Browsing by Author "Ojha, Anil Raj"
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Publication Clinical and Laboratory Presentations in Children Admitted with Dengue Infection(Perinatal Society of Nepal (PESON), 2024) Ojha, Anil Raj; Nepal, Archana; Tuladhar, Sucharita; Shrestha, Shailesh; Anjum, Firoz; Gurung, GrishaAbstract: Introduction: Dengue fever, caused by the dengue virus, presents with a spectrum of symptoms, ranging from mild to severe. This study aims to identify common clinical symptoms and laboratory parameter abnormalities in children with dengue infection. Methods: A prospective observational study was conducted at Patan Hospital over three months. Clinical signs, symptoms, and laboratory parameters of seropositive children for dengue were recorded using a structured proforma. Results: During the study period, dengue fever accounted for 24% (104) of admissions in the children’s ward. Among these, 61% tested positive for the NS1 antigen alone, 21% for both IgM and NS1, and 17% for IgM only. The male-to-female ratio was 1.6:1, with an average age of 7 years (±4.37). 46.2% (47) had dengue without warning signs, 51.9% (57) had dengue with warning signs, and 1.9% (2) had severe dengue. Fever was present in all cases, with an average duration of 3.88 days. Vomiting, abdominal pain, head ache and epistaxis was present in 31.7%), 27.9%, 20.2%, 16.3% respectively. Hypotension was noted in 7.7% (8) of cases. Laboratory findings showed that 50% had a white blood cell count below 4000, and 54.8% had a platelet count below 150,000, with 12.2% below 50,000. Serial tests indicated elevated hematocrit levels in 35 patients. Most children were hospitalized for 4-6 days, with a mean stay of 4.65 days (±1.90). Conclusion: Dengue fever is a prevalent infection in children, typically presenting with high fever, vomiting, abdominal pain, headache, hypotension, low platelet count, elevated hematocrit, and leucopenia.Publication Clinical Characteristics and Outcome of Multisystem inflammatory syndrome in Children in a Tertiary Care Center, Nepal(Perinatal Society of Nepal (PESON), 2024) Amatya, Puja; Rajbhandari, Rateena; Tuladhar, Sucharita; Basnet, Sangita; Ojha, Anil Raj; Shrestha, ShrijanaAbstract: Introduction: Multisystem inflammatory syndrome in children (MIS-C) manifests a few weeks after infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It is characterized by fever and multi-organ dysfunction. This disease has been increasingly reported from various countries since the outbreak of coronavirus in 2019. This study was done to determine the clinical characteristics and outcome of children with multisystem inflammatory syndrome in our settings. Methods: This was a retrospective study in children aged 1 month to 14 years fulfilling the World Health Organization case definition of MIS-C conducted between January 2020 and March 2022 in a tertiary care center, Nepal. The clinical characteristics, treatment and outcome parameters of these patients were reviewed and analyzed. Results: A total of 36 patients with MIS-C was reviewed, 20 (55.5%) were male with median age of 6 years (IQR 1.6-10). All children with MIS-C had fever while gastrointestinal symptoms were present in 24 (66.6%), cough in 15 (41.7%) and rash in 13 (36%). Twelve patients (33.3%) had cardiac symptoms of which 3 (8%) patients had dilated coronary arteries. Other presentations were Kawasaki disease like features (8), toxic shock syndrome (5), meningoencephalitis (3), subconjunctival hemorrhage (1), and pulmonary edema (1). Intravenous immunoglobulin was given in 18 (50%) patients, steroid in 23 (64%) and aspirin in 30 (83.3%) patients. All patients survived. Conclusion: The most common symptoms of multisystem inflammatory syndrome in children were fever, gastrointestinal symptoms, cough and rash. The overall outcome of patients even with severe disease was good.Publication Postnatal Growth Pattern of VLBW Infants Admitted at Patan Hospital - A Prospective Observational Study(Perinatal Society of Nepal (PESON), 2024) Paudeal, Subash; Ojha, Anil Raj; Chalise, Shiva Prasad Sharma; Twanabasu, Sajal; Sharma, SubasAbstract: Introduction: Very low birth weight (VLBW) infants (birth weight < 1500 g) comprise about one-third of neonatal deaths. Regular growth monitoring of these infants helps in assessing their nutritional status and identifies those with inadequate weight gain. Studies on postnatal growth velocities in VLBW infants have not been published so far in Nepal. Hence, this study aimed to describe postnatal growth pattern of VLBW infants admitted at Patan Hospital. Methods: It is a prospective observational study on VLBW infants admitted at Patan Hospital between March 17, 2021 and March 16, 2022. Weight, length, and head circumference (HC) were recorded and plotted on Fenton growth chart regularly until discharge. Data was entered into Microsoft Excel and analysed with SPSS version 25. Results: Seventy-two VLBW infants were admitted during the study period. Fiftyseven infants survived till they regained their birth weights and were included in final analyses. The mean weight gain velocity calculated from birth until discharge was 10.72 ± 2.98 g / kg / d and that after regaining birth weight was 17.33 ± 4.67 g / kg / d. These infants gained their length and HC on an average of 1.21 cm / week and 0.79 cm / week respectively. The incidence of postnatal growth failure at the time of discharge was 61.40%. Conclusions: The growth velocities in our VLBW infants is comparable to the standard recommended intrauterine rates. A large multi-centre prospective study is recommended to validate findings of this study