Browsing by Author "Rauniyar, Lalan Prasad"
Now showing 1 - 2 of 2
Results Per Page
Sort Options
Publication Empyema Thoracis in children: A Five-Year Analysis from a Tertiary Care Center in Eastern Nepal(Nepal Paediatric Society (JNPS), 2022) Kafle, Shyam Prasad; Koirala, Namu; Ahmad, Eqtedar; Rauniyar, Lalan Prasad; Bhatta,, MukeshAbstract: Introduction: Complicated community-acquired pneumonia resulting in empyema thoracis remains the largest single cause of morbidity and mortality worldwide in children. This study was carried out to evaluate the clinical profile, associated complications and outcome of empyema thoracis in children. Methods: A retrospective study was conducted in the Department of Paediatrics at a tertiary care center in Eastern Nepal. A total of 106 children were managed with the diagnosis of complicated pneumonia with effusion or empyema thoracis from March 2017 to February 2021 (Five years). Only those patients who had clinico-radiological evidence of pleural effusion or empyema thoracis and received treatment with or without intercostal chest tube drainage (ICD) as the initial procedure were enrolled in the study. Besides supportive treatments and antibiotics; streptokinase was instilled intrapleurally in all the patients for three days. Patients who did not respond underwent VATS / decortication. Results: Majority of the children (60.19%) were below five years of age and were males (73.58%). Majority (55.67%) had a right-sided pleural effusion and fever was the predominant symptom (55.66%) at presentation. The pleural fluid culture was sterile in more than half (55.66%) of the patients with Staphylococcus aureus grown in 33.96%. The three most common complications were subcutaneous emphysema, thickened pleura, and pyo-pneumothorax. The success rate of medical management was 83.96% and the mortality was low (2.84%). Conclusions: The success rate of conservative management with antimicrobial therapy, intercostal drainage and fibrinolytics in this study was high (83.96%) with no major adverse effects of fibrinolytic therapy in empyema thoracis.Publication Outcome of Malnourished Children Admitted in the Nutritional Rehabilitation Home(Nepal Health Research Council, 2023) Rauniyar, Lalan Prasad; Rouniyar, Maya; Jha, Rashmi; Yadav, Aman Kumar; Sah, Mukesh KumarAbstract Background: Globally, the burden of malnutrition, especially undernutrition, as well as the consequences of malnutrition is of the rise which is especially of significant concern for underdeveloped countries. Countries like Nepal are also facing a similar problem of malnutrition. In Madhesh province, among the under 5 children the incidence of chronic malnutrition is 29.3%. Our aim is to assess the malnourishment in the children of Madhesh province in Nepal. Methods: This cross-sectional quantitative study was carried out among 409 malnourished children who were admitted from July 17, 2018 to July 16, 2022 at NRH in Gajendra Narayan Singh Hospital. Collected data were fed into Microsoft-excel and analyzed using SPSS software, version-2016. As data were normally distributed, frequency, percentage, mean and standard deviation were calculated for descriptive analysis. To find out the association of categorical variables, the Chi-square test or Fisher’s Exact test was used where appropriate. P-value <0.05 was significant. Results: Out of 409 malnourished cases, 145 cases were SAM (SD<-3) and 264 cases were MAM (-2 to -3SD) at the time of admission. The mean increment in the weight was 1.14±0.44 kg. The average length of stay was 19.82±8.73 days. There is a significant difference (p<0.001) in the length of stay among the SAM and MAM cases of our study and a difference in the increment of weight in comparison to mean weight gain (1.14±0.44 kg) with respect to the length of stay of the malnourished child who stayed for more than 28 days and less. Conclusions: There is significant weight gain in malnourished children after management at the Nutritional Rehabilitation Center. Keywords: Height; increment in weight; malnourished child; moderate acute malnutrition; nutritional rehabilitation home