Browsing by Author "Yadav, Shankar Prasad"
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Publication Nucleated Red Blood Cell in Cord Blood as a Marker of Perinatal Asphyxia(Nepal Paediatric Society (JNPS), 2015) Kanodia, Piush; Bhatta, Nisha Keshary; Singh, Rupa Rajbhandari; Shah, Gauri Shankar; Yadav, Shankar Prasad; Yadav, Sunil KumarAbstract: Introduction: Perinatal asphyxia is a common problem with the incidence varying from 0.5 –2% of live births. According to World Health Organization, approximately 4 million babies die each year before they reach the age of one month. The number of NRBC/100 WBC is variable but is rarely greater than 10 in normal neonates. This simple test can be helpful in the rapid assessment of perinatal asphyxia. Material and Methods: This prospective case-control study and there were 82 newborns in Case and 82 newborns in Controls comprising of asphyxiated and nonasphyxiated neonates, respectively, over a period of 12 months. Results: Out of the 82 neonates in case group, fifty nine (59) neonates were found to have NRBC level ≥10/100WBC, out of which 58 (70.7%) were cases and 1(1.2%) was a control. NRBCs count of ≥10/100WBC were seen more in the newborn who had low 5 min Apgar score and in the newborn with severe HIE, these association were statistically significant (P value <0.001). The cut-off NRBC value of ≥10/100WBC also found to have a sensitivity of 70.30% with a specificity of 98.78%. NRBC has a positive predictive value of 98.31% with a negative predictive value of 77.14%. Significance and sensitive area for ROC curve was 0.875. The ROC curve was calculated with cut-off NRBC value of ≥10/100WBC. Conclusions: NRBC counts can be very useful to differentiate HIE newborns from non-HIE newborns which will help in appropriate management and better outcome of these newborns.Publication Poor Prognostic Indicators of Scrub Typhus(Nepal Paediatric Society (JNPS), 2016) Yadav, Shankar Prasad; Yadav, Sunil Kumar; Kanodia, Piush; Shah, Gauri Shankar; Bhattari, Narayan Raj; Uranw, SurendraAbstract: Scrub typhus is an emerging disease in the eastern part of Nepal. Varied clinical presentation and lack of laboratory resources make diagnosis difficult. As this was the first known epidemic in this part of Nepal, unawareness resulted in late presentation with multiple complications and mortality. Hence this cases series alerts the clinician to be speculative for early diagnosis and management.Publication Prevalence of Tuberculosis in Severe Acute Malnutrition: A Prospective Observational Study(Nepal Paediatric Society (JNPS), 2022) Thakur, Jitendra; Thakur, Ranjana; Bhatta, Nisha Keshary; Yadav, Shankar Prasad; Khanal, Basudha; Bhattarai, Narayan RajAbstract: Introduction: Tuberculosis (TB) and malnutrition are important causes of morbidity and mortality in children in the developing world. This study was done to determine the prevalence of tuberculosis in severe acute malnutrition (SAM) cases and to observe different presentations of SAM. Method: This prospective observational study was carried out in the Department of Paediatrics and Adolescent Medicine at a tertiary care center in Nepal for a duration of one year from December 2018 to November 2019. All cases of SAM meeting the inclusion criteria were evaluated with Mantoux test, chest X-ray, gastric aspirate / sputum analysis and gene-Xpert for diagnosis of TB. Other relevant investigations for diagnosis of TB were also sent as per the clinical scenario. Data were entered and analyzed using Microsoft excel. Descriptive statistics was used for analysis of data. Results: Total 107 SAM cases were analyzed. The hospital prevalence of wasting and severe wasting was 11.98% and 0.73% respectively. The prevalence of TB in SAM was 4.67%, commonest being pulmonary TB (60%). Among TB cases, 40% were without any systemic complaints. Only 19.6% cases presented with nutritional complaint. Conclusions: This study found that a significant percentage of cases with SAM had TB and hence adds on the importance of screening for TB (Pulmonary TB) in every case of SAM, irrespective of symptoms.Publication Rickets with Alopecia Signals Vitamin D Dependent Rickets Type II(Nepal Paediatric Society (JNPS), 2015) Yadav, Shankar Prasad; Bhatta, Nisha KesharyAbstract: Vitamin D-dependent rickets type II is a rare autosomal recessive disorder. We report 27 months female child with classical rachitic changes, very high level of 25-hydroxy Vitamin D, 1,25 (OH)2D and markedly elevated serum Alkaline phosphatase. Very high dose of oral calcium and vitamin D3 was prescribed with minor improvement in skeletal features and alopecia. This case report hints the physician to diagnose and manage Vitamin D-dependent rickets type II, when rachitic changes are associated with alopecia.Publication Role of Renal Biopsy in Managing Paediatric Renal Disease in a Tertiary Care Setting(Nepal Paediatric Society (JNPS), 2021) Yadav, Shankar Prasad; Thakur, JitendraAbstract Introduction: The contribution of renal biopsy is of major importance in many paediatrics renal diseases. This prospective study analysed the clinic-pathological spectrum of the biopsied cases, complications related to renal biopsy and its effect on management. Methods: USG guided percutaneous renal biopsy was performed in indicated children. Laboratory findings, complications of the procedure, histological diagnosis and its effect on management were obtained from all patients who underwent renal biopsy from April 2019 to March 2020. The data were finally analysed using descriptive statistics. Results: Total 50 cases were enrolled during the study period. There were 24 males and 26 females with age range from two to 16 years. The common indications for biopsy were acute nephritic syndrome (25 cases), including both primary glomerulonephritis (11 cases) and secondary glomerulonephritis (14 cases), of which lupus nephritis contributed (11/25) cases, followed by atypical/ steroid resistant or dependent nephrotic syndrome (18 cases). Among primary glomerulonephritis, diffuse proliferative glomerulonephritis was most common pathological finding (11/25). One had crescentric glomerulonephritis. Lupus nephritis predominantly had Class IV/V pathology (6/11). Of 18 nephrotic syndrome cases, nine had minimal-change-disease and five had focal-segmental-glomerulosclerosis. The complications associated with procedure were self-resolving gross hematuria in eight cases, perirenal hematoma requiring plasma transfusion in one case. Adequate renal tissue sample was obtained in 47 of the renal biopsies. Three cases underwent repeat biopsy. Immunosuppressive therapy was altered as per the biopsy report among 18 cases. Conclusions: Our study showed that renal biopsy is a safe, reliable and effective technique in children. It resolutes many diagnostic dilemma and helps in effective management.Publication Severe Acute Respiratory Distress in a Child with Hypereosinophilic Syndrome: A Case Report(Nepal Medical Association, 2024) Shah, Bipesh Kumar; Yadav, Shankar Prasad; Nagpal, Dheeraj; Pokhrel, Naveen; Lamichhane, SamikshaAbstract Hypereosinophilic syndrome with respiratory distress and multiorgan involvement is not so common in children. It is essential to identify this entity based on clinical, laboratory, and imaging features. Corticosteroids should be instituted at the earliest to stabilize the patient and prevent organ damage. Tropical infections are a common secondary cause in children warranting the administration of Diethylcarbamazine. We present a case of an adolescent male in respiratory distress with marked eosinophilia and organs involving the lungs (pulmonary infiltrates with effusion), heart (pericardial effusion), and abdomen (ascites with infiltrates in the liver) which was managed with steroids and anthelmintics. The case highlights the importance of identifying patients with Hypereosinophilic syndrome in pursuing thorough evaluation and commencing therapy.