Browsing by Author "Sharma, Yograj"
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Publication Mental Health of Mothers with Malnourished Children in Nepal: A Prospective Observational Study Authors(Nepal Health Research Council, 2023) Sharma, Asmita; Sharma, Yograj; Thapa, Asha; Kar, NilamadhabAbstract Background: Maternal mental health may influence the nutritional status of their children. It was intended to assess the mental health status of the mothers of children admitted to a nutrition rehabilitation center. We specifically explored the relationship between maternal mental health and malnutrition of the child; to observe any change of maternal depressive/anxiety symptoms and weight gain in the child following admission. Methods: In a prospective observational study, malnutrition of children was assessed based on weight for height z scores using the WHO Anthro-Survey-Analyser. We evaluated anxiety using the Generalized Anxiety Disorder Scale (GAD-7) and depression by Patient Health Questionnaire (PHQ-9). Demographic and clinical variables were collected. Results: The degree of malnutrition of the children at admission and discharge was: mild (3.6% v 31.7%), moderate (37.7% v 26.3%), severe (58.7% v 8.4%), and no malnutrition (0.0% v 33.5%) (p<0.001). At admission, 12% of mothers had anxiety, depression, or both, which decreased to 3.0% at the time of discharge. There was no difference in malnutrition scores among children of mothers with or without anxiety/depression at admission or discharge, except that children of depressed mothers continued to have significantly greater levels of malnutrition at discharge compared with the mothers without depression. Maternal anxiety or depression was not associated with the severity of malnutrition. Conclusions: A proportion of mothers of children with malnutrition had clinical anxiety and depression; and maternal mental health concerns, especially depression may influence the nutrition of children. It is imperative to explore maternal mental health routinely for malnourished children. Keywords: Anxiety; children; depression; malnutrition; mothers.Publication Nepal Paediatric Society Guideline for use of Antibiotics in Critically ill Children in the Pediatric Intensive Care Unit(Nepal Paediatric Society (JNPS), 2021) Shrestha, Dhruba; Amatya, Puja; Sharma, Arun; Shrestha, Shrijana; Sharma, Yograj; Pathak, Santosh; Pokharel, Prakash Jyoti; Shrestha, Nipun; Pokhrel, Santosh; Dongol, Srijana; Raya, Ganendra Bhakta; Ghimire, Amrit; Koirala, Janak; Basnet, SangitaAbstract: Justification: Overuse and administration of unnecessary and inappropriate antibiotics are the leading causes for the increased antimicrobial resistance worldwide. Judicious use of antimicrobials can prevent this phenomenon. Objective: Create a collaborative outline for the use of antibiotics in the paediatric intensive care unit for various infections, based on evidence, taking into consideration local antimicrobial susceptibility patterns. Process / Methods: Under the aegis of Nepal Paediatric Society, this guideline has been developed after several meetings of paediatricians working in various hospitals in different parts of Nepal, looking into the prevalent diseases and local sensitivity patterns of antibiotics. Recommendations: This guideline will help standardize the treatment protocol in paediatric intensive care units in Nepal and help paediatricians decide the appropriate use of antibiotics promptly while managing critically ill children. Keywords: Antibiotics; antibiotic sensitivity; antimicrobial resistance; critically ill child; Paediatric Intensive Care UnitPublication Preterm Neonates Admitted in the Neonatal Intensive Care Unit at a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2023) Sharma, Yograj; Pathak, Om Krishna; Poudel, Bipin; Sharma, Asmita; Sapkota, Ram Prasad; Devkota, KiranAbstract Introduction: Preterm birth, one of the leading causes of admissions to the Neonatal intensive care unit, is a major contributor to neonatal morbidity and mortality in developing countries. This study aimed to find out the prevalence of premature neonates admitted to the Neonatal Intensive Care Unit of a tertiary care centre. Methods: This descriptive cross-sectional study was conducted from clinical records of preterm neonates (born before 37 completed weeks of gestation) admitted in the Neonatal Intensive Care Unit from 16 July 2020 to 14 July 2021. Following ethical approval from the Institutional Review Committee (Reference number: 077/78-018), the patient’s clinical characteristics and systemic morbidities were recorded. Convenience sampling was done. Point estimate and 95% Confidence Interval were calculated. Results: Among 646 admissions, the prevalence of preterm neonates was found to be 147 (22.75%) (19.52-25.98, 95% Confidence Interval). The male: female ratio was 1.53:1. The median gestational age and birth weight were 33 weeks (Range: 24–36 weeks) and 1680 g respectively. A total of 73 (49.65%) delivery was followed by premature rupture of membrane. The morbidity due to respiratory problems was highest at 127 (86.39%), followed by metabolic at 104 (70.74%) and sepsis at 91 (61.90%). The renal system was the least affected 5 (3.40%). Conclusions: The prevalence of preterm neonates in the neonatal intensive care unit was higher than in other studies done in similar settings.