Journal Issue: Volume: 42, No. 3 (2022)
Loading...
Volume
Number
Issue Date
2022
Journal Title
Journal ISSN
ISSN 1990-7974 eISSN 1990-7982
Journal Volume
Articles
Clinical Profile and Outcome of Ventilated Children Admitted to Paediatrics Intensive Care Unit in a Tertiary Care Centr
(Nepal Paediatric Society (JNPS), 2022) Singh, Sandip Kumar; Khanal, Babita; Singh, Shivani
Abstract:
Introduction: Mechanical Ventilation is an essential tool in paediatric critical care unit. Judicious use of ventilation when indicated, is essential along with very close clinical and hemodynamic monitoring, for successful outcome. As prolonged ventilation is associated with numerous adverse outcomes, we tried to find out common complications associated with invasive mechanical ventilation and its outcome.
Methods: The study is an observational descriptive study conducted on mechanically ventilated children admitted to Paediatric Intensive Care Unit during 48 months period (November 2019 to October 2021). Demographic features included age, sex, reason for mechanical ventilation, duration of mechanical ventilation and any other comorbidities. Outcomes parameters included death in hospital, discharge from intensive care unit or shift to ward and left against medical advice (LAMA).
Results: Among 1352 children admitted to PICU, 212 children (15.68%) required invasive mechanical ventilation. Common causes for mechanical ventilation were sepsis / MODS in 22.64% cases, followed by pulmonary (20.28%) and CNS infections 39 (18.39%). 166 (78.30%) children were extubated successfully, 24 (11.32%) children expired and 22 (10.37%) went on LAMA. Mortality rate of 14.18% was found in children, who were ventilated for > 72 hours, which was statistically significant.
Conclusions: Ventilatory support is essential and lifesaving tool for critically ill children. Mortality rate was higher and statistically significant in children who were ventilated for > 72 hours.
Correlation between maternal weight gain and birth weight among term babies
(Nepal Paediatric Society (JNPS), 2022) Singh, Umesh; Acharya, Indira
Abstract:
Introduction: Healthy and well-nourished mother is likely to give birth to a healthy normal child with adequate birth weight. We aimed to determine the correlation of gestational weight gain and newborn’s birth weight.
Methods: We studied participant-level data for 295 pregnant women coming for delivery services between January 2018 and December 2020 at Shree Birendra Hospital, Chhauni, Kathmandu, Nepal. A retrospective data of pre-pregnancy body mass index, maternal weight gain during different trimesters of pregnancy were collected. The prevalence of small and large for gestational babies were compared with mother’s weight gain according to Institute of Medicine (IOM) guidelines. Pearson test was used to assess the correlation between gross maternal weight gain during pregnancy and birth weight.
Results: Among 295 women, 12.2% underweight, 55.6% normal weight, 26.1% overweight and 6.1% were obese. The overall mean gestational weight gain (GWG) was 11.78 kg. Birth weight of the babies ranged from 1500 gm to 5100 gm with mean weight of 3148 gm. Majority of small for gestational age and large for gestational babies were seen among women below and above IOM guidelines respectively.
Conclusions: Findings from this study suggest that maternal weight gain during pregnancy increases the birth weight. Across all BMI categories, insufficient GWG is associated with slightly increased risk of SGA, while relative risk of LGA is higher in excess GWG group.
Correlation of cord Blood pH with Nucleated RBC and Serum LDH in Neonates with Perinatal Asphyxia
(Nepal Paediatric Society (JNPS), 2022) S B, Chiranth; Avabratha, K. Shreedhara
Abstract:
Introduction: Perinatal asphyxia is one of the leading causes of neonatal mortality in developing countries. No single indicator has good diagnostic efficacy for perinatal asphyxia and only a combination of various indices may help in diagnosis. This study aims at determining the utility of serum lactate dehydrogenase (LDH) and cord blood nucleated red blood cell (nRBC) count as surrogate markers to pH in perinatal asphyxia.
Methods: It is an observational study done over a period of 18 months. All newborn babies fitting into inclusion criteria were enrolled into the study. After initial resuscitation, cord blood was sent for pH and nRBC analysis and serum LDH levels was estimated from first collected blood sample (within six hours). Data was collected on excel sheet, Pearson’s correlation coefficients and ROC curves were used to tabulate results.
Results: Our study included 74 neonates with perinatal asphyxia. Mean pH was 6.99 (SD - 0.138). Mean nRBC count was 38 / 100 WBC (SD17.9) and mean LDH level was 1478 IU / L (SD - 429). Cord blood pH showed significant (p < 0.001) correlation with raising nRBC count and LDH levels ROC plot showed nRBC count (AUC: 0.7866) and Serum LDH (AUC: 0.8143) as very good predictors of severe acidosis in perinatal asphyxia.
Conclusions: Cord blood nRBC count and serum LDH levels are significantly increased in perinatal asphyxia and correlate well with severity of acidosis. Nucleated RBC count and serum LDH can be used as surrogate markers to diagnose perinatal asphyxia.
Diagnostic Ability of Chest Ultrasound in Selective Paediatric Pneumonia Alternative to CT scan: A single-center Comparative Observational Study
(Nepal Paediatric Society (JNPS), 2022) Thareeb, Marwa Kareem; Zghair, Muna Abid Alghani; Hassan, Qays Ahmed
Abstract:
Introduction: Chest CT is the gold standard method of the diagnostic evaluation of patients with pneumonia. Lung sonography has been lately explored as an alternative modality to decrease radiation hazards. This study aimed to evaluate the diagnostic ability of lung ultrasonography in detecting paediatric pneumonia at presentation and follow up and comparing findings with chest CT scan.
Methods: A cross-sectional observational study was performed at a paediatric hospital from August 2019 to April 2021. We studied 106 children (ages from 45 days to 14 years) referred by the paediatrician with clinical data of pneumonia. All children underwent CT chest examination; 90 showed positive, while 16 showed no pneumonia. Ultrasonography was performed on all patients within 24 hours after CT examination.
Results: We found that lung ultrasound showed 100% specificity, 82.2%, sensitivity in the diagnosis of paediatric pneumonia, accuracy was 84.9%, positive predictive value was 100% and negative predictive value was 50%. Their sensitivity and specificity are 100% in complicated pneumonia by parapneumonic effusion, empyema, and abscess formation.
Conclusions: Chest ultrasound is a simple technique that can be performed in everyday practice, with high specificity and sensitivity compared to a chest CT scan in diagnosis and follow up of pneumonia in the pediatric age group.
Knowledge and Attitude of Nurses on Implementation of Atraumatic Care among Hospitalized Children in Eastern Nepal: A Cross-sectional Study
(Nepal Paediatric Society (JNPS), 2022) Mahato, Pramila; Shrestha, Rit; Karn, Basant Kumar; Chaudhary, Amit Kumar; Singh, Rakesh
Abstract:
Introduction: The modality and quality of care received during hospitalization affects a child’s response to their illness. Thus, any intervention delivered by healthcare providers including nurses must be based on principles of atraumatic care. This study aims to assess the knowledge and attitude of nurses in the implementation of atraumatic care among hospitalized children in a tertiary care center in Eastern Nepal.
Methods: A descriptive cross-sectional study was conducted among 106 nurses in a tertiary hospital from 4th January to 1st February 2020. Ethical approval was received from the Institutional Review Committee. Sampling was done by total population enumeration method. Data was collected using a self-administered three-part questionnaire and analyzed using Statistical Package for the Social Sciences version 11.5 by utilizing descriptive statistics.
Results: The mean knowledge and attitude of nurses towards implementation of atraumatic care among hospitalized children was found to be 14.90 ± 3.90 and 74.74 ± 7.5 respectively. Out of 106 nurses, 73 (68.90%) had adequate knowledge whereas 56 (52.80%) had favorable attitudes towards principles and implementation of atraumatic care, assessed using reliable scales. Variations due to socio-demographic and professional parameters were insignificant.
Conclusions: The study shows that majority of the surveyed nurses had adequate knowledge of the principles of atraumatic care and a favorable attitude towards its application among hospitalized children. However, the measured attitude of nursing practitioners was relatively lower in terms of favorability.