Browsing by Author "Sharma Chalise, Shiva Prasad"
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Publication Causes of Mortality in Low Birth Weight Babies at a Tertiary Care Hospital(Nepal Paediatric Society (JNPS), 2021) Sharma Chalise, Shiva Prasad; Mishra, Santosh Kumar; Kasakar, Prerana; Anjum, Md FirozAbstract: Introduction: Decreasing the neonatal mortality has been a major concern to decrease under five mortality rate. Low birth weight (LBW) and prematurity related deaths account to significant percentage of all neonatal deaths worldwide. Causes of mortality in LBW babies are not well documented. Hence this study aims to determine the causes of neonatal mortality among the LBW babies at Patan Hospital, Nepal. Method: It was a retrospective observational study done at the Department of Paediatrics, Patan Hospital, Lalitpur, Nepal. The study period was three years from April 2017 to March 2020. All LBW babies born within the study period were included. Perinatal audit and case records were reviewed and necessary data was extracted. Results were analyzed using appropriate tools. Results: Total LBW babies were 3028 which was 13% of all live births. Deaths among LBW were 83 comprising mortality rate of 26.7 per thousand live births. Among all neonatal deaths 76% of the deaths were LBW babies. Sixty very LBW babies died which contributed to 55% of total neonatal deaths. Mean birth weight was 1185 grams, median 1045 with standard deviation 571 with range of 500 to 2484 grams. Respiratory distress syndrome (35%), sepsis (29%), congenital anomalies (23%) and birth asphyxia (12%) were the most common causes of mortality. Conclusions: Respiratory distress syndrome and sepsis were the most common causes of neonatal mortality among LBW babies. Improved neonatal care with special focus to very and extremely LBW babies might help reduce neonatal mortality.Publication Implementation of Delayed Cord Clamping in a Tertiary care Hospital: A Quality Improvement Project(Nepal Paediatric Society (JNPS), 2023) Twanabasu, Sajal; Paudeal, Subash; Sharma Chalise, Shiva Prasad; Devkota, Sunita; Pokhrel, Yushu; Sharma, SubashAbstract: Introduction: Delayed cord clamping (DCC) is defined as the delay in the clamping of the umbilical cord for more than 60 seconds or when the umbilical cord pulsations have stopped. It has numerous benefits to the infants like increased circulating volume, increased hemoglobin / haematocrit levels, elevated iron stores, and decreased need for red blood cell transfusions. Despite evidence-based recommendation, delayed cord clamping is not practiced routine in some medical settings. Methods: This quality improvement project (QI Project) was conducted to implement delayed cord clamping in one of the tertiary care hospital through Plan-Do-Study-Act (PDSA) cycles. We wanted to improve practice of delayed cord clamping from baseline to 70% in babies delivered by Cesarean section in a tertiary care hospital at Lalitpur. We included term and preterm vigorous newborns delivered by uncomplicated lower segment cesarean section (LSCS). After orientation to the Department of Paediatrics and Obstetrics, project was carried out between August 2021 to October 2021. Data was compiled every two weeks and obstacles and shortcomings were discussed and multiple interventions were done accordingly. Results: Out of 916 deliveries via LSCS, after exclusion 805 eligible cases were assessed in three months. The percentage of Delayed cord clamping (DCC) among uncomplicated LSCS increased to 70% in the month of October. Conclusions: QI project was helpful in improving the compliance of Delayed cord clamping (DCC) in the clinical practice by addressing the problems encountered among the study population.