الفهرس 
PhototherapyOnly 14 pages are availabe for public view
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Abstract
Jaundice is the yellowish discoloration of sclera and skin in a newborn caused by increased serum bilirubin level. It is the most common reason for infants NICU admission during neonatal period.
Phototherapy and exchange transfusion are the treatment of choice in such cases. Zinc salts have a potential to inhibit enterohepatic circulation of bilirubin probably by precipitating unconjugated bilirubin in the intestine.
The role of zinc in a wide range of cellular processes including cell proliferation, reproduction, immune function and defense against free radicals, has been well established. Zinc is considered the most abundant trace intracellular element.
Zinc plays an important role in genetic stability. Significant amounts of zinc are incorporated in the nuclei. It is clear that mechanistically, zinc has a significant impact on DNA as a component of chromatin structure, DNA replication and transcription and DNA repair. Zinc is a component of more than 3000 zinc-associated transcription factors, including DNA-binding proteins with zinc fingers, and more than 300 enzymes.
Zinc plays an important role in protecting cellular components from oxidation and damage to DNA.
The present study was aimed to determine relation between serum Zinc level, DNA damage in term neonates with hyperbilirubinemia and under phototherapy.
This study include 120 full term neonates during the first week of life with good general condition who visited Almaza neonatal hospital with high level of indirect hyperbilirubinemia indicating admission. They were hospitalized and underwent phototherapy based on guidelines of AAP (2004) for the treatment of neonatal hyperbilirubinemia during the period from April 2018 till October 2018.
They were divided into 2 groups:-
group ”1”: (60 jaundiced newborn) in the first week of life. Who were hospitalized and underwent phototherapy and with low serum zinc level.
Group”2”: (60 jaundiced newborn) in the first week of life who was hospitalized and underwent phototherapy and with normal serum zinc level.
The study revealed the following results serum zinc were significantly lower in low Zinc group. Before phototherapy serum Zinc was 104.4±7.7 in low zinc group and serum zinc was 126.6 ± 3.9 in normal zinc group. After phototherapy serum Zinc was 104.4±7.7 in low zinc group and serum zinc was 126.6 ± 3.9 in normal zinc group there was no significant difference as regard zinc level before and after phototherapy in both groups.
DNA damage percentage in the tail was significantly higher in low Zinc group as DNA damage percentage in the tail was 4.9 ± 0.4 in low zinc group and 4.0± 0.3 in normal zinc group
No significant difference between the studied groups regarding duration of neonatal phototherapy (days).
There were significant negative correlations between DNA damage % in the tail and Zinc level on admission and discharge. No significant correlations between DNA damage percentage in the tail and Zinc and other maternal& neonatal variables.
No significant correlations between admissions Zinc, discharge Zinc and other maternal & neonatal variables.
Conclusions
This study concluded that:
- DNA damage % in the tail after phototherapy was significantly higher in low Zinc group.
- There was no significant difference as regards zinc level before and after phototherapy in both groups.
- DNA damage % in tail was highly encountered after phototherapy combined with low zinc level meanwhile phototherapy has no effect on serum zinc level.
Recommendations
Phototherapy use should be restricted to those with significant hyperbilirubinemia. The long-term effects of phototherapy on DNA should be assessed in future studies.
Future studies are important to determine the extent to which zinc deficiency enhances susceptibility to DNA-damaging agents or not.
We suggest that future studies on inhibiting bilirubin enterohepatic circulation in hyperbilirubinemia neonates to include therapeutic use of low absorbable (insoluble) zinc salts.
It is suggested that further studies to be conducted on the effect of phototherapy on the levels of magnesium, and zinc and copper on premature and pre-term infants.
We recommend that neonates should be evaluated for serum zinc level before phototherapy.