Journal Issue: Volume: 39, No. 3 (2019)
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Volume
Number
Issue Date
2019
Journal Title
Journal ISSN
ISSN 1990-7974 eISSN 1990-7982
Journal Volume
Articles
A Five Years Study of Occurrence and Associated Risk Factors for Birth Defects in a Tertiary Care Hospital in Central Nepal
(Nepal Paediatric Society (JNPS), 2019) Basaula, Yuba Nidhi; Paudel, Radha Kumari; Chapagain, Ram Hari
Abstract
Introduction: Congenital anomalies account for 7.0% of neonatal deaths in Nepal. The present study was carried out to determine the overall rate of congenital malformations, incidence and prevalence in live births, still birth and incidence affecting various organ systems, at Bharatpur Hospital, Nepal.
Methods: All the intramural deliveries between Jan 2015 to Dec 2019 were included in the study. All the newborns were looked for congenital malformations after birth within seven days. Antenatal ultrasonography findings were noted. 2D echocardiography was also used for all congenital heart diseases, along with routine X-ray chest. A total of 131 babies with congenital problem were studied and the information was recorded in WHO NBBD Proforma. Data were recorded in MS Excel and SPSS 16 version was used for analysis.
Results: Out of the total 60160 deliveries, 131 (0.21% of total birth) were with congenital malformations, sex wise distribution was 65 (49.5%) females and 63 (48.7%) males and three (1.8%) were ambiguous. Oro-facial malformation (49, 37.4%) was the commonest form of malformation followed by the musculoskeletal system (31, 23.6 %), centre nervous system (31, 23.6%) and congenital malformations of genital organs (8, 6.0%).
Conclusions: The incidence of congenital malformation in this study was 0.21%. Females were more common than males and oro-facial malformation was the commonest type of malformation. Lack of antenatal visit, lack of folic acid during pre-conception period and low socioeconomic status were the commonest risk factors.
Author Biographies
Yuba Nidhi Basaula, Bharatpur Hospital, Bharatpur, Chitwan, Nepal
Department of Paediatrics
Radha Kumari Paudel, Manmohan Memorial Institute of Health Sciences, Kathmandu, Nepal
Faculty of Nursing
Ram Hari Chapagain, National Academy of Medical Sciences / Kanti Children’s Hospital, Kathmandu, Nepal
Department of Paediatrics
Coexistence of Allergic Rhinitis in Children Attending Paediatric Asthma Clinic
(Nepal Paediatric Society (JNPS), 2019) Singh, Rajesh Kumar; Simalti, Ashish Kumar
Abstract
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 Paediatrics
Patient Awareness of Cost of Treatment at a Government Sponsored Hospital in India
(Nepal Paediatric Society (JNPS), 2019) Ritesh; Singh, Harsh Mohinder; Singh, Bikram Jit
Abstract:
Introduction: To evaluate the awareness amongst the beneficiary about the costs of medical services in a hospital which provides all services at no cost and also to analyse whether education level of the beneficiary client, number of days stayed in hospital and their prior exposure of being treated on payment in other hospital has some bearing on cost estimation by the participants.
Method: It was a cross sectional questionnaire based survey study. A total of 130 beneficiary clientele of a government hospital were interviewed. Two sample ‘t’ test and ANOVA were used for statistical analysis. Multivariate regression analysis was used to study effect of more than one independent variable on cost estimation. Scatter plot and box plots were used to study standard deviation.
Results: It revealed poor awareness of people in cost estimation of medical expenses. A significant ‘p’ value of < 0.05 was observed with respect to length of stay (p = 0.003), treatment modality (p = 0.000) and multivariate variable (treatment technique along with exposure to treatment in paid hospital, p = 0.008).
Conclusion: The beneficiary clientele in a hospital with free treatment generally not aware about the exuberant costs of treatment born by the state.
Author Biographies
. Ritesh, ITFH Tajikistan
Department of Pediatrics
Bikram Jit Singh, Maharishi Markandeshwar, Deemed to be University, Mullana, India
Department of Mechanical Engineering
Role of Lumbar Puncture in Late Onset Neonatal Sepsis
(Nepal Paediatric Society (JNPS), 2019) Das, Amit Kumar; Mishra, Deepak; Jha, Nitu Kumari; Mishra, Rakesh; Jha, Soniya
Abstract:
Introduction: Neonatal sepsis is a clinical syndrome characterized by signs and symptoms of infection with or without accompanying bacteremia in the first month of life. It is responsible for about 30-50% of the total neonatal deaths in developing countries. Neonatal sepsis can be divided into two sub-types depending upon whether the onset of symptoms within the first 72 hours of life (Early Onset Neonatal Sepsis) or after 72 hours of life (Late Onset Neonatal Sepsis ). Meningitis is an important complication of late onset neonatal sepsis.
Method: This was hospital based prospective observational study conducted among the neonates admitted with diagnosis of late onset neonatal sepsis in Neonatal Intermediate Care Unit (NIMCU) and Neonatal Intensive Care Unit (NICU) of Kanti Children’s Hospital from July 2016 to June 2017. The objective of this study was to evaluate the importance of performing LP in neonates with LONS.
Results: 16.8% neonates with late onset neonatal sepsis were found to have meningitis. Among the neonates with meningitis CRP was positive 57.2% and negative in 42.8 %. Among the cases with abnormal CSF findings, blood culture was sterile in 85% cases and organism was isolated 15% cases. In 88.8% cases with positive blood culture, no meningitis was detected. Lumbar puncture was traumatic in 1 neonate (0.8%) in first attempt. Apart from this no other complication of performing lumbar puncture was noted.
Conclusion: Lumbar puncture and CSF examination is mandatory in all cases with late-onset sepsis.
Author Biographies
Amit Kumar Das, Indira Gandhi Memorial Hospital, Male, Maldives
Consultant Paediatrician, Department of Paediatrics
Deepak Mishra, Kanti Children’s Hospital, Maharajgunj, Kathmandu, Nepal
Department of Paediatrics
Nitu Kumari Jha, National Academy of Medical Sciences, Kathmandu, Nepal
Department of Obstretics and Gynaecology
Rakesh Mishra, NAMS, Kathmandu, Nepal
Department of Orthopaedics
Soniya Jha, Ramlal Golchha Eye Hospital, Morang, Nepal
Medical Officer
Safety of Early Rescue Surfactant Replacement Therapy for Preterm Neonates with Respiratory Distress Syndrome at Neonatal Intensive Care Unit of a Tertiary Hospital
(Nepal Paediatric Society (JNPS), 2019) Yadav, Sunil Kumar; Giri, Arun
Abstract:
Introduction: Respiratory distress syndrome (RDS) is an acute disease of preterm neonates and is caused by the deficiency of pulmonary surfactant. Surfactant deficiency can lead to alveolar collapse, atelectasis, impaired gas exchange, severe hypoxia and acidosis. Surfactant replacement therapy (SRT) is an integral part of management of preterm neonates with respiratory distress syndrome. The objective of the study was to evaluate the safety of early rescue surfactant replacement therapy in RDS.
Methods: This was a prospective observational study conducted in a 17 bedded teaching and referral NICU of Eastern Nepal over a period of seven months. All preterm neonates with clinical and radiological features of RDS were enrolled in the study. The safety of early rescue SRT was evaluated by measuring the outcomes: incidence of pulmonary haemorrhage, apnea, hypoxia and cardiac arrest. All data were entered into the worksheet of SPSS software version (19.0) and descriptive statistics including percentages and frequencies was analysed. The level of statistical significance adopted was p-value < 0.05.
Results: The survival rate of preterm babies with SRT was 64.7% (22 babies). The incidence / prevalence of pulmonary haemorrhage, apnea, hypoxia, and cardiac arrest during or immediately after SRT was 14.7%, 5.9%, 5.9% and 2.9% respectively.
Conclusions: This study suggests that SRT is an effective, safe and feasible intervention in level-3 neonatal units and has the potential to reduce neonatal mortality. The study also emphasises on the fact that SRT should be provided in settings where there is adequate manpower, professional skills and desired infrastructure to administer surfactant.
Author Biographies
Sunil Kumar Yadav, Nobel Medical College Teaching Hospital, Biratnagar, Nepal
Department of Paediatrics and Neonatology
Arun Giri, Nobel Medical College Teaching Hospital, Biratnagar, Nepal
Department of Paediatrics and Neonatology