Browsing by Author "Bajracharya, Luna"
Now showing 1 - 2 of 2
Results Per Page
Sort Options
Publication Clinico-epidemiological Profile of Children with Diphtheria in Tertiary Care Hospital of Nepal(Nepal Paediatric Society (JNPS), 2022) Basnet, Srijana; Shrestha, Laxman; Bajracharya, LunaAbstract: Introduction: This study was conducted with the aim to describe the clinical presentation of diphtheria in children, relationship between clinical disease and immunization status, complications of the disease and adverse events due to anti diphtheria serum (ADS). Methods: All patients admitted at Tribhuvan University Teaching Hospital, Kathmandu from July 2016 to November 2018 with clinical diagnosis of diphtheria were included in this study. Results: There were total 12 children and age ranged from five to 15 years, out of which seven (58%) were males and five (42%) were females. All of them were immunized except one whose immunization status was unknown. All of them had tonsillopharyngeal diphtheria. Four patients (33%) also had nasal and five (42%) patients had additional laryngotracheal diphtheria. Seven patients had bull neck on presentation. Four patients had airway obstruction due to laryngotracheal diphtheria requiring tracheostomy. Throat swab for Corynebacterium Diphtheria by Albert stain and Gram stain were positive in 10 patients, and in nine, diagnosis was confirmed by culture. Six patients (50%) were given anti diphtheria serum (ADS) out of which four patients (66.66%) developed anaphylaxis. Myocarditis was the commonest complication seen in four patients (25%). All children with myocarditis developed complete heart block (CHB) and none of them survived. Conclusions: Tonsillopharyngeal diphtheria was the most common clinical presentation and myocarditis was highly fatal complication. This study emphasizes on the need for careful surveillance, early laboratory confirmation and careful administration of ADS in patients with clinical diagnosis of diphtheria.Publication Feasibility of Telemedicine for Follow up of Children with Established Seizure Disorder- A Tertiary Care Center Prospective Study(Nepal Paediatric Society (JNPS), 2023) Bajracharya, Luna; Shrestha, MerinaAbstract: Introduction: Medical information exchanged via electronic communications to improve a patient’s clinical health status by a physician without in-patient visit is telemedicine. Control of seizures with antiepileptic drugs, reassurance for compliance to drugs, regular monitoring of adverse effects of drugs in patient with established seizure can be possible through telemedicine. The main objective of this study was to evaluate feasibility of telemedicine for follow up of children with established seizure disorder. Methods: This study was conducted among children of age one to 16 years with an established seizure due to any cause presenting to the Paediatric Neurodevelopmental OPD of Tribhuvan University Teaching Hospital (TUTH) between October 1, 2018 and September 30, 2020. Mobile phone as a modality of telemedicine was used to inquire about seizure every month for 12 months and whenever necessary. Results: When parameters as seizure control, total cost and time spent per hospital visit, distance to TUTH were analyzed, more than 75% caregivers were satisfied with telemedicine. Greater age, appropriate development, focal onset of seizure, normal electroencephalogram and seizure adequately controlled by single antiepileptic drug were the favorable factors in better seizure control in children using telemedicine. Conclusions: Telemedicine for follow up of children with established seizure disorder seems to be a feasible and satisfactory option when implemented with caution and proper patient selection as it decreases unnecessary high expenses and time to hospital visit