Browsing by Author "Kansakar, Prerana"
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Publication Clinical Profiles of Neonates Born to COVID-19 Positive Mothers in a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2021) Chalise, Shiva Prasad Sharma; Mishra, Santosh Kumar; Chalise, Bimal Sharma; Rai, Punam; Paudel, Subash; Kansakar, Prerana; Ojha, Anil RajAbstract: Introduction: Nepal is one of the countries which has been hit hard by the COVID-19 pandemic and has resulted in high morbidity and mortality across all age groups including neonates. There has been a paucity of studies regarding maternal to neonatal COVID-19 transmission and the published studies also have a poor sample size to reach any definite conclusion. Hence this study was carried out to see the clinical profiles of neonates born to COVID-19 mothers. Methods: It was a descriptive cross-sectional study. The study was conducted at a tertiary care centre over the period of one year from April 2020 to March 2021 after taking ethical clearance from the Institutional Review Committee with reference number drs2105211526. Convenient sampling was done. All neonates born to COVID-19 positive mothers who were diagnosed by a real-time polymerase chain reaction of the nasopharyngeal swab during the time of delivery were included in the study. Data analysis was done using Statistical Package for Social Sciences 20 using appropriate tools. Results: A total of 105 babies born to COVID-19 positive mothers who were tested for COVID-19 infection were included in the study. Ten (9.5%) (3.89-15.10 at 95% Confidence Interval) of neonates born to COVID-19 positive mothers were positive for the COVID-19 virus. All the neonates born to COVID-19 positive mothers were discharged home except one case who had other comorbidities. Fever was present in four (40%) of COVID-19 positive neonates. Conclusions: There is a possibility of vertical transmission of coronavirus in neonates although the outcome is favourable.Publication Congenital Tracheoesophageal Fistula in Very Low Birth Weight Preterm Neonate with an Oligohydramnios as a Rare Presentation: A Case Report(Nepal Medical Association, 2020) Maharjan, Anu; Sharma, Amit Kumar; Kansakar, Prerana; K.C, Samyukta; Singh, YogendraAbstract: Tracheoesophageal fistula is a challenging anomaly with a rare prevalence with symptoms mainly respiratory, sometimes digestive. We present a rare case of oesophageal atresia with distal Tracheoesophageal fistula in a female child whose mother presented with severe oligohydramnios on ultrasonography with intrauterine growth retardation before cesarean section. After the birth of preterm and very low birth weight neonate, we initially diagnosed as respiratory distress syndrome with a club foot. However, we diagnosed oesophageal atresia with distal Tracheoesophageal fistula on the 2nd day as nasogastric tube insertion was failed beyond 10cm and confirmed by X-ray with a rubber catheter. Right thoracotomy with ligation of the fistula with end to end anastomosis was performed successfully without complications. Breastfeeding initiated and the child discharged after she started gaining weight. Early post-operation complication (anastomotic stricture) was noticed after 2 weeks; however, corrected with endoscopic balloon dilatation. Currently, the child is healthy weighing 10kgs at 18 months of age.Publication Outcome of Surfactant replacement therapy for respiratory distress syndrome in preterm babies(Nepal Paediatric Society (JNPS), 2022) Kansakar, Prerana; Shrestha, Narottam; Prajapati, Alisha; Chalise, Shiva Prasad; Mishra, Santosh KumarAbstract: Introduction: Surfactant is an important treatment modality in preterm babies with respiratory distress syndrome leading to decrease in mortality, morbidity and cost of treatment. Experiences on surfactant therapy in Nepal are scarce. This study was conceptualised to find the use and immediate outcome of surfactant therapy in preterm babies in a tertiary care hospital in Nepal. Methods: A cross-sectional study was done in preterm babies who received surfactant over period of five years at neonatal / pediatric intensive care unit at Patan Hospital, Lalitpur, Nepal. After approval from Institutional review committee, information on gestational age, sex, birth weight, doses of dexamethasone, doses and time surfactant delivery, complications and immediate outcome was retrieved from the files. Comparison between early and late rescue group was done. Data was analysed using SPSS 16. Results: Twelve babies (11.2%) needed a repeat dose of surfactant. Only 12 (11.2%) babies received early rescue surfactant. About 53 (49.5%) babies developed complications with hypotension being the most common seen in 38 (35.5%) babies. Complications were 75% and 46% in the early and late rescue group respectively (p - 0.22). The mortality was inversely proportional to the gestational age (p - 0.002) and birth weight (p < 0.05). Mortality was 16% in both the groups but the deaths related to complications of surfactant was all in the late rescue group. Conclusions: Complications were more in early rescue group and mortality was similar in both the groups, but mortality related to complications of surfactant was all in the late rescue group. Complications of surfactant therapy and mortality were inversely proportional to the gestational age and birth weight.