Effect of phototherapy on behaviour of jaundiced neonates.

Thirty full term newborns appropriate for gestational age with icterus neonatorum were divided into two groups of 15 each. Group I (study group) newborns had serum bilirubin in the range of 12.1 to 15.0 mg/dl. Group II (control group) included neonates with serum bilirubin in the range of 8 to 12.0 mg/dl. Only the study group was given phototherapy. The comparative study of neonatal behaviour in both these groups was done using BNBAS (Brazelton's neonatal behaviour assessment scale), 24 to 48 hrs, both after initiation and cessation of phototherapy in the study group and at corresponding postnatal ages in control group. Many newborns in the study group were on top feeds and had more crying episodes. The study group scores were significantly poorer in orientation response to visual inanimate, visual animate and visual and auditory animates in the cluster interactive processes. Followup assessment showed similar results in the same items. Other items in the same cluster and all items in the other clusters showed no significant difference in the two groups in the initial as well as followup assessments. As maternal separation during phototherapy also possibly affects neonatal behaviour, the effect of this factor can be minimized by keeping the phototherapy unit with the mother of the jaundiced baby. The mother should be encouraged to breast feed her baby regularly and have more mother-baby interaction.

Gall stones in children (non hemolytic) (case reports).

Gall bladder disease is considered rare in child hood and hence is frequently over looked in the differential diagnosis as the classical clinical picture and laboratory confirmation in adults does not apply to children. Attention must be paid to the possibility of gall stones in the evaluation of children with non specific abdominal symptoms. Ultrasonography has become a very accurate tool for the evaluation of these children. Once the diagnosis of cholelithiasis is established, elective cholecystectomy is the treatment of choice.

Neonatal behavior in full-term small for date.

Fifty newborns, 25 full term SFDs (small for date) and 25 full term AGAs (appropriate for gestational age) were taken up for comparative study of their behavior using BNBAS (Brazelton's neonatal behavior assessment scale). The study revealed that full term SFDs performed significantly poorly on all items under cluster interactive processes compared to their counterparts full term AGAs on day 1. They also showed similar poor performance in clusters of motor processes and organizational processes (State control). Follow up assessment on day 30 revealed significantly better performance in these clusters. However, the performance of SFD babies in all items of cluster of organizational processes (physiological response) was comparable to that of AGA babies in the initial as well as follow up assessments.