Wheeze among Pneumonia Patients in Paediatrics Department of Patan Hospital.

Background: Acute respiratory infections are major causes of morbidity and mortality in children in developing countries. It is estimated that 3.9 million children die annually from acute respiratary diseases and most of them in developing countries. In significant cases, wheeze is associated with Pneumonia. This study was done to find out the outcome of pneumonia patients admitted in the paediatric ward with wheeze and without wheeze in terms of hospital stay, age predominance, sex ratio, mortality and morbity of patients. Some comorbidies of patients were also studied, Methods: This was a retrospective study done in the paediatric ward of Patan Hospital from April-June 2004 to March-April 2006 AD with following inclusion and exclusion criteria. All the children presented to Emergency ward up to 14 years with symptoms and sign of pneumonia were included in the study(high grade fever with chills and rigor,cough,fast breathing,creps and wheeze in auscultation)Age more than 14 years,history of Asthma,Tuberculosis,Acute wheeze associated with cardiac problems were excluded from study.Pneumonia patients admitted not from Emergency department were also excluded from study. Pneumonia with wheeze, outcome, and the hospital stay were studied. The outcome was measured in terms of improvement, deterioration or death of patients. Co morbidities associated with Pneumonia were also studied. Results: Out of 4620 children admitted in pediatric ward eleven hundred and sixty four (Twenty five percent) cases were of pneumonia and among them two hundred eighty three(twenty four percent) had wheeze. Majority of patients with pneumonia having wheeze falls on age group in between 2 and 12 months, followed by 1-5 years. The male children were more frequently affected. The co morbidities were febrile seizure, acute gastroenteritis, sepsis and urinary tract infection. Conclusion: The children admitted in Paediatric ward with Pneumonia were eleven hundred and sixty four and with wheeze were two hundred and eight three. Among them male were more than females. Majority of patients falls on age group two to twelve months. and study showed that they had prolonged hospital stay in relation to without wheeze. Three percent of the cases had blood culture positive among eleven hundred and sixty four sample.

Japanese Encephalitis in Children admitted at Patan Hospital.

This is a hospital based retrospective study, which was done in Pediatric ward of Patan hospital. Study period was one and half year (from Srawan 2063 to 2064 poush).Data were taken from discharge book of Pediatric ward, from the record section of this hospital, and from JE surveillance office, WHO, Kathmandu. All children from 1 month to 14 years ,who were admitted in Pediatric ward with symptoms of Meningitis, Meningoencephalitis and Encephalitis were included in this study and patients more than 14 years of age and symptoms not suggestive of meningitis, meningoencephalitis or encephalitis were excluded from the study. Headache; vomiting and fever were the chief complaints of patients. Two patients died during study period. There were 16 patients with serologically confirmed Japanese encephalitis.

Burn injuries in pediatric population.

Burn injuries constitute a major concern in the pediatric age group with respect to morbidity and mortality particularly in children in developing countries. Burn injuries represent an extremely stressful experience for both the burn victims as well as their families. Burn injuries are least explored areas among other injuries in Nepal. We do not have any data on childhood burn injuries and this study is done to know the incidence, age, sexwise distribution and nature of childhood burn injuries at Patan Hospital. Hospital based prospective study done at Emergency and surgical department during one year period. Twenty children that had fulfilled hospital criteria for admission included in this study. All injuries were of accident in nature. Scald injuries were more than dry burn injuries. Children less than 5 years were more prone to injury than older children. Twenty one patients survived after treatment and one patient died due to sepsis. Mortality in this series is about four percent. Burn injury is a leading cause of unintentional injuries mainly seen in children less than 5 years of age with physical as well as psychological consequences.

Vectors of Japanese encephalitis virus (JEV): species complexes of the vectors.

The vectors of JEV are Cx. tritaeniorhynchus, Cx. vishnui, Cx. pseudovishnui, Cx. gelidus, Cx. fuscocephala, Cx. quinquefasciatus, Cx. pipiens pallens, Cx. bitaeniorhynchus, Cx. annulirostris, Aedes togoi, Ae. japonicus, Ae. vexans nipponii, Anopheles annularis and An. vagus. Cx. tritaeniorhynchus is in the tritaeniorhynchus complex, breeds in rice fields, ground pools in vast areas. Two types of mating behavior, eurygamy and moderate stenogamy were detected. In the case of the eurygamy type, the mosquitoes were from Southern Thailand and hilly areas near Kanchanaburi, Thailand. Female mosquitoes are usually dark in color, the cibarial armature has rod teeth and the posterior end of the cibarial armature is bowl shaped with a typical rim. The rim of the bowl is everted. The moderate stenogamy type were mosquitoes from the plain areas such as Bangkok, Ayutthaya, Suphan Buri and Saraburi. The posterior end of the cibarial armature is bowl shaped with a stout rim. The larvae were characteristic in their siphon index, antennal index, hair O of prothoracic segment, and comb scale number and arrangement. Cx. tritaeniorhynchus summorosus from Japan, Los Banos and Luzon, Philippines, differed from Cx. tritaeniorhynchus in that on the lateral plate of the phallosome tritaeniorhynchus teeth are somewhat weakly developed and only gently curved whereas in tritaeniorhynchus summorosus they are strongly developed, considerably longer, and sharply recurved. The siphons of larvae are short, the sides parallel and the apex truncate in tritaeniorhynchus whereas in tritaeniorhynchus summorosus they are long and slender. Cx. tritaeniorhynchus var. siamensis is possibly present. Colonies have been maintained in the Department of Medical Entomology for 31 generations. The characteristics are in hair O (short, less than 20 branches, and without secondary branching and the larval siphon (short and broad where the others are long). Cx. vishnui and Cx. pseudovishnui are in the vishnui complex. Cx. quinquefasciatus and Cx. pipiens pallens are in the Cx. pipiens complex comprising: (1) Cx. pipiens; (2) Cx. quinquefasciatus Say; (3) Cx. molestus Forskal; (4) Cx. pipiens pallens; (5) Cx. australicus; (6) Cx. globocoxitus. Anopheles annularis is a species complex evidenced by two types of polytene chromosomes.