Browsing by Author "Yadav, S"
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Publication Risk Factors for Severe Bronchiolitis in Children admitted at Birat Medical College Teaching Hospital(Kathmandu University, 2024) Yadav, S; Yadav, R; Mahat, RK; Rimal, HABSTRACT Background Bronchiolitis is the most common cause of hospitalization in infants under the age of 2 years. There are various risk factors associated with severe disease. Therefore, identifying risk factors of severe bronchiolitis and acting promptly is foremost to avoid its adverse outcome. Objective To find out the socio-demographic, clinical profile and risk factors associated with severe bronchiolitis. Method This was hospital based cross-sectional study of data of children between 3 months to 2 years admitted in the Department of Pediatrics with a clinical diagnosis of bronchiolitis from September 2023 to May 2024. Various factors were recorded to identify risk factors for severe bronchiolitis. Result Ninety children were included in the study with a majority of age group 3 to12 months (76%) and male to female ratio of 1.8. The most common symptoms were cough (85%), fever (76%), blocked nose (56%) and difficulty in breathing (35%). On applying bivariate analysis, age group, lack of exclusive breast feeding, having siblings and low maternal literacy were significant risk factors whereas on applying multivariate analysis, were found significant associations between having siblings (Adjusted Odd Ratio=5.555, 95% Confidence Interval=1.332-23.169, p value= 0.019) and low maternal literacy (Adjusted Odd Ratio =0.233, 95% Confidence Interval =0.063-0.859, p value= 0.002) for severe bronchiolitis. Conclusion In our study, cough and fever were the most common symptoms of bronchiolitis. Having siblings and low maternal literacy were the significant risk factors for severe bronchiolitis. KEY WORDS Bronchiolitis, Children, Risk factors, Severe disease, SiblingsPublication Spontaneous Pneumothorax: Follow up Treatment Outcome in a Tertiary Care Center of Eastern Nepal(Kathmandu University, 2020) Ghimire, RH; Ghimire, A; Bista, B; Yadav, S; Shreewastav, RKABSTRACT Background Spontaneous pneumothorax is not an uncommon medical emergency in pulmonary practice. Related data are not available in our setting. In emergency departments, clinical presentation is often confused with other cardiopulmonary problems. Follow up outcome is important for better patient care. Objective To study clinical profile and outcome after non surgical intervention in a tertiary care center. Method This was a prospective observational study carried out in Nobel Medical College, Biratnagar over last 3 years. We enrolled consecutive spontaneous pneumothorax patients over 15 years of age. Each data related to individual patients were collected in predefined proforma. To study follow up outcome of management, we used OPD attendance or if not possible took, at least two telephone numbers from the patients. All patients were followed for recurrences. Data was statistically analyzed using SPSS software. Result Over the last 3 years, we enrolled 65 spontaneous pneumothorax patients. Secondary spontaneous pneumothorax was more common (92.3%). Commonest presentations were acute pleuritic chest pain (92.3%), dyspnea (84.62%) and cough (92.3%). COPD (46.14%), PTB sequelae (15.38%), bronchiectasis (23.07%) and bullous lung disease (23.07%) were common risk factors. Tube thoracostomy (95.38%) with pleurodesis with iodopovidone (84.61%) led to lung expansion in 92.3% cases. During follow up, only 4.61% had recurrences of pneumothorax. There was one mortality. Conclusion Spontaneous pneumothorax is a common pulmonary emergency. Meticulous and careful assessment of the patients may help reach the diagnosis even in primary care setting. Tube thoracostomy followed by pleurodesis with iodo-povidone suffices in most circumstances leading lower future recurrences. KEY WORDS Nepal, Spontaneous pneumothorax, Treatment outcome