الفهرس 
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Abstract
Jaundice is one of the most common and annoying problem that can occur in the newborn. Although most jaundiced infants recover without any serious problems, there is always a risk of billirubin encephalopathy during the period of hyperbilirubinemia.
The treatment options available for neonatal jaundice include phototherapy, exchange transfusion, and drugs like phenobarbitone, intravenous immunoglobulin, metalloporphyrin and fenofibrate.
Phototherapy is the first line of treatment of unconjugated hyperbilirubinemia to reduce the serum level of unconjugated bilirubin levels.
Phototherapy though safe, is not free of side effects. Neonates receiving phototherapy have increased insensible water loss redistribution of blood flow, watery diarrhoea, irritability, rise in temperature, retinal damage, bronze baby syndrome, gonadal toxicity, impaired maternal-infant interaction, hypocalcaemia, riboflavin deficiency, DNA strand breakage, chromosomal mutations damage, and in few studies even thrombocytopenia.
Hypocalcemia is one important side effect of the phototherapy.
The present study was conducted as a cross sectional study on 20 control neonates with indirect hyperbilirubinemia (11male &9 female) they don’t receive phototherapy. & 50 jaundiced neonates (26 males &24 females) received phototherapy for treatment of physiological neonatal indirect hyperbilirubinemia. These neonates include (33 fullterm >37wk &17 preterm) .Cases were selected from those admitted to NICU .
All cases were taken after written concent of their parents.
Selected newborns show the following criteria:-
Inclusion criteria:- Being not receiving intravenous fluids. Being ≥ 3 days old. Total bilirubin level of 14 to 18 mg/dL, and direct bilirubin level ≤ 2 mg/dL. Both sexes (male – female).
Exclusion criteria :Infants with ABO and RH incompatibility. Infants with glucose-6-phosphate dehydrogenase (G6PD) deficiency, direct hyper-bilirubinemia, septicemia. Diseases leading to hyperbilirubinemia (Crigler-Najjar syndrome, Gilbert syndrome, liver diseases, hypothyroidism& hyperthyroidism, Infants of diabetic mother.
All study neonates were subjected to thorough history taking (personal data as Name, sex, age and order of birth, Prenatal history as maternal DM or hypertension, PROM, maternal blood group and Rh, natal history as gestational age, type of delivery, birth weight, assessment of APGAR score at 1, 5 minutes and BALLARD score to assess gestational age and postnatal history: infection, respiratory difficulty &NICU).
Full clinical examination either general examination as weight, length, head circumference and apparent congenital anomalies or systemic examination especially Abdominal examination: to exclude organomegaly. Baseline investigation which done before phototherapy include Complete Blood Count, Serum Total & direct bilirubin level, Serum sodium and potassium, Serum calcium, Blood grouping & Rh for infant & mother and C-Reactive Protein to exclude sepsis. Follow up for clinical data and Laboratory investigation after 72 hours phototherapy.
Naked neonates were placed while covering eyes and genitalia at a distance of 45-50 cm from phototherapy unit and were managed with continuous phototherapy. The position of the baby was changed from time to time. We begin with double or triple phototherapy then use single phototherapy according serum bilirubin.