Browsing by Author "Paudel, KP"
Now showing 1 - 3 of 3
Results Per Page
Sort Options
Publication A Case of Precocious Puberty in a Setting with Limited Resources(Kathmandu University, 2011) Paudel, KP; Giri, S; Shrestha, PS; Shrestha, L; Thapa, SB; Shrestha, MABSTRACT Precocious puberty is a rare condition characterized by the development of secondary sexual characteristics before the median age for the sex. It is either gonadotropin dependent also called as central or gonadotropin independent also known as peripheral type. Hypothalamamic Hamartoma is a common cause of the central or precocious puberty due to organic brain lesion. Here we present a two year male who presented us with precocious puberty due to a hypothalamic Hamartoma. KEY WORDS hypothalamic hamartoma, precociuos pubertyPublication Accuracy of 7-8-9 Rule for Endotracheal Tube Placement in Nepalese Neonates(Nepal Paediatric Society (JNPS), 2011) Paudel, KP; Nepal, D; Mahaseth, CAbstract: Introduction: Neonatal intubation is done for cardiopulmonary resuscitation, hypoxemia, and hypercapnia, for surfactant therapy or for airway protection. When correctly placed, endotracheal tube (ETT) tip should be at mid tracheal position which is half way between the clavicles and the carina to prevent complications of ventilation. Objective: To assess the accuracy of 7-8-9 Rule in neonates at Kanti Children’s hospital. Methodology: Prospective observational study was conducted in neonates who required oral intubations from July 2009 to December 2009 at NICU of Kanti Children’s Hospital. The initial ETT depth of insertion was determined using admission weight in the 7-8-9 Rule calculation. This depth was compared to the midtracheal depth to determine clinical accuracy of the 7-8-9 Rule. Results: Mean gestation age of the 69 infants was 36.01 weeks (26 to 42 weeks) and weight was 2411 g( 900 g to 3800 g ). 7 (10.1%) neonates weighed 1000 g or less, 19 (27.5%) weighed between 1001 to 2000 g, 31 ( 44.9%) weighed between 2001 to 3000 g, 12(17.4%) weighed between 3001 to 4000 g. The accuracy of 7-8-9 rule in clinical setting with auscultation and Chest x-ray resulted in ETT depth 0.11 cm above midtracheal position. (-1.5 to 1.5 cm). Using this rule ET tube was placed 0.11 cm above the mid tracheal position. Conclusions: The 7-8-9 Rule appears to be an accurate clinical method for endotracheal tube placement in Nepalese neonates.Publication Micro ESR in the evaluation of neonatal sepsis(Institute of Medicine, 2011) Paudel, KP; Adhikari, RKAbstract Introduction: Neonatal sepsis is a major cause of neonatal morbidity and mortality in the developing countries like Nepal. Early diagnosis and treatment is crucial for the outcome but it is difficult in many situations especially in places with limited resources. Objective of this study is to evaluate the role of micro ESR in the diagnosis of neonatal sepsis Methods: A prospective analytical study was done where newborns with suspected sepsis admitted for septic work up and IV antibiotics were included in the study. Micro ESR was measured with relevant septic screening investigations. The micro ESR value was compared to age specific normal values and the results were compared with various clinical presentations, laboratory findings and outcome variables. Results: Out of 111 babies micro ESR was elevated in 63 babies and blood culture was positive in 15 cases and meningitis was present in 8 cases. Total proven cases were 16 and probable sepsis were 34. Correlation of elevated micro ESR was statistically significant with PROM >18 hours, presence of clinical symptoms, clinical and systemic signs. It had significant clinical association with blood culture and CSF findings. The sensitivity, specificity, positive and negative predictive value compared with blood culture was 100%, 47.5%, 15.6% and 20.8%, comparing with proven or no sepsis cases was 70.5%, 48.1%, 36.9% and 50% respectively. Conclusions: Micro ESR is simple cheap and relatively sensitive, specific with good negative predictive value in the prediction of neonatal sepsis and can be useful test in settings with limited resources. Keywords: Micro ESR, neonate, sepsis