Browsing by Author "Bhatta, Mukesh"
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Publication 11β Hydroxylase Deficiency in a Child with Hypothyroidism: A Case Report(Nepal Medical Association, 2023) Shah, Bipesh Kumar; Koirala, Richa; Dhamala, Sumit; Bhatta, Mukesh; Khatiwada, ShekharAbstract Congenital adrenal hyperplasia occurs due to enzymatic defects in the adrenocortical steroidogenesis. 11β hydroxylase deficiency is the second most common cause of congenital adrenal hyperplasia which presents with hypertension and features of androgen excess. Hypertension has also been found to cause end-organ damage in children with 11β hydroxylase deficiency. We report a case of a 10-year-old male child with hypothyroidism under thyroid replacement therapy, presenting with features of severe hypertension and androgen excess, later on, diagnosed as congenital adrenal hyperplasia due to 11β hydroxylase deficiency.Publication Analysis of Predictors of Relapse in Children with Steroid Sensitive Nephrotic Syndrome(Nepal Paediatric Society (JNPS), 2017) Bhatta, Mukesh; Shah, Gauri Shankar; Mishra, Om PrakashAbstract: Introduction: Children with idiopathic nephrotic syndrome (INS) are steroid responsive but have relapses in subsequent non-treatment period. The objective of the present study was to analyze the factors which could predict relapses in these children. Material and Methods: Forty patients of INS aged 1-14 years of both gender were enrolled over one year period and followed for six months after treatment of initial episode of Nephrotic Syndrome. Results: The median age of children was 4.5 years and male to female ratio 1.9:1. There were 24(60%) relapses and 16(40%) non-relapses. The relapses had significantly higher mean total leukocyte count, serum urea, potassium and cholesterol than non-relapses. It was also observed that the median age of onset in relapses was significantly lower than non-relapses (p<0.001). Also, the median time to response to steroid therapy was longer in relapses than non-relapses (p<0.001). Children who relapsed had infections at the time of relapse. Conclusion: Thus, onset of disease in younger age group, late response to steroid therapy and presence of infections were found to be associated with relapses in these children.