Browsing by Author "Singh, Rajesh Kumar"
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Publication A Case of Hodgkin Lymphoma Presenting as Nephrotic Syndrome(Nepal Paediatric Society (JNPS), 2016) Dakhane, Yogesh Rambhau; Singh, Rajesh Kumar; Thapar, Rajeev KumarAbstract: Nephrotic changes as part of the paraneoplastic syndrome are rare in lymphoid malignancies. One percent of cases of Hodgkin's Lymphoma cases may present with nephritic syndrome. We are reporting a case which initially presented as nephritic syndrome and later was diagnosed to have of Hodgkin's Lymphoma and managed accordingly.Publication Breast Feeding as Analgesia in Neonates: A Randomized Controlled Trial(Nepal Paediatric Society (JNPS), 2016) Singh, Rajesh Kumar; Simalti, Ashish Kumar; Singh, DaljitAbstract: Introduction: Major myth regarding neonatal pain suggests that neonates because of their neurological immaturity do not experience pain. Although exact mechanism is not known, it is proposed that breast feeding through combination of various senses and the closeness of the infant’s mother, saturates the senses thus reducing perception of noxious stimuli. The objective of this study was to investigate the analgesic effect of breastfeeding during blood sampling through heel lance in healthy term neonates. Material and Methods: This was a Randomized controlled trial done in a Tertiary level Neonatal Intensive Care Unit. Sixty healthy term newborns, undergoing heel prick were included in study. Neonates were randomly assigned to two groups: Group I (breastfed) with; Group II (not breast fed). Babies were given heel prick and crying time, Heart rate, SpO2 and BP monitored. Changes in various physiological parameters following a heel prick were studied in two groups. Results: Neonates in both groups expressed pain by crying, increase in heart rate, fall in transcutaneous oxygen saturation and rise in blood pressure. Compared to control group, the babies who were breast fed were found to have lesser crying time (40.04 sec and 69.09 sec respectively, p<0.05) and lesser rise in heart rate (rise of 21.78 and 34.46 bpm respectively, p<0.03). In the breast fed group there was a trend to a lesser decrease in oxygen saturation and lesser rise in blood pressure though this was not statistically significant. Conclusion: Breast feeding offers a quick and effective means of reducing pain in neonates during routine neonatal procedures.Publication Clinical Spectrum of Malaria in Hospitalised Children at a Tertiary care Centre in North India - A Retrospective study(Perinatal Society of Nepal (PESON), 2025) Pandey, Charu; Singh, Rajesh KumarAbstract: Introduction : Malaria continues to cause high morbidity and mortality in the tropical countries, children being among the vulnerable age group. We conducted a retrospective study at a tertiary care centre in northern India to determine the pattern of the disease in our area. Methods: A descriptive retrospective in children aged 1 month to 18 years of age, admitted at our paediatric unit, with positive antigen test and/or peripheral smear for malaria. Presenting features, clinical signs, laboratory parameters, treatment and outcome were recorded. Statistical analysis was done using freely available software online. Results: 57 patients tested positive for malaria. The parasite species found in all positive tests was Plasmodium vivax. 22 (38.5%) of patients were classified as severe malaria. M:F ratio of 1.03:1. Fever was the most common presenting complain (100%), followed by pallor (52.6%) and persistent vomiting (35%). Antimalarial given was injection Artesunate in 53 (93%) of patients, oral artemeter lumefantrine was started as primary treatment in 3 (5.26%) patients, while chloroquine was given to only 1 (1.7%) patient. Blood component transfusion was required in 11 patients. 54 (94.7%) patients improved and were discharged, while 1(1.7%) patient was referred to higher centre, 2 (3.5%) patients left against medical advice. Mean duration of hospital stay was 6.2 (±2.35) days. Conclusions: Plasmodium vivax was the leading cause of malaria at our institute, causing both severe and uncomplicated malaria. Plasmodium vivax is no longer a benign entity.Publication Coexistence of Allergic Rhinitis in Children Attending Paediatric Asthma Clinic(Nepal Paediatric Society (JNPS), 2019) Singh, Rajesh Kumar; Simalti, Ashish KumarAbstract Introduction: Asthma and allergic rhinitis are considered manifestations of the chronic inflammatory respiratory syndrome of the common airways or united airways disease. We conducted a prospective epidemiological study to evaluate the prevalence of allergic rhinitis among children already diagnosed as having asthma. Methods: A prospective epidemiological study was carried out during 2015 to 2016 at a tertiary care centre in North India. The severity of asthma was classified according to the Global Initiative for Asthma (GINA) report & allergic rhinitis according to Allergic Rhinitis and Its Impact on Asthma (ARIA). Results: A total of 64 children were screened. After excluding five subjects (7.8%), 59 subjects with asthma were analysed. We could not find any definitive correlation between severity of asthma to severity of allergic rhinitis (p > 0.05). The prevalence of co morbidity of asthma and allergic rhinitis was maximum when onset of asthma was between three to six years (70%), was 40% for < three years and 50% when age of onset was six to nine years. The age of onset of asthma in children having asthma only was five years and that of children with both asthma and allergic rhinitis was 5.5 years. This difference was not significant (p > 0.05). Conclusion: There was a high prevalence of co morbidity (50.84%) of allergic rhinitis among patients with asthma. A positive correlation was found between duration and severity of asthma, but this was not observed for allergic rhinitis. In most cases asthma preceded or started with AR. Author Biographies Rajesh Kumar Singh, Command Hospital (Eastern Command) Kolkata, India Department of Paediatrics Ashish Kumar Simalti, Army Hospital Research and Referral, New Delhi, India Department of PaediatricsPublication Empyema in Children - Is Primary VATS the Preferred Strategy(Nepal Paediatric Society (JNPS), 2020) Singh, Rajesh Kumar; Gurudutta, Avathi Venkatesha; Chandrasekar, Supraja; Thomas, ArunAbstract: Introduction: Empyema thoracis (ET) is an accumulation of pus in the pleural space. Considering the advantages of Video Assisted Thoracoscopic surgery (VATS), including reduced length of hospitalisation, lower postoperative morbidity and mortality, VATS is the treatment of choice for cases of stage 3 empyema. The objective of this study was to study the age-sex profile, clinical presentation, etiologic agents, management and the overall treatment outcome of empyema thoracis after early VATS in children. Methods: This was a retrospective observational study, conducted in the Department of Paediatrics, Rangadore Memorial Hospital, Bangalore, from November 2018 to March 2020. All children in the age group of 0 to 18 years diagnosed to have pyogenic empyema and presenting in stage 1 and 2 during the study period were included in the study. In the present study, 15 children were found to be having empyema (stage 1 and 2). Results: Majority of patients (66.6%) were seen in the age group of one to five years. Fever (100%), breathlessness (66.66%), and cough (80%) were the commonest presenting features. Bacteriological isolation was possible only in three cases (20%). Patients were treated with antibiotics and primary VATS in majority of cases (55.33%). Average duration of hospital stay in VATS group was 12.11 days. Conclusions: Empyema thoracis mainly affects younger children. Common presenting features are fever, difficulty in breathing and cough. Appropriate antibiotics and early VATS may be acceptable modality for management of pyogenic empyema thoracis in children.Publication Factors Affecting Drug Compliance in Paediatric Asthma(Nepal Paediatric Society (JNPS), 2017) Singh, Rajesh Kumar; Thapar, Rajeev Kumar; Gupta, Rakesh Kumar; YV, AbhijitAbstract: Introduction: Childhood asthma is an immensely important chronic disease in children with increasing prevalence worldwide. Inhaled corticosteroids and bronchodilators are the key drugs in asthma therapy. Material and Methods: Compliance of childhood asthma was assessed at a tertiary care centre to find out the percentage of compliant Vs noncompliant patients and the reasons for the latter. If the patient had attended at least nine visits (> 75%) the previous year he was labelled compliant and those with less than six visits (<50%) were put in the non-complaint group. Results: Of the 374 patients attending the asthma clinic, 60 were randomly selected for the study of which 53 finally participated. In this study the compliance was 47% and gender predilection did not affect compliance. The distance a patient had to commute to reach the hospital and the mother’s education did not have any influence on the compliance. Older asthmatics exhibited better compliance in our study. Conclusion: Forty percent of our patients were compliant to regular use of prescribed medicine. Older age of the patients and care giver`s awareness about asthma were the two factors which are statistically significant in compliance with drug therapy in asthma. Gender of the patient, academic qualification and distance from the hospital did not have a significant effect on compliance.