Browsing by Author "Gupta, Pradeep Kumar"
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Publication Effectiveness of Kangaroo Mother Care in Early Weaning of Oxygen Therapy among Preterm Neonates in a Tertiary Care Center in Nepal: A Quasi-Experimental Study(Nepal APF Hospital, 2026) Karki, Rajani; Basnet, Sudha; Gupta, Pradeep Kumar; Thapa, June; Adhikari, Punam; Shah, Prakash ManAbstract: Introduction: Kangaroo Mother Care is a cost-effective intervention based on skin-to-skin contact and exclusive breastfeeding that improves survival in preterm and low birth weight infants. Early initiation of Kangaroo Mother Care during respiratory support has shown benefits in stabilizing vital parameters and improving oxygenation. The aim of this study was to find out the effectiveness of early Kangaroo Mother Care during oxygen therapy in preterm neonates. Methods: This was a quasi-experimental study conducted among 62 preterm neonates of less than 37 weeks of gestation who were on assisted respiratory support, admitted in neonatal ward and neonatal intensive care unit of Tribhuvan University Teaching Hospital from May 2023 to March 2024. Ethical approval was obtained from the Institutional Review Board of the Institute of Medicine (Reference no: 545(6-11) E2). The enrolled neonates were alternately assigned to the two groups interventional and conventional care group. Neonates in intervention group were started on KMC while still receiving oxygen therapy while the conventional care group received daily routine care. Data was collected in predesigned performa and was entered in Statistical Package for the Social Sciences version 26. Results: The duration of oxygen therapy was shorter in the Kangaroo Mother Care group than in the conventional group, with a mean difference of 29.30 h (95% CI 45.98 to 12.62; p=0.001). Hospital stay was shorter in the same group (6.47± 2.84 vs 7.55±3.74 days; p=0.215). Complications were also less frequent, and vital parameters improved significantly after one hour of Kangaroo Mother Care. Conclusions: Early Kangaroo Mother Care during oxygen therapy reduces duration of oxygen therapy, hospital stay and neonatal complications along with stabilization of vital parameters.Publication Retinopathy of Prematurity: Incidence, Risk Factors & Outcome in North Indian Rural and Semi-urban population(Nepal Paediatric Society (JNPS), 2022) Parihar, Kamal; Gupta, Pradeep Kumar; Singh, Vandana; Sharma, SanjayAbstract: Introduction: ROP is a challenge due to better premature survival. It has an increasing trend and is a preventable cause of vision loss. Its occurrence, severity and outcome in rural population is poorly studied. Methods: Ahospital based prospective observational longitudinal study was conducted on babies born at a tertiary care centre. Babies with gestation <32 weeks or birth weight < 1500 g were screened for ROP. Preterm babies of >32 weeks gestation with oxygen requirement, RDS, surfactant use, PDA, neonatal hyperbilirubinemia requiring phototherapy, septicemia, red cell transfusion due to anemia, need for inotropes were also included. Babies with ROP were assessed for severity as also need for intervention and were followed for12 months. Results: Of the 211 neonates screened, 51 had ROP. Frequency was inversely related to both birth weight and gestational age with no gender difference. Oxygen therapy (p 0.001), RDS (p 0.005), mechanical ventilation (p0.003) and septicemia (p 0.005) were main risk factors. Neonatal hyperbilirubinemia requiring phototherapy was found to be protective (p 0.0005). 15.68% cases required laser photocoagulation. During follow up, ROP regressed in all patients. Conclusions: Risk factors for ROP included oxygen usage, RDS, mechanical ventilation and septicemia. Blood products or inotropes use was not an independent factor. Neonatal hyperbilirubinemia was protective. When diagnosed early, outcome is good in ROP.Publication Serum Vitamin D levels in Children Receiving Sodium Valproate as Antiepileptic Medication in Uttar Pradesh, India(Perinatal Society of Nepal (PESON), 2025) Kathuria, Aarti; Dadoria, Ranjeeta; Gupta, Pradeep KumarAbstract: Introduction: Epilepsy is a common problem among children. Most of these children are under sodium valproate therapy. Valproate is known to cause fluctuations in serum vitamin D3 level. The present study aimed to assess impact of sodium valproate on serum vitamin D3 levels in ambulated epileptic rural children. Methods: A prospective study was conducted from January 2020 to June 2024 at a tertiary care centre in North India. Ambulatory children with epilepsy aged one to 18 years receiving sodium valproate monotherapy for more than six months were included. Children on valproate were cases and healthy volunteer children taken as controls. Data were analysed using SPSS v21 on Windows-10. Results: 130 children were enrolled. Vitamin D3 levels were significantly lower in children on valproate therapy compared to the controls. Mean levels in cases and controls were 14.98 + 2.19 ng / ml cf. 25.90 + 3.14 ng / ml respectively (P < 0.001). There was a strong negative correlation of duration of anti-epileptic drugs (AED) and vitamin D3 levels (Pearson’s correlation value of < .0001). Further, after vitamin D3 supplement of 60000 IU weekly for six weeks, 10% children did not achieve levels of 20 ng / ml (defined as cut off for deficiency). Conclusions: Study suggests that children on prolonged sodium valproate medication are at significant risk of vitamin D3 deficiency; vitamin D3 levels should be monitored and vitamin D3 supplementation considered. Vitamin D3 levels estimation after supplementation is important as repeat supplementation may be needed.