A Perspective Study on the Etiology of Diarrhea in Children Less than 12 Years of age attending Kanti Children’s Hospital.

Introduction: Diarrhea is the most common illness among children causing highest number of mortality and morbidity in the developing countries. Objective: This study was conducted to determine the etiological agents of diarrhea in children less than 12 years of age. Methods: The study was carried out in Tribhuvan University Teaching Hospital, Health Research Laboratory and stool specimen were collected from Kanti Children’s Hospital between February 2007 and August 2007. The specimens were processed by standard microbiological methods, serological diagnosis for the complete identification of bacterial isolate and use of Rotaclone for diagnosis for Rotavirus. Results: A total 500 specimen were processed and 312 (62.4%) cases were identified with enteropathogens. Out of 500, 165 (33%) showed significant bacterial growth, 110 (22%) single or multiple parasitic infestation, and 167 (21.4%) Rotavirus. Among the bacterial isolate, Escherichia. coli (20.2%) were highest in number, Entamoeba. histolytica (10%), among the protozoa and Ascaris lumbricoide (1.4%) among the helminth. Age group 0-2 years showed most number of cases. The prevalence of Rotavirus infection was more in Inpatient (65.4%) than Outpatient (34.6%) (P>0.05). Ethnicgroup wise distribution showed that Gurung/Magar/ Rai/Tamang were highly infected (34.6%) (P>0.05). Conclusion: The results showed that bacteria were the major etiological agents of diarrhea in children than parasites and Rotavirus. E. coli among the bacteria, E. histolytica among the parasite and Rotavirus constituted the major causative agents identified. The age group 0-2years was the most vulnerable group where most of the enteropathogens were detected.

Short duration anterior nasal packing after submucosal resection of nasal septum.

OBJECTIVES: To find out the shortest possible duration of nasal packing after submucosal resection (SMR) operation. To compare the outcome of the patients who underwent SMR operation and anterior nasal pack (ANP) removed after 24 hours with those who had ANP removed after 2 hours of operation. MATERIALS AND METHODS: A prospective randomized hospital based study was undertaken to compare the outcome of early removal of nasal packs after 2 hours of operation and after 48 hours. Seventy four patients undergoing SMR operation with ANP were divided in two groups. Group I: patients who underwent SMR and ANP removed after 24 hours to 48 hours (n= 37 patients). Group II: patients who underwent SMR and ANP removed after 2 hours (n= 37 patients). RESULTS: There was no significant difference between the two groups in terms of age distribution (p = 0.244), sex (p = 0.76), synaechia formation (p = 0.615) and bruise in the upper lip (p = 1.000). There were no complications following early (2 hours) removal of ANP except synaechia, no significant post-operative bleeding occurred and no post operative septal hematoma were noted. In addition, patients reported less post-operative discomfort when the packs were removed early in Group II. This practice reduced the length of hospital stay and therefore reduced costs. CONCLUSION: Our study shows that there is no significant difference in the post operative events and recovery between removal of ANP after 48 hours and after 2 hours of operation. This supports that ANP removal can safely be done after two hours of operation.