Pub Date : 2022-11-27DOI: 10.3126/jnps.v42i1.38113
Jayateertha Joshi, Owais Ahmed Mushtaq, Sayashi Roy, Suchetha S. Rao
Retroperitoneal teratoma is a rare occurrence in neonates. They are usually asymptomatic and the only finding may be abdominal distension. We report an unusual case of a large retroperitoneal teratoma in a neonate who presented with abdominal distension. Imaging done showed a cystic lesion with calcifications, internal septations and fat dense areas. It was successfully managed by surgical excision, findings of which were consistent with that of a mature cystic teratoma. Despite being rare, we must consider retroperitoneal teratomas as a differential diagnosis of an abdominal mass in a newborn. Early detection and complete surgical excision may be life-saving.
{"title":"Neonate with Retroperitoneal Mature Cystic Teratoma – A Case Report","authors":"Jayateertha Joshi, Owais Ahmed Mushtaq, Sayashi Roy, Suchetha S. Rao","doi":"10.3126/jnps.v42i1.38113","DOIUrl":"https://doi.org/10.3126/jnps.v42i1.38113","url":null,"abstract":"Retroperitoneal teratoma is a rare occurrence in neonates. They are usually asymptomatic and the only finding may be abdominal distension. We report an unusual case of a large retroperitoneal teratoma in a neonate who presented with abdominal distension. Imaging done showed a cystic lesion with calcifications, internal septations and fat dense areas. It was successfully managed by surgical excision, findings of which were consistent with that of a mature cystic teratoma. Despite being rare, we must consider retroperitoneal teratomas as a differential diagnosis of an abdominal mass in a newborn. Early detection and complete surgical excision may be life-saving.","PeriodicalId":39140,"journal":{"name":"Journal of Nepal Paediatric Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45875320","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 : 2022-11-27DOI: 10.3126/jnps.v42i1.39773
Pradip Kumar Paudel, S. Basnet, Merina Shreshtha
Introduction: Acute abdominal pain is a very common complaint for children presenting to the emergency department (ED). The purpose of this study was to compare efficacy of hyoscine and drotaverine for relieving acute nonspecific abdominal pain in children presenting to ED. Methods: Total of 52 children aged six years to 16 years were enrolled in a non-randomized trial at Paediatric ED of TUTH from Dec 2017 to June 2018, and randomly allocated to drotaverine or hyoscine groups; 26 in each group. Face pain score-revised tool was used to measure the efficacy of the drug. The primary outcome was to measure the reduction of face pain score (Self-reported) by at least 2 / 10 at 60 minutes after ingestion of study intervention. Other outcomes were requirement of rescue analgesia and adverse effects of drugs. Results: A total of 20 (77%) in hyoscine and 21 (81%) in drotaverine group responded to oral medication at the end of 60 minutes of oral administration and the difference was not statistically significant (p=0.808). Vomiting was only adverse event present in five (19%) in drotaverine and two (8%) in hyoscine groups, respectively. Conclusions: In this single center randomized controlled trial, both hyoscine and drotaverine were found to be equally efficacious for relieving acute non-specific abdominal pain in children.
{"title":"Efficacy of Hyoscine Butylbromide Versus Drotaverine in Relieving Acute Nonspecific Abdominal Pain in Children- A Non - Randomized Trial","authors":"Pradip Kumar Paudel, S. Basnet, Merina Shreshtha","doi":"10.3126/jnps.v42i1.39773","DOIUrl":"https://doi.org/10.3126/jnps.v42i1.39773","url":null,"abstract":"Introduction: Acute abdominal pain is a very common complaint for children presenting to the emergency department (ED). The purpose of this study was to compare efficacy of hyoscine and drotaverine for relieving acute nonspecific abdominal pain in children presenting to ED.\u0000Methods: Total of 52 children aged six years to 16 years were enrolled in a non-randomized trial at Paediatric ED of TUTH from Dec 2017 to June 2018, and randomly allocated to drotaverine or hyoscine groups; 26 in each group. Face pain score-revised tool was used to measure the efficacy of the drug. The primary outcome was to measure the reduction of face pain score (Self-reported) by at least 2 / 10 at 60 minutes after ingestion of study intervention. Other outcomes were requirement of rescue analgesia and adverse effects of drugs.\u0000Results: A total of 20 (77%) in hyoscine and 21 (81%) in drotaverine group responded to oral medication at the end of 60 minutes of oral administration and the difference was not statistically significant (p=0.808). Vomiting was only adverse event present in five (19%) in drotaverine and two (8%) in hyoscine groups, respectively.\u0000 Conclusions: In this single center randomized controlled trial, both hyoscine and drotaverine were found to be equally efficacious for relieving acute non-specific abdominal pain in children.","PeriodicalId":39140,"journal":{"name":"Journal of Nepal Paediatric Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44325040","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 : 2022-11-27DOI: 10.3126/jnps.v42i1.41453
Sukhdeep Kaur, Kunwar Pal Singh
Introduction: According to the third National Family Health Survey, 79% of Indian children are anaemic. Pica is characterized by the persistent ingestion of non-nutritive substances such as plaster, charcoal, chalk, and earth for at least one month in a manner that is inappropriate for their developmental level. We investigated the correlation between pica behaviour and anaemia in preschool children. Methods: In total, 103 children of ages six to 48 months attending the OPD were randomly included in this study for six months; they presented with clinical features of anaemia. Complete blood count and peripheral blood film examination were carried out. The children were assessed clinically for signs and symptoms of anaemia. History of ingestion of clay, sand, chalk, wall paints etc was asked from the parents. Results: Most of the children (90.3%) had microcytic hypochromic anaemia with a mean haemoglobin value of 8.82 g / dl. The mean age was 18 months, and boys slightly outnumbered girls. In total, 57.3% of children had a positive history of pica, and all of them were found to be anaemic. However, no significant statistical correlation was observed between anaemia and history of pica. Conclusions: All children with history of pica were anaemic and the most common type of anaemia was microcytic hypochromic. Although no significant statistical correlation was observed between and history of pica, it is very important for the clinicians to be cautious of this common condition and evaluate for anaemia
根据第三次全国家庭健康调查，79%的印度儿童患有贫血症。异食癖的特点是持续摄入非营养性物质，如石膏、木炭、粉笔和泥土至少一个月，其摄入方式不适合其发育水平。我们调查了异食癖行为与学龄前儿童贫血之间的关系。方法:共有103名6至48个月的儿童在门诊就诊，随机纳入本研究6个月;他们表现出贫血的临床特征。进行全血细胞计数和外周血膜检查。临床评估儿童贫血的体征和症状。向家长询问了摄入粘土、沙子、粉笔、墙漆等的历史。结果:绝大多数患儿(90.3%)为小细胞性低色素贫血，平均血红蛋白值为8.82 g / dl。平均年龄为18个月，男孩的数量略多于女孩。总共有57.3%的儿童有异食癖的阳性病史，并且他们都被发现有贫血。然而，贫血与异食癖病史之间没有显著的统计学相关性。结论:所有异食癖患儿均为贫血，最常见的贫血类型为小细胞性低色素血症。虽然异食癖和异食癖病史之间没有明显的统计学相关性，但临床医生对这种常见疾病保持谨慎并评估贫血是非常重要的
{"title":"Anaemia In Preschool Children:its Correlation With Pica","authors":"Sukhdeep Kaur, Kunwar Pal Singh","doi":"10.3126/jnps.v42i1.41453","DOIUrl":"https://doi.org/10.3126/jnps.v42i1.41453","url":null,"abstract":"Introduction: According to the third National Family Health Survey, 79% of Indian children are anaemic. Pica is characterized by the persistent ingestion of non-nutritive substances such as plaster, charcoal, chalk, and earth for at least one month in a manner that is inappropriate for their developmental level. We investigated the correlation between pica behaviour and anaemia in preschool children.\u0000Methods: In total, 103 children of ages six to 48 months attending the OPD were randomly included in this study for six months; they presented with clinical features of anaemia. Complete blood count and peripheral blood film examination were carried out. The children were assessed clinically for signs and symptoms of anaemia. History of ingestion of clay, sand, chalk, wall paints etc was asked from the parents.\u0000Results: Most of the children (90.3%) had microcytic hypochromic anaemia with a mean haemoglobin value of 8.82 g / dl. The mean age was 18 months, and boys slightly outnumbered girls. In total, 57.3% of children had a positive history of pica, and all of them were found to be anaemic. However, no significant statistical correlation was observed between anaemia and history of pica.\u0000Conclusions: All children with history of pica were anaemic and the most common type of anaemia was microcytic hypochromic. Although no significant statistical correlation was observed between and history of pica, it is very important for the clinicians to be cautious of this common condition and evaluate for anaemia","PeriodicalId":39140,"journal":{"name":"Journal of Nepal Paediatric Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47273024","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 : 2022-11-27DOI: 10.3126/jnps.v42i1.42662
Shreejana Singh, Saras Sharma, Bimal Tandukar, P. Silwal, M. Sharma
Introduction: Adolescence is the transitional phase of growth and development between childhood and adulthood with ages ranging from 10 to 19 years. Adolescent sexual and reproductive health (ASRH) services are the centers where adolescents can get access to their queries regarding health of both physical as well as psychological aspect. The objective of the study was to find out the knowledge and perception regarding ASRH services among adolescents attending a tertiary level hospital. Methods: A descriptive study was carried out among 112 adolescents attending adolescent clinic using a pretested structured interview schedule. Non probability purposive sampling technique was used. The data were analyzed using SPSS version 16 through descriptive statistical method and Inferential statistical methods. Results: The study revealed majority (58.0%) of respondents had moderate level of knowledge regarding ASRH (Mean value 68.89 ± 14.59 S. D). Respondent’s had high perception towards programmatic domain. Almost all (97.3%) of the respondents had positive perception towards ASRH services. There was no statistical significance between the level of knowledge and perception, level of knowledge and sociodemographic variables at 95% confidence level. Conclusions: The study concludes that adolescents have moderate level of knowledge regarding ASRH. Adolescents have an overall positive perception towards the ASRH services but they have negative perception towards the facility of ASRH services in comparison to programmatic domain.
青春期是儿童和成年之间生长发育的过渡阶段，年龄从10岁到19岁不等。青少年性健康和生殖健康(ASRH)服务是青少年可以获得有关身体和心理健康方面问题的中心。本研究的目的是了解在三级医院就诊的青少年对ASRH服务的了解和认知。方法:采用预先测试的结构化访谈表对112名青少年门诊就诊的青少年进行描述性研究。采用非概率目的抽样技术。数据分析采用SPSS 16版，采用描述性统计方法和推理统计方法。结果:大部分(58.0%)被调查者对ASRH有中等程度的认知(平均值68.89±14.59 S. D)，对程序性领域有较高的认知。几乎所有(97.3%)的受访者对ASRH服务有积极的看法。在95%的置信水平下，知识水平与感知水平、知识水平与社会人口学变量之间无统计学意义。结论:本研究认为青少年对ASRH有中等程度的认知。青少年对ASRH服务总体上有积极的看法，但与程序性领域相比，他们对ASRH服务的设施有消极的看法。
{"title":"Knowledge and Perception Regarding Adolescent Sexual and Reproductive Health Services among Adolescents attending a Tertiary Level Hospital","authors":"Shreejana Singh, Saras Sharma, Bimal Tandukar, P. Silwal, M. Sharma","doi":"10.3126/jnps.v42i1.42662","DOIUrl":"https://doi.org/10.3126/jnps.v42i1.42662","url":null,"abstract":"Introduction: Adolescence is the transitional phase of growth and development between childhood and adulthood with ages ranging from 10 to 19 years. Adolescent sexual and reproductive health (ASRH) services are the centers where adolescents can get access to their queries regarding health of both physical as well as psychological aspect. The objective of the study was to find out the knowledge and perception regarding ASRH services among adolescents attending a tertiary level hospital.\u0000 Methods: A descriptive study was carried out among 112 adolescents attending adolescent clinic using a pretested structured interview schedule. Non probability purposive sampling technique was used. The data were analyzed using SPSS version 16 through descriptive statistical method and Inferential statistical methods.\u0000Results: The study revealed majority (58.0%) of respondents had moderate level of knowledge regarding ASRH (Mean value 68.89 ± 14.59 S. D). Respondent’s had high perception towards programmatic domain. Almost all (97.3%) of the respondents had positive perception towards ASRH services. There was no statistical significance between the level of knowledge and perception, level of knowledge and sociodemographic variables at 95% confidence level.\u0000Conclusions: The study concludes that adolescents have moderate level of knowledge regarding ASRH. Adolescents have an overall positive perception towards the ASRH services but they have negative perception towards the facility of ASRH services in comparison to programmatic domain.","PeriodicalId":39140,"journal":{"name":"Journal of Nepal Paediatric Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45837208","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 : 2022-11-27DOI: 10.3126/jnps.v42i1.38454
Shrikiran Aroor, Suneel C Mundkur, Sandeep Kumar
Introduction: Viruses are common etiological agents of severe acute respiratory illness in under five children. Very few studies are available considering the profile of children with viral pneumonia admitted to paediatric intensive care unit (PICU) in our setting. Hence this study was done to describe the clinico- radiological profile and outcome of children diagnosed with viral pneumonia admitted to PICU. Methods: This was a retrospective descriptive study done in the PICU of a tertiary care hospital in South India. The presenting clinical features, blood parameters, chest radiography findings, course during the hospital stay and outcome of children with viral pneumonia (RT- PCR Positive) admitted to PICU were studied. Results: The aetiological profile of 28 children included - Influenza virus - 14 cases, Respiratory Syncytial Virus - 6 cases, Adeno virus - 4 cases, Human Boca virus - 2 cases, Human Rhino Virus - 1 case and Human metapneumo Virus - 1 case. Majority of children (50%) presented with severe respiratory distress. Predominant radiological picture included bilateral interstitial infiltrates followed by patchy alveolar consolidation. Eight children required mechanical ventilation. Complications included septic shock and MODS (n = 5), pneumothorax (n = 2), myocarditis (n = 2), pleural effusion (n = 1), ventilator associated pneumonia (n = 2) and pulmonary artery hypertension (n = 2). Mortality was observed in seven (25%) children. SpO2 / FiO2 ratio < 300, shock at admission, neutrophil leucocyte ratio > 2 and hypoalbuminemia were found to be significant predictors of mortality. Conclusions: Malnutrition and iron deficiency analmia were the common risk factors. Patchy alveolar consolidation is also a common radiological finding along with interstitial infiltrates. Hypoalbuminemia was a common finding among non-survivors.
{"title":"Clinico-radiological Profile and Outcome of Children with Viral Pneumonia admitted to Paediatric Intensive Care Unit in the pre COVID 19 period","authors":"Shrikiran Aroor, Suneel C Mundkur, Sandeep Kumar","doi":"10.3126/jnps.v42i1.38454","DOIUrl":"https://doi.org/10.3126/jnps.v42i1.38454","url":null,"abstract":"Introduction: Viruses are common etiological agents of severe acute respiratory illness in under five children. Very few studies are available considering the profile of children with viral pneumonia admitted to paediatric intensive care unit (PICU) in our setting. Hence this study was done to describe the clinico- radiological profile and outcome of children diagnosed with viral pneumonia admitted to PICU.\u0000Methods: This was a retrospective descriptive study done in the PICU of a tertiary care hospital in South India. The presenting clinical features, blood parameters, chest radiography findings, course during the hospital stay and outcome of children with viral pneumonia (RT- PCR Positive) admitted to PICU were studied.\u0000Results: The aetiological profile of 28 children included - Influenza virus - 14 cases, Respiratory Syncytial Virus - 6 cases, Adeno virus - 4 cases, Human Boca virus - 2 cases, Human Rhino Virus - 1 case and Human metapneumo Virus - 1 case. Majority of children (50%) presented with severe respiratory distress. Predominant radiological picture included bilateral interstitial infiltrates followed by patchy alveolar consolidation. Eight children required mechanical ventilation. Complications included septic shock and MODS (n = 5), pneumothorax (n = 2), myocarditis (n = 2), pleural effusion (n = 1), ventilator associated pneumonia (n = 2) and pulmonary artery hypertension (n = 2). Mortality was observed in seven (25%) children. SpO2 / FiO2 ratio < 300, shock at admission, neutrophil leucocyte ratio > 2 and hypoalbuminemia were found to be significant predictors of mortality.\u0000Conclusions: Malnutrition and iron deficiency analmia were the common risk factors. Patchy alveolar consolidation is also a common radiological finding along with interstitial infiltrates. Hypoalbuminemia was a common finding among non-survivors.","PeriodicalId":39140,"journal":{"name":"Journal of Nepal Paediatric Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47206312","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 : 2022-11-27DOI: 10.3126/jnps.v42i1.41183
Rimjhim Sonowal, Ashok Kumar V
Introduction: Complicated community-acquired pneumonia resulting in empyema thoracis remains the largest single cause of morbidity and mortality worldwide in children. This study was carried out to evaluate the clinical profile, associated complications and outcome of empyema thoracis in children. Methods: A retrospective study was conducted in the Department of Paediatrics at a tertiary care center in Eastern Nepal. A total of 106 children were managed with the diagnosis of complicated pneumonia with effusion or empyema thoracis from March 2017 to February 2021 (Five years). Only those patients who had clinico-radiological evidence of pleural effusion or empyema thoracis and received treatment with or without intercostal chest tube drainage (ICD) as the initial procedure were enrolled in the study. Besides supportive treatments and antibiotics; streptokinase was instilled intrapleurally in all the patients for three days. Patients who did not respond underwent VATS / decortication. Results: Majority of the children (60.19%) were below five years of age and were males (73.58%). Majority (55.67%) had a right-sided pleural effusion and fever was the predominant symptom (55.66%) at presentation. The pleural fluid culture was sterile in more than half (55.66%) of the patients with Staphylococcus aureus grown in 33.96%. The three most common complications were subcutaneous emphysema, thickened pleura, and pyo-pneumothorax. The success rate of medical management was 83.96% and the mortality was low (2.84%). Conclusions: The success rate of conservative management with antimicrobial therapy, intercostal drainage and fibrinolytics in this study was high (83.96%) with no major adverse effects of fibrinolytic therapy in empyema thoracis.
{"title":"Empyema Thoracis in children: A Five-Year Analysis from a Tertiary Care Center in Eastern Nepal","authors":"Rimjhim Sonowal, Ashok Kumar V","doi":"10.3126/jnps.v42i1.41183","DOIUrl":"https://doi.org/10.3126/jnps.v42i1.41183","url":null,"abstract":"Introduction: Complicated community-acquired pneumonia resulting in empyema thoracis remains the largest single cause of morbidity and mortality worldwide in children. This study was carried out to evaluate the clinical profile, associated complications and outcome of empyema thoracis in children.\u0000Methods: A retrospective study was conducted in the Department of Paediatrics at a tertiary care center in Eastern Nepal. A total of 106 children were managed with the diagnosis of complicated pneumonia with effusion or empyema thoracis from March 2017 to February 2021 (Five years). Only those patients who had clinico-radiological evidence of pleural effusion or empyema thoracis and received treatment with or without intercostal chest tube drainage (ICD) as the initial procedure were enrolled in the study. Besides supportive treatments and antibiotics; streptokinase was instilled intrapleurally in all the patients for three days. Patients who did not respond underwent VATS / decortication.\u0000Results: Majority of the children (60.19%) were below five years of age and were males (73.58%). Majority (55.67%) had a right-sided pleural effusion and fever was the predominant symptom (55.66%) at presentation. The pleural fluid culture was sterile in more than half (55.66%) of the patients with Staphylococcus aureus grown in 33.96%. The three most common complications were subcutaneous emphysema, thickened pleura, and pyo-pneumothorax. The success rate of medical management was 83.96% and the mortality was low (2.84%).\u0000Conclusions: The success rate of conservative management with antimicrobial therapy, intercostal drainage and fibrinolytics in this study was high (83.96%) with no major adverse effects of fibrinolytic therapy in empyema thoracis.","PeriodicalId":39140,"journal":{"name":"Journal of Nepal Paediatric Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45627476","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 : 2022-11-27DOI: 10.3126/jnps.v42i1.39225
S. Kavthekar, K. Amith, Anil Bapurao Kurane, Yoganand J Phulari
Stevens Johnson syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are hyper sensitive life - threatening rare dermatological reactions. In SJS - TEN overlap syndrome, the extent and severity of epidermal detachment is 10- 30%. Drugs like sulfonamides, nonsteroidal anti- inflammatory agents, antibiotics and anticonvulsants are the commonest precipitants. Here, we present a rare case of SJS - TEN overlap syndrome in a previously normal 11 years old girl after acetaminophen intake for fever. This case report is intended to make paediatricians aware that the adverse reaction like SJS - TEN overlap syndrome can develop with a drug like acetaminophen which is supposed to be the safest antipyretic in paediatrics.
{"title":"Acetaminophen induced Stevens Johnson syndrome - Toxic Epidermal Necrolysis Overlap Syndrome: A rare Adverse Reaction","authors":"S. Kavthekar, K. Amith, Anil Bapurao Kurane, Yoganand J Phulari","doi":"10.3126/jnps.v42i1.39225","DOIUrl":"https://doi.org/10.3126/jnps.v42i1.39225","url":null,"abstract":"Stevens Johnson syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are hyper sensitive life - threatening rare dermatological reactions. In SJS - TEN overlap syndrome, the extent and severity of epidermal detachment is 10- 30%. Drugs like sulfonamides, nonsteroidal anti- inflammatory agents, antibiotics and anticonvulsants are the commonest precipitants. Here, we present a rare case of SJS - TEN overlap syndrome in a previously normal 11 years old girl after acetaminophen intake for fever. This case report is intended to make paediatricians aware that the adverse reaction like SJS - TEN overlap syndrome can develop with a drug like acetaminophen which is supposed to be the safest antipyretic in paediatrics.","PeriodicalId":39140,"journal":{"name":"Journal of Nepal Paediatric Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43075311","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 : 2022-11-27DOI: 10.3126/jnps.v42i1.38310
S. Bajracharya, S. Shakya, Liza Nagarkoti, Rita Kumari Ban, K. Regmi
Introduction: Adolescence is a vulnerable period in which different physical, psychological and behavioral changes occur contributing to mental health issues. Depression and anxiety occur more commonly than would be expected by chance in children and adolescents. Undetected and untreated mental disorders can impair one’s ability to perform at school or work place, cope with daily life activities and can lead to severe mental disorders and related consequences. The aim of this study was to assess the levels of anxiety and depression and their predictors among the adolescents of Kathmandu, Nepal. Methods: A cross-sectional study was conducted in different higher secondary schools of Kathmandu. Cluster random sampling method was used to select 482 students of Grade XI and XII. Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI)-II were used to assess the levels of anxiety and depression. Results: Among 482 students, 230 (47.7%) were females and 252 (52.3%) were males with mean age of 17.25 (± 1.01) years. Majority (38.6%) had minimal anxiety and 11.6% had severe anxiety. On the other side, 45.9% had no depression and 16.4% had severe depression. Grade, sex, health problem, use of gadget and academic performance are found to be the predictors of anxiety, while, the predictors of depression are age, sex, health problem and academic performance. Conclusions: Anxiety and depression are found prevalent among the adolescents, which need to be explored and addressed immediately through appropriate measures. Psychological counseling and support services should be available to vulnerable students.
{"title":"Anxiety and Depression and their Predictors among School Adolescents of Kathmandu, Nepal","authors":"S. Bajracharya, S. Shakya, Liza Nagarkoti, Rita Kumari Ban, K. Regmi","doi":"10.3126/jnps.v42i1.38310","DOIUrl":"https://doi.org/10.3126/jnps.v42i1.38310","url":null,"abstract":"Introduction: Adolescence is a vulnerable period in which different physical, psychological and behavioral changes occur contributing to mental health issues. Depression and anxiety occur more commonly than would be expected by chance in children and adolescents. Undetected and untreated mental disorders can impair one’s ability to perform at school or work place, cope with daily life activities and can lead to severe mental disorders and related consequences. The aim of this study was to assess the levels of anxiety and depression and their predictors among the adolescents of Kathmandu, Nepal. \u0000Methods: A cross-sectional study was conducted in different higher secondary schools of Kathmandu. Cluster random sampling method was used to select 482 students of Grade XI and XII. Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI)-II were used to assess the levels of anxiety and depression.\u0000Results: Among 482 students, 230 (47.7%) were females and 252 (52.3%) were males with mean age of 17.25 (± 1.01) years. Majority (38.6%) had minimal anxiety and 11.6% had severe anxiety. On the other side, 45.9% had no depression and 16.4% had severe depression. Grade, sex, health problem, use of gadget and academic performance are found to be the predictors of anxiety, while, the predictors of depression are age, sex, health problem and academic performance.\u0000Conclusions: Anxiety and depression are found prevalent among the adolescents, which need to be explored and addressed immediately through appropriate measures. Psychological counseling and support services should be available to vulnerable students.","PeriodicalId":39140,"journal":{"name":"Journal of Nepal Paediatric Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48811993","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 : 2022-11-27DOI: 10.3126/jnps.v42i1.41095
J. Muduli, M. Mitra, A. Banerjee, A. Paul
SARS-CoV-2 virus primarily affects the respiratory system, although other organ systems are also involved. Though pulmonary arterial hypertension (PAH) has been described in as a sequela of COVID pneumonia in adults, only a coincidental association between pre-existing PAH and SARS-CoV-2 infection in children has been reported. To our knowledge, severe COVID pneumoniacausing PAH in children, especially in infancy has not been reported yet. With the meteoric spread of the pandemic and rapid development of newer mutated variants, the timely discovery of new drugs is near impossible. The idea of repurposing existing drugs to treat COVID-19 is an attractive strategy, especially if they are already approved (for other indications) and have wellestablished safety profiles. Sildenafil specifically targets pulmonary vasodilation, endothelial function, and vascular remodelling. It hence has emerged as an effective first - line oral therapeutic agent for patients with symptomatic PAH in all age groups. We present a case series of four cases where Sildenafil has been repurposed for the treatment of PAH associated with severe COVID-19 pneumonia in infancy.
{"title":"Role of Sildenafil in Severe COVID-19 Pneumonia in Infancy - A Case Series","authors":"J. Muduli, M. Mitra, A. Banerjee, A. Paul","doi":"10.3126/jnps.v42i1.41095","DOIUrl":"https://doi.org/10.3126/jnps.v42i1.41095","url":null,"abstract":"SARS-CoV-2 virus primarily affects the respiratory system, although other organ systems are also involved. Though pulmonary arterial hypertension (PAH) has been described in as a sequela of COVID pneumonia in adults, only a coincidental association between pre-existing PAH and SARS-CoV-2 infection in children has been reported. To our knowledge, severe COVID pneumoniacausing PAH in children, especially in infancy has not been reported yet. With the meteoric spread of the pandemic and rapid development of newer mutated variants, the timely discovery of new drugs is near impossible. The idea of repurposing existing drugs to treat COVID-19 is an attractive strategy, especially if they are already approved (for other indications) and have wellestablished safety profiles. Sildenafil specifically targets pulmonary vasodilation, endothelial function, and vascular remodelling. It hence has emerged as an effective first - line oral therapeutic agent for patients with symptomatic PAH in all age groups. We present a case series of four cases where Sildenafil has been repurposed for the treatment of PAH associated with severe COVID-19 pneumonia in infancy.","PeriodicalId":39140,"journal":{"name":"Journal of Nepal Paediatric Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48744330","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 : 2022-11-27DOI: 10.3126/jnps.v42i1.39409
J. Yeom, J. Seo, H. Youn
Henoch- Schönlein purpura (HSP) is the most common vasculitis of childhood. Subcutaneous edema in the extremities is a common finding of HSP, whereas lumbosacral edema is a rare presentation. We report a case of HSP in a six year old boy who visited the emergency department for acute - onset back pain with gait problems. An extensive radiologic workup was performed, but the patient was finally diagnosed with HSP based on knee and ankle edema with a few purpura. We described the clinical, imaging findings, and treatment of the current case and review the literature regarding this rare presentation of HSP.
{"title":"Lumbosacral Edema as an Unusual Presentation of Henoch-Schönlein purpura: A Case Report and Literature Review","authors":"J. Yeom, J. Seo, H. Youn","doi":"10.3126/jnps.v42i1.39409","DOIUrl":"https://doi.org/10.3126/jnps.v42i1.39409","url":null,"abstract":"Henoch- Schönlein purpura (HSP) is the most common vasculitis of childhood. Subcutaneous edema in the extremities is a common finding of HSP, whereas lumbosacral edema is a rare presentation. We report a case of HSP in a six year old boy who visited the emergency department for acute - onset back pain with gait problems. An extensive radiologic workup was performed, but the patient was finally diagnosed with HSP based on knee and ankle edema with a few purpura. We described the clinical, imaging findings, and treatment of the current case and review the literature regarding this rare presentation of HSP.","PeriodicalId":39140,"journal":{"name":"Journal of Nepal Paediatric Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49139802","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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