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Background and Objective: Jaundice is a common problem among neonate undiagnosed case finally lead to kern-icterus, with significant increasing rate of subsequent morbidity. This study was done to determine the etiology of of severe indirect hyperbilirubnemia in term neonates. Materials and Methods: This cross sectional descriptive study was performed in Taleghany hospital of Gorgan on neonates admitted due to severe hyperbilirubinemia from Sep 2004-Sep 2005. Severe hyperbilirubinemia was considered as bilirubin≥18 mg/dl in term neonates weighing more than 2500g. Bilirubin (total, direct), blood culture, retic count, coombs test, level of glucose 6 phosphate dehydrogenase enzyme, complete blood cell count, mother's and neonate's blood group, urine culture and C-reactive protein tests were measured. Results: 766 term neonates (>2500g) were hospitalized due to hyperbilirubinemia. Severe hyperbilirubinemia was detected in 12% of cases (54 boys, 38 girls). The etiology of 41 cases were unknown, 25 cases were diagnosed as sepsis, 15 neonates were glucose 6 phosphate dehydrogenase enzyme deficient, 7 cases had UTI, 3 neonates had ABO incompatibility and one neonate was due to breast feeding. Conclusion: This study indicated that the most common etiology of severe hyperbilirubinemia in this region is unknown. Sepsis, glucose 6 phosphate dehydrogenase enzyme deficiency, UTI, ABO incompatibility and breast feeding were among other reasons for severe indirect hyperbilirubinemia.

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Background and Objective: Gilbert's syndrome is a relatively common genetic disorder, which is caused by defection in uridine diphosphate glucuronosyl transferase enzyme. The indirect bilirubin increases in this syndrome, although the function of the liver is normal. Gilbert's syndrome can be seen in 3 to 10% of different populations. According to the differences in ethnic groups in Golestan Province, no studies have been conducted on the prevalence of the syndrome in the province, so far.This study was conducted to determine the prevalence of suspected Gilbertʼs syndrome in Golestan province in north of Iran.
Methods: This descriptive-analytical study was performed on 1664 subjects with 18-45 years old referring to rural and urban health centers in Golestan province, North of Iran during 2014. Liver function tests were normal in subjects. Fasting blood samples were taken from each subject and total bilirubin was tested. People with a total bilirubin of more than 1.5 mg/dl were treated with a single oral dose of rifampin 600 mg. After taking rifampicin, the individuals with an indirect bilirubin level of more than 1.3 mg/dl were found suspected of Gilbert’s syndrome.
Results: The prevalence of suspected Gilbert's syndrome was 5.8%. Moreover, suspected Gilbert’s syndrome was more common in males than females (10% in males and 4.3% in females) (P<0.05). According to ethnicity, the prevalence of suspected Gilbert's syndrome was 5.4%, 5.4%, and 6.8% in Sistani, Fars and Turkmen subjects, respectively. This difference was not significant. The prevalence of suspected Gilbert's syndrome in three ethnicities was higher in males than females and it was statistically significant in Sistani and Fars ethnicities (P<0.05) but not significant in Turkmen ethnicity.
Conclusion: Suspected cases of Gilbert's syndrome were more common in men than women, and more prevalent in the Turkmen ethnic group.