Browsing by Author "Dongol, Srijana"
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Publication Nepal Paediatric Society Guideline for use of Antibiotics in Critically ill Children in the Pediatric Intensive Care Unit(Nepal Paediatric Society (JNPS), 2021) Shrestha, Dhruba; Amatya, Puja; Sharma, Arun; Shrestha, Shrijana; Sharma, Yograj; Pathak, Santosh; Pokharel, Prakash Jyoti; Shrestha, Nipun; Pokhrel, Santosh; Dongol, Srijana; Raya, Ganendra Bhakta; Ghimire, Amrit; Koirala, Janak; Basnet, SangitaAbstract: Justification: Overuse and administration of unnecessary and inappropriate antibiotics are the leading causes for the increased antimicrobial resistance worldwide. Judicious use of antimicrobials can prevent this phenomenon. Objective: Create a collaborative outline for the use of antibiotics in the paediatric intensive care unit for various infections, based on evidence, taking into consideration local antimicrobial susceptibility patterns. Process / Methods: Under the aegis of Nepal Paediatric Society, this guideline has been developed after several meetings of paediatricians working in various hospitals in different parts of Nepal, looking into the prevalent diseases and local sensitivity patterns of antibiotics. Recommendations: This guideline will help standardize the treatment protocol in paediatric intensive care units in Nepal and help paediatricians decide the appropriate use of antibiotics promptly while managing critically ill children. Keywords: Antibiotics; antibiotic sensitivity; antimicrobial resistance; critically ill child; Paediatric Intensive Care UnitPublication Neurodevelopmental Outcome Following Therapeutic Hypothermia for Perinatal Asphyxia: A Cohort Study(Perinatal Society of Nepal (PESON), 2025) Dongol, Srijana; Poudyal, Prithuja; Thapa, SameeraAbstract: Introduction: Therapeutic hypothermia is recommended for the treatment of neonates with hypoxic-ischemic encephalopathy (HIE). We conducted a cohort study to assess the neuroprotective benefits of therapeutic hypothermia by analyzing the survival and neurodevelopmental outcomes of neonates with moderate to severe HIE who underwent therapeutic hypothermia compared to those who did not. Methods: Neonates with gestational age >36 weeks and age <6 hours with moderate to severe HIE were included in the study. Those who underwent therapeutic hypothermia according to a predefined criteria were assigned to the hypothermia group, while those who did not receive hypothermia served as the control group. Neurodevelopmental outcomes were assessed using the Ages & Stages Questionnaires (ASQ-3) at 3, 6, and 12 months of age. Results: A total of 208 asphyxiated newborns were included in the study, with 100 in the therapeutic hypothermia group and 100 in the control group. Mortality was higher in the control group compared to the hypothermia group. Neurodevelopmental outcomes at 3, 6, and 12 months were significantly better in the hypothermia group compared to the control group. Conclusion: Our study suggests that therapeutic hypothermia in term newborns with moderate to severe HIE is associated with improved survival and reduced neurologic sequelae. These findings support the implementation of therapeutic hypothermia as a standard treatment for neonates with perinatal asphyxia.