Browsing by Author "Pradhan, Shikhar"
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Publication Correlation Between Transcutaneous Bilirubin and Total Serum Bilirubin Before Initiation of Phototherapy in Neonates of Tertiary Care Centre of Nepal(Nepal Paediatric Society (JNPS), 2023) Mishra, Deepak; Yadav, Arabindra; Bhatta, Nisha Keshary; Shah, Lokraj; Pradhan, Shikhar; Soni, Prakash KumarAbstract: Introduction: Jaundice is the predominant health issue within the initial week of an infant’s life, impacting 60% of full-term and 80% of preterm newborns. Blood sampling for serum bilirubin measurement not only induces pain but also carries the potential for long-term consequences on neurodevelopment due to pain. Noninvasive transcutaneous bilirubin (TcB) devices, which serve as pointof-care instruments, not only save time but are also more cost-effective. This study’s primary objective is to explore the correlation between Delta MBJ20 transcutaneous bilirubinometer measurements and TSB levels determined through the Diazo method. Methods: This prospective observational research was conducted on newborn infants who received routine TSB tests during their care in the NICU, nursery, and neonatal ward at BPKIHS. TcB measurements were taken on both the sternum and forehead of neonates within a 30-minute window around the time of blood collection for the TSB assay, before phototherapy was initiated. The study involved analyzing a linear regression plot between the mean TcB readings from the forehead and sternum in relation to the mean TSB levels. Results: Ordinary Least Squares (OLS) linear regression analysis for TSB and forehead TcB indicates a significant positive strong linear relationship between the two measurements (r = 0.722, R2 = 0.52, P < 0.001). A similar pattern of linear relationship was observed between the sternum TcB and TSB (r = 0.771, R2 = 0.59, P < 0.001). Conclusion: TcB measurements from the forehead or sternum prove to be valuable non-invasive screening tools for non-severe hyperbilirubinemia in neonates.Publication High Problematic Screen Exposure among Children Aged 2-5 Years Visiting the Department of Pediatrics of a Tertiary Care Centre(Nepal Medical Association, 2023) Shakya, Henish; Acharya, Sharda; Pradhan, Shikhar; KC, DivyaAbstract Introduction: The effects of problematic screen exposure in the early years have adverse effects on cognition, reasoning, executive, and social skills, and physical health. The study aimed to assess the prevalence of problematic screen exposure in children between 2 to 5 years of age visiting the Department of Paediatrics of a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among caregivers of children aged 2 to 5 years of age in a tertiary care centre from 16 July 2023 to 30 September 2023 after an ethical clearance from the Institutional Review Committee. This study excluded children with chronic disease and behavioural disorders. The problematic screen exposure was assessed using the Problematic Screen Exposure Score. A convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Among 310 respondents, 216 (69.67%) (64.55-74.79, 95% Confidence Interval) children had a high problematic screen exposure score. The mean age of children was 3.46±1.033 with 89 (41.20%) children having their first exposure before 12 months of age, 131 (60.64%) exceeding daily usage of >2 hr, and 198 (91.66%) children viewing age-inappropriate media content. Conclusions: The prevalence of high problematic screen exposure was comparable to that of the prevalence found in studies done in similar settings.Publication pH Prodigy: Predicting early Neonatal Destiny in Perinatal Asphyxia through cord Blood’s Crystal ball(Nepal Paediatric Society (JNPS), 2024) Mishra, Deepak; Bhatta, Nisha Keshary; Yadav, Arabindra; Shah, Lokraj; Pradhan, Shikhar; Soni, Prakash KumarAbstract: Introduction: Perinatal asphyxia, a condition affecting blood flow or gas exchange during birth, is a major contributor to neonatal morbidity and mortality. It adversely impacts various body systems, including renal, CNS, cardiac, and pulmonary functions. Common assessment methods, like Apgar scores, have limitations in subjectivity and sensitivity. Advanced technologies like aEEG and MRI, while more predictive, may lack universal accessibility. Studies exploring cord blood gas analysis as a link to short-term outcomes show promise in addressing perinatal asphyxia-related morbidity and mortality, particularly in resource-constrained settings such as ours. Methods: This one-year prospective cohort study at B.P. Koirala Institute of Health Sciences, Dharan, Nepal included 150 inborn newborns of 37 weeks or more who exhibited either an Apgar score of less than 7 at 5 minutes of life. They were subjected for estimation of umbilical cord blood pH, APGAR score, and outcome looked were NICU admission, seizure incidence, hypoxic ischemic encephalopathy assessment by Sarnat and Sarnat score, neurological status, duration of hospital stay, and final outcome (Discharge, LAMA, death). Results: Neonates with lower pH values have a higher likelihood of NICU admission, seizures, and hypoxic ischemic encephalopathy, extended hospital stays and increased mortality rates. A strong negative correlation between pH and hypoxic ischemic encephalopathy was observed, with a correlation coefficient of - 0.8112 (p < 0.001). Notably, pH emerged as the most significant independent predictor for hypoxic ischemic encephalopathy and abnormal neurologic examination (hypotonia). Conclusion: Umbilical cord blood pH is valuable predictor of early neonatal outcome in perinatal asphyxia.