Browsing by Author "Chalise, Shiva Prasad"
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Publication Neonatal Sequential Organ Failure Assessment Score to Predict Mortality in Neonatal Intensive Care Unit at Tertiary Care Center(Nepal APF Hospital, 2025) K.C., Ganesh; Shah, Ganesh; Chalise, Shiva Prasad; Shrestha, Bijesh; Shrestha, Sailesh; Gautam, Tilak; Khanal, IneshAbstract: Background: The Neonatal Sequential Organ Failure Assessment (nSOFA) score is a tool used to evaluate degree of organ dysfunction in critically ill neonates admitted to neonatal intensive care units (NICUs). The nSOFA score is based on respiratory, cardiac and hematological parameters (total score ranges from 0 to 15). This study aims to evaluate the applicability of nSOFA score to predict neonatal mortality in NICU of Patan Hospital. Methods: This prospective observational study was conducted at the NICU of Patan Hospital, Lalitpur, Nepal from May 2023 to November 2024. The parameters of nSOFA score were recorded at admission and between 48-72 hours of admission. Data were analyzed using EPI-INFO and Easy R software. Results: Among 134 neonates, 105 (78%) survived, and 29 (22%) did not. At admission, a nSOFA score ≥4 had a sensitivity of 69%, specificity of 91.4%, positive predictive value (PPV) of 69% and negative predictive value (NPV) of 91.4% for predicting mortality. At 48-72 hours, a cutoff score of ≥5 showed a sensitivity of 75.7%, specificity of 99%, PPV of 96.6% and NPV of 91.4%. Conclusion: The nSOFA score is a important tool for predicting neonatal mortality in NICUs and can be used to guide clinical decision-making.Publication Outcome of Surfactant replacement therapy for respiratory distress syndrome in preterm babies(Nepal Paediatric Society (JNPS), 2022) Kansakar, Prerana; Shrestha, Narottam; Prajapati, Alisha; Chalise, Shiva Prasad; Mishra, Santosh KumarAbstract: Introduction: Surfactant is an important treatment modality in preterm babies with respiratory distress syndrome leading to decrease in mortality, morbidity and cost of treatment. Experiences on surfactant therapy in Nepal are scarce. This study was conceptualised to find the use and immediate outcome of surfactant therapy in preterm babies in a tertiary care hospital in Nepal. Methods: A cross-sectional study was done in preterm babies who received surfactant over period of five years at neonatal / pediatric intensive care unit at Patan Hospital, Lalitpur, Nepal. After approval from Institutional review committee, information on gestational age, sex, birth weight, doses of dexamethasone, doses and time surfactant delivery, complications and immediate outcome was retrieved from the files. Comparison between early and late rescue group was done. Data was analysed using SPSS 16. Results: Twelve babies (11.2%) needed a repeat dose of surfactant. Only 12 (11.2%) babies received early rescue surfactant. About 53 (49.5%) babies developed complications with hypotension being the most common seen in 38 (35.5%) babies. Complications were 75% and 46% in the early and late rescue group respectively (p - 0.22). The mortality was inversely proportional to the gestational age (p - 0.002) and birth weight (p < 0.05). Mortality was 16% in both the groups but the deaths related to complications of surfactant was all in the late rescue group. Conclusions: Complications were more in early rescue group and mortality was similar in both the groups, but mortality related to complications of surfactant was all in the late rescue group. Complications of surfactant therapy and mortality were inversely proportional to the gestational age and birth weight.