Browsing by Author "Mishra, Om Prakash"
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Publication Analysis of Predictors of Relapse in Children with Steroid Sensitive Nephrotic Syndrome(Nepal Paediatric Society (JNPS), 2017) Bhatta, Mukesh; Shah, Gauri Shankar; Mishra, Om PrakashAbstract: Introduction: Children with idiopathic nephrotic syndrome (INS) are steroid responsive but have relapses in subsequent non-treatment period. The objective of the present study was to analyze the factors which could predict relapses in these children. Material and Methods: Forty patients of INS aged 1-14 years of both gender were enrolled over one year period and followed for six months after treatment of initial episode of Nephrotic Syndrome. Results: The median age of children was 4.5 years and male to female ratio 1.9:1. There were 24(60%) relapses and 16(40%) non-relapses. The relapses had significantly higher mean total leukocyte count, serum urea, potassium and cholesterol than non-relapses. It was also observed that the median age of onset in relapses was significantly lower than non-relapses (p<0.001). Also, the median time to response to steroid therapy was longer in relapses than non-relapses (p<0.001). Children who relapsed had infections at the time of relapse. Conclusion: Thus, onset of disease in younger age group, late response to steroid therapy and presence of infections were found to be associated with relapses in these children.Publication Comparison of Efficacy of First Haemodialysis Session for Correction of Metabolic Disturbances in Acute Kidney Injury and Chronic Kidney Disease in Children(Nepal Paediatric Society (JNPS), 2021) Verma, Shubham; Abhishek, Abhinay; Mishra, Om Prakash; Singh, Ankur; Prasad, RajnitiAbstract: Introduction: Acute kidney injury and chronic kidney disease present with various complications like electrolyte disturbances, metabolic acidosis and fluid overload in children. The objective of the study was to compare the efficacy of the first session of haemodialysis in children with acute kidney injury stage 3 and chronic kidney disease G5 treated by dialysis for immediate recovery of renal functions in terms of reduction in the level of azotemia, correction of fluid and electrolyte imbalances, metabolic acidosis, and improvement in clinical status. Methods: This was a cross-sectional comparative observational study conducted on 13 patients of acute kidney injury stage 3 and 46 patients with chronic kidney disease G5, who required haemodialysis. Their clinical assessment, fluid status, renal function tests, electrolyte, bicarbonate were done at admission and completion of the first session of heamodialysis. Results: The age group of children was six to 16 years (median 11.4 years). There were six males (46%) and seven females (54%) in the acute kidney injury group and 29 (63%) males and 17 (37%) females in chronic kidney disease G5 groups. Sepsis (31%) and glomerulonephritis (31%) were common etiologies detected for acute kidney injury while in chronic kidney disease G5, congenital anomalies of the kidney and the urinary tract were the commonest (50%). There were significant reductions in the levels of serum urea and creatinine and a rise in blood pH, bicarbonate level, and base excess following the first session of haemodialysis in comparison to pre-dialysis values in both AKI and CKD. Conclusions: The study demonstrated improvement in the clinical parameters and biochemical parameters equally after the first dialysis sessions in both groups. This is one of the effective renal replacement therapy and should be instituted wherever indicated to improve the immediate outcome of the patients.Publication Steroid Sensitive Nephrotic Syndrome Presented as Posterior Reversible Encephalopathy Syndrome - A Rare Case Report(Nepal Paediatric Society (JNPS), 2020) Abhinay, Abhishek; Shankar, Jata; Rao, Sunil Kumar; Mishra, Om PrakashAbstract: Posterior reversible encephalopathy syndrome (PRES) is a rare serious syndrome of central nervous system that can develop in both adults and children. It is characterised by acute onset of headache, confusion, seizures, or focal neurological deficits along with radiological abnormalities in the parietal and occipital lobes. In the past, this syndrome has been mainly described in adults but rare in children. However, it is not uncommon in paediatric nephrology. Hypertension, renal disease, immunosuppression, and chemotherapy of malignancies are triggers for PRES. Here, we report a case of 12 years old boy with steroid-sensitive nephrotic syndrome presenting as PRES.