Browsing by Author "Shrestha, SM"
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Publication Disease Profile and Hospital Outcome of Newborn Admitted to Neonatal Intermediate Care Unit at Tertiary Care Center in Nepal(Kathmandu University, 2017) Chapagain, RH; Basaula, YN; Kayatha, M; Adhikari, K; Shrestha, SMABSTRACT Background Neonatal mortality rate (NMR) is decreasing in Nepal but at a slower pace than infant and child mortality. In order to improve neonatal outcome, Care of sick children can be done better so as to aid in reducing neonatal mortality rate. Objective The objective was to identify pattern of diseases and outcome admitted to Neonatal Intermediate care Unit (NIMCU). Method A retrospective study was conducted at Neonatal Intermediate care Unit of Kanti Children’s hospital from Bhadra 2071 to Shravan 2073 (August 2014 to July 2016). Result Total 1286 neonates were admitted in Neonatal Intermediate care Unit with the highest admission in the months of Bhadra (August-September) 12.52% and the lowest in Push (December-January) 4.82%. Among the admitted cases, 1,028 (80.0%) were full term while 256 (20.0%) were preterm. Among the total admission, 43.6% were less than 7 days old which is the most vulnerable period during the newborn phase. Admission due to neonatal sepsis was 892 (69.36%). Among them, 628 (70.40%) were late onset neonatal sepsis while 264 (29.60%) were early onset. Neonatal jaundice accounted for 12.36% (159) of the cases while Hypoxic Ischemic Encephalopathy accounted for 4.80% (62) of cases. Congenital Heart Disease were 53 (4.12%) and neonatal pustulosis were 27 (2.20%). Meningitis accounted for 45 (3.49%) of cases and UTI 29 (2.22). Death during treatment were 18 (1.39%). 7% of cases deteriorated and referred to NICU while, 3.2 % of cases were referred to other centers and 5.1% of cases were either discharged on request or left against medical advice. Conclusion Neonatal sepsis including both early and late onset, Congenital Heart disease, birth asphyxia and neonatal Jaundice accounted for majority of admission in NICU. Three of four these etiologies are preventable up to some extent. KEY WORDS Morbidity, mortality neonate, sepsis, outcomePublication Visual outcome of laser treatment in diabetic retinopathy(Kathmandu University, 2007) Shrestha, S; Karki, DB; Byanju, R; Malla, OK; Shrestha, SM; Pradhananga, CLObjective: To determine the visual outcome of laser treatment in diabetic retinopathy. Design: Prospective, non-comparative case series. Materials and methods: A total of 80 eyes of 50 patients with diabetic retinopathy in different stages were photocoagulated using diode green laser. Focal laser only was given in 46 eyes and pan retinal photocoagulation only was given in 29 eyes while 3 eyes received focal laser and pan retinal photocoagulation. One eye was given grid laser only and one eye received both grid and focal laser. The best corrected visual acuity was noted and fundus examination was carried out prior to laser therapy and at the last follow-up and results were compared. Results: Non- proliferative diabetic retinopathy was present in 76%. Following laser treatment, best corrected visual acuity improved in 52.50%, remained static in 35% and deteriorated in 12.5%. Maculopathy improved in 52%, remained static in 6% and deteriorated in 2% in right eyes while there was no maculopathy in 40% in right eyes. Similarly, maculopathy improved in 38% and remained same in 10% while 52% had no maculopathy in left eyes. After laser treatment, NVD (OD) regressed in 6% and remained unchanged in 4%. Similarly, NVE (OD) regressed in 18% and remained unchanged in 4% and NVE (OS) regressed in 18% and remained unchanged in 2% following laser therapy. Conclusion: Timely and adequate laser treatment helps in saving the vision in patients with diabetic retinopathy. Key words: Diabetic retinopathy, Diabetic maculopathy, Diode laser, Pan retinal photocoagulation, Visual outcome