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NepMed is a Nepal MEDLINE(Medical Literature Analysis and Retrieval System Online) by Nepal Health Research Council(NHRC). It includes bibliographic information for articles from academic biomedical journals covering medicine, dentistry, nursing, pharmacy, dentistry veterinary medicine, and allied health sciences.

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Publication

Prevalence of Double Nutrition Burden Among Adolescent Girls of Assam, Northeast India

(Nepal Paediatric Society (JNPS), 2014) Sharma, Jyotismita; Mondal, Dr Nitish

Abstract: Introduction: Prevalence of the malnutrition is a very common phenomenon in the developing countries leads to high mortality, morbidity and long-lasting physiologic effects. The present study was conducted among adolescent populations residing in rural regions with an aim to determine the prevalence of double nutritional burden (e.g., thinness and overweight) in Karbi-Anglong district of Assam, Northeast India. Materials and Methods: The present cross-sectional study was conducted among 1228 heterogeneous groups of adolescent girls aged 10- 16 years residing in rural areas of Diphu, Karbi-Anglong, Assam is using simple random sampling method. The anthropometric measurement of height and weight were recorded using the standard procedure. The Body mass index (BMI=weight/height2, kg/m2) was calculated. Recently proposed, the BMI based age sex specific international references and cut-offs of Cole et al. was used to assess the prevalence of thinness and overweight. Results: The overall prevalence of overweight and thinness was found to be 8.13% and 19.14% respectively. The age specific prevalence of overweight and thinness was found to be higher among 11 years (12.00%) and 16 years (31.13%) respectively. Conclusion: The present study shows the magnitude of thinness is a still greater nutritional problem than overweight in rural adolescent girls in India. The results of the present study will be useful for the policy makers in their endeavour to formulate various developmental strategies and health care programmes of the population concern to combat the double burden of nutrition.

Publication

Percutaneous Endoscopic Gastrostomy in Children: Experience from Single Center of a Developing Country

(Nepal Paediatric Society (JNPS), 2014) Kehar, Mohit; Wadhwa, Nishant; Upadhyay, Satyam

Abstract: Introduction: Nutrition is of paramount importance for adequate growth and development of a child. Various routes of providing enteral nutrition to a paediatric patient are by nasogastric, nasojejeunal and gastrostomy which can be placed surgically or endoscopically. The objectives of this study were to review cases with percutaneous endoscopic gastrostomy (PEG) procedure and patient characteristics, indications, complications and outcome of PEG tube insertion in children at our center. Materials and Methods: This was a prospective study carried out in Sir Ganga Ram Hospital in New Delhi, India for a period of two years from August 2010 to August 2012. It included patients in whom PEG tube were placed during the study period and have had at least one year of post procedure follow up. Demograhic details, duration of procedure, complications, initial weight and height and then at 3 month, 6 months and 12 months of PEG tube placement were also recorded. Data between groups was compared using ANOVA and within groups across follow-ups was done using paired t-test. Results: Fourty six PEG insertions were performed during the study period, 26 twenty six conversions to BRT or Mickey button and ten PEG removals. The main indications for PEG insertion were Cerebral palsy with feeding difficulty (47.8 %). Erythema at the PEG insertion site was the most common complication (21%). There was significant improvement in the weight and height in all age group of patients at 3, 6 and 12 months post procedure with a p value <0.5. The average weight gain after 3, 6 and 12 months was 1.3 kg, 2.8 kg and 4.2 kg and the average height gain after 3, 6 and 12 months was 1.6 cm, 2.5 cm and 4.13 cm respectively. Conclusions: PEG is effective means for optimizing the nutritional goals of patients who are nutritionally debilitated with minimal complications.

Publication

Nutritional Status of Under-Five Children in Western Nepal

(Nepal Paediatric Society (JNPS), 2014) Shrestha, Bandana

Abstract: Introduction: Undernutrition is a major health problem in developing countries which may have adverse effects on growth and development of an individual. The objectives of this study were to assess the prevalence and grades of malnutrition in children below 60 months of age, attending outpatient department at Gandaki Medical College teaching hospital. Materials and Methods: A prospective study was conducted among 556 children below 60 months of age from August to December 2013. Weight and length/height were measured using standard technique and were plotted on WHO centiles curves and severity determined based on WHO classification. The prevalence of underweight, stunting and wasting were determined by anthropometry. Results: Based on WHO classification, out of 556 children, 20.2% were underweight, 34% were stunted and 15.1% were wasted respectively. Of them, severe underweight were 4.7%, severe stunted were 14.1% and severe wasted were 7.2% respectively. Conclusion: A high prevalence of undernutrition exists in under- five children attending a tertiary hospital in a western region of Nepal.

Publication

Neonatal Near Miss Cases of Different Health Facilities

(Nepal Paediatric Society (JNPS), 2014) Manandhar, Sunil Raja; Manandhar, Dharma S; Adhikari, Dhruba; Shrestha, Jyoti Raj; Rai, Chandra; Rana, Hari; Paudel, Mohan

Abstract: Introduction: The near miss concept and the criterion-based clinical audit are proposed as useful approaches for obtaining such information in newborn health care. There is currently no Standard definition and criteria for neonatal near miss especially for the community level intervention. Thus, lifesaving interventions could be an entry point to initiate the development of the neonatal near-miss definition. Mother and Infants Research Activities and Health Right International (HRI) developed a new tool for assessing neonatal near miss cases based on the Community based newborn care package programme. This is a part of operational research programme on strengthening the health facilities of Electoral constituency No; 2 of Arghakhanchi district of Nepal. The objective of this study was to identify and analyze neonatal near miss cases at different health facilities of Electoral constituency No; 2 of Arghakhanchi district, Nepal. Materials and Methods: One day of training on identifying neonatal near miss cases was given by an expert at Arghakhanchi district hospital to the health facilities staff in two groups. Health facility staffs were trained on identifying neonatal near miss cases and completing the modified neonatal near miss case forms. Neonatal near miss cases were documented for nine months period. Results: There were a total of 28 cases of neonatal near miss reported from different health facilities. Among them, 90% babies were delivered at health facility and 72% babies were of normal birth weight. Low birth weight incidence is 21% among near miss cases. Neonatal near miss contributed possible severe bacterial infection/ severe infection 47%, birth asphyxia in 43% cases and very low birth weight 7%. Conclusions: Birth asphyxia and PSBI were the two most common causes of neonatal near miss in the health facilities of Arghakhanchi district. There is a need to improve the quality of neonatal care in health facilities to properly manage these neonatal near miss cases which were referred to higher centre.

Publication

Comparative Study of Diagnostic Markers in Neonatal Sepsis

(Nepal Paediatric Society (JNPS), 2014) Sonawane, Vijay Baburao; Gaikwad, Sonali U; Kadam, Nitin N; Gavhane, Jitendra

Abstract: Introduction: Neonatal septicemia is one of the commonest causes of neonatal mortality and morbidity. The objectives of this study were intended for qualitative and quantitative analysis of diagnostic markers in neonatal sepsis. Materials and Methods: This is a hospital based study conducted over three years (Aug 2005 – Aug 2008). Hundred and sixty neonates, delivered in the hospital, having risk factors for neonatal sepsis, along with those coming to hospital with signs and symptoms of sepsis up to 28 days of life (as study group ) along with normal newborns admitted to the postnatal ward without high risk factors (control group) were enrolled for this study. Comparative study on various diagnostics markers such blood culture, CBC,CRP, IT ratio and Micro-ESR was carried out to know their sensitivity and specificity. Results: E.Coli was the most common organism responsible for sepsis. CRP was reported to be highly sensitive (84.21%), and CBC was highly specific (75.00%), IT ratio has sensitivity of 62.5% and specificity of 56.25% while Micro-ESR has shown sensitivity of 50.0% and specificity of 62.5%,Out of 160 cases, blood culture (BacTalert) showed growth in48 cases in study group while two cases in control group. Thus blood culture positivity was 60%. Conclusion: Blood culture is the gold standard for the diagnosis of septicemia. CRP is most sensitive while CBC is most specific marker in neonatal sepsis.

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