Browsing by Author "Pradhan, Bulbul"
Now showing 1 - 2 of 2
Results Per Page
Sort Options
Publication Dengue and Scrub Typhus Co-infection at a Tertiary Care Centre in Nepal: A Case Series in Pediatric Patients(Nepal Medical Association, 2025) KC, Sriram; Pradhan, Bulbul; Khanal, Inesh; Shrestha, Aakripa RaniAbstract This case series highlights four pediatric patients with coinfection of dengue fever and scrub typhus, presenting at Patan Hospital. Dengue fever is caused by flavivirus transmitted by Aedes mosquitoes, and scrub typhus is caused by Orientia tsutsugamushi transmitted by Leptotrombidium mites, which share overlapping symptoms such as fever, headache, and abdominal pain, complicating the diagnosis. The cases were from different geographical regions of Nepal with varied presentation: from febrile illness to severe manifestations like meningoencephalitis and raised intracranial pressure. Two patients presented with hepatosplenomegaly, one with severe rash, and another with pneumonia-like symptoms. Laboratory findings confirmed coinfection, and management included IV antibiotics, antipyretics, and supportive management. Complications such as thrombocytopenia, transaminitis, and allergic reactions required interventions. This case series highlights the importance of early suspicion and treatment of coinfection to reduce prolonged hospitalization and prevent end-organ dysfunction, and mortality, especially in endemic regions.Publication Platelet Indices as Predictive Marker of Prognosis in Critically IllChildren Admitted to Pediatric Intensive Care Unit: An ObservationalStudy(Nepal APF Hospital, 2026) Shrestha, Sailesh; K.C., Sri Ram; Gautam, Tilak; Khanal, Inesh; Shrestha, Sheshna; Pradhan, BulbulAbstract: Introduction: Platelets play a key role in hemostasis and inflammatory processes. Routinely available platelet indices, platelet count, mean platelet volume, platelet distribution width, and plateletcrit may serve as useful prognostic markers in critically ill children. This study aimed to evaluate their role using routine complete blood count tests. Methods: A one-year prospective observational study was conducted in the Pediatric Intensive Care Unit of a tertiary hospital in Nepal from May 2023 to April 2024. Ethical approval was sought from the Institutional Review Committee (Ref: PMP2305161725). A convenience sampling technique was used. Platelet indices were compared with mortality, need for mechanical ventilation, inotropes, and hospital stay, using Receiver Operating Characteristic analysis to identify predictive cut-off values. Data were managed using Epidemiologic Information, Microsoft Excel, and Easy R. Results: Marked differences in platelet indices were noted across clinical outcomes. Survivors had significantly higher platelet count (270.75 ± 136.06) and plateletcrit (0.37 ± 0.15) than non-survivors (130.25 ± 86.72 and 0.21 ± 0.12, respectively; p < 0.001). Patients requiring inotropes had lower platelet count (184.32 ± 114.57) and plateletcrit (0.27 ± 0.16), but higher Mean platelet volume, platelet distribution width, and platelet distribution width-to-platelet count ratio (p < 0.001). Similarly, those requiring invasive mechanical ventilation had lower platelet count (195.01 ± 125.30) and plateletcrit (0.29 ± 0.16), but higher mean platelet volume and platelet distribution width-to-platelet count ratio (p < 0.001). Platelet count had the highest sensitivity (90.30%) for predicting mortality, while platelet distribution width had the highest specificity (86.7%). The platelet distribution width-to-platelet count ratio showed good sensitivity (77.40%) and specificity (79.20%) at a cutoff of 0.09. Conclusions: Platelet indices are valuable prognostic markers for critically ill children. However, further research with larger sample sizes, multicenter designs, and serial monitoring of platelet indices is needed to validate these findings.