Browsing by Author "Basnet, Sahisnuta"
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Publication High Red Cell Distribution Width as a Biomarker of Mortality in Critically Ill Paediatric Patients(Nepal Paediatric Society (JNPS), 2020) Gauchan, Eva; Basnet, SahisnutaAbstract: Introduction: Red cell distribution width (RDW) is a frequently overlooked parameter in routine haematological reports. It is a simple and inexpensive test which has been found by many adult studies to be a prognostic indicator of mortality in intensive care units. The objective of this study was to see if high RDW could be used as a marker to predict mortality in critically ill children. Methods: This was a prospective observational study conducted in the paediatric intensive care unit (PICU) of a tertiary hospital of Western Nepal over a period of one year. Study subjects were selected by purposive sampling method. RDW at admission and relative change in RDW (ΔRDW) was compared to see if they had any role in predicting mortality in this group of children. Receiver operating curve analysis was plotted to find an optimal cut-off point to define high and low RDW and various outcome parameters were analysed. Results: Out of 131 children, there were 12 (9.1%) mortalities. Admission RDW was higher in the death group as compared to the survivor group (17 vs 14.6; p = 0.012). Similar finding was seen with ΔRDW (0.45 vs 0.00; p = 0.006). ΔRDW above the cut-off value of 0.15 was found to be associated with a generally more complicated course during hospitalisation as well as had more risk of mortality. Conclusions: Both RDW and ΔRDW above the cut-off value were found to be associated with mortality. In addition, high ΔRDW was also found to predict a more complicated course during hospitalisation.Publication Nasal Bubble Continuous Positive Airway Pressure: An Experience in a Neonatal Unit in a Tertiary Teaching Hospital in Pokhara(Nepal Paediatric Society (JNPS), 2021) Basnet, Sahisnuta; Adhikari, Suraj; Mishra, AparnaAbstract Introduction: Nasal bubble continuous positive airway pressure (NBCPAP) is a modality used for respiratory distress in newborns and provides respiratory support by preventing atelectasis and reducing the work of breathing. The objective of this study was to determine the efficacy, outcomes and complications of NBCPAP in term and preterm newborns requiring NBCPAP. Methods:A prospective observational study was conducted on 75 neonates with mild to moderate respiratory distress requiring respiratory support from August 2020 to December 2020. Assessment of baseline characteristics, indications, complications and outcomes of NBCPAP was carried out on the studied newborns. Outcomes were considered as either success (improvement) or failure (need for mechanical ventilation). Results: The median gestational age was 38 weeks (IQR:35-39 weeks). The median birth weight was 2600 gm (IQR: 2000- 3000 gm). The commonest indication for the requirement of NBCPAP was neonatal sepsis (34%). A total of 65 (86.7%) neonates could be successfully weaned off NBCPAP. Complications were noted in 23 neonates. Modified Downes score on admission (adjusted OR 5.34, 95% CI 1.75- 16.35) and gestational age (adjusted OR 0.68, 95% CI 0.51- 0.92) were independent predictors of failure of NBCPAP. Conclusions: NBCPAP can be successfully utilised in preterm and term babies with mild to moderate respiratory distress. The major predictors of failure of NBCPAP are decreasing gestational age and increasing Downes score.Publication Neonatal Intensive Care Unit Admissions among Preterm Babies in a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2022) Basnet, Sahisnuta; Adhikari, Suraj; Jha, Jyoti; Pandey, Mahendra RajAbstract Introduction: Preterm babies are born before 37 completed weeks of gestation. It is an important cause of neonatal morbidity and mortality. This study aimed to find out the prevalence of neonatal intensive care unit admissions among preterm babies in a tertiary care centre. Methods: A descriptive cross-sectional study on a total of 133 preterm infants was conducted in a tertiary care centre from November, 2020 to April, 2021 with ethical approval from the Institutional Review Committee (Reference number: 380). Preterm babies who met the eligibility criteria were included in the study. Convenience sampling was done. Data were analysed using the Statistical Package for the Social Sciences version 20.0. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage for binary data. Results: Out of 133 preterm babies, 54 (40.60%) (32.25-48.95 at 95% Confidence Interval) had neonatal intensive care unit admissions. Hyaline membrane disease was the most common illness in preterm neonates 34 (62.96%) followed by neonatal sepsis 20 (37.03%). Conclusions: The prevalence of neonatal intensive care unit admissions among preterm babies in our study was similar to other studies done in similar settings. Preterm newborns are significantly vulnerable and maternal risk factors should be taken into account. Anticipated preterm deliveries should have mandatory institutional delivery and adequate postnatal care is needed to improve the outcomes of preterm babies.