Browsing by Author "Dongol, Srijana"
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Publication Clinical Profile and Outcome of Acute Encephalitis Syndrome in Dhulikhel Hospital of Nepal(Nepal Paediatric Society (JNPS), 2012) Dongol, Srijana; Shrestha, Shreema; Shrestha, Narayan; Adhikari, JAbstract: Introduction: Acute encephalitis syndrome (AES) is a constellation of clinical signs and or symptoms i.e. acute fever with acute change in mental status. AES may be present as encephalitis, meningoencephalitis or meningitis. It can be associated with severe complication, including impaired consciousness, seizure, limb paresis or death. Materials and Methods: Study consisted of retrospective analysis of hospital records of children up to 16 years of age admitted with diagnosis of AES in the department of Paediatrics Dhulikhel Hospital, Kathmandu University Teaching Hospital, Dhulikhel Kavre from January 2010 to December 2011. Results: During the two years (January 2010 to December 2011), 47 patients of AES were admitted. Among the admitted cases there were 34 male and 13 female patients. Meningitis cases were 29, encephalitis cases were 14 and 4 meningoencephalitis cases. Among the meningitis cases, viral meningitis accounted for 12, bacterial meningitis accounted for 15 and 1 tubercular meningitis.One was eosinopilic meningitis in which the causative organism was found to be fasciolosis by ELISA. Viral encephalitis was found to be the most common cause of encephalitis. Sensorineural hearing loss was seen in 3 cases, subdural effusion in 1 and hydrocephalus in 1. One patient had intracranial hemorrhage with hemiparesis as a complication of eosinophilic meningitis. Conclusion: Acute encephalitis syndrome is one of the most common causes of PICU admission in Dhulikhel hospital. Bacterial meningitis was common among the acute encephalitis syndrome followed by viral meningitis. One case of eosinophilic meningitis with intracranical hemorrhage and hemiparesis was found. Sensorineural hearing loss was found to be commonest complication.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.