الفهرس 
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Abstract
Unconjugated bilirubin is produced by the catabolism of heme
in the reticuloendothelial system.
Jaundice, or yellowish discoloration of the skin, can occur due
to an increased amount of bilirubin pigment in the blood.
Neonatal jaundice is a common condition among newborns
throughout the world. More than half of term and preterm neonates
developed neonatal jaundice in their first week of life.
More than 60% of neonates develop jaundice during the first
week of life. Mostly, in these neonates, the level of serum bilirubin
lies within the physiologic range. Between 6% and 15% of neonates
develop hyperbilirubinaemia serum total bilirubin (STB) levels that
have a high likelihood of requiring intervention to prevent bilirubin
toxicity).
Neonates with severe hyperbilirubinaemia was in danger
because of possible accumulation of bilirubin in tissues, particularly in
the brain causing bilirubin induced encephalopathy and its chronic
sequelae such as cerebral palsy, sensorineural hearing loss, intellectual
difficulties or gross developmental delays.
Several lines of evidence suggest the importance of intestinal
metabolism of unconjugated bilirubin (UCB) in the pathogenesis of
neonatal jaundice.
Moreover, it has been recently postulated that increased
enterohepatic circulation (EHC) of bilirubin that may occur with ileal
inflammation, resection or bypass results in biliary hypersecretion of
bilirubin with enhanced black pigment gallstone formation.
Enterohepatic circulation may be exaggerated in the neonatal
period, in part because the newborn intestinal tract is not yet colonized
with bacteria that convert unconjugated bilirubin (UCB) to
urobilinogens and because intestinal beta glucuronidase activity is
high.
Zinc is one of the essential elements in neonatal growth,
protein synthesis and regulation of inhibitory and stimulatory synapses
of the brain. Zinc lower the bilirubin levels by inhibition of the normal
enterohepatic circulation of unconjugated bilirubin (UCB).
Oral zinc salts, which flocculate at physiological pH, reduce the
serum total bilirubin, presumably by precipitating unconjugated
bilirubin from unsaturated micellar solution of bile salts and
consequently inhibit the enterohepatic circulation of bilirubin.
The aim of the study was to evaluate the effect of oral zinc
therapy on healthy term neonate developed jaundice during treatment
with phototherapy.
In our randomized clinical trial a total of 100 fullterm healthy
neonate ages 2-7 days with uncomplicated physiological jaundice
whom required phototherapy were enrolled in the study. Neonates
with Rhesus, blood group isoimmunisation, with major gross
congenital anomaly, sepsis and Neonates whom required treatment
for jaundice within 24 hours of birth were excluded from the study.
Parental consent was obtained before the study and the neonates
included in the study were randomly assigned to one of two groups.:
Group(1): to whom oral zinc, in a dose of 5 mg twice daily from 2-5
days in combination with phototherapy, the drug was administered
into the mouth of the infant by the plastic measure. group (2): was
received phototherapy without oral zinc. The total serum bilirubin
level was measured at the beginning, 12 hours, 24 hours for both
groups. These cases were obtained from NICU Department, Faculty
of Medicine, Menoufia University Hospital . The cases were admitted
during the period between January 2016 and January 2017.
Our results showed that:
There was no statistical significant difference between both
groups regarding method of delivery, gender, gestational age, age on
admission.
There was no statistical significant difference between both
groups regarding previous sibling with jaundice, previous sibling
needing phototherapy.
There was no statistical significant difference between both
groups regarding laboratory test, neonatal blood group and maternal
blood group.
There was no statistical significant difference between both
groups regarding body weight on admission and show significant
difference and more body weight gain in group (1).
There was a statistical significant difference between both
groups regarding decrease total bilirubin level at 12h.24h in group (1)
compared to group(2) and no significant difference regarding total
bilirubin level on admission.
There was statistical significant difference regarding less
duration of phototherapy in group (1) compared to group (2.
There was no statistical significant difference between both
groups regarding occurrence of vomiting, rash, diarrhea as a side
effect during study.
We concluded that administration of oral zinc decreases serum
UCB levels and decrease the duration of phototherapy in neonatal
jaundice.