Journal Issue: Volume: 27, No. 2 (2007)
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Volume
Number
Issue Date
2007
Journal Title
Journal ISSN
ISSN 1990-7974 eISSN 1990-7982
Journal Volume
Articles
The Future of Paediatric Surgery in Nepal Authors
(Nepal Paediatric Society (JNPS), 2007) Thapa, NB
NA
Polio Eradication Efforts in Nepal
(Nepal Paediatric Society (JNPS), 2007) Suvedi, BK
Abstract:
Nepal has made tremendous effort for polio eradication. The efforts are based on the global polio eradication strategies. Despite all the efforts as per the global strategies, wild poliovirus is still present in the country. The importance of water, hygiene and sanitation is stressed as an additional strategy in still persisting areas.
Efficacy of Albendazole and Short-Course Prednisolone Treatment in Children with One or Two Ring-Enhancing Lesions of Neurocysticercosis: A Randomized Controlled Trial
(Nepal Paediatric Society (JNPS), 2007) Swain, PK; Thapalial, A; Das, RN; Dhaliwal, MS; Subedi, K
Abstract:
Context: Neurocysticercosis is a endemic disease in Nepal causing social and financial burden on society and developmental problem in children. Aims: To determine the efficacy of albendazole plus oral prednisolone in children with 1 or 2 ring-enhancing lesions (by CT) on resolution of lesions and recurrence of seizure.
Setting and Design: Randomized controlled open trial.
Methods and Materials: Children with 1 or 2 ring-enhancing lesions < 20 mm in diameter on computed tomography scan, likely to have Neurocysticercosis, were assigned to treatment & control groups. Children assigned to the treatment group (n = 50) were given 2.0 mg/kg per day prednisolone orally for 5 days plus 15 mg/kg per day albendazole on third day for 28 days. Anti epileptic drugs were given to both groups {including Control group (n = 51)}.
Statistical Analysis: The results were analysed with the use of Epi Info version 6.04 and Stata version;7 software.
Results: The lesions resolved completely or partially in more children in the treated group compared with the control group (p = .04 & p = 0.03). The proportion of children who had seizures was significantly lower in the treated group compared with the control group at 6 months (10% versus 33%; p = .006) and 12 months (14% versus 38%; p = .003).
Conclusion: Albendazole plus Prednisolone increased resolution of lesions on computed tomography scan and reduced the risk of subsequent recurrence of seizures among children with Neurocysticercosis.
Clinical and Bacteriological Profiles of Blood Culture Positive Sepsis in Newborns
(Nepal Paediatric Society (JNPS), 2007) Shrestha, P; Das, BK; Bhatta, NK; Jha, DK; Das, B; Setia, A; Tiwari, A
Abstract:
Neonatal infections currently cause about 1.6 million deaths annually in developing countries. Sepsis and meningitis is responsible for most of these deaths. This study was undertaken to determine the clinical presentations, bacteriological profiles and antibiotic sensitivity patterns of isolates from blood cultures of neonates admitted in a tertiary care hospital in Eastern Nepal. All blood culture reports (n=103) during January 2006 - February 2007 from newborns admitted in neonatal division at BP Koirala Institute of Health Sciences, Nepal were analyzed and antibiotic sensitivity patterns were studied. The positive blood culture was 20% (103/513). Most (97.1%) of the sepsis was caused by single organism, while polymicrobial aetiology was observed in 2.9% cases. Meningitis was documented in 9(8.7%) cases. Staphylococcus aureus (38.8%) and coagulase negative staphylococcus (CONS) (21.3%) are the commonest isolates in blood culture. Among gram-negative organisms, Klebsiella species (11.6%) and Enterobacter species (9.7%) were the leading cause of neonatal sepsis. Majority of newborns with neonatal sepsis presented with refusal to feeds (42.7%), fever (41.7%) and jaundice (41.7%). Most of the organisms showed sensitivity with amino glycosides (gentamicin and amikacin) and third generation cephalosporins. It is concluded that Staphylococcus aureus, CONS, and Klebsiella species remain the principal organisms causing neonatal sepsis and first line antibiotics like amino glycosides should be first choice of drugs.
Role of Serum Alanine Aminotransferase Aspartate Aminotransferase and Alkaline Phosphatase in Early Detection of Protein Energy Malnutrition
(Nepal Paediatric Society (JNPS), 2007) Karmacharya, K; Islam, MN
Abstract:
Objective: Although Protein Energy Malnutrition (PEM) has been studied extensively; the best criteria for its detection in early stages have not been established. This study was carried out to observe the change in transaminases, alkaline phosphatase levels when compared with control and also to see their relationships with various grades of PEM. Then to see if certain biochemical parameters could be used to detect malnutrition in early stage.
Methods: Cross sectional study between Jan 1999-Dec 2000,124 children from 5 months to 5 years were included in the study. Out of 124 children 98 (79%) were cases and 26 (21%) normal age matched healthy controls. Cases were divided into groups as per Gomez classification (Group 1-Grade I PEM, 37;Group 2- Grade II PEM, 34; Group 3- Grade III PEM27; and Group 4 26 Healthy controls). Three serum enzymes, Alanine aminotransferase (ALT), Aspartate aminotransferase (AST) and Alkaline Phosphatase (ALP) was analyzed and for statistical analysis student's "t" test was used.
Results: The mean serum values +SD of ALT (Grade I PEM-41.40 +13.25,Grade II PEM-31.53+10.6,GradeIIIPEM-33.77+12.45,Control-23.11+8.73) and Aspartate aminotransferase (Grade I PEM-42.8+11.06,Grade II PEM 31.47+8.32,GradeIII PEM 35.00+10.86, Control-25.42+8.77) in patients with PEM were significantly (p <. 0.001) higher than controls. The degree of increase in serum values of these two enzymes was maximum in cases with Grade I PEM. The mean serum values of Alkaline phosphatase (Grade I PEM-403.40+100.76, Grade II PEM-294.23+50.40,Grade III PEM-221.26+94.09,Control-894.5+ 126.28) in cases of PEM were significantly lower than controls, lowering being maximum in PEM Grade III.
Conclusion: It can be concluded that abnormalities in blood levels of these enzymes occur in any form of PEM and these are related to the severity of the disease. Hence this may be helpful in early diagnosis of PEM where clinical features are equivocal.
Key words: Protein Energy Malnutrition, Enzymes, Alanine Aminotransferase, Aspartate aminotransferase, Alkaline phosphatase