الفهرس 
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Abstract
Perinatal hypoxic-ischemic encephalopathy (HIE) is an important cause of brain injury in the newborn and can result in devastating consequences. The principle mechanisms underlying neurological damage in HIE resulting from hypoxemia and/or ischemia is deprivation of glucose and oxygen supply which cause energy failure.
DKK1 is a secreted protein involved in embryonic development and known as a potent inhibitor of the Wnt signaling pathway, which plays a critical role in cell patterning, proliferation, and fate determination during embryogenesis.
We aimed to determine the serum level of Dkk-1 in peripheral blood of neonates with Hypoxic Ischemic Encephalopathy (HIE) and its role as prognostic marker.
This case–control study was conducted at NICU Menoufia University Hospitals from November 2019 to April 2020.The Institute Ethics Committee of Faculty of Medicine, Menoufia University, approved the protocol of the study and written informed consent for inclusion will be obtained from the parents of each neonate.
Patient Groups divided into 2 groups: group 1 (Patient group): 15 asphyxiated neonates based on Leven stage, infants who fulfilled three or more of the clinical and biochemical criteria. group 2 (Control group): 15 healthy neonates (no signs of fetal distress, pH more than 7.2 and Apgar scores at 1 and 5 min more than 7).
Asphyxia was defined according to an Apgar score less than 3 at the 5th min, pH less than 7.0, or BE less than -12 in cord blood or venous blood taken from newborns within 60 min of birth, or the need for positive pressure ventilation (more than 3 min). Full history taking stressing on Prenatal, natal, postnatal, past family history. Maternal history and delivery history lay stress on, history suggestive of perinatal asphyxia, APGAR score of newborns was evaluated at 1, 5 and 10 min. Complete physical examination including: General and Systemic Examination: Chest, cardiac, Neurological examination (within the first 24 h after birth and for 7 d to classify, HIE according to the criteria of Sarnat and Sarnat).