Browsing by Author "Upadhyay, Satyam"
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Publication Endoscopic Profile of Children with Colorectal Polyps Attending a Tertiary Centre(Nepal Paediatric Society (JNPS), 2017) Upadhyay, Satyam; Sharma, Anna; Sapkota, PrabitaAbstract: Introduction: Polyps are the most common causes of colorectal bleeding in children. This report describes an endoscopic profile of children with colorectal polyps at Nepal Medical College and Teaching Hospital. Materials and Methods: This prospective study was conducted in children who were evaluated for painless lower GI bleed who underwent colonoscopyin Nepal Medical College, Kathmandu, Nepal from November 2014 to May 2017. Patients with age of presentation less than or equal to 18 years and diagnosed endoscopically to have colorectal polyp were included in the study and were followed up till histopathological reports. Results:A total of 35children with colorectal polyps were identified. Twenty-three (65.7%) patients were males and 12 (35.3%) were females, male/ female ratio being 2.1: 1. The mean age of the patients at the time of diagnosis was 5.2 years (±3.7 years), (range 1.3-13.5) years. The duration of bleeding varied from 1 week to 3 years (mean 13 months), and 23 (67.6%) children were symptomatic for more than 12 months. All patients (100%) had painless rectal bleed, eight (23.5%) presented with anaemia and two of them requiring blood transfusion before the procedure (< 7.0 gm/dl),seven (20.5%) patients had blood and mucus in stools, six (17.6%) of them had rectal mass (prolapsed polyp). Conclusion:Juvenile colorectal polyps are the most common cause of painless rectal bleeding in young children. In the majority, these are solitary, occur in the rectosigmoid. Delay in treatment may cause anaemia.Colonoscopic snare polypectomy is a safe therapeutic modality.Publication Percutaneous Endoscopic Gastrostomy in Children: Experience from Single Center of a Developing Country(Nepal Paediatric Society (JNPS), 2014) Kehar, Mohit; Wadhwa, Nishant; Upadhyay, SatyamAbstract: Introduction: Nutrition is of paramount importance for adequate growth and development of a child. Various routes of providing enteral nutrition to a paediatric patient are by nasogastric, nasojejeunal and gastrostomy which can be placed surgically or endoscopically. The objectives of this study were to review cases with percutaneous endoscopic gastrostomy (PEG) procedure and patient characteristics, indications, complications and outcome of PEG tube insertion in children at our center. Materials and Methods: This was a prospective study carried out in Sir Ganga Ram Hospital in New Delhi, India for a period of two years from August 2010 to August 2012. It included patients in whom PEG tube were placed during the study period and have had at least one year of post procedure follow up. Demograhic details, duration of procedure, complications, initial weight and height and then at 3 month, 6 months and 12 months of PEG tube placement were also recorded. Data between groups was compared using ANOVA and within groups across follow-ups was done using paired t-test. Results: Fourty six PEG insertions were performed during the study period, 26 twenty six conversions to BRT or Mickey button and ten PEG removals. The main indications for PEG insertion were Cerebral palsy with feeding difficulty (47.8 %). Erythema at the PEG insertion site was the most common complication (21%). There was significant improvement in the weight and height in all age group of patients at 3, 6 and 12 months post procedure with a p value <0.5. The average weight gain after 3, 6 and 12 months was 1.3 kg, 2.8 kg and 4.2 kg and the average height gain after 3, 6 and 12 months was 1.6 cm, 2.5 cm and 4.13 cm respectively. Conclusions: PEG is effective means for optimizing the nutritional goals of patients who are nutritionally debilitated with minimal complications.