الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Neonatal jaundice is a common problem worldwide. Jaundice is observed during the first week of life in approximately 60% of term infants and 80% of preterm infants and it is effectively treated with phototherapy. Phototherapy is the single most common intervention used for treatment of neonatal jaundice. Effective phototherapy device needs to deliver light with a light emission spectrum within the bilirubin absorption spectrum (400-520nm) and a peak emission of 450±20nm. This study was conducted on one hundred full term neonates with indirect hyperbilirubinenia, recruided from the neonatal intensive care unite (NICU), Aga Hospital, Eldakahlia government, during the period from September 2012 to June 2013. Ethical approval for the study was obtained from the Aga hospital together with an approval from the Research Ethics Committe of the Faculty Medicine, Menofiya University. Our aim was to study the effect of using low cost reflecting curtains on the management of neonatal indirect hyperbilirubinemia by phototherapy as regards: • Efficacy. • Duration of phototherapy. • Complications The recruided 100 jaundiced term neonates were divided into two groups; 1) the study group which included 50 neonates receiving single phototherapy in incubators covered with aluminum foil as a reflecting surface; 2) the control group which included 50 neonates receiving single phototherapy in incubators not covered with aluminum foil. Summary and Conclusion 96 Inclusion criteria: 1) Full term newborn. 2) Average birth weight. 3) Indirect hyperbilirubinemia indicated for phototherapy according to the American Academy of Pediatrics curves. Exclusion criteria: 1) Sepsis. 2) Respiratory distress. 3) Bilirubin levels close to exchange transfusion or below the American Academy of Pediatrics curves. All newborns enrolled in the study were subjected to the following: • Full history taking. • Thorough clinical examination. • The following investigations: 1- Complete blood count. 2- Reticulocytic count. 3- Blood group and Rh of the baby. 4- Blood group and Rh of the mother. 5- Coombs test. 6- Serum bilirubin (total - direct) at the start of phototherapy. 7- Transcutaneous bilirubin (TCB) measurement using transcutaneous bilirubinometer at the start of phototherapy, every six hours in first day, then every twelve hours till discharge. 8- Another TCB measurement done twenty four hours after being off phototherapy. Summary and Conclusion 97 9- Irradiance was measured in the units of the study and control groups at the center with phototherapy radiometer. Data were collected, coded and processed by SPSS version 13 and the results were put in tables and graphs. Our results showed that: 1. There was no significantly statistical difference between the 2 groups as regards different demographic data as age, sex and gestitional age. 2. No significantly statistical difference was found between the 2 groups as regards addmision weight, length, head circumference and body surface area (p>0.05). 3. Their was no significant difference between the two group as regards the etiological diagnoses with most of cases in both groups were due to ABO incompatibility (54% in the study group and 48% in control group). 4. There was no significant statistical difference as regards, total & direct serum bilirubin, hemoglobin, WBCs, platelets, reticulocytic count and coombs test between the studied groups (p>0.05). 5. No significant statistical difference was found between TSB measurements (18 ± 1.9 mg/dl) and TCB measurements (17.8 ± 2 mg/dl) in all cases included in our study. 6. The decrease of TCB by time was significantly more in the study group than the control group. 7. More neonates became off phototherapy within the study group than the control group with a significantly lower numbers Summary and Conclusion 98 continuing on phototherapy since the end of the 24 h duration of phototherapy. 8. The rate of bilirubin decline during phototherapy was significantly higher in the study group (0.25 ± 0.1 mg/dl/hr) than the control group (0.15 ± 0.06 mg/dl/hr) with p<0.001. 9. The duration of phototherapy was significantly lower in the study group (42.12 ± 16.9 hour) than the control group (60.96 ± 15.6 hour) with p<0.001. 10. The cost of therapy in LE/case was significantly lower in the study group (337 ± 135.5 LE/case) than the control group (337 ± 135.5 LE/case) with p<0.001. In conclusion, using low cost reflecting curtains, made from aluminum foil, around the phototherapy unit reduce the duration of single phototherapy and consequently the cost and infant–mother disconnection. This encourage its use not only in developing, but also in developed countries.