Browsing by Author "Paudel, Pradip Kumar"
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Publication Efficacy of Hyoscine Butylbromide Versus Drotaverine in Relieving Acute Nonspecific Abdominal Pain in Children- A Non - Randomized Trial(Nepal Paediatric Society (JNPS), 2022) Paudel, Pradip Kumar; Basnet, Sudha; Shreshtha, MerinaAbstract: Introduction: Acute abdominal pain is a very common complaint for children presenting to the emergency department (ED). The purpose of this study was to compare efficacy of hyoscine and drotaverine for relieving acute nonspecific abdominal pain in children presenting to ED. Methods: Total of 52 children aged six years to 16 years were enrolled in a non-randomized trial at Paediatric ED of TUTH from Dec 2017 to June 2018, and randomly allocated to drotaverine or hyoscine groups; 26 in each group. Face pain score-revised tool was used to measure the efficacy of the drug. The primary outcome was to measure the reduction of face pain score (Self-reported) by at least 2 / 10 at 60 minutes after ingestion of study intervention. Other outcomes were requirement of rescue analgesia and adverse effects of drugs. Results: A total of 20 (77%) in hyoscine and 21 (81%) in drotaverine group responded to oral medication at the end of 60 minutes of oral administration and the difference was not statistically significant (p=0.808). Vomiting was only adverse event present in five (19%) in drotaverine and two (8%) in hyoscine groups, respectively. Conclusions: In this single center randomized controlled trial, both hyoscine and drotaverine were found to be equally efficacious for relieving acute non-specific abdominal pain in children.Publication Morbidity and Mortality Profile of Neonates Admitted in Neonatal Intensive Care Unit(Nepal Health Research Council, 2023) Paudel, Pradip Kumar; Bhandari, Prakreeti; KC, Nawaraj; Devkota, BibekAbstract Background: The neonatal period faces the greatest risk of death as they are vulnerable to sepsis, birth asphyxia, hypoxic injuries etc. A substantial disparity exists in NMR between Nepal and other developed countries and among different provinces of Nepal as well. This study was conducted to describe the pattern of neonatal admission, and immediate hospital outcomes from NICU located in a remote part of Nepal. Methods: This prospective study was conducted in The Province Hospital, Karnali, Nepal over a period of six months (June 2021 to Dec 2021 AD). The variables used were neonatal age, sex, gestation, birth weight, maternal age, mode and place of delivery. Neonatal morbidities and final outcomes at discharge were recorded in a predesigned proforma. Results: A total of 396 neonates included, the majority were inborn 283(71%), male 241(61%), term 301(76%) and had normal birth weight 279 (70.4%). Neonatal sepsis 188(37.2%), prematurity 95(24%), and birth asphyxia 55(15.2%) were main indications for hospitalization. The majority 337(85%) improved after treatment, while 33(8.3%) died, 12 (3%) left against medical advice and 14(3.5%) cases were referred. Preterm neonates had thrice the risk of mortality than term neonates (OR =3.27). Low birth weight (< 2500 grams) had higher odds of poor outcomes (OR =3.5). Low maternal age (<20 years), prematurity, LBW, mechanical ventilation and inotrope use were predictors of poor outcomes. Conclusions: Neonatal sepsis, prematurity and perinatal asphyxia were the most common causes of NICU admissions. Mechanical ventilation, inotropes use, extreme prematurity, low birth weight and younger age of the mother were predictors of poor outcome. Keywords: Karnali; morbidity; mortality; neonates.Publication Was It Pneumothorax? A Case Report of a Neonate with Congenital Pulmonary Airway Malformation from Rural Nepal(Nepal Paediatric Society (JNPS), 2022) Paudel, Pradip Kumar; Devkota, Pragya; Devkota, BibekAbstract: Formerly called congenital cystic adenomatoid malformation (CCAM), congenital pulmonary airway malformation (CPAM) is a rare but most common congenital lung malformation that may manifest as an asymptomatic lesion at birth or in later life. The diagnosis may be difficult and is easily confused for pneumothorax often resulting incorrect ICD insertion on an emergency basis, which causes complications and delays accurate diagnosis. We report a case of a neonate, who presented with increasing respiratory distress at birth and hyperlucency in a chest radiograph initially misdiagnosed as pneumothorax and ICD inserted, later correctly diagnosed as CPAM type I with help of a CT chest. This case report is presented to highlight that CPAM is a rare cause of respiratory distress in newborns at birth.