Papers by Nagendra Chaudhary
Journal of Universal College of Medical Sciences, May 11, 2023
Neonatal seizure, a common problem encountered in neonatal intensive care unit (NICU) setting, is... more Neonatal seizure, a common problem encountered in neonatal intensive care unit (NICU) setting, is an important determinant of outcome of neurological disorders in newborn period. The aim of the study was to study the clinical and etiological profile of neonatal seizures along with their outcomes.
Journal of Clinical and Diagnostic Research, 2021
Introduction: Feeding intolerance is common among the preterm neonates and is associated with dif... more Introduction: Feeding intolerance is common among the preterm neonates and is associated with different co-morbidities like respiratory depression, respiratory distress syndrome, apnea, hyperbilirubinaemia, and hypoxic ischaemic encephalopathy. Aim: To find the incidence of feeding intolerance in preterm neonates from 28-34 weeks of gestation along with the clinical signs and co-morbidities associated with feeding intolerance. Materials and Methods: A prospective observational hospital based study was conducted in Neonatal Intensive Care Unit (NICU) and postnatal ward of Universal College of Medical Sciences, a tertiary care hospital situated in western Nepal for 12 months (June 2018 to May 2019). All admitted preterm neonates between 28-34 weeks of gestation were included in the study and were followed-up for any neonatal morbidities along with feeding intolerance. Feeding intolerance was defined when the newborn had vomiting and/or abdominal distension and/or increased gastric residual volume with normal disruption of feeding process. Babies with feeding intolerance were subjected to final analysis for clinical signs and co-morbidities. Results: Out of 490 admitted preterm babies (28-34 weeks), 54 (11.02%) had feeding intolerance with 33 (61.1%) babies in the very low birth weight group. The mean birth weights of the total enrolled babies (n=490) and feed intolerant (n=54) babies were 1550 gm and 1418 gm, respectively. Different co- morbidities associated with feeding intolerance were respiratory distress (25.9%), respiratory distress syndrome (22.2%), jaundice (16.7%), apnea (5.6%) and necrotising enterocolitis (3.7%). Among the total 37 preterm deaths, four babies were in the feeding intolerance group. Majority of all feed intolerant babies had vomiting 49 (90.7%) followed by gastric residue (57.4%), abdominal distension (55.6%), and reduced or absent bowel sounds (7.4%), respectively. The incidence of feeding intolerance was increased in babies fed with formula feed (p=0.46) and when feeding was started <24 hours (p=0.22) but the results were statistically insignificant. Conclusion: The incidence of feeding intolerance was 11.02% in the preterm neonates (28-34 weeks) with high proportion in very low birth weight babies. Vomiting, gastric residue and abdominal distension were three important signs of feeding intolerance in newborns.
Clinical Case Reports, Feb 1, 2023
Inequalities in Respiratory Health
Introduction : Neonatal sepsis is one of the major causes of morbidity and mortality in the newbo... more Introduction : Neonatal sepsis is one of the major causes of morbidity and mortality in the newborn. Early diagnosis of neonatal septicemia is the cornerstone for the successful management and favorable outcome. It is a challenge because of non-specific symptoms and signs of neonatal sepsis. Gastric aspirate cytology has been used for the diagnosis of neonatal infection. The presence of more than five polymorphs per high power field co-relate with neonatal infection. Objective To study correlation between positive gastric aspirate and development of early onset neonatal sepsis. Methods This is a Prospective Hospital based cross sectional Study conducted at Neonatal Intensive Care Unit (NICU) of Department of Pediatrics, Manipal Teaching Hospital, Pokhara, Nepal from November 2017 to May 2019. A total of 96 cases who were admitted in NICU suspected with EONS were included in the study. Under all aseptic conditions, nasogastric tube was inserted and gastric fluid was collected and sen...
Journal of Universal College of Medical Sciences, Feb 8, 2018
Journal of Universal College of Medical Sciences, 2021
Journal of Universal College of Medical Sciences, Aug 9, 2022
Poisoning in children is one of the leading public health problem in low and middle income countr... more Poisoning in children is one of the leading public health problem in low and middle income countries and a common cause of morbidity and mortality. MATERIAL AND METHODS This prospective observational study was conducted for one year from 1 June, 2019 to 31 May 2020 to study the clinicoepidemiological pattern and outcome of children with poisoning in a tertiary care hospital of Western Nepal. RESULTS Total 38 children with poisoning were admitted and enrolled during the study period. The frequency of poisoning in children aged 0-5 years, 6-10 years and 11-16 years were 47.4%, 18.4% and 34.2% respectively. Poisoning was predominant in females (n=21, 55.3%). Majority poisoning cases (55.3%) were noticed in between May to August. More than three-fourth of the poisoning cases were noticed in the afternoons and evenings. Pesticides (organophosphorus, fungicide, herbicide, aluminium phosphide, and household rodenticides/insecticides) constituted 55.7% of total poisoning cases. Household rodenticides/ insecticides, volatile hydrocarbons and organophosphorus poisonings were noticed in 23.7%, 15.8% and 13.2% respectively. Three-fourth of the cases were symptomatic during the presentation where vomiting (76.3%), abdominal pain (34.2%) and constricted pupils (18.4%) were three major clinical symptoms and signs due to poisoning. About 84.2% cases survived. Complications were observed in about 15.8% cases where shock and respiratory failure was seen in 10.5% each followed by pneumonia (7.9%) and hepatitis (5.3%). CONCLUSION Poisoning was common in children less than 5 years of age and majority of them were accidental in nature. Household rodenticides/insecticides, volatile hydrocarbons and organophosphorus poisonings were common types of poisoning.
Journal of Universal College of Medical Sciences
INTRODUCTION Low birth weight has been defined by World Health Organization (WHO) as weight at bir... more INTRODUCTION Low birth weight has been defined by World Health Organization (WHO) as weight at birth of <2500 grams (5.5 pounds). Low birth weight is more common in developing than developed countries. Intrauterine growth restriction, prematurity or both cause low birth weight. It contributes to a range of poor health outcomes and it is closely associated with fetal and neonatal mortality and morbidity, inhibited growth and cognitive development, and Non-communicable Diseases (NCDs) later in life. Low birth weight infants are about 20 times more likely to die than heavier infants. MATERIAL AND METHODS A cross-sectional design was used to find out the prevalence and predictors of low birth weight among 327 singleton neonates delivered in a Universal College of Medical Sciences, Teaching Hospital, Bhairahawa, Nepal by using Enumerative sampling technique. Semi-structured, pre-tested interview and record report was used to collect data and analyzed by using descriptive and inferential...
Journal of Universal College of Medical Sciences, 2015
Journal of Nepal Medical Association, 2018
Journal of Universal College of Medical Sciences
INTRODUCTION: Practice of exclusive breast feeding has dramatically reduced infant mortality in d... more INTRODUCTION: Practice of exclusive breast feeding has dramatically reduced infant mortality in developing countries due to reduction in diarrhea and infectious diseases. We conducted a study to assess the feeding practices among mothers with children less than 12 months of age attending the immunization clinic of UCMS hospital, Nepal. MATERIAL AND METHODS: A hospital based cross sectional study was carried out in the immunization clinic of Pediatric ward of UCMS, Nepal for a period of four months. Mothers of child of 0-12 months were included in the study. Sample size was 372 which was based on the number of mothers visited Pediatric ward for immunization of their child of age group 0-12 months during the duration of the study. Mothers were interviewed by using a pre-validated structured questionnaire. Data was analyzed by using SPSS version-20 software and presented by descriptive statistics as frequency and percentages. RESULTS: Most of the children were above six months, 56.5% w...
Cerebral salt wasting (CSW) syndrome is an important cause of hyponatremia in head injuries apart... more Cerebral salt wasting (CSW) syndrome is an important cause of hyponatremia in head injuries apart from syndrome of inappropriate antidiuretic hormone (SIADH). Proper diagnosis and differentiation between these two entities are necessary for management as the treatment is quite opposite in both conditions. Fludrocortisone can help in managing CSW where alone saline infusion does not work. We report a 17-month-old female child with head injury managed successfully with saline infusion and fludrocortisone.
International Journal of Pediatrics
Objectives. Chikungunya and scrub typhus infection are important causes of undifferentiated fever... more Objectives. Chikungunya and scrub typhus infection are important causes of undifferentiated fever in tropical zones. The clinical manifestations in both conditions are nonspecific and often overlap. This study compares the clinical manifestations and the outcome of chikungunya with chikungunya-scrub typhus coinfection in children. Methods. A hospital-based observational study was conducted in children below 15 years of age over 16-month duration in 2017-2018. Chikungunya was diagnosed by IgM ELISA. All positive chikungunya cases were subjected to scrub typhus testing, dengue testing, leptospira testing, and malaria testing. Clinical manifestations and outcomes of all patients were recorded. Results. Out of the 382 admitted cases with fever, 11% ( n = 42 ) were diagnosed with chikungunya, and the majority ( n = 30 , 71.4%) were male. Among the 42 chikungunya cases, 17 (40.5%) tested positive for scrub typhus and one positive for falciparum malaria. Out of a total of 42 chikungunya ca...
Journal of Pakistan Association of Dermatology, 2016
Transient acantholytic dermatosis was described by Grover. Its definite cause and pathogenesis is... more Transient acantholytic dermatosis was described by Grover. Its definite cause and pathogenesis is unknown. A 22-year-old man presented to our out-patient department with multiple itchy vesicles and pustules on the neck and chest. The biopsy was done and histopathology findings revealed focal acantholytic dyskeratosis. Case was diagnosed as Grover’s disease. Patient was given vitamin A 50000 IU per day and later dapsone was added. Patient was advised to avoid sunlight and heat. This is the first case of biopsy confirmed Grover’s disease fromNepal.
Health Science Reports, 2021
Small for gestational age (SGA) is common among newborns in low‐income countries like Nepal and h... more Small for gestational age (SGA) is common among newborns in low‐income countries like Nepal and has higher immediate mortality and morbidities.
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Papers by Nagendra Chaudhary