Browsing by Author "Rajbhandari, Rateena"
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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 Factors Contributing to Pneumonia in Children Under five Years of age in Nepal(Nepal Paediatric Society (JNPS), 2023) Shrestha, Ira; Bhandary, Shital; Rajbhandari, RateenaAbstract: Introduction: Pneumonia is the biggest infectious killer of children under five years of age, especially in poor countries. In addition to the immune system of the children, various factors play a vital role in developing pneumonia in these children. We aimed to analyze the factors in Nepal Demography and Health Survey 2016 that could contribute to developing pneumonia in children under 5. Methods: We used the 2016 Nepal Demographic and Health Survey (NDHS) dataset in this analysis. According to World Health Organization (WHO), pneumonia is diagnosed in under five population as having cough and / or difficult breathing, with / without fever. We considered pneumonia if at least two of these symptoms were present. We created three separate variables: having cough (Yes = 1, No = 0), difficulty breathing (Yes = 1, No = 0) and with fever (Yes = 1, No = 0). We assessed the association between pneumonia and other categorical variables using chi-square test and compared means using independent samples t-test. Results: In bivariate analysis, wealth index, use of drug for intestinal parasite and history of diarrhea in past two weeks had statistically significant association in occurrence of pneumonia in children under five years of age. However, in multivariate analysis, occurrence of pneumonia was 1.78 times higher in children with history of recent diarrhea after controlling for wealth index and drug for intestinal parasite. Conclusion: Measures that could prevent the occurrence of diarrhea could also prevent the development of pneumonia in children under five years of age.