Lead toxicity as a result of herbal medication

Awareness about the toxic effects of non-essential metals is still lacking in developing countries. Lead is one among them, which ranks second in the Agency for Toxic Substances and Disease Registry’ s top 20 lists of toxic metals. Some of the herbal medicines prepared from certain roots and leaves are known to contain this toxic metal at alarming levels. We have a case of a person who suffered from the toxic effects of lead such as vomiting and colicky abdominal pain after consuming a herbal remedy for Jaundice treatment. This went unrecognized initially because of the presence of multiple problems like Malaria and Renal calculi. Lead poisoning as causative factor for anemia, vomiting and colic were confirmed only when blood lead concentration was estimated. A combination of chelation therapy and nutritional supplementation was found to be useful in reducing the body lead burden.     

梗阻性黄疸大鼠肝脏损害及血清毒性物质变化

目的：探讨梗阻性黄疸（梗黄）大鼠肝脏损害及其血清毒性物质的变化。方法：采用胆总管结扎方法建立梗阻性黄疸大鼠模型,将36只大鼠随机分为假手术（sham）组6只、梗阻性黄疸（CBDL）组30只（CBDL组又分为1周、2周、3周、4周、5周亚组,每组6只）。监测各组血液TNF-α、内毒素、肝功能变化。结果：CB—DL组均可见肝细胞坏死及增生,汇管区可见胆管扩张、胆汁淤积,肝组织改变随梗阻时间的延长而逐渐加重,血清内毒素及TNF-α含量与梗阻时间明显相关。结论：CBDL大鼠肝脏形态改变明显,血ALT、TBIL、内毒素、TNF-α含量明显升高,并与梗黄时间有关。     

Antioxidant status in neonatal jaundice before and after phototherapy

Phototherapy has been related to increased oxidative stress and lipid peroxidation. In the present study, thirty full term jaundiced neonates with appropriate weight were analyzed before and after completion of phototherapy for malondialdehyde (MDA), reduced glutathione (GSH), total thiols, vitamin C and superoxide dismutase (SOD) levels in hemolysate and albumin levels in plasma. These parameters were analyzed in cord blood samples of 20 healthy neonates as control. It was observed that levels of MDA were elevated significantly (p<0.001) in patients as compared to controls and that the levels increased significantly after phototherapy (p<0.001). Levels of SOD were also found to be increased significantly as compared to controls and the levels rose after phototherapy (p<0.001). On the other hand, the levels of non-enzymatic antioxidants such as GSH, total thiols and vitamin C were significantly low (p<0.001) as compared to controls and the levels decreased significantly after phototherapy (p<0.001). The plasma albumin levels also were found to be decreased significantly after phototherapy (p<0.01). Therefore, phototherapy increases oxidative stress and should be used with care.     

A study of prolonged jaundice screen in healthy term babies

Prolonged jaundice in most of the term babies is associated with breast milk but in some cases it can be a marker for a range of hepatobiliary, hematological, metabolic, endocrine, infectious and genetic disorders that are associated with significant mortality and morbidity if not diagnosed in time. A diagnosis of conjugated hyperbilirubinaemia warrants urgent investigation. Protocols for investigating prolonged jaundice screen vary in complexity and the yield from screen has not been assessed. In order to address these issues, we carried out a study on healthy term babies referred to our day unit with prolonged jaundice. Infants were examined by pediatrician and investigations done as per unit protocol. Prolonged jaundice screen was found to be helpful in excluding biliary atresia and to support the diagnosis of breast milk jaundice. Present study concluded that negative prolonged jaundice screen is reassuring in healthy term babies and further investigations are unwarranted unless otherwise specified.