32 research outputs found
Trend of Breastfeeding and its Impact on Morbidity in Children in a Tertiary Care Hospital in Kathmandu
No full textIntroduction: WHO advocates for exclusive breastfeeding in infants till six months of age. Exclusive breastfeeding has been estimated to reduce 70% of infection related mortality in children. This study aims to elaborate the current trend of breastfeeding and its impact on common infectious morbidities in children.
Methods: This study was a prospective longitudinal study done at Kathmandu Medical College Teaching Hospital with a sample size of 103 infants. Detailed proforma including sociodemographic data, breastfeeding related data and morbidities were collected at one and half months of life. The patients were followed up at 6 months of age again and the same proforma was again filled up. Statistical analysis was done with SPSS 20.0 and various associations were elucidated.
Results: A total of 103 infants were analyzed. Males were 58 in numbers with mean birth weight of the infants being 3048±537 grams. Breast feeding was initiated within an hour in around 37%. At one and half months of age, 63% reported of exclusive breastfeeding which decreased to 23% at 6 months of age. Breastfeeding for at least 45 days decreased the incidence of Acute Respiratory Infections(ARI), Acute Otitis Media(AOM) and diarrheal diseases although statistically significant difference was found with only ARIs.
Conclusion: Prevalence of exclusive breastfeeding is low in the study. The study has also shown that breastfeeding significantly reduces incidence of common infectious morbidities in infants
Prevalence of Perinatal Asphyxia in Neonates at a Tertiary Care Hospital: A Descriptive Cross-sectional Study
No full textIntroduction: Perinatal asphyxia is one of the major causes of perinatal and early neonatal mortality in developing countries. The main objective of this study was to observe the prevalence of perinatal asphyxia in babies born at Kathmandu Medical College Teaching Hospital.
Methods: This was a descriptive cross-sectional study conducted at Kathmandu Medical College Teaching Hospital over six month period (January to June 2019). All preterm, term and post term babies delivered at Kathmandu Medical College Teaching Hospital were included. Ethical clearance was received from Institutional Review Committee of Kathmandu Medical College (Ref.:2812201808). Convenient sampling method was applied. Data analysis was done in Statistical Package for Social Sciences (SPSS 18), point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data.
Results: A total of 1284 babies delivered over six months period were enrolled in this study and 47 (3.66 %) babies were asphyxiated, at 95% Confidence Interval (2.64%-4.68%). The mean birth weight of asphyxiated babies was 2759.75±65 grams and gestational age was 37.57±2 weeks. Among asphyxiated babies, 15 (32%) babies were normal, 15 (32%) babies were in Hypoxic Ischemic Encephalopathy stage I, 14 (30%) were in stage II and 3 (6%) were in stage III. Twenty Three (49%) asphyxiated babies had antenatal risk factors and all 47 babies had intrapartum risk factors leading to asphyxia.
Conclusions: Prevalence of perinatal asphyxia was lower compared to that of other similar tertiary care hospitals. Perinatal asphyxia remains a major cause of neonatal morbidity and mortality
Micro-Erythrocyte Sedimentation Rate in Neonatal Sepsis of a Tertiary Hospital: A Descriptive Cross-sectional Study
No full textIntroduction: Neonatal sepsis is the most important cause of morbidity and mortality among low
birth weight and preterm babies in developing countries. The main objective of this study is to find
the level of micro-Erythrocyte sedimentation rate in neonatal sepsis.
Methods: This is a descriptive cross-sectional study conducted at the neonatal unit over six months
period (November 2019 to April 2020). All preterm, term and post-term babies with neonatal sepsis
delivered at Kathmandu Medical College Teaching Hospital were enrolled. Ethical clearance was
received from the Institutional Review Committee of Kathmandu Medical College (Ref: 181020191).
Convenient sampling method was applied and statistical analysis was done with Statistical package
for social sciences 19 version.
Results: Out of 75 babies, confirm sepsis is 13 (17.3%), probable sepsis is 40 (53.4%) and suspected
sepsis 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 elevated
micro- 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 neonatal
sepsis
Isolated gross haematuria: A rare clinical presentation in neonate with urinary tract infection
No full textGross haematuria is uncommon in the fi rst month of life and etiologies of haematuria in the newborn is different from those in older children. we reported a six days old term male baby who was brought by parents with isolated complain of red colored urine for one day and his mother had culture positive urinary tract infection prior to delivery. The baby was diagnosed to have culture positive urinary tract infection. Our fi ndings suggest the diversity of clinical presentation of urinary tract infection in neonates and also some relationship between the history of urinary tract infection in mother and occurrence of urinary tract infection in neonate. </jats:p
Guillain Barré Syndrome in a three year old child under treatment for atypical febrile seizure: A case report
No full textGuillain-Barré syndrome is the most common cause of acute fl accid paralysis in healthy infants and children. It has an annual incidence of 0.6 to 2.4 cases per 100,000 population and occurs at all ages and in both sexes. The incidence is lower in children ranging from 0.38 to 0.91 cases per 100,000 in the studies and most of these cases ranging from four years to 18 years of age. Hence, the true incidence is even lesser in child younger than four years. We report a case of an early presentation of Guillain-Barré syndrome in child who was also a case of atypical febrile seizure under sodium valproate. Keeping in mind all the possibilities of acute onset weakness including orthopedic problems, possible side effect of valproate and possible new seizure, treatment was started early solely based on history and physical examination later confirmed by laboratory investigations.Journal of Kathmandu Medical College Vol. 6, No. 1, 2017, page: 35-37</jats:p
100 Comparision of effect of dry cord care versus chlorhexidine cord care on cord separation time in healthy newborns
No full textAssessment of the Required Subdivision Index for autonomous ships based on equivalent safety
No full textIn recent years, a significant amount of research has been conducted on autonomous ships. Since it is assumed that these ships will sail with a significantly reduced crew or even without people on board, the design of the ship needs reconsideration. The absence of people on board and the associated safety measures could result in a more efficient design. However, to achieve the required design freedom, the existing regulatory framework will have to be amended. In this article, we will focus on potential changes in the Convention for Safety Of Life At Sea (SOLAS) and in particular on the Required Subdivision Index. The evaluation is performed by using the principle of equivalent safety, which will ensure that unmanned ships will be at least as safe as manned ships. The index gives a requirement for the allowed probability of sinking when a ship is damaged due to collision or contact. The safety level is related to the safety of ship, cargo, environment and crew. If the crew is no longer present, the consequences of an incident will be less severe, since the probability of casualties is no longer present. If the principle of equivalent safety is applied, a lower subdivision index can be accepted for unmanned autonomous vessels. In this article, the level of risk that a manned ship is subjected to will be derived by means of a risk analysis. In this risk analysis all logical consequences of a collision will be taken into account, covering both the probability of losing the entire ship and the consequences of the cases where the ship will not sink. Thereafter, the Required Subdivision Index for unmanned ships, which ensures an equivalent safety level to an equivalent manned ship, is established. The sensitivity of the result to changes in the data is discussed as well.Ship Design, Production and Operation
A technique for fast and safe collection of urine in newborns
No full textBackground: Urine collection in children especially in new born is a great challenge. A wide range of clinical interventions for urine collection is described in the literature, including non-invasive and invasive methods. Mid-stream urine collection is considered the most appropriate technique for older children. Here we are testing a method for obtaining mid- stream urine sample in newborns.Objective: To test a technique of urine collection for obtaining mid-stream urine sample in newborns.Method: A prospective feasibility study of a technique of urine sample collection based on bladder and lumbar stimulation maneuvers done in 100 newborns of less than 28 days of life over a period of one month. The main variable was the success rate in obtaining a midstream urine sample collection within four minutes and secondary variables were time required to obtain the sample and associated complications.Results: Mid- stream urine sample was collected successfully in 91% of babies. Mean time required for urine collection was 59.7 seconds with standard deviation of 46.4 seconds and median time was 47 seconds. No untoward complication other than controlled crying was seen.Conclusion: This is a quick and safe technique for mid-stream urine sample collection in newborn with high success rate and minimal discomfort.Journal of Kathmandu Medical CollegeVol. 5, No. 3, Issue 17, Jul.-Sep., 2016, Page: 82-84</jats:p
Diaphragmatic Hernia in a Preterm with Congenital Heart Defects with Successful Outcome: A Case Report.
No full textUNLABELLED: Congenital diaphragmatic hernia is an anatomical defect of the diaphragm that is often associated with serious cardiopulmonary complications. It can also be associated with many other problems like multi systemic anomalies, chromosomal aneuploidy and prematurity. Of these, cardiac defects, liver herniation and prematurity seem to have a pivotal role in affecting the outcomes of repair. We hereby present a preterm newborn with such multiple defects repaired on 15th day of life and post operatively managed in a Neonatal Intensive Care Unit with a successful outcome. The key learning objective for our team in this case was to identify the steps taken that led to a successful management of a low birth weight preemie with multiple defects in a resource limited set up.
KEYWORDS: congenital diaphragmatic hernia; preterm; surgical repair; ventricular septal defect
