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.
Recent Publications
Incidence of Retinopathy of Prematurity and Its Association with Oxygen Therapy in Preterm Low Birth Weight Babies
(Nepal Paediatric Society (JNPS), 2015) Pal, AK; Sur, Somen; Gupta, AK
Abstract:
Introduction: The objectives of this study were to study the incidence and risk factors of retinopathy of prematurity (ROP) among preterm low birth weight babies and its association with oxygen therapy.
Material and Methods: During one year study period, 50 neonates, who had fulfilled the inclusion criteria (born at gestational age ≤ 35 wks), were included in the present study. They were examined by indirect ophthalmoscopy by an ophthalmologist in NICU or ophthalmology outdoor. Staging of ROP was done according to the International classification. Data obtained from this study were entered in Microsoft Excel and subsequently analysed in SPSS version 20.0.
Results: Among study population, 12 neonates (24%) showed evidence of retinopathy of prematurity, and Stage 2 ROP was most common (41.7%) within this group. Those neonates who had born ≤28 wks gestational age, showed more incidence (75%) of ROP. There was significant association between ROP and prematurity, low birth weight, mechanical ventilation, duration and concentration of oxygen therapy.
Conclusion: Apart from prematurity and low birth weight, oxygen therapy also carries significant risk for ROP. Thus, judicious use of oxygen in premature babies can reduce incidence of ROP significantly.
Home Management of Childhood Diarrhoea by Mothers Presenting at a Tertiary Hospital in Bangladesh
(Nepal Paediatric Society (JNPS), 2015) Akhtaruzzaman, Muhammad; Hossain, Md Anwar; Choudhury, Ahmed Murtaza; Islam, Md Nazul; Dhar, Sonjib Kumar
Abstract:
Introduction: Diarrhoea is a leading cause of under-five morbidity and mortality. Most of the diarrhoeal episodes are treated initially at home by mothers. The objective of the study was to assess mothers’ knowledge and practice of home management of diarrhoea.
Material and Methods: This hospital based descriptive cross sectional study was carried out in Mymensingh Medical College Hospital. Three hundred and sixty children under five years of age having acute diarrhoea were included in the study by systematic random sampling. A structured pretested interview schedule was used to collect data. There were 11 knowledge and 11 practice questions; each was scored a point if correctly answered. The level of knowledge and the level of practice both were classified as poor for score 0-5 and good for score 6-11.
Results: Of the 360 mothers, 45.55% had a good level of knowledge, while 33.89% had good level of practice. Both higher knowledge and practice score was significantly (p<0.001) associated with mother’s age, educational level and occupation and father’s educational level occupation and income. After adjusting for other factors, mother’s age was significantly associated with level of knowledge (p=0.003) and mother’s educational level was significantly associated with both level of knowledge (p=0.001) and practice (p=0.002) in home management of diarrhoea.
Conclusion: The study has shown a low level of knowledge and practice in mothers regarding management of diarrhoea. The educational programs for mothers must be an essential part of the health facility programs.
Cord Serum Bilirubin Level in Predicting the Development of Significant Hyperbilirubinemia in Newborns with ABO Incompatibility
(Nepal Paediatric Society (JNPS), 2015) Arora, Sunita; Shifali
Abstract:
Introduction: Neonatal hyperbilirubinaemia is common problem which is benign in majority of neonates. Rh iso immune hemolytic disease as a cause of hyperbilirubinemia is becoming nearly nonexistent due to the use of prophylactic anti D. Hence Isoimmune hemolytic disease due to ABO incompatibility assumes significance as a cause of significant hyperbilirubinaemia. This study was conducted to determine the incidence of ABO incompatibility, ABO iso immune disease in new born, to determine critical cord serum bilirubin level to predict subsequent significant hyperbilirubinemia.
Material and Methods: The study was done in neonatal ICU of a tertiary care hospital where 100 full term healthy newborns with B.W≥2500gm and gestational age ≥37 wk with blood group A, B, AB, born to mothers with O blood group without simultaneous Rh incompatibility at SGRDIMSR were included. Serum bilirubin was measured approximately at 12-24hrs, 36-48hrs, 60-72hrs.
Results: Out 100 ABO incompatible newborns 33(33%) developed ABO isoimmune disease manifesting as significant hyperbilirubinaemia with any of the four total serum bilirubin levels exceeding threshold levels defined for phototherapy. TSB of ≥ 2.16mg/d1 from cord blood has a sensitivity of 100% specificity of 89.55%, NPV 100% and PPV of 82.50% to predict significant hyperbilirubinaemia.
Conclusion: A critical cord S.bilirubin between 2.16 mg/d1 and 4.09mg/d1 will predict all newborns who will have significant hyperbilirubinaemia and can be used as a safe demarcator to decide time of discharge. Any therapeutic intervention if necessary can be started as early as possible.
Clinical Profile of Children with Acute Febrile Encephalopathy in a Tertiary Health Care Center of Nepal
(Nepal Paediatric Society (JNPS), 2015) Sharma, Poonam; Sarmah, BK; Kayastha, Pawana; Shrestha, Asim; Tiwari, Damodar
Abstract:
Background: Acute febrile encephalopathy is a common and severe neurological syndrome that is associated with significant morbidity and mortality in children. The etiologies differ according to geographical regions and appropriate and efficient protocols for investigations and management requires proper understanding of various potential etiologies.
Methods: In this prospective observational study, 54 children of one month to 14 years presenting to the hospital with acute onset of fever with altered sensorium were clinically evaluated and investigated. Clinical examinations included temperature, pulse rate, heart rate, blood pressure, coma severity by GCS, respiratory pattern and detail systemic and CNS examination. Etiology of acute febrile encephalopathy was based on clinical history, examination and relevant laboratory investigations.
Results: The incidence of acute febrile encephalopathy was 5.5% of the total hospital admissions. There were 35(64.8%) boys and 19(35.2%) girls. The maximum number of children 24(44.4%) were between one to five years of age. The most common presenting complains besides fever and altered sensorium were seizures and vomiting which was present in 59.3% and 46.3% of children respectively. Signs of meningeal irritation, hypertonia, brisk deep tendon reflexes and extensor plantar response was present in 50%, 24%, 29.6%, and 44.4% respectively. The diagnosis based on clinical findings and laboratory investigations were viral encephalitis 34(63%), bacterial meningitis 12(22.2%), cerebral malaria 4(7.4), enteric encephalopathy 3(5.6%) and hepatic encephalopathy 1(1.9%).
Conclusion: Viral encephalitis and bacterial meningitis are the most common cause of acute febrile encephalopathy. Preventive strategies can be done to decrease the incidence.
Clinical Profile and Outcome of Mechanically Ventilated Neonates in a Tertiary Level Hospital Authors
(Nepal Paediatric Society (JNPS), 2015) Shrestha, Prabina; Basnet, Srijana; Shrestha, Laxman
Abstract:
Introduction: Many sick neonates admitted to neonatal intensive care unit (NICU) require mechanical ventilation but it is associated with various complications and the outcome of neonates is unpredictable. This study aims to identify the indications for mechanical ventilation, complications, co-morbid conditions and outcome of those neonates in terms of survival.
Materials and Methods: Retrospective observational study of all neonates who underwent mechanical ventilation from 1 January 2014 to 31 December 2014 in NICU, Tribhuvan University Teaching Hospital. Medical records of the patients were retrieved from hospital record section to collect the relevant data.
Results: One-third of admitted neonates in NICU required mechanical ventilation (MV). Commonest indication was severe respiratory distress (70%) followed by perinatal asphyxia (12%) and recurrent apnea (8%). Disease pattern were sepsis (37.2%), RDS of prematurity (17.6%), perinatal asphyxia (11.7%), meconium aspiration syndrome (9.8%), apnea of prematurity (7.8%) and congenital pneumonia (4%). Hospital acquired sepsis was a major complication occurring in 47% patients on mechanical ventilation. Survival rate among neonates on MV was 33%. Survival was better with increasing birth weight and gestational age. Survival was 100% in congenital pneumonia, 50% in perinatal asphyxia, 50% in recurrent apnea, 26% in sepsis, 20% in MAS and 0% in RDS of prematurity.
Conclusion: Survival rate of neonates on mechanical ventilation in NICU was 33%. Sepsis was a major problem in NICU, which must be addressed to improve outcome.