Browsing by Author "Bhattarai, Susan"
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Publication Bacteriological Profile and Antibiotic Sensitivity Pattern of Neonatal Sepsis in Central Paediatric Referral Hospital in Nepal(Nepal Paediatric Society (JNPS), 2019) Bhattarai, Susan; Chapagain, Ram Hari; Mishra, Deepak; Shrestha, Anil Kumar; Shrestha, Sushan ManAbstract: Introduction: Neonatal sepsis is the most common cause of neonatal morbidity and mortality. The causative organisms of neonatal sepsis are changing and so do their antibiotic sensitivity pattern. So it is important to regularly monitor the change in bacteriological profile and their antimicrobial sensitivity pattern to help update the treatment guidelines of neonates. This study aimed to study the microbiological patterns of neonatal sepsis and their antibiotic susceptibility pattern in a tertiary care centre in Kathmandu. Methods: A prospective study was carried out among cases of neonatal sepsis admitted in Neonatal Intermediate Care Unit (NIMCU) of a tertiary care referral hospital from August 2015 to August 2016. Prospective data were collected with pretested and standardised proforma and analysed using SPSS version 20. Results: Out of 311 neonates admitted over a period of one year with diagnosis of neonatal sepsis, male:female ratio was 2.1:1. Among them 234 (75.2%) cases were of LONS and 77 (24.8%) were of EONS. Blood culture was positive in 47 neonates (15.1%). The organisms isolated included staphylococcus aureus (34.0%), klebsiella (32%), CONS (24%), escherechia coli (6%) and enterobacter (4%). In LOS, gram positive organisms staphylococcus and CONS were the commonest ones (61.4%). In EOS, gram negative organism klebsiella (65%) was more common. Most of staph aureus were susceptible to penicillins, amikacin and cefotaxime. Klebsiella was found to be resistant to penicillins, amikacin and cefotaxime. Conclusion: There is possible increasing incidence of gram positive septicemia in LONS and increasing emergence of resistance of kleibsella to the common antibiotics ampicillin, amikacin and cefotaxime.Publication Morbidity and Mortality Pattern of Patients Admitted into Paediatric Intensive Care Unit of Tertiary Level Hospital of Nepal(Nepal Paediatric Society (JNPS), 2020) Shrestha, Anil Kumar; Bhattarai, Susan; Paudel, Prajwal; Basel, Prem LalAbstract: Introduction: The paediatric intensive care unit (PICU) takes care of critically ill paediatric patients. Regular evaluation of the outcomes of patients admitted to PICU is important to assess the effectiveness of various interventions. This study aimed to find the morbidity and mortality pattern of patients admitted to PICU of tertiary level Paediatric hospital of Nepal. Methods: We conducted a retrospective, cross sectional observational study using the records of all the patients admitted to PICU of a tertiary level hospital from January 2017 to August 2017. We collected data on age, sex, geographical distribution, duration of PICU stay and the morbidity and mortality outcomes. Outcome is classified as transfer to ward, leave against medical advice (LAMA) and death. Data were analysed descriptively using SPSS version 23. Results: Out of 358 patients admitted to PICU, the mean age was 1.83 years. Majority were infants (54.5%) with male:female ratio of 1.8:1. The major causes of PICU admission were respiratory disease (27.7%) followed by CNS disease (19.6%) and infections (17.3%). The average length of stay was 6.27 days. Overall mortality was 22.7%. Conclusion: Respiratory infections were the primary cause of PICU admission and overall mortality rate was high at 22.7%. However, mortality rate was even worse for patients with multi-system involvement. We need prospective studies to examine the underlying reasons for mortality among patients with multi-system involvement.Publication Vitamin D Deficiency among Blood Transfusion-Dependent Beta Thalassemia Children Admitted to Tertiary Level Pediatric Hospital in Nepal: A Descriptive Cross-Sectional Study(Nepal Medical Association, 2024) Shrestha,Anil Kumar; Sherpa, Sangay Chultim; Gyawali, Bindu; Sharma, Manisha; Adhikari, Santosh; Shrestha, Suchitra; Bhattarai, Susan; Thapa, Sagar; Sharma, Devashish; Paudel, Prajwal; Gyawali, SushilAbstract Introduction: Children with beta thalassemia are on regular blood transfusions, which could result in iron deposition in the liver causing decreased synthesis of Vitamin D-25OH. There are limited publications on the association of Vitamin D deficiency with blood transfusion-dependent thalassemia in the Nepalese population. This study aims to determine the prevalence of Vitamin D deficiency among blood transfusion-dependent beta-thalassemia patients. Methods: This was a descriptive cross-sectional study conducted among beta-thalassemia major patients under 15 years of age, receiving regular blood transfusion, from July 17, 2022, to July 16, 2023, after attaining ethical approval from Ethical Review Committee, (reference number 155). Data were collected using convenience sampling, and descriptive analyses were performed using Microsoft Excel and Statistical Package for Social Sciences (SPSS) 2024. Results: A total of 127 blood transfusion-dependent beta-thalassemia major patients were included in the study, of whom 82 (64.56%) were female. Among these patients, 104 (81.88%) were aged between 5 and 14 year. Among 127, 41 (32.28%) had Vitamin D insufficiency, and 31 (24.40%) had Vitamin D deficiency. There were 12 (9.44%) underweight children. Conclusions: Vitamin D deficiency was seen in more than half of the children with blood transfusion dependent beta thalassemia major.