Introduction: Birth defects are structural and functional anomalies that present before, at birth, or later in life. This study aimed to find out total incidence, type of structural birth defects in live born babies in Nepal. Methods: The study was conducted at a tertiary level maternity hospital in Nepal from 14 April 2018 to 13 April 2019. Data was collected on online Newborn Birth Defect data base developed by WHO South- East-Asia Regional Office. All live born babies with external and internal birth defects confirmed by radiographic, ultrasonography and echocardiography until seven days of life were included. Ethical approval was obtained from Institutional Review Committee of hospital. Results: Total of 21,564 live babies were delivered during one-year study period. Out of these, 220 (1.02%) had one or more birth defects. Number of male babies {130 (59%)} were more than female {89 (40.9%)}. 176 (80%) babies with the malformation were born to mother within age group 20 to 35 years. Of the total 220 babies with birth defects, 197 (89.5%) had isolated malformations and remaining 23 (10.4%) had sequence malformations. The most frequent malformations involved cardiovascular system 125 (56.8%) followed by gastrointestinal system 37 (16.8%), musculoskeletal system 34 (15.4%) and central nervous system 18 (8.1%). Conclusions: Incidence of overall birth defects in this study was found to be 1.02% in which cardiovascular system anomalies was the most common followed by gastrointestinal, musculoskeletal and central nervous system anomalies.
{"title":"Incidence of Birth Defects among Live Born Neonates at Tertiary Level Maternity Hospital in Nepal","authors":"Shristi Shakya, Kalpana Upadhaya Subedi, Megha Mishra","doi":"10.3126/jnps.v42i2.41093","DOIUrl":"https://doi.org/10.3126/jnps.v42i2.41093","url":null,"abstract":"Introduction: Birth defects are structural and functional anomalies that present before, at birth, or later in life. This study aimed to find out total incidence, type of structural birth defects in live born babies in Nepal.\u0000Methods: The study was conducted at a tertiary level maternity hospital in Nepal from 14 April 2018 to 13 April 2019. Data was collected on online Newborn Birth Defect data base developed by WHO South- East-Asia Regional Office. All live born babies with external and internal birth defects confirmed by radiographic, ultrasonography and echocardiography until seven days of life were included. Ethical approval was obtained from Institutional Review Committee of hospital.\u0000Results: Total of 21,564 live babies were delivered during one-year study period. Out of these, 220 (1.02%) had one or more birth defects. Number of male babies {130 (59%)} were more than female {89 (40.9%)}. 176 (80%) babies with the malformation were born to mother within age group 20 to 35 years. Of the total 220 babies with birth defects, 197 (89.5%) had isolated malformations and remaining 23 (10.4%) had sequence malformations. The most frequent malformations involved cardiovascular system 125 (56.8%) followed by gastrointestinal system 37 (16.8%), musculoskeletal system 34 (15.4%) and central nervous system 18 (8.1%).\u0000Conclusions: Incidence of overall birth defects in this study was found to be 1.02% in which cardiovascular system anomalies was the most common followed by gastrointestinal, musculoskeletal and central nervous system anomalies.","PeriodicalId":39140,"journal":{"name":"Journal of Nepal Paediatric Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49420677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-31DOI: 10.3126/jnps.v42i3.46876
Chiranth S B, K. Avabratha
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.
{"title":"Correlation of cord Blood pH with Nucleated RBC and Serum LDH in Neonates with Perinatal Asphyxia","authors":"Chiranth S B, K. Avabratha","doi":"10.3126/jnps.v42i3.46876","DOIUrl":"https://doi.org/10.3126/jnps.v42i3.46876","url":null,"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.\u0000Methods: 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.\u0000Results: 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.\u0000Conclusions: 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.","PeriodicalId":39140,"journal":{"name":"Journal of Nepal Paediatric Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49647416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-31DOI: 10.3126/jnps.v42i3.45540
S. Swaroop, Medha Mittal, Smita Nair, Reetika Saini, J. Bagla
Introduction: Various research works have reported elevated serum homocysteine levels with the use of antiepileptic drugs. This may lead to an increased risk of atherosclerosis, a higher seizure frequency and may also cause cognitive decline. Methods: Twenty five children (Two to 12 years) on valproate monotherapy for more than one year and the same number of age and sex-matched healthy controls were enrolled. Venous blood samples were analyzed for serum homocysteine, vitamin B12 and folic acid levels. All biochemical parameters were compared between the groups. Results: The antiepileptic drug users had significantly lower serum homocysteine levels and higher B12 levels as compared to the controls. But serum folate levels were similar between the groups. No correlation of serum homocysteine levels was observed with either serum folate, B12 or valproate. Conclusions: The use of valproate monotherapy for epilepsy in the Indian paediatric population does not increase the risk of hyperhomocysteinemia.
{"title":"Serum Homocysteine Levels in Indian Children on Valproate Monotherapy","authors":"S. Swaroop, Medha Mittal, Smita Nair, Reetika Saini, J. Bagla","doi":"10.3126/jnps.v42i3.45540","DOIUrl":"https://doi.org/10.3126/jnps.v42i3.45540","url":null,"abstract":"Introduction: Various research works have reported elevated serum homocysteine levels with the use of antiepileptic drugs. This may lead to an increased risk of atherosclerosis, a higher seizure frequency and may also cause cognitive decline.\u0000Methods: Twenty five children (Two to 12 years) on valproate monotherapy for more than one year and the same number of age and sex-matched healthy controls were enrolled. Venous blood samples were analyzed for serum homocysteine, vitamin B12 and folic acid levels. All biochemical parameters were compared between the groups.\u0000Results: The antiepileptic drug users had significantly lower serum homocysteine levels and higher B12 levels as compared to the controls. But serum folate levels were similar between the groups. No correlation of serum homocysteine levels was observed with either serum folate, B12 or valproate.\u0000Conclusions: The use of valproate monotherapy for epilepsy in the Indian paediatric population does not increase the risk of hyperhomocysteinemia.","PeriodicalId":39140,"journal":{"name":"Journal of Nepal Paediatric Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43431748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-31DOI: 10.3126/jnps.v42i3.46172
Pramila Mahato, Rit Shrestha, B. K. Karn, Amit Kumar Chaudhary, Rakesh Singh
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.
住院期间接受的护理的方式和质量影响儿童对疾病的反应。因此，包括护士在内的医疗保健提供者提供的任何干预措施都必须基于无创伤护理原则。本研究的目的是评估护士的知识和态度，在实施无创伤护理的住院儿童在尼泊尔东部的三级护理中心。方法:对某三级医院106名护士于2020年1月4日至2月1日进行描述性横断面研究。已收到机构审查委员会的伦理批准。抽样采用总体抽样法。采用自我管理的三部分问卷收集数据，并利用描述性统计方法使用Statistical Package for the Social Sciences version 11.5进行分析。结果:护理人员对住院患儿实施无创性护理的平均知识和态度分别为14.90±3.90和74.74±7.5。106名护士中，73名(68.90%)对无创性护理的原则和实施有充分的了解，56名(52.80%)对无创性护理的原则和实施有良好的态度。由于社会人口统计学和专业参数的变化是微不足道的。结论:调查显示，大部分受访护士对住院儿童无创性护理的原则有足够的了解，对无创性护理在住院儿童中的应用持积极态度。然而，护理从业人员的测量态度在好感度方面相对较低。
{"title":"Knowledge and Attitude of Nurses on Implementation of Atraumatic Care among Hospitalized Children in Eastern Nepal: A Cross-sectional Study","authors":"Pramila Mahato, Rit Shrestha, B. K. Karn, Amit Kumar Chaudhary, Rakesh Singh","doi":"10.3126/jnps.v42i3.46172","DOIUrl":"https://doi.org/10.3126/jnps.v42i3.46172","url":null,"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.\u0000Methods: 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.\u0000Results: 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.\u0000Conclusions: 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.","PeriodicalId":39140,"journal":{"name":"Journal of Nepal Paediatric Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46848779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: The coronavirus pandemic constrained medical colleges to discontinue face-to-face learning activities and suddenly switch to an online learning model. Technology is making its way into medical education, also being advocated by the medical commission, though students’ perception is still poorly understood. This study aimed to investigate the medical students’ perspectives on online learning. Methods: It was a cross-sectional, questionnaire-based study to assess the demographics, merits, demerits, recommendations, and suggestions for online learning by medical undergraduates. A combination of multiplechoice, Likert scale-based, and open-ended questions was used. Results: The student-perceived merits of e-learning were flexibility in timings, convenience, self-directed learning approach, and prevention of pandemic spread. The demerits viewed were lack of personal interaction with teacher and batchmates, increased distractions, lack of high-speed internet, and less / no hands-on experience. The classroom teaching was the favoured teaching method (45.7%) and easy to comprehend (55.8%). The recommendations included: medical curriculum should not be completely e-learning based (84.1%), training for using online applications (51.4%), providing high-speed internet and apps with no time limit (83.7%), taking online tests (64.4%), student’s feedback (75%), and frequent online demonstrations and simulations (64.9%). Overall, 52.4% of students’ morale was positive towards e-learning. Students rated blended teaching as the preferred teaching method. Conclusions: Medical students still prefer face-to-face learning and opted for blended learning over complete e-learning. Appropriate steps like training faculties, providing high-speed internet, taking formative tests, giving online demonstrations, involving simulations, and student feedback can improve e-learning quality.
{"title":"Medical Undergraduate Students’ Viewpoint on Online Learning During COVID-19 Pandemic","authors":"Ekansh Rathoria, Richa Rathoria, Umang Singal, Asheesh Pratap Singh, Utkarsh Bansal, Prashant Agrawal","doi":"10.3126/jnps.v42i3.46062","DOIUrl":"https://doi.org/10.3126/jnps.v42i3.46062","url":null,"abstract":"Introduction: The coronavirus pandemic constrained medical colleges to discontinue face-to-face learning activities and suddenly switch to an online learning model. Technology is making its way into medical education, also being advocated by the medical commission, though students’ perception is still poorly understood. This study aimed to investigate the medical students’ perspectives on online learning.\u0000Methods: It was a cross-sectional, questionnaire-based study to assess the demographics, merits, demerits, recommendations, and suggestions for online learning by medical undergraduates. A combination of multiplechoice, Likert scale-based, and open-ended questions was used.\u0000Results: The student-perceived merits of e-learning were flexibility in timings, convenience, self-directed learning approach, and prevention of pandemic spread. The demerits viewed were lack of personal interaction with teacher and batchmates, increased distractions, lack of high-speed internet, and less / no hands-on experience. The classroom teaching was the favoured teaching method (45.7%) and easy to comprehend (55.8%). The recommendations included: medical curriculum should not be completely e-learning based (84.1%), training for using online applications (51.4%), providing high-speed internet and apps with no time limit (83.7%), taking online tests (64.4%), student’s feedback (75%), and frequent online demonstrations and simulations (64.9%). Overall, 52.4% of students’ morale was positive towards e-learning. Students rated blended teaching as the preferred teaching method.\u0000Conclusions: Medical students still prefer face-to-face learning and opted for blended learning over complete e-learning. Appropriate steps like training faculties, providing high-speed internet, taking formative tests, giving online demonstrations, involving simulations, and student feedback can improve e-learning quality.","PeriodicalId":39140,"journal":{"name":"Journal of Nepal Paediatric Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42783118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-31DOI: 10.3126/jnps.v42i2.40619
K. Konda, Swapna Lingaldinna, Sadiqua Anjum, M. Alimelu, Himabindu Singh, Apoorva Tadury
Introduction: Administration of LISA using thin and soft catheters like 5 F orogastric tube, though less invasive, is technically challenging and needs expertise. We hypothesized, use of a 2 mm Endotracheal (ET) tube for administration of LISA could be an easy and convenient alternative. Methods: This is a prospective, single-centric, quasi-random, pilot trial conducted in the inborn unit of a tertiary care hospital from May 2020 - December 2020. All the inborn preterm (28 - 34 weeks) neonates with respiratory distress requiring surfactant were alternately allocated to receive LISA using a 5 F infant feeding tube or an uncuffed 2.0 size ET tube. The primary outcome was successful administration of surfactant defined as a procedure without any need for positive pressure ventilation. Results: In our study, 25 neonates were enrolled in each arm. Administration of LISA using 2 mm ET tube was associated with better success of surfactant administration with lesser incidence of PPV (20 vs 11, p < 0.05), desaturation (5 vs 12, p < 0.05), and bradycardia (3 vs 10, p < 0.05) compared to LISAOG. Conclusions: Administration of LISA using a 2 mm ET is an easily adaptable and convenient alternative that is well tolerated by the neonates without any adverse effects.
简介：使用薄而软的导管（如5 F胃导管）进行LISA给药，虽然侵入性较小，但在技术上具有挑战性，需要专业知识。我们假设，使用2毫米的气管插管（ET）给药LISA可能是一种简单方便的替代方法。方法：这是一项前瞻性、单中心、准随机的试点试验，于2020年5月至2020年12月在一家三级护理医院的先天性病房进行。所有患有呼吸窘迫需要表面活性物质的先天性早产（28-34周）新生儿被交替分配使用5F婴儿喂养管或2.0尺寸的未切割ET管接受LISA。主要结果是成功地给予表面活性剂，这是一种不需要任何正压通气的程序。结果：在我们的研究中，每只手臂有25名新生儿入选。使用2mm ET管施用LISA与表面活性剂施用的更好成功相关，PPV（20 vs 11，p＜0.05）、去饱和（5 vs 12，p＜0.01）、，和心动过缓（3比10，p＜0.05）。结论：使用2mm ET给药LISA是一种易于适应和方便的替代方案，新生儿耐受性良好，没有任何不良反应。
{"title":"Less Invasive Surfactant Administration (LISA) in Premature Neonates, using 5F feeding tube versus 2 mm Endotracheal tube – An Innovative, Pilot study","authors":"K. Konda, Swapna Lingaldinna, Sadiqua Anjum, M. Alimelu, Himabindu Singh, Apoorva Tadury","doi":"10.3126/jnps.v42i2.40619","DOIUrl":"https://doi.org/10.3126/jnps.v42i2.40619","url":null,"abstract":"Introduction: Administration of LISA using thin and soft catheters like 5 F orogastric tube, though less invasive, is technically challenging and needs expertise. We hypothesized, use of a 2 mm Endotracheal (ET) tube for administration of LISA could be an easy and convenient alternative.\u0000 Methods: This is a prospective, single-centric, quasi-random, pilot trial conducted in the inborn unit of a tertiary care hospital from May 2020 - December 2020. All the inborn preterm (28 - 34 weeks) neonates with respiratory distress requiring surfactant were alternately allocated to receive LISA using a 5 F infant feeding tube or an uncuffed 2.0 size ET tube. The primary outcome was successful administration of surfactant defined as a procedure without any need for positive pressure ventilation.\u0000Results: In our study, 25 neonates were enrolled in each arm. Administration of LISA using 2 mm ET tube was associated with better success of surfactant administration with lesser incidence of PPV (20 vs 11, p < 0.05), desaturation (5 vs 12, p < 0.05), and bradycardia (3 vs 10, p < 0.05) compared to LISAOG.\u0000Conclusions: Administration of LISA using a 2 mm ET is an easily adaptable and convenient alternative that is well tolerated by the neonates without any adverse effects.","PeriodicalId":39140,"journal":{"name":"Journal of Nepal Paediatric Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49299647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
During the second wave of Covid-19 pandemic, children presented with myriad of central nervous system manifestations and one of them was Guillain-Barré syndrome (GBS). It is caused by various viruses including recent Covid-19 infection by either direct invasion or post infectious process. Most of these cases were reported in adults and very few in children. Here, we report a case series of five children with GBS along with positive Covid-19 antibodies, probably first from India. All patients responded well to intravenous immunoglobulin without any residual weakness. Hence, we could probably link casual association of Covid-19 infection with GBS.
{"title":"Guillain Barre Syndrome as a Presentation of post Covid-19 Infection among Children: A Case Series","authors":"Kavthekar Saiprasad Onkareshwar, Patil Rahul Ravso, Narahari Venkata Susmitha, Jadhav Vilas Maruti, Patil Nivedita Balasaheb, Kurane Anil Bapurao","doi":"10.3126/jnps.v42i3.45157","DOIUrl":"https://doi.org/10.3126/jnps.v42i3.45157","url":null,"abstract":"During the second wave of Covid-19 pandemic, children presented with myriad of central nervous system manifestations and one of them was Guillain-Barré syndrome (GBS). It is caused by various viruses including recent Covid-19 infection by either direct invasion or post infectious process. Most of these cases were reported in adults and very few in children. Here, we report a case series of five children with GBS along with positive Covid-19 antibodies, probably first from India. All patients responded well to intravenous immunoglobulin without any residual weakness. Hence, we could probably link casual association of Covid-19 infection with GBS.","PeriodicalId":39140,"journal":{"name":"Journal of Nepal Paediatric Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42436810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-31DOI: 10.3126/jnps.v42i2.44318
S. Basnet, Surabhi Aryal, L. Shrestha
Introduction: With advances in therapies during antenatal and perinatal period, there has been apparent decrease in incidence and mortality due to respiratory distress syndrome (RDS). However, there is paucity of data on exact incidence and outcome of RDS in resource limited setting. This study was conducted with the primary aim to describe the outcome of RDS and analyze the predictors for mortality. Methods: A prospective observational study was conducted in the Neonatal Intensive Care Unit (NICU) and Neonatal Unit of Tribhuvan University Teaching Hospital (TUTH), Kathmandu, Nepal from October 2019 to April 2021. Results: A total of 94 preterm newborns developed RDS giving prevalence of 20.5 per 1000 live birth cohort at TUTH. Incidence of RDS among preterm babies was 14.6%. The median duration of continuous positive airway pressure (CPAP) was 48 hours (Range 8 - 192 hours). Inhospital mortality rate was 15 (15.96%). Lower gestational age and premature rupture of membrane (PROM) were significantly associated with higher mortality whereas Normal Vaginal delivery (NVD) was associated with lower mortality. Logistic regression analysis for risk of dying for the cohort predicted that lower birth weight (AOR = 0.99; 95% CI = 0.99 - 0.99; P = 0:01), sepsis (AOR = 145.14; 95% CI = 5.04 - 4175.15; P = 0:004) are independently associated with increased risk of dying whereas increase duration of NICU stay decreased the risk (AOR = 0.71; 95% CI = 0.54 - 0.91; P = 0:01). Conclusions: The mortality rate decreases with increasing gestational age and birth weight. A number of neonatal factors, either in isolation or in combination, were significantly associated with in-hospital mortality
随着产前和围产期治疗的进步，呼吸窘迫综合征(RDS)的发病率和死亡率明显下降。然而，在资源有限的情况下，关于RDS的确切发生率和结果的数据缺乏。本研究的主要目的是描述RDS的结果并分析死亡率的预测因素。方法:于2019年10月至2021年4月在尼泊尔加德满都特里布万大学教学医院(TUTH)新生儿重症监护病房(NICU)和新生儿病房进行前瞻性观察研究。结果:共有94名早产新生儿发生RDS，每1000名活产队列患病率为20.5。早产儿RDS发生率为14.6%。持续气道正压通气(CPAP)的中位持续时间为48小时(范围8 - 192小时)。住院死亡率15例(15.96%)。低胎龄和胎膜早破(PROM)与较高的死亡率显著相关，而正常阴道分娩(NVD)与较低的死亡率相关。对队列死亡风险的Logistic回归分析预测，低出生体重(AOR = 0.99;95% ci = 0.99 - 0.99;P = 0:01)、脓毒症(AOR = 145.14;95% ci = 5.04 - 4175.15;P = 0:004)与死亡风险增加独立相关，而新生儿重症监护病房住院时间延长则降低了死亡风险(AOR = 0.71;95% ci = 0.54 - 0.91;P = 0:01)。结论:新生儿死亡率随胎龄和出生体重的增加而降低。许多新生儿因素，无论是单独的还是联合的，都与住院死亡率显著相关
{"title":"Incidence, Outcome and Predictors of Mortality in Respiratory distress syndrome (RDS): A Prospective Cohort Study at Tertiary Care Hospital in Nepal","authors":"S. Basnet, Surabhi Aryal, L. Shrestha","doi":"10.3126/jnps.v42i2.44318","DOIUrl":"https://doi.org/10.3126/jnps.v42i2.44318","url":null,"abstract":"Introduction: With advances in therapies during antenatal and perinatal period, there has been apparent decrease in incidence and mortality due to respiratory distress syndrome (RDS). However, there is paucity of data on exact incidence and outcome of RDS in resource limited setting. This study was conducted with the primary aim to describe the outcome of RDS and analyze the predictors for mortality.\u0000Methods: A prospective observational study was conducted in the Neonatal Intensive Care Unit (NICU) and Neonatal Unit of Tribhuvan University Teaching Hospital (TUTH), Kathmandu, Nepal from October 2019 to April 2021.\u0000Results: A total of 94 preterm newborns developed RDS giving prevalence of 20.5 per 1000 live birth cohort at TUTH. Incidence of RDS among preterm babies was 14.6%. The median duration of continuous positive airway pressure (CPAP) was 48 hours (Range 8 - 192 hours). Inhospital mortality rate was 15 (15.96%). Lower gestational age and premature rupture of membrane (PROM) were significantly associated with higher mortality whereas Normal Vaginal delivery (NVD) was associated with lower mortality. Logistic regression analysis for risk of dying for the cohort predicted that lower birth weight (AOR = 0.99; 95% CI = 0.99 - 0.99; P = 0:01), sepsis (AOR = 145.14; 95% CI = 5.04 - 4175.15; P = 0:004) are independently associated with increased risk of dying whereas increase duration of NICU stay decreased the risk (AOR = 0.71; 95% CI = 0.54 - 0.91; P = 0:01).\u0000 Conclusions: The mortality rate decreases with increasing gestational age and birth weight. A number of neonatal factors, either in isolation or in combination, were significantly associated with in-hospital mortality","PeriodicalId":39140,"journal":{"name":"Journal of Nepal Paediatric Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45668135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-31DOI: 10.3126/jnps.v42i2.39150
Sunita Arora, G. Narang, Anmol Kaur, T. Kaur
Chylothorax is a rare cause of non immune hydrops fetalis & presents with respiratory distress at birth. We present a late preterm diagnosed antenatally as hydrops with chylothorax with bilateral pleural effusion and respiratory distress at birth requiring mechanical ventilation. Baby was managed successfully with intercostal drainage, octreotide infusion & MCT milk formula.
{"title":"Congenital Chylothorax as a Cause of Non Immune Hydrops: A Case Report","authors":"Sunita Arora, G. Narang, Anmol Kaur, T. Kaur","doi":"10.3126/jnps.v42i2.39150","DOIUrl":"https://doi.org/10.3126/jnps.v42i2.39150","url":null,"abstract":"Chylothorax is a rare cause of non immune hydrops fetalis & presents with respiratory distress at birth. We present a late preterm diagnosed antenatally as hydrops with chylothorax with bilateral pleural effusion and respiratory distress at birth requiring mechanical ventilation. Baby was managed successfully with intercostal drainage, octreotide infusion & MCT milk formula.","PeriodicalId":39140,"journal":{"name":"Journal of Nepal Paediatric Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49413204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Umbilical granuloma is a common umbilical problem in infants. Although various modalities are available for the treatment of umbilical granulomas, the best method remains controversial. A 7-week-old infant presented with umbilical granuloma followed by omphalitis. We treated the omphalitis first to prevent local inflammation. On the following day, the umbilical granuloma was successfully cut off with a nylon suture thread. No residue of the granuloma was left behind and no signs of local inflammation appeared. Umbilical granuloma can be successfully removed with a nylon suture thread. Treatment for omphalitis before granuloma removal may be useful to prevent local inflammation.
{"title":"A Novel Strategy for Umbilical Granuloma Removal: Cutting off with a Nylon Suture Thread","authors":"Kazuto Taniguchi, Kazutaka Mizuta, Kazuyasu Uemichi","doi":"10.3126/jnps.v42i3.45499","DOIUrl":"https://doi.org/10.3126/jnps.v42i3.45499","url":null,"abstract":"Umbilical granuloma is a common umbilical problem in infants. Although various modalities are available for the treatment of umbilical granulomas, the best method remains controversial. A 7-week-old infant presented with umbilical granuloma followed by omphalitis. We treated the omphalitis first to prevent local inflammation. On the following day, the umbilical granuloma was successfully cut off with a nylon suture thread. No residue of the granuloma was left behind and no signs of local inflammation appeared. Umbilical granuloma can be successfully removed with a nylon suture thread. Treatment for omphalitis before granuloma removal may be useful to prevent local inflammation.","PeriodicalId":39140,"journal":{"name":"Journal of Nepal Paediatric Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43338208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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