scholarly journals Burden and spectrum of neonatal surgical diseases in a tertiary hospital: a decade experience

2018 ◽  
Vol 5 (3) ◽  
pp. 798 ◽  
Author(s):  
Prashanth Madapura Virupakshappa ◽  
Nidhi Rajendra
Keyword(s):  
Neonatal Intensive Care ◽  
Hypertrophic Pyloric Stenosis ◽  
College Teaching ◽  
Anorectal Malformations ◽  
Tertiary Hospital ◽  
Newborn Period ◽  
Surgical Interventions ◽  
Medical College ◽  
Surgical Emergencies ◽  
Hospital Pediatric

Background: Surgical emergencies in the newborns are an important and integral part of neonatal admissions in any tertiary Neonatal intensive care units. Surgical emergencies in the newborn constitute congenital anomalies and acquired neonatal emergencies. It is necessary to know the burden of these illnesses and their spectrum by regular auditing the data available to understand the relative incidence and outcome of these neonatal emergencies. Aims and objective of the study is to determine the spectrum of the different neonatal surgical emergencies (congenital and acquired) admitted, operated and managed in a tertiary NICU from June 2001 to May 2011(10 yrs) in a medical college teaching hospital in South IndiaMethods: The data was collected by retrospectively auditing the hospital pediatric and neonatal admission registry, neonatal surgical registry, admission case sheets from June 2001 to June 2011 (10 yrs). Data was analysed. Only confirmed post-operative surgical diagnosis were considered for inclusion in the study.Results: Of the 13,118 newborns admitted in the NICU in 10 years, 601 cases (4.6%) were surgical neonates which were treated in the unit. 83.5% of surgical neonates were operated for congenital surgical disorders. Gastrointestinal anomalies (50%) were the leading causes of neonatal surgical emergencies. Anorectal malformations (18.5%), idiopathic hypertrophic pyloric stenosis (10.6%) and esophageal atresia with/without tracheo-esophageal fistula (8.7%) were the leading surgical causes which needed immediate surgical intervention in the newborn period. 28 different spectrum of cases were operated including 15 rarer once (<1% incidence each).Conclusions: Surgical new-borns comprises of an important and integral part of neonatal admissions (4.6/100 neonatal admissions). The incidence of the rarer diseases constitutes 8% of the total surgical cases. Gastrointestinal anomalies are the leading causes requiring surgical interventions in the immediate newborn period. It is worthy to understand the spectrum of illnesses in any tertiary unit by regularly auditing the data available.

scholarly journals Outcome of Respiratory distress in Neonates with Bubble CPAP at Neonatal Intensive Care Unit of a Tertiary Hospital

2019 ◽  
Vol 57 (216) ◽  
Author(s):  
Sunil Raja Manandhar
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Continuous Positive Airway Pressure ◽  
Neonatal Intensive Care Unit ◽  
Respiratory Distress ◽  
Airway Pressure ◽  
Neonatal Intensive Care ◽  
Positive Airway Pressure ◽  
College Teaching ◽  
Medical College

Introduction: Respiratory distress is one of the commonest problem seen in neonates during admission in Neonatal Intensive Care Unit. Hyaline Membrane disease, Meconium Aspiration Syndrome, septicemia, congenital pneumonia, Transient Tachypnea of Newborn are the major causes of respiratory distress in neonates. Bubble Continuous Positive Airway Pressure is a non-invasive respiratory support delivered to a spontaneously breathing newborn to maintain lung volume during expiration. The main objective of this study was to observe the outcome of respiratory distress in neonates with Bubble Continuous Positive Airway Pressure. Methods: This was a descriptive cross-sectional study conducted at Kathmandu Medical College Teaching Hospital over six months (October 2018 – March 2019) period. All preterm, term and post term babies with respiratory distress were included. Ethical clearance was received from Institutional Review Committee of Kathmandu Medical College and statistical analysis was done with SPSS 19 version. Results: Sixty three babies with respiratory distress were included in this study with 45 (71%) male predominance. The mean birth weight receiving Bubble Continuous Positive Airway Pressure was 2661.75±84 gms and gestational age was 36.67±3.4 wks. The Bubble Continuous Positive Airway Pressure was started at 8.05±2 hr of life and duration of Bubble Continuous Positive Airway Pressure required for settling respiratory distress was 95.71±3 hrs. Out of 63 babies, improvement of respiratory distress in neonates with Bubble Continuous Positive Airway Pressure was 39 (61%) with confidence interval of (38-62) whereas 24 (39%) babies required mechanical ventilation and other modalities. Conclusions: This study concludes usefulness of Bubble Continuous Positive Airway Pressure in neonates with respiratory distress.

scholarly journals Nutritional Status of Under-Five Children in Western Nepal

2014 ◽  
Vol 34 (2) ◽  
pp. 119-124 ◽  
Author(s):  
Bandana Shrestha
Keyword(s):  
Who Classification ◽  
College Teaching ◽  
Standard Technique ◽  
Tertiary Hospital ◽  
Major Health Problem ◽  
Under Five ◽  
Under Five Children ◽  
Medical College ◽  
High Prevalence ◽  
A Prospective Study

Introduction: Undernutrition is a major health problem in developing countries which may have adverse effects on growth and development of an individual. The objectives of this study were to assess the prevalence and grades of malnutrition in children below 60 months of age, attending outpatient department at Gandaki Medical College teaching hospital.Materials and Methods: A prospective study was conducted among 556 children below 60 months of age from August to December 2013. Weight and length/height were measured using standard technique and were plotted on WHO centiles curves and severity determined based on WHO classification. The prevalence of underweight, stunting and wasting were determined by anthropometry.Results: Based on WHO classification, out of 556 children, 20.2% were underweight, 34% were stunted and 15.1% were wasted respectively. Of them, severe underweight were 4.7%, severe stunted were 14.1% and severe wasted were 7.2% respectively.Conclusion: A high prevalence of undernutrition exists in under- five children attending a tertiary hospital in a western region of Nepal.DOI: http://dx.doi.org/10.3126/jnps.v34i2.10566J Nepal Paediatr Soc 2014;34(2):119-124      

scholarly journals Maternal and Foetal outcome in Cholestasis of Pregnancy

2017 ◽  
Vol 14 (1) ◽  
pp. 32-35 ◽  
Author(s):  
Kavita Sinha ◽  
Subhash Pandey ◽  
C. R. Das
Keyword(s):  
Neonatal Intensive Care ◽  
Age At Onset ◽  
College Teaching ◽  
High Risk Group ◽  
Foetal Distress ◽  
Preterm Baby ◽  
Medical College ◽  
Membrane Rupture ◽  
Increased Risk ◽  
Foetal Outcome

Background: Obstetric cholestasis has been associated with an increased risk of preterm delivery, intrapartum meconium, foetal distress and intrauterine foetal death.Objectives: To know the perinatal outcome of cholestasis in pregnancy.Materials & Methods: This is a hospital based Observational study conducted in the department of Obstetrics & Gynaecology at Nepalgunj Medical College Teaching Hospital Kohalpur between August 2015 to January 2016.A total of 40 patients were included in the study with diagnosis of obstetric cholestasis. Data were recorded & analysed.Results: The study group of 40 mothers delivered 40 new born. Mean age group of women in the study was 24.9±5.5 years & 70% were primigravida. The mean gestational age at onset of pruritus was 30.33±4.24 weeks. The rate of caesarean section was 40%. Premature membrane rupture noted in 20% cases while 17.5% were postpartum haemorrhage. Regarding foetal outcome; meconium baby 32.5%, Intrapartum foetal distress 17.5%, preterm baby 10% while 37.5% were complication free. There was 2.5% of intrauterine foetal death, where pregnancy continued beyond 38 weeks. Thirteen new borns (32.5%) were admitted to neonatal intensive care unit.Conclusion: Cholestasis in pregnancy is high risk group with adverse perinatal outcomes.JNGMC Vol. 14 No. 1 July 2016, page: 32-35

Prevalence and Etiology of Neonatal Jaundice in a Tertiary Care Hospital

2021 ◽  
Vol 18 (2) ◽  
pp. 35-38
Author(s):  
Niraj Acharya ◽  
Chandra Prasad Paneru
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Sepsis ◽  
Neonatal Intensive Care ◽  
Neonatal Jaundice ◽  
Serum Bilirubin ◽  
College Teaching ◽  
Total Serum ◽  
Common Cause ◽  
Medical College

Introduction: Neonatal jaundice is a major clinical condition worldwide occurring in upto 60% of term and 80% preterm newborn in the first week of life. Neonatal jaundice is defined as total serum bilirubin level above 7 mg/dl. Aims:  This study was done to find out the prevalence and etiology of neonatal jaundice in neonates admitted to Neonatal Intensive Care Unit (NICU) of Nepalgunj Medical College Teaching Hospital (NGMCTH) Kohalpur, Banke. Methods: It was a prospective cross sectional hospital based study conducted from November 2018 to November 2019 in Neonatal Intensive Care Unit of Nepalgunj Medical College Teaching Hospital. All neonates with clinical jaundice and hyperbilirubinemia with total serum bilirubin of ≥7 mg/dl were subjected to complete history taking, through physical examination and investigations. Results: Out of 892 neonates who developed clinical jaundice, 640 neonates whose parents gave consent were included in the study. The prevalence of neonatal jaundice was found to be 39.85% with male to female ratio of 1.79:1. In the present study pathological jaundice was seen in 74.94% whereas physiological jaundice in 23.66%. Among the various etiologies of pathological jaundice, neonatal sepsis (44.52%) was found to be the most common cause followed by ABO incompatibility (12.18%) and Rh incompatibility (7.03%). Conclusion: The prevalence of neonatal jaundice in present study was 39.85% and the most common cause was neonatal sepsis .The prevalence of jaundice was more in preterm than in term neonates. Neonatal jaundice is very common morbidity in NICU especially in preterm babies.

scholarly journals Micro-Erythrocyte Sedimentation Rate in Neonatal Sepsis of a Tertiary Hospital: A Descriptive Cross-sectional Study

2020 ◽  
Vol 58 (226) ◽  
Author(s):  
Sunil Raja Manandhar ◽  
Rydam Basnet
Keyword(s):  
Erythrocyte Sedimentation Rate ◽  
Sedimentation Rate ◽  
Neonatal Sepsis ◽  
College Teaching ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Medical College ◽  
Erythrocyte Sedimentation

Introduction: Neonatal sepsis is the most important cause of morbidity and mortality among lowbirth weight and preterm babies in developing countries. The main objective of this study is to findthe level of micro-Erythrocyte sedimentation rate in neonatal sepsis. Methods: This is a descriptive cross-sectional study conducted at the neonatal unit over six monthsperiod (November 2019 to April 2020). All preterm, term and post-term babies with neonatal sepsisdelivered at Kathmandu Medical College Teaching Hospital were enrolled. Ethical clearance wasreceived from the Institutional Review Committee of Kathmandu Medical College (Ref: 181020191).Convenient sampling method was applied and statistical analysis was done with Statistical packagefor social sciences 19 version. Results: Out of 75 babies, confirm sepsis is 13 (17.3%), probable sepsis is 40 (53.4%) and suspectedsepsis is 22 (29.2%). Micro-Erythrocyte sedimentation level is elevated (≥15mm in 1st hr) in 25 (33.3%)babies with a mean micro-Erythrocyte sedimentation level 9.32±5.4 (2-18) mm in 1st hr. The elevatedmicro- Erythrocyte sedimentation level was seen in relation to sepsis types and C-reactive protein. Conclusions: The bedside micro-Erythrocyte sedimentation level aids in the diagnosis of neonatalsepsis.  

scholarly journals Screening of Thyroid Disorder among Pregnant Ladies in a Tertiary Hospital of Nepal

2019 ◽  
Vol 21 (3) ◽  
pp. 235-239
Author(s):  
Biloni Shrestha ◽  
P. Adhikari
Keyword(s):  
College Teaching ◽  
First Trimester ◽  
Tertiary Hospital ◽  
Fetal Outcome ◽  
Endocrine Disorders ◽  
Thyroid Disorder ◽  
Medical College ◽  
Physiological Changes In Pregnancy ◽  
Antithyroid Peroxidase Antibody ◽  
In Pregnancy

Thyroid disorders (TD) are the second most common endocrine disorders seen in pregnancy. Many physiological changes in pregnancy lead to hypothyroidism in pregnancy. Hypothyroid in pregnancy is associated with many adverse maternal and fetal outcomes. Objective of this study was to find the prevalence of TD in pregnancy in Nepal Medical College Teaching Hospital (NMCTH), Antithyroid Peroxidase Antibody (TPO-Ab) positive cases with hypothyroidism and to evaluate maternal fetal outcome in hypothyroid pregnancies. This was a prospective hospital based observational study. The study was done in Department of Obstetrics and Gynecology, NMCTH from August 2018 to July 2019. Among 420 pregnant ladies 71.0% were euthyroid, 25.7% were hypothyroid (25.2%of subclinical and 0.5% overt), 3.3% were hyperthyroid (0.7% of overt) and 6.4% were TPO-Abpositive with hypothyroidism. Inspite of treatment, Gestational hypertention, Pre-eclampsea and LSCS is significantly high in hypothyroid pregnancy than euthyroid pregnancy. High prevalence of hypothyroidism in this study necessitates universal screening of TD at first trimester of pregnancy.

scholarly journals Study of Children with Recurrent Pneumonia Admitted in a Tertiary Hospital

2019 ◽  
Vol 21 (1) ◽  
pp. 65-69
Author(s):  
Prashant Rijal ◽  
L Lama ◽  
S Shrestha ◽  
P Kakshapati ◽  
R Nayak
Keyword(s):  
Risk Factors ◽  
College Teaching ◽  
Life Time ◽  
Tertiary Hospital ◽  
Recurrent Pneumonia ◽  
Medical College ◽  
History Of ◽  
Underlying Disorder ◽  
Underlying Diseases ◽  
Underlying Risk

 Recurrent pneumonia usually occurs due to an underlying disorder that negatively affects local or systemic defence mechanisms. The aim of this study was to find out the prevalence and risk factors associated with recurrent pneumonia in children and to determine possible strategic plan needed for better clinical outcome. Children between 2 months to 15 years old who had a history of 2 or more episodes of pneumonia per year, or 3 or more episodes in a life time were investigated prospectively at Nepal Medical College Teaching Hospital. Out of 653 children admitted for pneumonia, 74 (11.3 %%) met the criteria for recurrent pneumonia. Among 74 children with recurrent pneumonia, underlying risk factors was demonstrated in 65 patients (87.8%). Most common underlying diseases were aspiration syndrome in 21.6% patients, congenital heart disease in 13.5% patients and bronchial asthma in 12.1% children. No predisposing illness could be demonstrated in 12.1% patients. Approximately 1 in 9 children with pneumonia in our hospital had recurrent pneumonia. Aspiration syndrome was the most common underlying illnesses for undiagnosed recurrent pneumonia in children.

scholarly journals Status of Scar in Repeat Cesarean Section in a Tertiary Hospital

2016 ◽  
Vol 4 (1) ◽  
pp. 42
Author(s):  
Subha Shrestha ◽  
Raju Shakya ◽  
Buddhi Kumar Shrestha ◽  
Narinder Kaur ◽  
Babita Thapa
Keyword(s):  
Cesarean Section ◽  
Placenta Previa ◽  
College Teaching ◽  
Tertiary Hospital ◽  
Cesarean Scar ◽  
Medical College ◽  
Trial Of Labor ◽  
The Status ◽  
Repeat Cesarean Section ◽  
Scarred Uterus

Introduction: In modern Obstetrics, with rising trends of primary Cesarean section (CS) for fetal and maternal interests, pregnancy over the scarred uterus is a challenge to all treating obstetricians. How better the cesarean scar is sutured, its exact fate in next pregnancy is still not measurable. Objective of this study was to evaluate the status of previous cesarean scar during repeat cesarean section (RCS) and calculate the maternal morbidity in those cases in a tertiary hospital.   Methods: It was a descriptive, retrospective study conducted at department of Obstetrics of Lumbini Medical College Teaching Hospital. The study was conducted from 15th July 2014 to 14th July 2015. The data were retrieved from the department of Medical Records. Women undergoing RCS were enrolled. The status of scar was evaluated in terms of intact scar, scar rupture, scar dehiscence, thin lower uterine segment, scar placenta previa, and adhesions as indicator of scar integrity.   Results: There were 534 (25.4%) CS among 2,098 deliveries during the study period. Ninety one (17.04%) of them were RCS. Elective RCS were 73.6% (n=67), and emergency RCS were 26.4% (n=24). Eighty two (90.1%) women had RCS once and 9 (9.9%) had RCS for second time. Scar was intact in 22 (91.6%), scar dehiscence in 1 (8.3%), scar with adhesions in 1 (8.3%) among  emergency RCS and intact in 53 (91.3%) and scar with adhesions in 5 (8.7%) among elective RCS. Among nine women of two RCS, three (37.5%) had thin scar, five (62.5%) had well formed scar,  seven (87.5%) had intact scar, and one (12.5%) had scar with adhesion. There was no scar dehiscence and no scar rupture in two RCS women.  Adhesions were documented twice higher in women whose primary CS was undertaken outside our hospital. Placenta previa and placenta accreta each were found in two cases.   Conclusion: Most of the scars of repeat Cesarean section were healthy with no scar rupture. We can consider trial of labor for scarred uterus with strict vigilance and in need,  CS is always at option.

scholarly journals Clinical Profile and Outcome of Asphyxiated Newborn in a Medical College Teaching Hospital

2016 ◽  
Vol 4 (1) ◽  
pp. 1
Author(s):  
Kiran Panthee ◽  
Kiran Sharma ◽  
Balkrishna Kalakheti ◽  
Kul Thapa
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Survival Rate ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Perinatal Asphyxia ◽  
College Teaching ◽  
Inclusion Criteria ◽  
Mortality And Morbidity ◽  
Medical College

Introduction: Perinatal asphyxia, a major topic in neonatology, is a severe condition which has a high impact on neonatal mortality and morbidity and neurological and intellectual development of the infant. It is defined by WHO as "failure to initiate and sustain breathing at birth". It is estimated that around four million babies are born asphyxiated and among those one million die and an equal number of babies develop serious neurological consequences ranging from cerebral palsy and mental retardation to epilepsy. This study was done to identify the occurrence, clinical profile and, immediate outcome of perinatal asphyxia in Lumbini Medical College Teaching Hospital.   Methods: It was a retrospective study where 82 cases who fulfilled the inclusion criteria were included between December 2014 to November 2015. Inclusion criteria included newborns with: a) Apgar score equal to or less than six at five minutes, b) requirement of  more than one minute of positive pressure ventilation, c) signs of fetal distress (heart rate of less than 100 beats per minute, late decelerations).   Results: Out of total 425 neonatal intensive care unit (NICU) admissions, 82 (19.3%) cases were of asphyxia among which 56 were inborn and 26 were referred from outside. Of those 82 cases, 47 (57.3%) cases developed hypoxic ischemic encephalopathy (HIE); HIE stage I had good outcome with survival rate of 95% and HIE stage III had poor outcome with survival rate of only 25%.   Conclusion: Despite advances in management of neonates, perinatal asphyxia is still the leading cause of neonatal intensive care unit admission and mortality and morbidity in neonates.

Sign in / Sign up

Export Citation Format

Share Document