Journal Issue: Volume: 31, No. 1 (2011)
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2011
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ISSN 1990-7974 eISSN 1990-7982
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Articles
Bacteriological Profile of Neonatal Sepsis: A Hospital Based Study
(Nepal Paediatric Society (JNPS), 2011) Shrestha, NJ; Subedi, KU; Rai, GK
Abstract:
Introduction: Neonatal sepsis is a major cause of mortality and morbidity in newborn. There are many factors that contribute to neonatal sepsis. The organisms responsible for early onset and late onset sepsis are different.
Objective: This study was conducted to analyze the organisms responsible for early onset and late onset neonatal sepsis.
Materials and Methods: A prospective hospital based study over the period of one year was conducted at neonatal intermediate care unit of Kanti Children's Hospital, Maharajgunj, Kathmandu, Nepal.
Results: Organisms were isolated in 6.1% of the collected blood samples. The male female ratio of culture proven sepsis was 1.9:1. Escherichia coli were found to be the most common organism in both early onset and late onset sepsis. Staphylococcus aureus was more common in late onset sepsis than early onset sepsis.
Conclusion: Escherichia coli were the most common organism in both early onset and late onset sepsis. Staphylococcal aureus was significantly more common in late onset sepsis than early onset sepsis.
Childhood Intussusception: A Prospective Institutional Study at BPKIHS
(Nepal Paediatric Society (JNPS), 2011) Shakya, VC; Agrawal, CS; Sinha, AK; Bhatta, NK; Khaniya, S; Adhikary, S
Abstract:
Introduction: Intussusception is the commonest cause of bowel obstruction in infancy and childhood. The present study deals with the presentation, management and outcome of children presenting with intussusception at the Department of Surgery, B. P. Koirala Institute of Health Sciences, Dharan, Nepal.
Materials and Methods: Forty-seven children presenting at Department of Surgery, B. P. Koirala Institute of Health Sciences over a 5-year period were prospectively studied.
Results: There were 27 (58.6%) males and 20 (41.4%) females, with male-to-female ratio of 1.4:1. The ages ranged from 2 months to 13 years, with a median age of 30 months. The mean duration of presentation was 10.7 ± 30.66 days (range 1-180 days). The triad of abdominal pain, bloody mucoid stools and palpable abdominal mass was seen in 10 (21%) of the cases. Surgical exploration was done in 42 (89.3%) patients. The commonest lead point was non-specific hyperplastic lymph nodes, occurring in 22 (54.3%), followed by idiopathic variety (16.6%), Meckel's diverticulum (9.5%), ileocaecal junction (7.1%), submucous lipoma (4.7%), Non- Hodgkin's lymphoma (4.7%), appendix (2.3%) and a mucosal polyp (2.3%). Overall mortality rate was 6.3%.
Conclusion: The presenting age group and the time of presentation are higher than other studies. The mortality rate of 6.3% is comparable to other studies in the developing world. Earlier presentation could have avoided surgery, with a higher possibility of cases being managed conservatively.
Clinical Profile and Outcome of Childhood Tuberculosis at Dhulikhel Hospital
(Nepal Paediatric Society (JNPS), 2011) Shrestha, S; Marahatta, SB; Poudyal, P; Shrestha, SM
Abstract:
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Background: Children contribute a significant proportion of the tuberculosis (TB) burden in Nepal and suffer severe TB related morbidity and mortality, particularly in endemic areas. Diagnosis and management of pediatric TB especially Extra pulmonary TB (EPTB) is challenging.
Objectives: The present study was designed to study clinical, laboratory characteristics and outcome of childhood tuberculosis. Methods: A prospective analysis of 60 cases of TB children within three years period was conducted at Pediatric Department, Dhulikhel Hospital and followed up till child completely recovered.
Results: In the present study 60 children had clinical and lab evidence of tuberculosis and received anti tubercular therapy. Extra pulmonary tuberculosis was common (78.3%) than pulmonary tuberculosis (21.6%). BCG scar was absent in eight (13.33%) and absent BCG vaccination was significantly associated with disseminated TB (p<0.05). The most frequently seen symptoms were fever (65 %), cough (46.67 %) and abdominal distension (36.67%). Hepatomegaly (45%), ascites (33.33%), lymphadenopathy (23.33 %) and splenomegaly (11.67 %), and are common signs. Malnutrition seen in (33.3%) with more malnourished children with disseminated TB than in other diagnosis (p<0.001). Mantoux test was positive in (48.3%). Isolation of AFB was possible only in (8.33%). Among 60 cases (60%) were recovered completely with the primary regimen, (5%) recovered with extending the duration of primary regimen to three more months. (25%) failed to follow up, while (6.67%) died.
Conclusion: EPTB is common than pulmonary TB. Among 60 cases 36 (60%) recovered completely with the primary regimen, three cases (5%) recovered with extending the duration with primary regimen. Fifteen cases (25%) failed to follow up, while four cases (6.67%) died.
Growth Pattern and Prevalence of Underweight and Stunting Among Rural Adolescents
(Nepal Paediatric Society (JNPS), 2011) Bisai, S; Bose, K; Ghosh, D; De, K
Abstract:
Introduction: A cross-sectional study of 1094 (boys = 665; girls = 429) rural school children aged 11- 18 years of Midnapore Sadar North subdivision, Paschim Medinipur District, West Bengal, India, was undertaken to evaluate their growth pattern and nutritional status.
Methodology: Anthropometric measurements including weight and height were measured following standard techniques. Underweight and stunting were used as indicators of nutritional status. Underweight and stunting were defined as weight-for-age (WAZ) and height-for-age (HAZ) <-2 z-scores, respectively, of the National Centre for Health Statistics (NCHS) guidelines.
Results: Results revealed that boys were significantly heavier than girls from age 16 onwards; they were also significantly taller from age 14 years. The mean WAZ for boys and girls were -1.488 and -1.417, respectively. The corresponding mean values for HAZ were -1.317 and -1.486. The overall rates of underweight and stunting were 28.3% and 27.8%, respectively. The prevalence of underweight was significantly higher among boys (31.0%) than girls (24.2%). These rates for stunting were 27.4% and 28.4%, for the boys and girls. The rate of underweight and stunting was more in late adolescents (15-18 years) than early adolescents (11-14 years). In boys, the prevalence of stunting was significantly (1.5 times) more in late adolescents than early adolescents. According to the WHO classification for assessing severity of malnutrition, the rates of stunting were medium in both sexes. The rates of underweight were high and very high for girls and boys, respectively.
Conclusion: In conclusion, present study provided evidence that the nutritional status of these adolescents were not satisfactory especially among late adolescents.
Review of Paediatrics In-Patient at Nepal Medical College and Teaching Hospital
(Nepal Paediatric Society (JNPS), 2011) Upadhyay, S; Sharma, A; Rijal, P; Shrestha, S
Abstract:
Introduction: This retrospective study was undertaken to analyze the disease pattern in the Pediatric ward in a Medical College. After analyzing the data, our study would emphasize on the prevention and the management modality of the most prevalent diseases in the community.
Methodology: This study was carried out retrospectively for one year from January 2008 - December 2008 on the basis of age and sex and the frequency of disease according to the system involved.
Results: A total number of 453 patients were admitted during the study period. There were 267(59%) male and 186(41%) female children. Less than five years age group accounted for 180(39.7%) excluding the neonate. In the study period, respiratory tract infections were the commonest cause of admission in all age group 198(43.7%), gastrointestinal including diarrhoeal diseases were 112(24.7%), enteric fever comprised of 22(5%), and other disease comprised of about 143(31.5%) of the total admissions. CNS diseases comprised of 43(9%) of which 7(16%) were meningitis and meningoencephalitis, 26(60%) of the total CNS cases were due to febrile convulsion. Respiratory diseases were found to be the major cause of morbidity in children.
Conclusion: Children under five years age being the most common age group amongst all, with infection being the most predominant cause of Pediatric morbidity, the WHO/UNICEF algorithm for Integrated Management of Childhood Illness (IMCI) is specifically suited for the developing country like ours.