Browsing by Author "Malla, Tejesh"
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Publication A Scenario of Poisoning in Children in Manipal Teaching Hospital(Nepal Paediatric Society (JNPS), 2011) Malla, Tejesh; Malla, Kalpana K; Rao, KS; Gauchan, Eva; Basnet, Sahisnuta; Koirala, DPAbstract: Objective: To see the pattern and prevalence of poisoning in children in Manipal Teaching Hospital, Pokhara. The cases were also considered in relevance to the age groups with various agents, the commonly observed clinical features in various poisonings and mortality. Study design: Hospital based retrospective study. Study period: 4 years (January 2006 – January 2010). Study place: Department of Paediatric, Manipal Teaching Hospital, Pokhara. Material and Methods: A detailed study of all the case files of the children admitted with various acute poisonings, where the causative agent was known, was done. Results: A total number of 94 children (56 males & 38 females) were admitted with poisoning (1.79% of the total admissions) during that period. Maximum number of children were of the preschool age group i.e. < 5 years (64.89%). Organophosphorus Compounds (OPC) (27%) and Kerosene Oil (23%) were the two most frequent agents involved. The other agents included Snake bite (19%), Drugs/ Chemicals (16%), Dhatura (12%), and Mushroom poisoning (3%). The most common nature of poisoning noted was accidental (95%). The mortality rate observed was 6.38%. Conclusion: OPC and Kerosene Oil poisoning were the two most common poisoning observed in this study comprising almost half the cases; accidental poisoning was the most common pattern noted and there was a male predominance. Early recognition and timely treatment can decrease the mortality.Publication Is Low Hemoglobin Level a Risk Factor for Acute Lower Respiratory Tract Infections?(Nepal Paediatric Society (JNPS), 2010) Malla, Tejesh; Pathak, Om K; Malla, Kalpana KAbstract: Objective: This prospective study was conducted to evaluate whether a low hemoglobin level, was a risk factor for Acute Lower Respiratory Tract Infections (ALRTI) in children. Methods: 150 Children of all age groups who came to the outpatient department and those admitted for ALRTI were included in the study. Age and sex-matched 140 children, not having any respiratory illness, were taken as control. The study period was from March 2006 - March 2007. Detailed clinical and laboratory evaluation of the enlisted patients was done. All were subjected to detail investigations. Results: Radiological evidence of pneumonia was present in 70 (50 %) children.Hyperinflated lungs were seen in 40 (29%) and was normal in 30 (21.4%) cases. Blood culture was positive in 14 (10%) children of study group and none among control group. Klebsiella was the commonest organism isolated 6 (4.2%) in blood culture positive cases. The mean Hemoglobin (Hb) level of study group was 9.88 gm% and it was 12 gm% in control group.96 (68.6%) of study group and 30 (21.42%) of control group had anemia. Of the anemic children, 79 (82.3%) in study group had iron deficiency, and 17 (17.7%) had normocytic normochromic anemia. These values were 18 (33.3%) and 36 (66.6%) respectively for control group. Low hemoglobin level was a risk factor (p<0.001) ALRTI. Conclusion: Anemic children were 3.2 times more susceptible to ALRTI compared to the control group and and iron deficiency anemia was predominating. Supplemental iron therapy may reduce the incidence of ALRTI. Prevention of anemia, due to whatever etiology is also essential.Publication Type II Vitamin D Dependent Rickets: A Case Report(Nepal Paediatric Society (JNPS), 2010) Malla, Kalpana K; Malla, Tejesh; Shaw, Chandan; Thapalial, AnnaAbstract: Vitamin D-dependent rickets Type II is a rare autosomal recessive disorder. Alopecia of the scalp or the body is seen in some families with Vitamin D-dependent rickets Type II. We report a child with this disease, and review the salient features of this disease with emphasis on the associated alopecia. Due to lack of facilities for estimation of 1, 25(OH)2 D and parathyroid hormone, alopecia remains the only clue to the diagnosis of this rare syndrome in association with resistant rickets.