Browsing by Author "Shrestha, Manju"
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Publication Early Behavioural Signs among Nepalese Children with Autism Spectrum Disorder: A Descriptive Cross-sectional Study(Nepal Medical Association, 2024) Shrestha, Manju; Suwal, Rinkal; Thapa, Niranjan; Chhetri, Suchit Thapa; Kunwor, Bishal; Regmi, Shiva Kumar; Shrestha, Osha; Mehta, BipinAbstract Introduction: Autism Spectrum Disorder is a complex neurodevelopmental condition. Early identification of symptoms is crucial for timely intervention, yet diagnosing very young children can be challenging due to the variability in symptom presentation and the influence of other developmental factors. This study aimed to find the prevalence of the emergence of early behavioural signs in Nepalese children with Autism Spectrum Disorder. Methods: A descriptive cross-sectional study was conducted at the Centre for Autism in Kathmandu, Nepal, from January 2023 to June 2023. Ethical approval was obtained, and a sample of 120 children diagnosed with Autism Spectrum Disorder was included in the study. Convenience sampling method was used. Point estimate at 95% Confidence Interval was calculated. Results: Among 120 children with Autism Spectrum Disorder, the prevalence of emergence of early behavioural signs was seen in 112 (93.33%) (88.83-97.77, 95% Confidence Interval) children. Conclusions: This study provides insights into the emergence of early behavioural signs in Nepalese children with Autism Spectrum Disorder which align with global patterns in prevalence and severity.Publication Hyperthyroidism in Down’s Syndrome – A Rare Association(Nepal Paediatric Society (JNPS), 2022) Shrestha, Manju; Agrawal, Jyoti; Rai, Basant; Chaudhary, ShipraAbstract: Trisomy 21 is the most common chromosomal abnormality in paediatric population, and the most common cause of intellectual disability. The most common endocrine disease in these population is hypothyroidism. Hyperthyroidism is rare in patients with Down syndrome, but is likely to be underestimated. Hyperthyroidism treatment strategy is highly important for an undisturbed and balanced development of the children.The objective of this case report is to highlight the importance of hyperthyroidism in Down syndrome which is the rare presentation, to best of our knowledge.Publication Maternal Smoking during Pregnancy and its Association with Low Birth Weight(Nepal Paediatric Society (JNPS), 2022) Shrestha, Manju; Mandal, Anju; Gupta, Sweta Kumari; Baidya, ManishAbstract: Introduction: Maternal smoking has been an important risk factor for low birth weight (LBW), preterm birth as well as small for gestational age. In this study, we try to analyze the association of maternal smoking during the different stages of pregnancy with outcome of birth weight. Methods: This is a cross-sectional hospital-based study, which was undertaken comprising of 1240 singleton live born baby in a Tertiary Care Teaching Hospital, Nepal. The enrollment occurred between June 2012 and May 2016 (Four years) among mothers who smoked any time during the current pregnancy. Based on the amount of smoking, the mothers with cigarette smoking were divided into four groups which includes: preconception, the first trimester, second trimester and third trimester. The data analyses were performed using Logistic regression and 95% confidence interval along with p-value. A p-value < 0.05 was considered statistically significant. Results: Of a total of 1240 singleton births, 328 (26.5%) were LBW. Among them, 149 (12.1%) of the mothers reported smoking during pregnancy. When compared with the nonsmoking groups, all the maternal smoking groups had higher incidences of LBW infants, especially when the mothers smoked > 10 cigarettes / day and during any stage of conception. Conclusions: Smoking during pregnancy is associated with an increased incidence of LBW among the infants. In addition, the newborns of mothers who smoked >10 cigarettes / day were most susceptible to having LBW, irrespective of the stage of pregnancy during which the mothers smoked.Publication Prevalence and Associated Factors of Malnutrition in Under Five Children in Eastern Nepal: A Hospital Based Study(Nepal Paediatric Society (JNPS), 2023) Shrestha, Manju; Rai, Basant; Agrawal, Jyoti; Chaudhary, Shipra; Shrestha, Kala; Singh, Rupa Raj BhandariAbstract: Introduction: Malnutrition among children remains one of the most important causes of morbidity and mortality in the developing countries like Nepal. Multiple interrelated determinants are involved in causing malnutrition that needs to be catered. This study aims to assess the prevalence and associated factors of malnutrition among under-five children in eastern Nepal. Methods: This is a hospital-based correctional study. The enrolment occurred between Jan 2018 and Dec 2019 among children who visited nutrition clinic in our hospital. The data analyses were performed using Logistic regression and 95% confidence interval along with p-value. A p-value < 0.05 was considered statistically significant. Results: A total of 310 children were analyzed for malnutrition. Among them, the prevalence of underweight, stunting and wasting was 34.10, 32.45, 17.54 % respectively. Among them, majority of the mother belonged to young age group between 18- 25 years, 216 (69.68%) were females and 120 (38.71%) and Majority of malnutrition fell in the age group of 12 – 23 months. Mother’s age, mother’s education, family size, economic status, child’s age and sex, exclusive breast, ethnicity, mother’s occupation and total family size were found to be significantly associated with malnutrition. Conclusions: This study highlights serious concern of malnutrition among under five years old children in eastern part of Nepal. Multiple hierarchically interrelated determinants associated with child, mother and the social environmental factors were found significant in malnutrition among the children.Publication Socio Economic and Maternal Reproductive factors affecting Low Birth Weight Babies in Central Nepal(Nepal Paediatric Society (JNPS), 2016) Shrestha, Manju; Gupta, Sweta Kumari; Sharmah, Bhawani Kant; Baidya, ManishAbstract: Introduction: Low Birth weight is one of the most sensitive and reliable predictors of health and also an essential determinant of mortality, morbidity and disability in infancy and childhood. Globally, about one sixth of all newborns are low birth weight (LBW <2500 grams), which is the single most important underlying risk factors for neonatal deaths. It is estimated that 18 million babies are born with Low Birth Weight and half of them are born in south Asia. Over three – quarters of newborns death in Nepal occur in LBW babies. The estimates of prevalence of LBW in Nepal have ranged from 14% in community based studies to 32% in hospital based ones, overall being 27%.Objectives were to study the various socioeconomic and maternal reproductive factors related to low birth weight babies in Central regional part of Nepal. Material and Methods: Cross-sectional and observational study was undertaken from October 2012 to September 2014 comprising of 350 singleton live born baby admitted in NICU of Tertiary Care Teaching Hospital, Chitwan. Results: The common risks factors for LBW were significantly associated with low socio- economic status, maternal age, maternal education, occupation of mother, maternal smoking, maternal alcohol intake, number of ANC visit with significant p-value of <0.05. Conclusion: LBW mostly associated with maternal factors can be addressed directly by improving the socioeconomic factors (maternal age, educational level and economic status) and health status of pregnant women by supplementations, family planning services and female education.