Browsing by Author "Chand, Bharat"
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Publication Clinical Characteristics and Hematologic Profile of Children Admitted to a Tertiary Hospital with Dengue Virus Infection: A Cross-sectional Study(Rapti Academy of Health Sciences (RAHS), 2025) Chand, Bharat; Thakuri, Pushpa Chand; Shrestha, Anil; Poudel, DrishtiAbstract: Introduction: Dengue is an arboviral disease spread by mosquitoes, predominantly affecting tropical and subtropical regions. In Nepal, dengue cases have highest burden in the Bagmati region, including Kathmandu. Clinically, dengue manifests with asymptomatic to severe infection characterized by systemic symptoms. This study aims to identify the clinical characteristics and hematologic profile of children admitted with dengue fever in a tertiary hospital in Kathmandu. Methods: A cross-sectional study was carried out at Nepal APF Hospital, a tertiary care facility in Kathmandu, Nepal. Enumerative sampling was used to gather secondary data of 49 children under the age of 18 who were hospitalized with positive dengue tests (NS1 antigen or IgM antibody positive) between September 2022 and November 2024. Dengue was categorized as per the 2009 WHO classification. Descriptive statistics and Kruskal-Wallis test was performed. Results: Majority of the patients (77.5%) had dengue without warning signs, 20.41% had warning signs and only 2.04% had severe dengue. All the patients had fever when they first arrived. Headache (57.1%), Arthralgia/Myalgia (53.1%), Nausea and Vomiting (24.5%) and Cough (22.4%), were common clinical characteristics. Abdominal pain (p-value <0.05) and epistaxis (p-value <0.05) was significantly associated with severity of dengue infection. There was a sharp rise in incidence of dengue cases in the month of September. Majority of children admitted had Leukopenia (69.4%) and thrombocytopenia (57.1%). 83.7% of children were Non-Structural protein 1 (NS1) positive and 32.7% were IgM positive whereas none were IgG positive. Conclusion: Fever is the most common sign of a dengue infection. Leucopenia and thrombocytopenia are the most prevalent test findings. Children are especially susceptible to dengue during the monsoon season. It is critical to be aware of these clinical and laboratory markers to diagnose and manage denguePublication Epidemiological and Clinical Profile of COVID-19 in Nepali Children: An Initial Experience(Nepal Paediatric Society (JNPS), 2020) Sharma, Arun K; Chapagain, Ram H; Bista, Krishna P; Bohara, Roma; Chand, Bharat; Chaudhary, Nanda K; Mishra, Pradip; Sandeep, Shrestha; Rana, Netra; Singh, Jamun; Baseula, Yuba Nidhi; Sharma, Yog Raj; Sharma, Samana; Ghimire, SunitaAbstract: Introduction: COVID-19 has spread all around the world with huge toll of human lives and suffering since it evolved in China. Nepal had slow rise in morbidity due to COVID 19 in early days but has been gripped by the pandemic's exponential growth lately. This study was conducted with the aim to describe the clinical and epidemiological features of Nepali children in early phase of the pandemic. Methods: This was an observational study conducted at 11 COVID care centres designated by the Government of Nepal with availability of supervision by paediatricians between January and August 2020 in children under 18 years of age diagnosed with COVID 19. Data was collected based on definitions outlined in data collection resources available at WHO-ISARIC Global COVID-19 clinical resources platform and analysed. Results: One hundred and twenty one children diagnosed with COVID 19 who presented to the designated centres were enrolled. Majority of children (83.4%) were identified as a part of contact tracing, 28.1% had an identified contact to a person with COVID 19 prior to their diagnosis and 20.7% had another household member diagnosed with COVID 19. The mean age of admitted children was 8.8 years (SD 5.6 years) with the largest proportion being adolescents (40.5%). Male (58.7%) children were more commonly affected. There were 15 (12.4%) infants and 8 (6%) of them were under two months of age. Most children (87, 71.9%) were asymptomatic, 21 (22.3%) had mild symptoms and six (4.9%) had moderately severe symptoms. Fever (18.2%) was the most commonly reported symptom. All children were discharged after a median of 14 days of hospitalisation. Conclusions: Nepali children of all ages are affected by COVID 19 and present with asymptomatic or mildly symptomatic infection. Fever and respiratory symptoms are the most commonly reported symptoms. Most children do not develop complications. Continued surveillance in larger population of children as the pandemic unfolds will generate more stringent observations.Publication Nutritional Status of Children Under Five Years in a Tertiary Care Center: A Cross-Sectional Study(Nepal APF Hospital, 2025) Chand, Bharat; Poudel, Drishti; Shrestha, Anil; Thakuri, Pushpa Chand; Thapa, Madhu; Shahi, AnitaAbstract: Introduction: Malnutrition remains a leading cause of under-five mortality globally and in Nepal, with significant rates of stunting, wasting, and underweight. Despite national progress, child nutrition challenges persist, especially among vulnerable groups in hospital settings. This study assesses the nutritional status of under-five children attending a tertiary care center in Nepal. Methods: This descriptive cross-sectional study was conducted among 260 under-five children attending the Pediatric Department of Nepal APF Hospital, Kathmandu, from February to June 2025 after ethical approval. Data were collected through face-to-face interviews with caregivers and anthropometric measurements. Nutritional status was assessed using WHO standards. Descriptive statistics, chi-square test, and logistic regression were used for analysis. Results: Among 260 children under five years, the overall prevalence of malnutrition was 30%, including 10% stunted, 11.2% wasted, and 15.4% underweight. Malnutrition was significantly associated with the child’s age (p < 0.001), with children below 24 months more likely to be malnourished. Father's education level also showed a significant association (p = 0.005), where lower paternal education correlated with higher malnutrition rates. No significant associations were observed with maternal, environmental, or child-rearing characteristics. Conclusion: The present study found a notable burden of malnutrition among under-five children visiting a tertiary care center in Kathmandu with younger age and father’s education significantly associated with malnutrition. Targeted early-life nutritional interventions and improved parental education can help to improve the nutritional status of under five children.