Journal of Nepal Paediatric Society

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https://imsear.searo.who.int/handle/123456789/146370

Editor in Chief: Dr Arun Neopane

ISSN 1990-7974 (Print) 1990-7982 (Online)

Language: English

Peer-reviewed open access journal indexed in Index Medicus

Website: https://www.nepjol.info/index.php/JNPS/index

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Now showing 1 - 20 of 211

A 14-year-old boy with Isolated Tuberculous Orchitis.
(2009-01) Gurubacharya, R L; Gurubacharya, S M
The genitourinary tract is the most common extrapulmonary site affected by tuberculosis1. The male genital organs are involved in more than 50% of patients2. The epididymis is the commonest structure to be involved, followed by the seminal vesicles, prostate, testis, and the vas deferens3. An isolated tuberculous orchitis without epididymal involvement is rare. This case report describes extra pulmonary tuberculosis with exclusively testicular presentation. The confirmatory diagnosis of which was made by FNAC of the testis. It provides a successful diagnosis, thereby preventing unnecessary orchidectomy.
Accuracy of 7-8-9 Rule for Endotracheal Tube Placement in Nepalese Neonates.
(2011-09) Paudel, K P; Nepal, D; Mahaseth, C
Introduction: Neonatal intubation is done for cardiopulmonary resuscitation, hypoxemia, and hypercapnia, for surfactant therapy or for airway protection. When correctly placed, endotracheal tube (ETT) tip should be at mid tracheal position which is half way between the clavicles and the carina to prevent complications of ventilation. Objective: To assess the accuracy of 7-8-9 Rule in neonates at Kanti Children’s hospital. Methodology: Prospective observational study was conducted in neonates who required oral intubations from July 2009 to December 2009 at NICU of Kanti Children’s Hospital. The initial ETT depth of insertion was determined using admission weight in the 7-8-9 Rule calculation. This depth was compared to the midtracheal depth to determine clinical accuracy of the 7-8-9 Rule. Results: Mean gestation age of the 69 infants was 36.01 weeks (26 to 42 weeks) and weight was 2411 g( 900 g to 3800 g ). 7 (10.1%) neonates weighed 1000 g or less, 19 (27.5%) weighed between 1001 to 2000 g, 31 ( 44.9%) weighed between 2001 to 3000 g, 12(17.4%) weighed between 3001 to 4000 g. The accuracy of 7-8-9 rule in clinical setting with auscultation and Chest x-ray resulted in ETT depth 0.11 cm above midtracheal position. (-1.5 to 1.5 cm). Using this rule ET tube was placed 0.11 cm above the mid tracheal position. Conclusions: The 7-8- 9 Rule appears to be an accurate clinical method for endotracheal tube placement in Nepalese neonates.
Accuracy of 7-8-9 Rule: Neonatal Endotracheal Intubation.
(2012-01) Sakhuja, P; Whyte, H; Finan, E
Achondroplasia: Case Report and Review of Literature.
(2011-09) Shah, G S; Shrivastava, M K; Shah, D; Gupta, N
A two month old male child presented to emergency of B. P. Koirala Institute of Health Sciences (BPKIHS), Dharan and was admitted to Paediatric ward with history of fever, cough and respiratory distress. On examination the breathing was rapid and shallow. The child was small for age with an upper to lower segment ratio of 1.9. The anteroposterior diameter of thorax was reduced. We report a very rare case of achondroplasia which was recognized in a two month age child who presented with severe pneumonia. Usually the clinically features of achondroplasia is more prominent when the child is growing in height but we diagnosed it in a two months child after performing the skeletal survey.
Acute Renal Failure and Seizure following Multiple Wasp Stings: A Case Report.
(2012-01) Kumar, M K; Thakur, S N
Wasps and bees descend from order Hymenoptera. All social wasps belong to family Vespidae. Their stings are not usually life threatening, causing mainly local reactions and rarely anaphylaxis and serious systemic manifestations. Though a few stings cause no major problems, multiple stings can cause serious effects like massive hemolysis, acute renal failure, encephalopathy, multiorgan dysfunction. We report a six years boy with acute renal failure and seizure following multiple wasp stings.
An Adolescent Boy with Acquired Epileptic Aphasia –Landau Kleffner Syndrome: A rare case report.
(2011-01) Sharma, S R; Sharma, N; Yeolekar, M E
A 13 year adolescent boy presented with complaints of progressive loss of speech and seizure disorder for the past 1 year. The boy was developmently normal before the onset of illness. There was history of subtle trauma to head. He started communicating with signs followed by paucity of speech progressed to complete aphasia and abnormal behavior in the form of burst of aggressiveness and hyperactivity. Boy had partial, generalized tonic-clonic seizures occurred during sleep. Mental status examination revealed abnormal behaviour, attention deficits, auditory agnosia and aphasia (both expressive and receptive). All relevant investigations including BERA were normal.EEG showed repetitive spikes and wave activity in bilateral parietooccipital regions during nonrapid eye movement. Clinical features and EEG led to a diagnosis of Landau Kleffner Syndrome . He was started on Lamotrigine, steroid and speech therapy. The boy started showing improvement of symptoms in form of understanding of short sentences.
Adolescent Pregnancy Complication and Wastage in Bangladesh.
(2010-09) Rahman, M M; Hasan, M; Akter, S; Sultana, P
Introduction: Pregnancy among adolescents is a health risk for the individual as well as the fetus. The main aim of this study is to examine the pregnancy complications and its outcome among adolescent women in Northern region (Rajshahi) of Bangladesh. Methods: The analysis is based on a part of faculty research; University of Rajshahi funded study on adolescent motherhood and pregnancy complications in the region, which involved a micro level survey of 400 adolescent conception aged 10-19 and indepth interviews with 37 adolescents who had experienced pregnancy wastage. The indicator of poor pregnancy outcomes analysed includes pregnancy or delivery complications and pregnancy wastage. Results: A striking finding is the higher proportions suffer pregnancy problems, especially in cases of early conception. In particular, younger adolescent aged under 20 years has been observed to have the highest proportions of delivery complications and pregnancy wastage due to insufficient intake foods and possible biological immaturity. Conclusion: Early teenage pregnancy and its effects pose very severe different pregnancy and delivery complications consequently wastage.
All About Medical Journals and Articles.
(2008-01) Vidya Shankar, C
Anthropometric Assessment for Adolescent Pregnancy: A Descriptive Study on Married Adolescents in Bangladesh.
(2010-09) Haque, M N
Background: Adolescent childbearing has emerged as a major concern in Bangladesh due to its shorter term adverse effects on both the mothers and babies born to adolescent mothers. Bangladesh is one of the vulnerable countries in the world and the most vulnerable country in South Asian region regarding early motherhood risks. Most of the adolescents pelvis is not mature enough for childbirth and malnutrition may stunt normal growth of adolescent women. But a greater proportion of currently married adolescent women want a child very soon. Hence it is needed to assess adolescent women’s physical and nutritional status for making future pregnancy outcomes safer. Objectives: This study aims to evaluate the physical and nutritional status of married adolescent women for pregnancy by calculating prevalence of low weight, low height, stunting and thinness. Methodology: For assessing pre-pregnancy physical and nutritional status of married adolescent women, data extracted from Bangladesh Demographic and Health Survey (BDHS)–2004. Based on fundamental anthropometric variables (weight and height), stunting and thinness profile of study population has been prepared. Also, group mean of weight and height, prevalence of low weight (<45kg) and low height (<145 cm) have been calculated. Results: Adolescent women, on average, are at vulnerable for childbirth regarding their weight in the study results. For instance, more than 64% of married non-pregnant adolescent women’s weights are less than 45 kg and more than 15% of married non-pregnant adolescent women belong to height less than 145 cm in Bangladesh. It is also estimated that more than 16% and around 50% of married non-pregnant adolescent women were thin and stunted respectively in Bangladesh. Conclusion: Since early childbearing is a social norm in Bangladesh and many of married adolescent women are not physically fit for pregnancy, so it is necessary to encourage married adolescent women to delay childbearing through community education and by encouraging them to use family planning services. It should be necessary to pay special emphasizes for improving adolescent women’s nutritional status through the country’s Health, Nutrition and Population Sector Program or through National Nutrition Program (NNP).
Anthropometric Measurements in Different Ethnic groups of Nepalese New Borns.
(2012-01) Malla, K; Mall, T; Rao, S; Gauchan, E; Basnet, S; Koirala, D P
Introduction: There is a wide variation in normal birth weight, length and head circumference of newborns. The standards formulated by Western workers may not be very reliable to this part of world because of wide variations in normal range of length, weight and head circumference in different ethnic groups. This study aims to determine the anthropometric values – birth weight, length and head circumference in Term and Preterm newborns of different ethnic groups in this region of the country and to see if this can be used as a standard for taking the anthropometric measurements. Materials and Methods: A prospective study of 600 newborns born in Manipal Teaching Hospital, Pokhara from July 2009–June 2010. A detailed anthropometric measurement (weight, length, and head circumference) of all newborns was taken on 3rd day of life. Results: Six major Ethnic groups were noted Brahmin, Gurung, Dalit, Chettri, Magar and Newar. There were 54 % males and 46% females among which 18.16% were preterms, 20.66% small for gestation age, 81.50% term and 0.33% posterm. The mean weight, length and head circumference of term babies were 2.817±0.61 gms, 47.68±2.48 cm, 33.56±2.02 cm and for preterm babies it was 2.215± 0.41 gms, 46.36±2.39 cm, 32.23±2.03 cm respectively. There were 25% low birth weight (n=151, highest number in Brahmins-27%), 74.16% normal weight (n=445) and 0.66% over weight (n=4, all were gurungs) babies. In Term newborns weight, length and head circumference was noted to be highest in Gurungs (3.3004gms, 49.35cm, 34.72cm) and was statistically significant (p<0.000). Weight and length of Brahmins was lowest (2.578 gms, 45.49cm) and head circumference was lowest in Dalits (30.88cm, statistically significant<0.000). In case of preterms highest weight and length was seen in Magars (2.387gms, 47.90cm) but head circumference was highest in Gurungs (34.18cm) whereas weight was lowest in chettri (2.1609gms), length in Brahmin (44.61cm) and OFC in Dalits (29.92cm). These parameters were directly proportion with gestation age and was statistically significant (p<0.000). Conclusion: The present study highlights the mean weight, length and head circumference of term and preterm newborns in different ethnic groups and gestation age. These parameters were directly proportion to gestation age but were variable in different Ethnic groups. Therefore a study in larger population could give us a different standard for anthropometric measurements in Nepalese newborns.
Apert Syndrome (Acrocephalosyndactyly): A Rare Syndromic Craniosynostosis.
(2009-07) Shrestha, M; Shah, G; Adhikari, N
We report a premature infant who had multisutural craniosynostosis with pointed head, syndactyly of 2nd, 3rd and 4th fingers of all four limbs and other findings that were consistent with Apert syndrome. This is perhaps the first case of Apert Syndrome reported from Nepal.
Apple Peel Small Bowel, A Review of Four Cases Surgical and Radiographic Aspects.
(2011-09) Akinola, R A; Osuoji, R I
Background: Although apple peel intestinal atresia is rare and is associated with a high mortality and morbidity, there is a dearth of its report in African literature. This study reviews four of the cases seen in a state teaching hospital in Lagos, considering the radiographic findings, surgical management and outcome. A brief review of literature is also undertaken. Aims and Objectives: To correle the plain radiographic findings with the surgical findings of neonates gathered over a six year period and to evaluate their surgical management, hoping to further help improve management of such neonates’ in future in resource limited regions such as ours. Methodology: It was a retrospective case series of four neonates who were brought in over a period of six years and operated after an initial plain abdominal X-ray. They were done as emergency cases, consent was obtained from their parents and the study was approved by the research and ethics committee. Operative findings were subsequently correlated with their radiographic findings and the surgical outcomes and follow up were documented. Conclusion: This study revealed that “the triple bubble sign” is a common radiographic finding in Apple Peel deformities, as well as gangrene of the jejunum and ileum at surgery.
Are we Practicing Evidenced Based Medicine for Common Paediatric Problems.
(2009-07) Sharma, Pushpa Raj
Article from the Past.
(2009-07) Shrestha, Y B
Asthma: A Risk Factor for Dental Caries.
(2010-09) Thomas, M S; Parolia, A; Kundabala, M
This report points out a correlation between asthma and dental caries. It also gives certain guidelines on the measures to be taken in an asthmatic to negate the risk of dental caries.
Avoiding Plagiarism and Self-Plagiarism.
(2010-05) Adhikari, Neelam
Bacteriological Analysis and Antibiotic Sensitivity Pattern of Blood Culture Isolates in Kanti Children Hospital.
(2010-05) Karki, S; Rai, G K; Manandhar, R
Introduction: As antibiotic sensitivity pattern to common pathogen has been changing day by day, so it has been necessary to study about bacteriological analysis and antibiotic sensitivity pattern. Therefore, the purpose of this study was to analyze on data on bacteremia in children, the pathogen involved and sensitivity pattern. Objectives: The aim of this study was to determine the bacteriological profile and antibiotic sensitivity pattern of blood culture isolates from Kanti Children Hospital. Method: All blood culture reports (n=9856) during one year period (April 2007 to March 2008) included in the study were analyzed and the sensitivity pattern were recorded. In this retrospective study, we reviewed records of patients from Kanti Children Hospital from April 2007 to March 2008. Results: The positivity of blood culture was 4.2% (414/9856). Out of them, 269 (65%) were positive for Staphylococcus aures, 121(29.3%) E coli, 13(3.1%) Klebsiella pneumonia, 6(1.4%) Streptococcus pneumonia and 5(1.2%) Streptococcus viridence. Staphylococcus aureus was found most sensitive to Chloramphenicol (88.8%) followed by Amikacin (87.5%), Ofloxacin (76.5%), Ciprofloxacin (72%) and least sensitive to Ampicillin, Cloxacillin and Penicillin. E.coli was found most sensitive to Amikacin (74.7%) followed by Ofloxacin (69.9%), Ciprofloxacin (56.4%) and least sensitive to Cephalexin, Gentamycin and Ampicillin. Klebsiella pneumoniae was found most sensitive to Amikacin (91.7%) followed by Ofloxacin (87.5%), Chloramphenical (81.8%) and least sensitive to Cotrimoxazole and Gentamycin. It is 100% resistance to Ampicillin and Erythromycin. Streptococcus pneumoniae was most sensitive to Penicillin, Chloramphenical (100%) followed by Ampicillin and Erythromycin (83.3%) and least sensitive to Cotrimoxazole. Streptococcus viridence was most sensitive to Chloramphenical (100%) followed by Erythromycin (80%), Penicillin (75%) and least sensitive to Cotrimoxazole. Conclusion: This highlights the variable nature of antibiotic susceptibility patterns both in time and location around different geographical locations and within the same country as well. Therefore, it is advisable to continuously evaluate the sensitivity-resistance pattern of isolates so as to make a rational use of antibiotics.
Bacteriological Profile of Neonatal Sepsis: A Hospital Based Study.
(2011-01) Shrestha, N J; Subedi, K U; Rai, G K
Introduction: Neonatal sepsis is a major cause of mortality and morbidity in newborn. There are many factors that contribute to neonatal sepsis. The organisms responsible for early onset and late onset sepsis are different. Objective: This study was conducted to analyze the organisms responsible for early onset and late onset neonatal sepsis. Materials and Methods: A prospective hospital based study over the period of one year was conducted at neonatal intermediate care unit of Kanti Children’s Hospital, Maharajgunj, Kathmandu, Nepal. Results: Organisms were isolated in 6.1% of the collected blood samples. The male female ratio of culture proven sepsis was 1.9:1. Escherichia coli were found to be the most common organism in both early onset and late onset sepsis. Staphylococcus aureus was more common in late onset sepsis than early onset sepsis. Conclusion: Escherichia coli were the most common organism in both early onset and late onset sepsis. Staphylococcal aureus was significantly more common in late onset sepsis than early onset sepsis.
Bilateral Congenital Cataract Associated with Multiple Epiphyseal Dysplasia: A case Report.
(2012-01) Adhikari, S; Shrestha, U; Nepal, P; Singh, J L
Cataract in children has varied etiology. It may be associated with systemic diseases including skeletal dysplasias. However cataract in Multiple Epiphyseal Dysplasia is a rare association. A child presented with bilateral dense posterior sub capsular cataract and multiple bony abnormalities. Clinical and radiographic findings suggested the disease to be Multiple Epiphyseal Dysplasia. The aim of presenting this case is to report a case of congenital cataract having a rare association with the Multipe Epiphyseal Dyspalsia.
Biochemical Markers in Perinatal Asphyxia.
(2011-05) Naithani, M; Simalti, A K
Early assessment of the severity of an acute cerebral lesion secondary to hypoxia-ischemia or other pathologic conditions may provide a very useful basis for preventive or therapeutic decisions in pediatric patients. In the present review, we discuss the diagnostic and prognostic value of a series of biochemical parameters, with special reference to the diagnosis of neonatal HIE. Currently many specific biochemical markers of brain injury are being investigated to assess regional brain damage after perinatal asphyxia in neonates of which serum protein S-100β, brain-specific creatine kinase, neuron-specific enolase, IL6 and urinary uric acid levels appear promising in identifying patients with a risk of developing hypoxic-ischemic encephalopathy. Whether detection of elevated serum concentrations of these proteins reflects long-term neurodevelopmental impairment remains to be investigated.

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