Depression, Anxiety and Stress among School-going Adolescents of a Secondary School: A Descriptive Cross-sectional Study.

Introduction: Mental health of adolescents can affect growth and development, decrease school performance, and impair social relationships with peers and families. The COVID-19 pandemic has changed the social and educational scenario and affected the psychological condition of children and adolescents. This study aimed to find out the prevalence of depression, anxiety and stress among school-going adolescents in a secondary school. Methods: A descriptive cross-sectional study was done among school-going adolescents of a school from 1 October 2021 to 31 November 2021. Ethical approval was taken from the Institutional Review Committee (Reference number: 0609202101). Data was collected using a questionnaire consisting of sociodemographic parameters and a diagnosis of depression anxiety and stress was made using a standard scale. The whole sampling method was used. Percentage and frequency were calculated for binary data. Results: Among 95 patients, the depression was found in 31 (32.63%), anxiety in 36 (37.89%), and stress in 3 (3.16%). Conclusions: The prevalence of depression, anxiety and stress was lower than in other studies done in similar settings. The mental health status of school-going adolescents should be identified and appropriate timely interventions need to be taken. Family members, teachers and the concerned authorities should give emphasis to the psychological well-being of the adolescents. Keywords: adolescent; anxiety; depression; stress.

Anxiety during COVID -19 among School Going Adolescents of Six Private Schools in Kathmandu Valley: A Descriptive Cross-sectional Study.

INTRODUCTION: Psychological health problems are common in adolescent and young adults. The psychological well-being is greatly influenced by stressful environment and the coping mechanism of an individual. The 2019 Coronavirus disease has caused unprecedented morbidity and mortality worldwide owing to its high infectivity and mortality. In addition to these physical manifestations, psychological impact has also been substantial. This study is a descriptive cross-sectional study done to find out the prevalence of anxiety disorder and its severity during the COVID-19 pandemic in school going adolescents of Kathmandu valley. METHODS: A descriptive cross-sectional study was carried out among adolescents from August 15 to September 30, 2020. Two private schools from each district in the Kathmandu valley i.e. Kathmandu, Lalitpur and Bhaktapur were included in the study using convenient sampling. Ethical clearance was obtained from Institutional Review Committee (reference no: 1208202007). All data were inserted on Microsoft Excel 2016 and analysed using Statistical Package for the Social Sciences version 20. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. RESULTS: Among 358 students, 165 (46.1%) at 95% Confidence Interval (40.8-51.2) were found to have anxiety. Out of these patients, 115 (69.7%) had mild, 39 (23.6%) had moderate and 11 (6.7%) had severe anxiety. The mean age was 16.17±1.57 years. CONCLUSIONS: This study shows that a remarkably higher number of children had symptoms of anxiety disorder. Majority of the children with anxiety had mild form. The study further highlights the need of emotional support to adolescent children during the current ongoing pandemic.

Pneumothorax in a Preterm Neonate: A Case Report.

A pneumothorax is an abnormal collection of air in the pleural space between the lung and chest wall. Although this condition commonly occurs in adults, it can also present as complication in neonates requiring assisted ventilation and has high morbidity and mortality. Chest tube placement and needle drainage are some common approaches in management. A late preterm infant born at 35+2 weeks of gestation was admitted in Neonatal Intensive Care Unit for the management of respiratory distress. He was kept on mechanical Continuous Positive Airway Pressure owing to worsening respiratory distress. Chest X-ray revealed pneumothorax that was successfully managed with venous catheter drainage on second intercostal space with underwater seal. He was discharge on 10th day of Neonatal Intensive Care Unit admission with stable vitals and normal breathing pattern.

Multiple Neonatal Teeth in a Preterm Neonate: A Case Report.

Prematurity and low birth weight are significantly associated with delayed dentition. Few cases of the eruption of a tooth immediately at or after birth in preterm neonates have been reported in the literature, although this is a rare presentation. The aetiology of this rare biological aberration is yet to be established but has been associated with hereditary predilection, nutritional factor, endocrine causes, infection, and some syndromes. Here, we present a case of a preterm male neonate at 28 weeks of gestation with very low birth weight and respiratory distress who presented with three neonatal teeth, two maxillary central incisors, and one mandibular central incisor and its subsequent management.

Diagnosis of Achondroplasia at Birth: A Case Report.

Autosomal dominant mutations in fibroblast growth factor receptor 3 cause achondroplasia, the most common form of dwarfism in humans. Achondroplasia is a genetic disorder causing rhizomelic shortening of limbs. Head is often large with prominent forehead causing vaginal delivery difficult. A twenty-one years old multipara mother gave birth to a baby with achondroplasia via spontaneous vaginal delivery with episiotomy without any complication. Achondroplasia, in this case, was diagnosed on the basis of antenatal ultrasonography finding, clinical features and radiological finding of the baby. He was admitted in the special baby care unit for observation and discharged on the next day as no complications were noted. Keywords: achondroplasia; dwarfism; ultrasonography.

Congenital Adrenal Hyperplasia with Salt Wasting Crisis: A Case Report.

Congenital Adrenal Hyperplasia is a group of autosomal recessive disorders due to deficiencies of enzymes involved in steroidogenesis. The most common form is a 21-hydroxylase deficiency which can be classical or non-classical. The severe form also called Classical Congenital Adrenal Hyperplasia is usually detected after birth to infant period. If Congenital Adrenal Hyperplasia is not diagnosed and treated early, neonates are susceptible to sudden death in the early weeks of life. We report a case of thirty-five days male with a salt-wasting variant of congenital adrenal hyperplasia. The diagnosis was based on an elevated level of 17-hydroxyprogesterone. He was managed and life long oral Prednisolone and Fludrocortisone were prescribed. Keywords: 21-hydroxylase, congenital adrenal hyperplasia, case report.

Posterior Reversible Encephalopathy Syndrome in a Patient with Post Streptococcal Glomerulonephritis: A Case Report.

Posterior reversible encephalopathy syndrome is a clinical-radiological syndrome neurological disorder with varied symptoms which include headache, visual field defects, seizures, altered consciousness. It is a rare complication of post-streptococcal glomerulonephritis and results in life-threatening manifestations if not managed on time. Although reversible by definition, complications like status epilepticus, intracranial hemorrhage, and ischemic infarction may lead to mortality and morbidity. We report a case of a 9-year-old female patient with posterior reversible encephalopathy syndrome who presented with multiple episodes of seizures and bilateral painless loss of vision for 1 day. Due to her severity, a computed tomography scan was sent which revealed a hypodense lesion in the brain. She was admitted to the pediatric intensive care unit and managed with supportive care for 6 days where she died on the 6th day. Vital signs are simple but important and if overlooked can lead to a series of complicated events.