Browsing by Author "Ghimire, Jagat Jeevan"
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Publication Application of Pediatric Risk of Mortality (PRISM) III Score in Predicting Mortality Outcomes(Nepal Health Research Council, 2023) Joshi, Prakash; Agrawal, Sumit; Ghimire, Jagat Jeevan; Shrestha, Pun Narayan; Najala Khatun,; Banjara, Megha RajAbstract Background: Children admitted in a pediatric intensive care unit have a high risk of mortality. Pediatric risk of mortality III score in first 24 hours of admission has increasingly been used to predict mortality. The objective of this study was to evaluate the validity of Pediatric risk of mortality score in prediction of mortality among the patient admitted in pediatric intensive care unit. Methods: This prospective observational study was conducted at pediatric intensive care unit of a government pediatric hospital from January to June 2021. Patients between 1 month to 14 years of age and meeting the inclusion criteria were enrolled. Pediatric risk of mortality III score was calculated within 24 hours of admission. Patients were followed up for outcome measure as survivors and non survivors. Chi square test and logistic regression analysis were used to find the association of predictors and the score. Results: The mean Pediatric risk of mortality III score was lower in survivors than in non-survivors (4.67 ± 3.8 versus 14.10 ± 6.07; p<0.001). Those requiring inotropic and ventilator support have significantly higher mortality [49.4 versus 0.6 (p<0.001) and 81.8 versus 1.5 (p<0.001) respectively]. Minimum systolic blood pressure, abnormal pupillary reflex, increased blood urea nitrogen and decreased platelet were the significant (p<0.001) risk factors. The area under the Receiver Operating Characteristic curve was 0.916±0.024 (p<0.001) and goodness-of-fit test showed no significant difference between observed and expected mortalities (p=0.186). Conclusions: The Pediatric risk of mortality score constitutes a useful prognostic tool in predicting the mortality. Key words: Mortality; pediatrics; pediatric intensive care unit; risk score,Publication Profile of Neurosyphilis Patients Admitted to a Tertiary Care Centre of Nepal: An Observational Study(Nepal Medical Association, 2025) Giri, Uma; Tangbetani, Laila Lama; karki, Anupama; Ghimire, Jagat JeevanAbstract Introduction: Neurosyphilis is a rare complication of untreated syphilis with limited literature.We aimed to look for demographic characters and clinical presentation of patients admitted with the diagnosis of neurosyphilis. Methods: This was an observational cross-sectional study that included analysis of records of neurosyphilis patients admitted to the National Academy of Health Sciences, Kathmandu, Nepal, from May 2015 to April 2024. All patients diagnosed with neurosyphilis were included, while those with incomplete data were excluded. The Centers for Disease Control and Prevention criteria were used to define and categorize neurosyphilis. Continuous variables were summarized as mean ± standard deviation for normally distributed data or as median and interquartile range for skewed data. Categorical variables were described using numbers and percentages. Results: A total of 53 cases were included in the study, with 31 (58.49%) males. The median age was 46 years (interquartile range: 37–60 years). Decreased vision was ovserved in 30 (56.60%) patients, and redness of the eye in 11 (20.75%) and headache in 4 (7.55%). Eye signs were observed in 43 (81.13%) patients. Cerebrospinal fluid Venereal Disease Research Laboratory (VDRL) test was positive in 11 (20.75%) cases. Based on Centers for Disease Control and Prevention criteria, 11 (20.75%) patients had verified neurosyphilis, 34 (64.15%) had likely neurosyphilis, and 8 (15.09%) had possible neurosyphilis. Iintramuscular benzathine penicillin was administered in 26 (49.06%) patients. Conclusions: There were more male patient with Neurosyphilis in our population. Decreased vision was the most common presentation. Likely neurosyphilis was most common diagnosis among studied population.