الفهرس 
AcknowledgementOnly 14 pages are availabe for public view
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Abstract
Neonatal jaundice is one of the most common clinical problems seen during the first week of life, affecting about 60% of healthy term babies and 80% of preterm babies. Prematurity, physiological jaundice, ABO incompatibility and RH incompatibility are the most common causes of neonatal jaundice. Bilirubin has a negative effect on the central nervous system, especially in newborns and can cause cerebral dysfunction, which can lead to permanent neurological damage or death. Phototherapy is useful in the treatment and prevention of neonatal hyperbilirubinemia. Phototherapy can also cause skin rashes, diarrhea, high body temperature, chills, trauma to the eye, bronze baby and DNA damage. Phototherapy is less effective in treating jaundice caused by cholestasis. Although the underlying mechanism for conventional phototherapy-induced hypocalcemia is not fully understood. Several recent studies have shown that phototherapy can effectively reduce neonatal hyperbilirubinemia. However, this treatment modality may itself result in the development of hypocalcemia and create serious complications including convulsion and related conditions. The current study aimed to determine the effect of phototherapy on serum calcium level in neonatal jaundice after 48 hours of exposure to phototherapy We enrolled 40 neonates admitted to Neonatal Intensive Care Unit in Assiut University Children Hospital. Those were stable term neonates with jaundice who require management with phototherapy and are fed with full strength formula or breast fed. We excluded jaundiced neonates with hypocalcemia, needing exchange transfusion, hypothyroidism, of diabetic mother, jaundiced infants with other illness as severe RDS, perinatal asphyxia, severe sepsis or hemolytic disease of newborn and jaundiced infants with congenital abnormalities. Their mean age was 61.03 ± 39.78 hours; we found there was a male predominance among admitted neonates with a prevalence of 60%. We found that most admitted patients (80%) were delivered via Cesarean section (CS). We also found that their gestational ages range between 37 and 41 weeks with a mean of 37.8 ± 0.82 weeks. The effectiveness of phototherapy in the management of neonatal jaundice is well known. In the present study total bilirubin levels have significantly decreased over 48 h of admission from 13.46 ± 4.77 to 9.89 ± 3.62 mg/dl (p<0.001). Similarly, there was a significant decrease in serum indirect bilirubin levels from 12.52 ± 4.17 to 9.09 ± 3.47 over 48 hours of admission (P<0.001). For serum Ca levels, we found the total serum Ca levels significantly decreased over admission period from 9.72 ± 0.58 to 9.41 ± 0.47 mg/dl (p<0.001), as well as ionised serum Ca levels significantly decreased over admission period from 1.19 ± 0.11 to 1.07 ± 0.12 mg/dl (P<0.001) In this study we assessed the correlation between total serum calcium and different variables but none of them had significant correlation with calcium level. Icteric term newborns on phototherapy should be closely monitored for serum calcium level and for signs of hypocalcemia. To held further studies with higher number of patients in multi-centers.