Occipital Encephalocele with Multiple Birth Defects: A Case Report.

A full-term female baby presented at 24 hours of life at the emergency department with occipital encephalocele, bilateral cleft lip, and cleft palate. She was born to a second gravida mother with no consanguinity between the parents. On examination, encephalocele was 10centimeters x 7centimeters in size with bilateral cleft lip and palate. It presents the opportunity for healthcare professionals to learn about a group of congenital neurological disorders in the content of a rare case presentation and highlights the importance of ultrasonography in the antenatal period for the detection of neural tube defects in the early stage for proper counselling and management. A compulsory prenatal diagnosis of the suspected family should be done by the intervention of the public sector of any country so that we can prevent and avoid abnormal birth.

A Five Years Old Child with Failure To Thrive and Vomiting Presenting as a Diagnostic Dilemma: A Case Report.

Vomiting with failure to thrive in older children is a diagnostic challenge due to the diversity in the diagnosis. We report a case of a five-years-old girl with failure to thrive, history of recurrent vomiting and intermittent colicky pain abdomen since 45 days of life. Intestinal malrotation with Ladd's band was diagnosed based on clinical acumen, high- resolution computed tomography, barium follow through and intraoperative findings. Exploratory laparotomy with Ladd's procedure was performed under general anesthesia which showed malrotation at the duodenojejunal junction with a short route of mesentery with floating caecum with Ladd's band. Failure to thrive with malrotation of the gut in the older age group is rare in itself. As there are very few cases reported in this age group, so we undertook to report this case to increase the awareness of knowledge concerning the diagnosis and timely management to prevent the comorbidity of this condition.

Prevalence of Ventilator Associated Pneumonia in Neonates in A Tertiary Care Hospital in Western Nepal.

INTRODUCTION: Ventilator-associated pneumonia is a serious problem which needs to be addressed for a better outcome of the ventilated babies. The present study is undertaken to find out the prevalence of ventilator-associated pneumonia in neonates in a tertiary care hospital in western Nepal. METHODS: A descriptive cross-sectional study was carried out in a tertiary care hospital in the western region of Nepal from March 2016 to February 2019 after approval from the Institutional review committee. Sample size was calculated and convenience sampling was done to reach the sample size. Data were collected from hospital records and entered in Statistical Package for the Social Sciences, point estimate at 95% confidence interval was calculated along with frequency and proportion for binary data. RESULTS: Out of 95 patients ventilated in neonatal intensive care unit in the last 3 years, 23 (24.01%) developed ventilator-associated pneumonia. Prevalence of ventilator-associated pneumonia is 23 (24.01%) at 95% (14%-34%). Late onset ventilator associated pneumonia was seen in 15 (15.78%) while early onset ventilator associated pneumonia was seen in 8 (8.42%). CONCLUSIONS: Prevalence of ventilator associated pneumonia in neonates in tertiary care hospital is high compared to other studies conducted in neonates.

Prevalence of Type I Lip Print among Medical Students in a Medical College of Nepal.

INTRODUCTION: Lip prints, due to their unique patterns are typical to an individual, hence, used for personal identification. They vary in predominance, gender and race among different populations. The objective is to study their distribution among medical students and identify the predominant type. METHODS: The descriptive cross-sectional study was conducted on the medical students of Nepalese Army Institute of Health Sciences, from April 2019 to May 2019 after the ethical approval. Convenience sampling was used. The prints were classified according to Suzuki and Tsuchihashi. The collected data was entered in SPSS to determine the frequency and percentage. Sub group analysis was done on basis of gender and types of lip print. RESULTS: Out of 205 participants, prevalence of type I lip print among medical students is 70 (34.1%). Type I lip print was found to be most common followed by Type II in 57 (27.8%) and Type V in 6 (2.9%). One hundred forty one (68.8%) were male and 64 (31.2%) were female. The predominating pattern in RUQ; LUQ; LLQ; RLQ among male and female is Type I 46 (32.6%) and Type I 39 (27.7%); Type II 39 (27.7%) and Type II 44 (31.2%); Type I 19 (29.7%) and Type II 19 (29.7%); Type I 31 (48.4%)and Type I 27 (42.2%) respectively. CONCLUSIONS: Type I was the most common while Type V was the least common lip print. However, there was variation in its frequency and distribution according to the quadrant and sex.

Prevalence of Maternal Anemia in A Tertiary Care Hospital in Western Nepal.

INTRODUCTION: Maternal anemia is a common problem in developing countries like Nepal accounting for around 30-50% of women becoming anemic during pregnancy. The present study aims to find out the prevalence of maternal anemia in a tertiary care hospital in Western Nepal. METHODS: A descriptive cross-sectional study was carried out at Devdaha Medical College, Bhaluhi, Rupandehi, Nepal from October 2018 to May 2019 after taking ethical approval from the institutional review committee with the approval number: 012/2018. Three eighty three samples were taken and convenient sampling was done to reach the sample size. Data were collected from the study population after taking consent and entered in a predesigned proforma. It was then entered in an SPSS; point estimate at 95% CI was calculated along with frequency and proportion for binary data. RESULTS: During the study period, out of 383 mothers, 230 (60.2%) mothers were anemic at 95% CI (10.6-10.8%); of which 172 (74.8%) were moderately anemic while 58 (25.2%) were mild anemic. The mean maternal Haemoglobin was 9.5±1.76SD. The mean maternal age was 24.24±3.26 SD; mean gestational age at the time of delivery was 36.08±1.77 SD. CONCLUSIONS: The prevalence of maternal anemia in this study is found to be higher than the national data which implies that maternal anemia is still a public health issue which needs to be addressed in spite of safe motherhood program launched by the government of Nepal.

Clinical Profile of Neonates with Respiratory Distress in a Tertiary Care Hospital.

INTRODUCTION: Respiratory distress in newborns is a very common reason for admission in Neonatal Intensive Care Unit which may be transient or pathological; morbidity is high if not prompted for early diagnosis and treatment. The present study is undertaken to find out the clinical profile of neonates with respiratory distress in infants in a tertiary care hospital in western Nepal. METHODS: A descriptive cross-sectional study was carried out in a tertiary care hospital in the western region of Nepal from April 2017 to March 2018 after approval from the institutional review committee. Sample size was calculated and consecutive sampling was done to reach the sample size. Data were collected from the study population after taking consent and entered in a predesigned proforma. It was then entered in a Statistical Package for Social Sciences, data analysis was done to find frequency and proportion for binary data. RESULTS: Tachypnea was the most common presentation 77 (69.36%). Out of 1694 live deliveries during the study period, the prevalence of respiratory distress was 6.55 % in the total live deliveries while 30.83 % in admitted cases in Neonatal Intensive Care Unit. Survival rate was 95.50% while mortality rate accounted for 4.50%. CONCLUSIONS: Perinatal asphyxia accounted for the commonest cause of respiratory distress. To lessen the morbidity and mortality of the neonates with respiratory distress it is advocated that we practice proper and timely neonatal resuscitation, recognize the risk factors as early as possible so that perinatal asphyxia can be minimized.