Browsing by Author "Dongol, Singh S"
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Publication Placebo Controlled Introduction of Prophylactic Supplementation of Probiotics to Decrease the Incidence of Necrotizing Enterocolitis at Dhulikhel Hospital in Nepal(Kathmandu University, 2017) Dongol, Singh S; Klobassa, DS; Resch, B; Urlesberger, B; Shrestha, RPBABSTRACT Background Although recent reports suggest that the use of probiotics may enhance intestinal functions in premature infants, the mechanisms are unclear, and open questions remain regarding the safety and its efficacy. Objective The objective of this study is to evaluate the efficacy of probiotics on prevention of necrotizing enterocolitis in preterm infants in Nepal. Method We conducted a randomized, double blind, placebo controlled study of 72 hospitalized preterm infants. They were randomly allocated to receive probiotics (lactobacillus rhamnosus 35) at a dose of 0.8 mg in infants >1500 gms and 0.4 mg in infants <1500 gms in 2 ml of expressed breast milk two times daily or the same amount of expressed breast milk as placebo (without probiotics). Result Seventy-two patients were studied. The probiotics group (n=37) and placebo group (n=35) showed similar clinical characteristics. The incidence of necrotizing enterocolitis was found less frequently in the probiotic group (6/37, 16.2%) compared to the control group (10/35, 28.6%), this difference was not significant (p=0.16). This is 12.35% reduction in the incidence of necrotizing enterocolitis. Among the risk factors for necrotizing enterocolitis, pregnancy risk factors and perinatal risk factors were not significant. However neonatal risk factors were more frequent in the probiotic group (59.3%, n=32) than in the placebo group (40.7%, n=22), the difference was significant (p=0.02). Conclusion In the western world probiotics have been shown to be preventive in regard to necrotizing enterocolitis incidence. The present randomized trial showed a trend towards necrotizing enterocolitis minimal reduction in Nepal too. Further studies in a larger cohort are warranted to prove this effect for preterm infants. KEY WORDS Necrotizing enterocolitis, Placebo, ProbioticsPublication Risk Factors Associated with Childhood Asthma - A Case Control Study(Kathmandu University, 2018) Dongol, Singh S; Shrestha, AABSTRACT Background Asthma is one of the most common chronic childhood illnesses with rapidly increasing prevalence in low income countries. For planning effective intervention to reverse this condition we need a better understanding of the risk factors for asthma in early life. Objective To identify the risk factors associated with childhood asthma and its morbidity patterns. Method The case control study was conducted in the pediatric department of Dhulikhel hospital, Kathmandu University hospital, Dhulikhel from March 2016 to March 2017. The control group was composed of 175 age matched children attending the outpatient clinic with non pulmonary health problem. Data was collected through Performa and analyzed using SPSS version 23. The association of asthma with genetic and environmental risk factors was evaluated by univariant (chi-square or Fisher’s exact test) and binomial logistic regression. Result Childhood asthma was more common in male children between 1-5 years. Majority of children 77(44%) were graded as mild persistent asthma. Risk factor associated with asthma include family history of asthma (OR0.06; 95%CI .005-0.94, p=0.04), nonexclusive breast feeding (OR18.42; 95% CI 2.56-132.3, p=0.004), allergic disorder in children (OR0.003; 95%CI 0.000-0.037, p=0.0001). Conclusion Family history of asthma, allergic history in the patient and nonexclusive breast feeding were significantly associated with asthma. There is no significant association of asthma with exposure to allergic food, exposure to smoke and domestic animals. KEY WORDS Breastfeeding, Childhood asthma, Risk factor