NepMed Repository :: Browsing by Author "Shrestha, Sabina"

Browsing by Author "Shrestha, Sabina"

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Congenital Heart Disease among Children Undergoing Echocardiography in the Department of Paediatrics of Tertiary Care Centre: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2024) Chimoriya, Romila; Chimoriya, Ritesh; Shrestha, Mandira; Shrestha, Sabina; Shah, Kailash; Lama, Lopsang; Rana, Kritika
Abstract Introduction: Congenital heart disease in children are a major cause of infant mortality and morbidity. It is important to detect and manage these disorders timely as they are preventable. The objective of this study was to find out proportion of congenital heart disease in children in paediatric department in a tertiary hospital. Methods: This is a descriptive cross-sectional study carried out in the Department of Paediatric at Nepal Medical College and Teaching Hospital where all children (0-18 years) suspected to have congenital heart disease who underwent echocardiography were studied over a period of 1 year (2020-2021). The presence or absence of congenital heart disease were confirmed by echocardiography performed by paediatric cardiologist. The socioeconomic variables,clinical features and echocardiography findings were noted. Results: Out of total 249 patients,the proportion of patients diagnosed to have cardiac disorders was 73 with male predominance of 165 (66.26%). The most common age group was found to be neonates 111 (44%).The notable clinical features were murmur 47 (18.87%), tachypnoea 27 (10.84%) ,tachycardia 27 (10.84%) and cyanosis 9 (3.61%), clubbing 2 (0.80%), oedema 1 (0.40%), hypertension 9 (3.65%), murmur 47 (18.87%).Out of the total, there were 49 (19.67%) cases of acyanotic congenital heart disease, and 27 (10.84%) cases of cyanotic congenital heart disease. Conclusions: Our study focuses on early recognition of cardiac diseases which is crucial for preventing morbidity and mortality.
Culture Positive Cases of Ophthalmia Neonatorum in a Tertiary Care Centre of Nepal: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2021) Shrestha, Sabina; Manandhar, Sunil Raja; Malla, Om Krishna
Abstract: Introduction: Ophthalmia neonatorum although runs a benign course mostly, sometimes may progress to sight threatening complications. The study was conducted to find the prevalence of culture positive cases of opthalmia neonatorum. Methods: It was a descriptive cross-sectional study conducted at a tertiary care center from January to December 2019. Ethical clearance was obtained from institutional review committee of Kathmandu Medical College. Convenience sampling was done. All data were entered into excel and, then for analysis, exported to Statistal Package for Social Sciences version 21. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: The prevalence of culture positive cases of opthalmia neonaturum is 10 (55.55%) (32.61-78.49 at 95% Confidence Interval). The causative organisms were coagulase negative Staphylococcus 4 (40%), Staphylococcus aureus 3 (30%), Klebsiella 2 (20%) and Pseudomonas 1 (10%). Culture sensitivity of the isolated organisms were different according to the patient even in case of the same organism. Vancomycin 7 ( 70%) was the most sensitive antibiotic followed by Ciprofloxacin 6 (60%), Amikacin 5 (50%) and Cloxacillin 5 (50%) while Azithromycin 1 (10%), Cefixime 1 (10%) and Cotrimoxazole 1 (10%) were the least sensitive. Conclusions: Staphylococcus species was the most common organism isolated from neonates with ophthalmia neonatorum and vancomycin was the most sensitive antibiotic.
Depression, Anxiety and Stress among School-going Adolescents of a Secondary School: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2023) Shrestha, Sabina; Phuyal, Rajan; Chalise, Pratikshya
Abstract Introduction: Mental health of adolescents can affect growth and development, decrease school performance, and impair social relationships with peers and families. The COVID-19 pandemic has changed the social and educational scenario and affected the psychological condition of children and adolescents. This study aimed to find out the prevalence of depression, anxiety and stress among school-going adolescents in a secondary school. Methods: A descriptive cross-sectional study was done among school-going adolescents of a school from 1 October 2021 to 31 November 2021. Ethical approval was taken from the Institutional Review Committee (Reference number: 0609202101). Data was collected using a questionnaire consisting of sociodemographic parameters and a diagnosis of depression anxiety and stress was made using a standard scale. The whole sampling method was used. Percentage and frequency were calculated for binary data. Results: Among 95 patients, the depression was found in 31 (32.63%), anxiety in 36 (37.89%), and stress in 3 (3.16%). Conclusions: The prevalence of depression, anxiety and stress was lower than in other studies done in similar settings. The mental health status of school-going adolescents should be identified and appropriate timely interventions need to be taken. Family members, teachers and the concerned authorities should give emphasis to the psychological well-being of the adolescents.
Diaphragmatic Hernia in a Preterm with Congenital Heart Defects with Successful Outcome: A Case Report
(Nepal Medical Association, 2022) Manandhar, Sunil Raja; Shrestha, Ashish Lal; Shrestha, Sabina; Basnet, Rydam
Abstract Congenital diaphragmatic hernia is an anatomical defect of the diaphragm that is often associated with serious cardiopulmonary complications. It can also be associated with many other problems like multi systemic anomalies, chromosomal aneuploidy and prematurity. Of these, cardiac defects, liver herniation and prematurity seem to have a pivotal role in affecting the outcomes of repair. We hereby present a preterm newborn with such multiple defects repaired on 15th day of life and post operatively managed in a Neonatal Intensive Care Unit with a successful outcome. The key learning objective for our team in this case was to identify the steps taken that led to a successful management of a low birth weight preemie with multiple defects in a resource limited set up.
Dry Eyes among Visual Display Terminal Users Visiting the Outpatient Department of Ophthalmology of a Tertiary Care Centre
(Nepal Medical Association, 2023) Sharma, Dikchhya; Shrestha, Sabina
Abstract Introduction: Visual display terminal usage has increased substantially in recent years across all age groups and is considered one of the major risk factors for dry eye disease. Early assesment of dry eyes and prevention is important. The aim of this study is to find the prevalence of dry eyes among visual display terminal users visiting the Outpatient Department of Ophthalmology of a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among patients visiting the Department of Ophthalmology in a tertiary care centre after receiving ethical approval from the Institutional Review Committee. Data was collected from 1 October 2021 to 31 March 2022. Convenience sampling method was used. The point estimate was calculated at a 90% Confidence Interval. Results: Among 94 visual display terminal users, the prevalence of dry eyes was 55 (58.51%) (50.18-66.84, 90% Confidence Interval). Conclusions: The prevalence of dry eyes among visual display terminal users visiting the Outpatient Department of Ophthalmology was similar to other studies done in similar settings.
Feeding Intolerance among Preterm Neonates Admitted to the Neonatal Intensive Care Unit at a Tertiary Care Centre: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2022) Kayastha, Pawana; Shrestha, Sabina; Subba, Ashish
Abstract Introduction: Premature infants frequently suffer from feeding intolerance related to prematurity and are highly associated with morbidity and mortality. Breast milk is fundamental to the improvement of the infant’s immature vulnerable framework and decreases child mortality. The aim of this study was to find out the prevalence of feeding intolerance in premature neonates admitted to the neonatal intensive care unit of a tertiary care centre. Methods: This descriptive cross-sectional study was carried out among premature infants admitted to the Neonatal Intensive Care Unit of a tertiary care hospital, from 15 December 2021 to 15 May 2022 after receiving ethical approval from the Institutional Review Committee (Reference number: 2211202103). Convenience sampling was done. Point estimate and 95% Confidence Interval were calculated. Results: Among the 55 preterm neonates, the prevalence of feeding intolerance was 21 (38.18%) (25.34-51.02, 95% Confidence Interval). Conclusions: The study showed that the prevalence of feeding intolerance among neonates was higher than in studies conducted in similar settings.
Hypoplastic Left Heart Syndrome: A Case Report
(Nepal Medical Association, 2023) Manandhar, Sunil Raja; Ghimire, Anjila; Rai, Dipendra; Shrestha, Sabina; Adhikari, Pritha
Abstract Hypoplastic left heart syndrome is a rare critical congenital heart defect constituting a prevalence of 1/3,500 to 1/12,500 live births in which there is obstructions to the blood flow within the left heart. Here we present a case of a full-term 38 weeks male baby with a birth weight of 3.5 kg, and no obvious physical deformity referred to our centre at 22 hours of life for respiratory distress and cyanosis. At 23 hours of life, he was diagnosed with hypoplastic left heart syndrome and kept on Prostaglandin E1 infusion till the 12th day of life. The baby had a large ventricular septal defect and atrial septal defect with a severely hypoplastic left ventricle, hypoplastic aortic root, ascending aorta and post-ductal coarctation of the aorta. The diagnosis was reconfirmed by computed tomography cardiac angiography on the 10th day of life with the same cardiac findings suggestive of hypoplastic left heart syndrome.
Knowledge, Attitude and Practices among Mothers of Children 6 to 24 months of Age Regarding Complementary Feeding
(Nepal Medical Association, 2020) Shrestha, Sabina; Pokhrel, Manoj; Mathema, Smriti
Abstract: Introduction: Complementary foods fill the gap between the total nutritional needs of the child and the amounts provided by breast milk. Inappropriate feeding practices are a major cause of the onset of malnutrition in young children. The objective of this study was to assess the knowledge, attitude, and practices of mothers of children between 6 to 24 months of age regarding complementary feeding. Methods: This Knowledge, Attitude, and Practice Study was conducted among 250 mothers in Kathmandu Medical College and Teaching Hospital from June 2019 to November 2019 after obtaining ethical approval from the institutional review committee (Ref no. 150320199). Convenient sampling method was applied. The mothers of children between 6 to 24 months were interviewed using a structured questionnaire to ascertain the knowledge, attitude, and practices regarding complementary feeding. Statistical analysis was done using SPSS version 20. Results: Two hundred and fifty mothers were interviewed. 151 (60.4%) mothers knew initiation of breastfeeding soon after birth and 179 (71.6%) were knowledgeable about exclusive breastfeeding for 6 months. 161 (64.4%) mothers knew the proper age of initiating complementary feeding but only 139 (55.6%) mothers practiced it. Early initiation of complementary feeding was done by 87 (34.8%) mothers while 24 (9.6%) mothers delayed it beyond 6 months. Conclusions: There was a gap in knowledge and practice among mothers regarding adequate age of initiation of complementary feeding, complementary foods, preparation, and practices.
Neonates Born Through Meconium-stained Amniotic Fluid among Deliveries in a Tertiary Care Centre: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2022) Shrestha, Sabina; Pokhrel, Manoj; Manandar, Sunil Raja
Abstract Introduction: The mortality and morbidity of meconium aspiration syndrome in neonates born with meconium-stained amniotic fluid in developing countries are still high. In Nepal, few studies have estimated the prevalence of meconium-stained amniotic fluid among newborns. The study aimed to find out the prevalence of neonates born through meconium-stained amniotic fluid among deliveries in a tertiary care centre. Methods: This descriptive cross-sectional study was conducted among neonates born in a tertiary care centre from November 2021 to March 2022. Neonates born during the study period with meconium-stained amniotic fluid were studied. Ethical approval was obtained from the Institutional Review Committee. Convenience sampling method was used. With permission from the Department of the Neonatal Intensive Care Unit, the data were collected and entered in a Microsoft Excel sheet. Point estimate and 95% Confidence Interval were calculated. Results: Among 576 neonates, the prevalence of neonates born through meconium-stained amniotic fluid was 77 (13.37%) (10.59-16.15, 95% Confidence Interval). Conclusions: The prevalence of neonates born through meconium-stained amniotic fluid was found to be similar to other studies done in similar settings.
Post-Transplant Fecal Carriage of Antibiotic Resistant and ?-Lactamases-Producing Enterobacteriales among Renal Transplant Recipients
(Nepal Health Research Council, 2023) Joshi, Bindira; Yadav, Santosh Kumar; Hada, Manju Shree Shakya; Shrestha, Sabina; Shrestha, Kalpana Kumari; Shrestha, Pukar Chandra; Awal, Bal Krishna
Abstract Background: The intestinal colonization and transmission of antibiotic-resistant Enterobacteriales to renal transplant recipients may pose a threat to them because they are profoundly immunocompromised and vulnerable to infection. Hence, it is crucial to identify these antibiotic-resistant fecal Enterobacteriales harboring high-risk populations. The objective of this study was to determine antibiotic resistance as well as ?-lactamases production in fecal Enterobacteriales among renal transplant recipients. Methods: The stool samples, one collected from each transplant recipient, were processed for isolation and identification of Enterobacteriales and were tested for their antibiotic susceptibility, extended-spectrum ?-lactamase, and metallo-?-lactamase production by standard methods. Results: A total of 103 Enterobacteriales comprising of Escherichia coli (86.4%), Klebsiella species (11.7%), and Citrobacter species (1.9%) were isolated and more than 60% of the E. coli were found resistant to ceftazidime and ciprofloxacin and around half of the Klebsiella species were resistant to ceftazidime and fluroquinolones. The extended-spectrum ?-lactamase production was seen in 3.4% and 8.3% and metallo-?-lactamase production in 24.7% and 33.3% of E. coli and Klebsiella species, respectively. The high proportion of ?-lactamase-producers were resistant to piperacillin-tazobactam, meropenem, gentamicin, and amikacin than ?-lactamases non-producers. Conclusion: Since the antibiotic resistance is higher in fecal Enterobacteriales, each renal transplant recipient should be screened for these highly resistant intestinal colonizers after transplantation in order to prevent infections and to reduce the rate of transplant failure due to infections. Keywords: Antibiotic resistance; ?-lactamases; enterobacteriales; fecal carriage; renal transplantation. Author Biographies Bindira Joshi, Department of Pathology, Shahid Dharmabhakta National Transplant Centre, Bhaktapur, Nepal Santosh Kumar Yadav, Province Public Health Laboratory, Madhesh Province, Janakpurdham, Nepal
Visual Functions in Patients with Optic Neuritis Pre and Post Treatment: An Observational Study
(Nepal Medical Association, 2025) Malla, Shailiya; Shrestha, Sabina
Abstract Introduction: Optic neuritis is an inflammatory condition affecting the optic nerve. It presents with sudden diminution of vision, also affecting colour vision, contrast sensitivity and stereoacuity. Steroids are given in optic neuritis to reduce inflammation of optic nerve. The aim of this study was to compare the visual functions in patients with optic neuritis before and after treatment with steroid therapy. Methods: This prospective study was conducted from November 2021 to October 2022 in the Department of Ophthalmology of a tertiary-level hospital. Thirty-seven eyes affected by optic neuritis of were included in the study. All the patients were given IV methylprednisolone for 3 consecutive days followed by oral prednisolone for 11 days in tapering doses. Visual functions such as visual acuity, colour vision, contrast sensitivity and stereoacuity at presentation and after treatment were compared. Results: Among 37 eyes, 24 (64.86%) had best corrected visual acuity <1/60-perception of light at presentation, improving after six weeks with 21 (56.76%) achieving visual acuity 6/6-6/18. At presentation, only 1 (2.71%) had normal colour vision while at six weeks, 9 (24.32%) had normal colour vision. Contrast sensitivity could not be assessed in 29 (78.37%) cases at presentation due to poor vision, which reduced to 12 (32.43%) at six weeks. None had good stereoacuity at presentation; however, 6 (16.22%) had good stereoacuity after six weeks. Conclusions: The study showed that steroid therapy improved visual functions in patients with optic neuritis.

Browsing by Author "Shrestha, Sabina"

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