Browsing by Author "Bhatta, Anwesh"
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Publication Anxiety during COVID -19 among School Going Adolescents of Six Private Schools in Kathmandu Valley: A Descriptive Cross-sectional Study Authors(Nepal Medical Association, 2021) Bhatta, Anwesh; Kafley, Rishi Kesh; Yadav, Rishi Kesh; Phuyal, Rajan; Chikanbanjar, Vijaya KumarAbstract: Introduction: Psychological health problems are common in adolescent and young adults. The psychological well-being is greatly influenced by stressful environment and the coping mechanism of an individual. The 2019 Coronavirus disease has caused unprecedented morbidity and mortality worldwide owing to its high infectivity and mortality. In addition to these physical manifestations, psychological impact has also been substantial. This study is a descriptive cross-sectional study done to find out the prevalence of anxiety disorder and its severity during the COVID-19 pandemic in school going adolescents of Kathmandu valley. Methods: A descriptive cross-sectional study was carried out among adolescents from August 15 to September 30, 2020. Two private schools from each district in the Kathmandu valley i.e. Kathmandu, Lalitpur and Bhaktapur were included in the study using convenient sampling. Ethical clearance was obtained from Institutional Review Committee (reference no: 1208202007). All data were inserted on Microsoft Excel 2016 and analysed using Statistical Package for the Social Sciences version 20. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Among 358 students, 165 (46.1%) at 95% Confidence Interval (40.8-51.2) were found to have anxiety. Out of these patients, 115 (69.7%) had mild, 39 (23.6%) had moderate and 11 (6.7%) had severe anxiety. The mean age was 16.17±1.57 years. Conclusions: This study shows that a remarkably higher number of children had symptoms of anxiety disorder. Majority of the children with anxiety had mild form. The study further highlights the need of emotional support to adolescent children during the current ongoing pandemic.Publication Macrophage Activation Syndrome secondary to Systemic Juvenile Idiopathic Arthritis: A Case Report(Nepal Medical Association, 2021) Kafle, Rishikesh; Bhatta, Anwesh; Gami, Sumit; Sapkota, Abhin; Sharma, Dipesh; Yadav, Arabindra; Chikanbanjar, Vijaya KumarAbstract: Macrophage activation syndrome is a rare but a life threatening condition commonly associated with Systemic Juvenile Idiopathic Arthritis. Its clinical presentation includes fever, hepatosplenomegaly, hypertriglyceridemia, hypofibrinogenemia, hyperferritinemia and impaired liver enzymes. The symptoms are alarming yet non-specific and often lead to a delayed diagnosis. A 12 year male presented with a history of intermittent fever and was started on antibiotics but failed to respond after several days of hospital stay. After a series of investigations to rule out multiple diagnoses he was diagnosed as a case of Macrophage Activation Syndrome secondary to Systemic onset Juvenile Arthritis and was treated with steroids.Publication Nepal Paediatric Society Clinical Guidance for Management of Sepsis and Septic Shock in the Paediatric Intensive Care Units in Nepal(Nepal Paediatric Society (JNPS), 2021) Basnet, Sangita; Shrestha, Dhruba; Amatya, Puja; Sharma, Arun; Bajracharya, Binod Lal; Shrestha, Anil; Shrestha, Sudeep; Rajchal, Pramila; Kafle, Raju; Shrestha, Devendra; Puri, Sangeeta; Bhatta, Anwesh; Pathak, Om Krishna; Shrestha, ShrijanaAbstract: Justification: Sepsis is a major cause of morbidity and mortality in Nepal. There is a lack of standardisation in the management of severe sepsis and septic shock. Additionally, international guidelines may not be completely applicable to resource limited countries like Nepal. Objective: Create a collaborative standardised protocol for management of severe sepsis and septic shock for Nepal based on evidence and local resources. Process / Methods: Paediatricians representing various paediatric intensive care units all over Nepal gathered to discuss clinical practice and delivery of care of sepsis and septic shock under the aegis of Nepal Paediatric Society. After three meetings and several iterations a standardised protocol and algorithm was developed by modifying the existing Surviving Sepsis Guidelines to suit local experience and resources. Recommendations: Paediatric sepsis and septic shock definitions and management in the early hours of presentation are outlined in text and flow diagram format to simplify and standardise delivery of care to children in the paediatric intensive care setting. These are guidelines and may need to be modified as necessary depending on the resources availability and lack thereof. It is recommended to analyse data moving forward and revise every few years in the advent of additional data.