Role of bilirubin as antioxidant in neonatal jaundice and effect of ethanolic extract of sweet lime peel on experimentally induced jaundice in rat.

Bilirubin above a threshold level is toxic to human system and is excreted in urinary and through gastrointestinal tract. The role of bilirubin as antioxidant is debatable. This paper aims at elucidating the role of bilirubin as an antioxidant in neonatal jaundice patients. It is observed that bilirubin up to 6 mg/dl in blood acts as an antioxidant and above 12.5 mg/dl is strongly prooxidant. Phototherapy is the accepted therapeutic management of neonatal jaundice and has been shown to enhance the oxidative stress. Approaches have been taken to formulate a herbal medication which will reduce bilirubin level in the neonates without inducing additional damages. The ethanolic extract of sweet lime peel, administered orally at a dose of 72 microg is found to reduce the oxidative stress in erythrocytes of phenylhydrazine-induced jaundiced rats treated with phototherapy.

effect of clofibrate on neonatal jaundice

Hyperbilirubinemia is a common problem in newborn infants and may progress to kernicterus if not treated. The objective of this study was to determine the therapeutic effect of clofibrate in full-term healthy neonates with non-hemolytic hyperbilirubinemia. A randomized clinical trial was performed on two groups of healthy full-term neonates with jaundice. Clofibrate group, [n = 50], received a single dose of oral clofibrate [100 mg/kg], plus phototherapy, while the control group [n = 50], received only phototherapy. The mean plasma total bilirubin levels at 12, 24, and 48 hours after treatment were significantly lower in the clofibrate treated group, as compared with the control group [p = 0.001]. At 48 hours of treatment, 48% of patients in the clofibrate group, had bilirubin levels < 12 mg/dl in comparison with 16% of control group [p = 0.001]. Treatment with elfibrate also resulted in a shorter duration of hospital stay as compared to control group [P = 0.001]. A single oral dose of clofbrate [100 mg/kg] along with photo therapy is more effective than photo therapy alone in treatment of non-haemoly tic hypoerbilirution emia in full-term healthy newborn in fants

Effect of clofibrate in jaundiced term newborns.

OBJECTIVE: Clofibrate is a glucuronosyl transferase inducer that has been proposed to increase the elimination of bilirubin in neonates with hyperbilirubinemia. The aim of this study was to characterize the therapeutic effect of clofibrate in neonates born at full term and present with non-hemolytic jaundice. METHODS: A clinical controlled study was performed in two groups of healthy full term neonates. Thirty neonates were treated with a single oral dose of clofibrate (100 mg/kg) plus phototherapy (clofibrate-treated group) while another 30 neonates (control group) received only phototherapy. RESULT: The mean plasma total bilirubin levels of 12th, 24th and 48th hours were significantly lower in the clofibrate-treated group as compared with the control group (P < 0.0001, P < 0.0001 and P = 0.004, respectively). Treatment with clofibrate also resulted in a shorter duration of jaundice and a decreased use of phototherapy (P < 0.0001). No side effects were observed. CONCLUSION: Although other pharmacological agents such as metalloporphyrins and Sn-mesoporphyrin also seem to be effective in decreasing bilirubin production, these products are not available for routine use and cannot be used because the safety of these drugs has to be confirmed prior to their widespread use. Therefore, clofibrate is now the only available pharmacological treatment of neonatal jaundice.

Phototherapy for neonatal jaundice

About 60% of fullterm and 80% preterm of infants develop neonatal jaundice which is either physiological or pathological in nature. One of modality of treatment is phototherapy which was discovered by the observation of one of the nurses when she noticed the decline in severity of jaundice in newborn infants who exposed to sun light. There are different colors of light that used in phototherapy, the best one is blue, then yellow then white, the action of phototherapy is made absorption of light by skin and by two mechanism photoisomerization and conversion into non toxic substance called lumirubin. The photothearpy used light with wave length 420-470 nm, so there is common mistake in population when they use the ordinary light at home as photothearpy this may expose the infant to danger of light and to delay in management of jaundice

Hiperbilirrubinemia do recém-nascido: tratamento / Neonatal hyperbilirrubinemia: treatment

O autor apresenta uma atualização da conduta no tratamento de icterícia neonatal, fazendo considerações acerca do histórico e aprofundando-se nos métodos de fototerapia, exsangilineotransfusão e outros mais recentes. Apresenta sua experiência pessoal através de normas para o tratamento e tece considerações acerca da prevenção da encefalopatia bilirrubínica.

The author presents an up-date about the treatment of neonatal jaundice, from the historical aspects to the actual "state of the art", considering phototherapy, exchange-transfusion and some modern approaches to the problem. His personal experience is focused through guidelines for the treatment and the prevention of bilirrubin encephalopathy.

Fenobarbital, fototerapia e incompatibilidade ABO / Phenobarbital, phototherapy and incompatibility ABO

O presente trabalho tem como objetivo avaliar a eficácia do fenobarbital no controle da icterícia de crianças com possibilidade de incompatibilidade sangüínea materno fetal pelo sistema ABO, (ISMF ABO) como terapêutica coadjuvante à fototerapia. Participaram do estudo 93 crianças de termo, tipo A ou B, com mäe tipo O e que ficaram ictéricas, necessitando de fototerapia. Alternadamente, por ordem de entrada no estudo, as crianças receberam fenobarbital ou näo. A droga foi administrada na dosagem de 3mg/Kg/dia, divididos em duas tomadas diárias. Näo foram demonstradas diferenças estatisticamente significativas entre os dois grupos quanto ao número de dosagens de bilirrubina por criança, tempo de fototerapia, tempo de internaçäo, número de exsangüíneo-transfusöes realizadas, o valor máximo de bilirrubina detectado e ritmo de evoluçäo de bilirrubina plasmática em períodos de 24 horas após o início do tratamento. Conclui-se que näo se encontra suporte para o uso de rotina do fenobarbital, na terapêutica da hiperbilirrubinemia em crianças com possibilidade de ISMF-ABO

Tratamiemto de los icteros del recién nacido con un inductor enzimático, el metilfenobarbital / Management of icterus in neonates with an enzymatic inductor, methylphenobarbital

Se realiza un estudio doble ciego. se utilizó un inductor enzimático, el metilfenobarbital y un placebo para evaluar los efectos del primero sobre los icteros del recién nacido. Los pacientes se dividieron en 2 grupos: uno que comprendia a niños con peso entre 2 500 y 3 499 g y otro, con peso entre 3 500 y 4 000 g. Para el primer grupo se utilizó una dosis de 30 mg del producto y para el segundo 40 mg. Las cifras de bilirrubina disminuyeron significativamente en el primer grupo, no así en el segundo. Se especuló que el no resultado significativo en el segundo grupo pudo haber sido por una dosis insuficiente del metilfenobarbital