low density lipoproteins in the subjects with R+R? genotype were found while there was no association between this polymorphism and coronary stenosis with ≥50 % in the Zanjan population.     

Role of Heme Oxygenase, Leptin, Coenzyme Q10 and Trace Elements in Pre-eclamptic Women

The objective of this study to evaluate heme oxygenase (COHb), leptin and coenzyme Q10 (CoQ10) in pre-eclamptic women. Also Zinc, copper, Iron, total iron binding capacity, Ferritin and uric acid were assessed. 120 female subjects were included in this study. They were divided into, 60 female with normal pregnancy attending the outpatient clinic, 60 pre-eclamptic patients were recruited from obstetrics and gynaecology department El-kasr El-Aini hospital. The results showed that in pre-eclampatic group, leptin level was significantly increased while COHb and CoQ10 was significantly decreased. It is concluded that hemeoxygenase, leptin and coenzyme CoQ10 can be considered as new markers for prediction of pre-eclampsia.     

Clinical and Biochemical Effects of Environmental Tobacco Smoking On Pregnancy Outcome

The effects of environmental tobacco smoke (ETS) are less studied especially on neonates. This study evaluates the clinical and biochemical effects in neonates exposed to ETS during pregnancy. Two hundred pregnant women asked to complete the questioners about their ETS. Ninety from them were enrolled in biochemical assays as two groups according to ETS. The cotinine level determined in saliva and serum of mothers to confirm their tobacco exposure. The routine tracheal suction from the fetus was used to determine the level of neuron specific enolase (NSE), soluble E-cadherin, sApo-1/Fas, nitric oxide (NO) and cotinine. In clinical assessment, the percent of full term babies in non-exposed group (72 %) are higher compared to exposed group (67 %). Apgar score at the first min, admission to intensive care unit (ICU) and morbidity during the first month shows statistical significance increase in exposed compared to non-exposed group (p = 0.03, 0.05, 0.01, respectively). The new born weight in exposed group significantly decreased compared to non-exposed group (2,850 g ± 3.74 vs 2,967.67 g ± 3.34; p = 0.02). In biochemical assessment, NSE and sE-cadherin significantly increased, while NO significantly decreased (p = 0.000) in exposed compared to non-exposed group. There is a positive correlation between level of cotinine and both NSE, sE-cadherin (r = 0.7, 0.9; p = 0.000, 0.006, respectively). To our knowledge, this is the first study link between prenatal tobacco exposure (PTE) and biochemical parameters measured in tracheal suction. PTE will lead to decrease in birth weight most probably by decreasing NO, sFas, and increasing sE-cadherin. While, increased morbidity of neonates in the exposed group could be attributed to cessation of breast feeding and its complication and increased NSE in the studied markers.     

3,3′-Diindolylmethane Encapsulated Chitosan Nanoparticles Accelerates Inflammatory Markers,ER/PR,Glycoprotein and Mast Cells Population During Chemical Carcinogen Induced Mammary Cancer in Rats

The present study aimed to investigate the effect of 3,3′-diindolylmethane (DIM) on inflammatory markers, estrogen receptors (ER), progesterone receptors (PR), level of glycoprotein and the mast cell population in 7,12-dimethylbenz (a) anthracene (DMBA) 25 mg/kg b.wt. induced rat mammary carcinogenesis. After 8 weeks of tumor formation, rats had access to an oral administrated with DIM 10 mg/kg b.wt. and DIM@CS-NP 0.5 mg/kg body weight respectively for 8 weeks. The oral administration of DIM@CS-NP 0.5 mg/kg b.wt. suppressed the Cox-2, NF-κB and TNF-α protein expression on DMBA induced rats compared to DIM 10 mg/kg b.wt. The ER/PR levels were increased on DMBA induced rats, treated with DIM@CS-NP 0.5 mg/kg b.wt. reduced ER/PR level as well as glycoprotein and mast cell population than DIM 10 mg/kg b.wt. The result shows that, DIM@CS-NP 0.5 mg/kg b.wt. has the potentially inhibit abnormal levels of inflammatory markers, ER, PR, levels of glycoprotein and mast cell population compared to DIM 10 mg/kg b.wt.     

Kinetic analysis of LDL oxidation in IHD and IHD risk subjects in Indian population

High plasma concentration of low-density lipoprotein (LDL) is associated with increased risk of atherosclerosis. Modified forms of LDL, especially oxidized LDL play a major role in its pathogenesis. This article gives detailed insight into the kinetics ofin vitro LDL oxidation by copper at different concentrations in normal and high-risk group subjects. Basal level of oxidatively modified LDL was significantly higher in ischaemic heart disease (IHD) and IHD hyperlipidemic subjects compared to normolipidemic and, hyperlipidemic control subjects, respectively. Derivatization of amino groups of apo-lipoprotein as monitored by estimating free amino groups concentration, was significantly higher in high-risk group and established IHD cases. Kinetics of oxidation was studied with two different concentrations of CuSO₄ (2.5 mM and 7.5 mM). thiobarbituric acid reactive substances (TBARS) level increases with time, and up to 95% oxidation was observed in 8 hr. About 60–65% less free amino groups were observed in native-LDL isolated from IHD patients compared to normal subjects. Study also showed an increase in two oxidative products studied, 20α-OH-cholesterol and 4-cholesten-3-one with oxidation time accompanied by corresponding decrease in LDL cholesterol. Increase in oxidative species was more evident in high-risk group and IHD patient. Basal level of oxidatively modified LDL measured in terms of TBARS was significantly higher in present study, strongly support that the extent of LDL oxidation monitored as TBARS and FAG level in circulating-LDL could be used as risk marker for high risk group.     

Serum Ischemia-Modified Albumin in Preterm Babies with Respiratory Distress Syndrome

Infants with respiratory distress syndrome (RDS) may suffer from severe hypoxia, asphyxia. In this study, we aimed to evaluate serum ischemia-modified albumin (IMA) level as a diagnostic marker for hypoxia in preterm infants with RDS. Thirty-seven premature newborns with RDS were allocated as the study group and 42 healthy preterm neonates were selected as the control group. IMA was measured as absorbance unit (ABSU) in human serum with colorimetric assay method which is based on reduction in albumin cobalt binding. IMA levels were significantly higher in neonates with RDS as compared to the control group (P < 0.001). Cut-off value of IMA (ABSU) was 0.72, the sensitivity level was 91.9 %, the specificity was 78.6 %, positive predictive value was 79.1 % and negative predictive value was 91.7 % at RDS. Area under curve values was 0.93 (P < 0.001; 95 % CI, 0.88–0.98) in the receiver operating characteristic curve. We concluded that elevated blood IMA levels might be accepted as a useful marker for hypoxia in newborn with RDS.