Browsing by Author "Giri, P"
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Publication Acute Kidney Injury in Neonates with Perinatal Asphyxia in a Tertiary Care Hospital of Nepal: a cross-sectional study(Kathmandu University, 2025) Gautam, S; Gautam, P; Chaudhary, A; Dahal, A; Manandhar, A; Giri, P; Dulal, A; Pokhrel, SABSTRACT Background Renal involvement is the most common form of systemic complication in neonates with perinatal asphyxia. Acute Kidney Injury (AKI) can be oliguric or non oliguric. There is no consensus on the definition of acute kidney injury in neonates, which makes early diagnosis and management difficult. Acute kidney injury leads to significant morbidity and mortality in neonates. Objective Current study aims to explore the prevalence of Acute Kidney Injury in Neonates with perinatal asphyxia and its relation to the severity of Hypoxic Ischemic Encephalopathy (HIE). Method A single-center, retrospective, cross-sectional study was carried out to analyze the cases of perinatal asphyxia in the Neonatal Intensive Care Unit (NICU) and Neonatal Ward (NNW) for a period of three years (September 2020 to August 2023) in a tertiary care center. The study analyzed 195 neonates with perinatal asphyxia and Hypoxic Ischemic Encephalopathy (HIE). Data analysis was done using Statistical Package for Social Sciences (SPSS) version 25. Descriptive statistics(mean ± SD for continuous variables; percentages for categorical variables) and chi-square test (to compare categorical associations) were applied. The prevalence of acute kidney injury and its relation to grades of HIE were determined using a chi-square test. Result The prevalence of acute kidney injury among cases of perinatal asphyxia was 17.4%. The prevalence of acute kidney injury increased with an increase in the grading of hypoxic ischemic encephalopathy. Acute kidney injury was predominant among males with a male-to-female ratio being 3.2:1. Oliguric acute kidney injury was more common than non-oliguric acute kidney injury. 8.8% of cases had mortality, with the majority of cases being hypoxic ischemic encephalopathy grade II. The Chi- square test found a statistically significant association between hypoxic ischemic encephalopathy grades and acute kidney injury (p value=0.0113, i.e., p < 0.05) Conclusion Acute kidney injury remains one of the common complications of Perinatal Asphyxia (PA). There was a significant association between acute kidney injury cases and grades of Hypoxic Ischemic Encephalopathy (HIE), with HIE II being the most common type. Screening for acute kidney injury in case of hypoxic ischemic encephalopathy should be prioritized. KEY WORDS Acute kidney injury, Birth asphyxia, Oliguria, Perinatal asphyxiaPublication Prevalence of Renal and Urinary Tract Diseases among Pediatric Cases Admitted in a Tertiary Hospital in Developing Country(Kathmandu University, 2024) Gautam, S; Gautam, P; Chaudhary, A; Dahal, A; Giri, P; Poudel, SABSTRACT Background Kidney disease includes diseases of the glomerulus, tubular disorders, and conditions associated with hematuria or proteinuria. Urinalysis can be a reliable and easy tool to screen. Objective In this study, we aim to study the prevalence of renal and urinary tract diseases among the pediatric population in a tertiary hospital in Nepal. Method A single-center retrospective cross-sectional study was conducted from 2022 to 2023 in the pediatric department. Information was obtained regarding clinical- epidemiological profile, associated condition, investigations, diagnosis, and duration of hospital stay, management, and outcome. Result The prevalence of renal disease was 5.6%, with urinary tract infection being the most common diagnosis. Maximum cases presented between one and five years with a male-to-female ratio of 1.1:1 and 80.9% of the patients had new onset disease. The mean duration of hospital stay was six days. The mortality rate in renal diseases was 3.2%. Conclusion Renal diseases make up a significant portion of pediatric admissions. Renal diseases contribute to significant morbidity and mortality. A large number of cases of renal diseases are due to infective etiology hence they are preventable and curable. Renal disease in children presents with vague symptoms and signs. Routine screening of renal diseases is needed for early diagnosis and reduction in morbidity and mortality. KEY WORDS Kidney diseases, Pediatrics, Urinary tract infectionPublication Toothbrush, an Unusual Foreign Body(Kathmandu University, 2021) Bhattarai, A; Adhikari, D; Paudyal, N; Giri, P; Khadka, A; Devkota, YABSTRACT Accidental consumption of foreign body is a common presenting complain among patients especially in young age group. Majority of patients can be discharged safely after reassurance while a fraction of patient requires observation and further management. Here we report a case of a 35-year-old gentleman who presented to the out-patient department of our hospital in June 2021 for accidental ingestion of toothbrush. After detailed history and physical examination upper gastrointestinal endoscopy was planned for the patient. Failed endoscopic removal was considered the indication for surgery. A supraumbilical midline incision was used to remove the toothbrush. Following the surgical removal, he was managed conservatively and was discharged without significant complications. We describe this case in detail in addition to reviewing the pertinent literature. KEY WORDS Endoscopy, Foreign body, Surgery