Browsing by Author "Shrestha, Prabina"
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Publication Clinical Profile and Outcome of Mechanically Ventilated Neonates in a Tertiary Level Hospital Authors(Nepal Paediatric Society (JNPS), 2015) Shrestha, Prabina; Basnet, Srijana; Shrestha, LaxmanAbstract: Introduction: Many sick neonates admitted to neonatal intensive care unit (NICU) require mechanical ventilation but it is associated with various complications and the outcome of neonates is unpredictable. This study aims to identify the indications for mechanical ventilation, complications, co-morbid conditions and outcome of those neonates in terms of survival. Materials and Methods: Retrospective observational study of all neonates who underwent mechanical ventilation from 1 January 2014 to 31 December 2014 in NICU, Tribhuvan University Teaching Hospital. Medical records of the patients were retrieved from hospital record section to collect the relevant data. Results: One-third of admitted neonates in NICU required mechanical ventilation (MV). Commonest indication was severe respiratory distress (70%) followed by perinatal asphyxia (12%) and recurrent apnea (8%). Disease pattern were sepsis (37.2%), RDS of prematurity (17.6%), perinatal asphyxia (11.7%), meconium aspiration syndrome (9.8%), apnea of prematurity (7.8%) and congenital pneumonia (4%). Hospital acquired sepsis was a major complication occurring in 47% patients on mechanical ventilation. Survival rate among neonates on MV was 33%. Survival was better with increasing birth weight and gestational age. Survival was 100% in congenital pneumonia, 50% in perinatal asphyxia, 50% in recurrent apnea, 26% in sepsis, 20% in MAS and 0% in RDS of prematurity. Conclusion: Survival rate of neonates on mechanical ventilation in NICU was 33%. Sepsis was a major problem in NICU, which must be addressed to improve outcome.Publication Kikuchi Fujimoto as an Initial Presentation of Systemic Lupus Erythromatosis(Nepal Paediatric Society (JNPS), 2021) Basnet, Srijana; Shrestha, Laxman; Shrestha, PrabinaAbstract: Kikuchi-Fujimoto Disease (KFD) is a rare benign, condition of necrotising histiocytic lymphadenitis. In this case report, we discuss a case of 10 year old male patient who presented with a fever, rash and generalised lymphadenopathy that was not attributable to the more common causes. Axillary lymph node biopsy confirmed the diagnosis of KFD. Treatment with prednisolone improved his symptoms but after six months he had recurrence of his symptoms. He was investigated again and finally met diagnostic criteria for SLE. This case report highlights importance of close follow up in a child with KFD.Publication Mortality and Morbidity Pattern of Preterm Babies at a Tertiary Level Hospital in Nepal(Nepal Paediatric Society (JNPS), 2013) Shrestha, Laxman; Shrestha, PrabinaAbstract: Introduction: Preterm birth is a major determinant of neonatal mortality and morbidity and has long-term adverse consequences for health. The objectives of this study were to find the demographic characteristics and clinical course of preterm babies admitted at Neonatal Unit of TU Teaching Hospital. Materials and Methods: A retrospective study was done by collecting data from labour room, NICU and by reviewing medical records of all preterm babies admitted to NICU in 2011. Results: There were total of 266 preterm deliveries in TUTH in the year 2011. About 45% of them required NICU admission. Ninety five babies were included in the study. Most common cause of premature delivery was maternal pregnancy induced hypertension (26%). Other causes were preterm premature rupture of membrane (24%) and in 25% of cases the cause was unknown. There were 10 (10.5%) severe preterm babies with mean weight 1.4 ± 0.3 kg, 27 (28.5 %) moderate preterm babies with mean weight 1.8 ± 0.4 kg and 58 (61%) late preterm babies with mean weight 2.2 ± 0.5 kg. Respiratory distress syndrome (RDS) was seen in 32% babies, hyperbilirubinemia in 40% babies, sepsis occurred in 37% and NEC in 4%. Hypothermia was seen in 10.5% and hypoglycemia in 5% babies. Apnea of prematurity was seen in 7% babies. Mechanical ventilation was required in 7% babies. The overall mortality was 12%. The main causes of death were respiratory distress syndrome and sepsis. The mean duration of stay was 10.2±8.8days. The survival rate of severe preterm babies was 80%, moderate preterm babies was 78% while that of late preterm was 95%. Conclusion: The main causes of morbidities in preterm babies were respiratory distress, hyperbilirubinemia and sepsis. Respiratory distress syndrome and sepsis were the predominant causes of mortality in these babies.