Browsing by Author "Rajkarnikar, Ramana"
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Publication An Infant with Congenital Diaphragmatic Eventration with Dextrocardia: A Case Report(Nepal Medical Association, 2022) Rajkarnikar, Ramana; Thami, Rabin; Dahal, Priyanka; Lacaul, Robal; Shrestha, RashmiAbstract: Diaphragmatic eventration is a rare condition, and its association with dextrocardia is even a rarer clinical entity. Patients are usually asymptomatic, but the typical features include rapid breathing and recurrent respiratory infections. Here we present a rare case of a seven months old infant, who presented with cough, noisy breathing and chest retraction. The patient was diagnosed to have dextrocardia with diaphragmatic eventration with pneumonia by chest imaging and was treated in coordination with the medical team for underlying pneumonia. Afterwards, plication of the diaphragm was done through the trans-abdominal approach and the symptoms gradually improved postoperatively. For dextrocardia, since there were no structural abnormalities, the patient was kept in regular follow-up in the pediatric cardiology unit. Though most patients are asymptomatic, diaphragmatic eventration increases the risk of recurrent chest infection and hampers the quality of life of the patient, so timely diagnosis and intervention will greatly improve their quality of life.Publication Intussusception among Children Admitted in a Department of Pediatric Surgery of a Tertiary Care Centre: A Descriptive Cross-Sectional Study(Nepal Medical Association, 2023) Rajkarnikar, Ramana; Singh, Suraj; Joshi, Mridul Prasad; Kayastha, AnujAbstract Introduction: Intussusception is the second most common cause of acute abdominal pain in infants and preschool children. The aetiology for intussusception is idiopathic at this age. Hydrostatic reduction and exploratory laparotomy with proceed are the options for the management of intussusception. The aim of this study was to find out the prevalence of intussusception among patients admitted to the Department of Pediatric Surgery of a tertiary care centre. Methods: This is a descriptive cross-sectional study conducted among admitted patients in the Department of Pediatric Surgery of a tertiary care centre after ethical approval from the Ethical Committee (Reference number: A37-77/78). Data were collected from 1 January 2018 to 31 December 2020 from admitted children aged 6 months to 5 years of age. Data collection was done from the hospital record section using the convenience sampling method. Point estimate and 95% Confidence Interval were calculated. Results: Among 1785 admitted patients, 267 (14.96%) (13.31-16.61, 95% Confidence Interval) were found to have intussusception. Among them, the hydrostatic reduction was successful in 246 (92.13%). Meanwhile, 21 (7.86%) of cases underwent laparotomy. The peak age of patients was seen in 148 (55.43%) in the age group of 1-3 years. Conclusions: Intussusception is one of the common surgical emergencies in children. Hydrostatic reduction of intussusception is a simple and effective method for the treatment of intussusception in children.