Browsing by Author "Mishra, Santosh Kumar"
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Publication Causes of Mortality in Low Birth Weight Babies at a Tertiary Care Hospital(Nepal Paediatric Society (JNPS), 2021) Sharma Chalise, Shiva Prasad; Mishra, Santosh Kumar; Kasakar, Prerana; Anjum, Md FirozAbstract: Introduction: Decreasing the neonatal mortality has been a major concern to decrease under five mortality rate. Low birth weight (LBW) and prematurity related deaths account to significant percentage of all neonatal deaths worldwide. Causes of mortality in LBW babies are not well documented. Hence this study aims to determine the causes of neonatal mortality among the LBW babies at Patan Hospital, Nepal. Method: It was a retrospective observational study done at the Department of Paediatrics, Patan Hospital, Lalitpur, Nepal. The study period was three years from April 2017 to March 2020. All LBW babies born within the study period were included. Perinatal audit and case records were reviewed and necessary data was extracted. Results were analyzed using appropriate tools. Results: Total LBW babies were 3028 which was 13% of all live births. Deaths among LBW were 83 comprising mortality rate of 26.7 per thousand live births. Among all neonatal deaths 76% of the deaths were LBW babies. Sixty very LBW babies died which contributed to 55% of total neonatal deaths. Mean birth weight was 1185 grams, median 1045 with standard deviation 571 with range of 500 to 2484 grams. Respiratory distress syndrome (35%), sepsis (29%), congenital anomalies (23%) and birth asphyxia (12%) were the most common causes of mortality. Conclusions: Respiratory distress syndrome and sepsis were the most common causes of neonatal mortality among LBW babies. Improved neonatal care with special focus to very and extremely LBW babies might help reduce neonatal mortality.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.