Browsing by Author "Shah, Subhash Chandra"
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Publication Clinical Laboratory Profile of Blood Culture Proven Enteric Fever in Children(Nepal Paediatric Society (JNPS), 2018) Shah, Subhash Chandra; Neupane, Prashank Shree; Guragain, Anusmriti; Dhakal, Ajaya KumarAbstract: Introduction: Enteric fever has diverse clinical presentations and laboratory findings and blood culture is gold standard for diagnosis in the children. This study was done to analyse clinical profile and laboratory findings in culture proven enteric fever. Material and Methods: The study was descriptive observational study carried out in the patient aged 14 years of age or less admitted with culture proven enteric fever admitted in a Paediatric ward of a tertiary medical centre in Lalitpur, Nepal from April 2009 to February 2018. Results: Forty children with blood culture proven were enrolled in the study. All children had fever with the mean duration of 5.3 days (1-14). The most common associated symptoms were gastrointestinal which included anorexia (47.5%), pain abdomen (37.5%), vomiting (37.5%), diarrhoea (15%) and constipation (5 %). Splenomegaly (25%) and hepatomegaly (17.5%) were the commonest signs. The majority of children (80%) had normal total leucocyte count and 32.5% of them had anaemia. There were no children with thrombocytopenia. Salmonella typhi and Salmonella paratyphi A were isolated in 70% and 30% of children respectively. None of the isolates showed drug resistance against ceftriaxone, chloramphenicol, cotrimoxazole, gentamicin, norfloxacin and ofloxacin. There was no mortality. Conclusions: Enteric fever should be suspected in all the children with fever for more than five days along with anorexia, gastrointestinal associated symptoms and normal white blood counts.Publication Profile of Macrosomic Babies at a Tertiary Level Hospital(Nepal Paediatric Society (JNPS), 2015) Shah, Subhash Chandra; Shrestha, Devendra; Dhakal, Ajaya Kumar; Shakya, Arati; Shakya, Henish; Pradhan, AmitaAbstract: Introduction: Macrosomia is known to be associated with adverse neonatal outcomes. The aim of this study was to estimate the incidence of macrosomia in a tertiary teaching hospital of Nepal based on local intrauterine foetal growth percentile curve according to gestational age, risk factors for morbidity and mortality and neonatal outcome of macrosomia. Materials and Methods: This was a descriptive observational study done on live term macrosomic babies delivered during the study period at KIST Medical College Teaching Hospital, Lalitpur Nepal. The maternal and neonatal records of macrosomic babies were reviewed. All the macrosomic babies were followed up till discharge. Macrosomic babies needing admission into the neonatal care unit were considered as ones with complication. Maternal and neonatal risk factors associated with neonatal complications were analysed. Results: Among total of 2922 live singleton deliveries, 342 (11.7%) babies were macrosomic. The neonatal complications associated with macrosomia were seen in 19.6%. The risk factors significantly associated with neonatal complications were mode of delivery via caesarean section, instrumental delivery and 1 min low Apgar score. Maternal diabetes leading to macrosomia however was seen in only one case. The most common neonatal complications were neonatal sepsis (11.4%), significant hyperbilirubinaemia (2%) and transient tachypnoea of newborn (1.6%). Conclusions: Neonatal sepsis was the major cause of morbidity even in the macrosomic babies. Importance of early interventions for prevention and management of macrosomic babies with neonatal sepsis needs to be emphasized.