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Background: In Nepal where there is lack of health facilities in rural areas, health camps play an important role in providing health services. It is important to analyse health camps to determine the area of need and further planning. An analysis of a multispecialty health camp was done in Aurahi of Mahottari district which is one of the most rural areas of Nepal. Objectives: To quantitatively determine the population utilising the multispecialty health along with the patients’ demographic data and major health problems present in the area. Methods: A descriptive cross sectional study was conducted among 2560 people attending a health camp organised during 19th to 25th December 2019. Information was collected using registers with consent. Ethical clearance for the study was obtained from the Institutional Review Committee (IRC). The data were entered and analysed in Microsoft Excel. Results: Two thousand five hundred and sixty people which comprised 8.06% of the total population of the municipality reached out for services at the health camp. The number and percentage of population attending respective speciality were Nutrition - 869 (33.93%), Dental - 429 (16.75%), Gynaecology - 398 (15.50%), Medicine - 268 (10.46%), Obstetrics - 218 (8.52%), non-specific symptoms - 152 (5.94%), Dermatology - 122 (4.77%), ENT - 82 (3.22%) and Surgery - 50 (1.97%) respectively. Conclusion: The study shows presence of significant unmet health needs in this rural district of Nepal due to the lack of basic health services in the region.

Background: Umbilical cord infection (omphalitis) is a major cause of neonatal mortality and morbidity in a developing country like Nepal. Detached umbilical stump is an important colonizing site for different types of bacteria and it also provides direct access to bloodstream. Hence, inadequate cord care may lead to omphalitis as well as neonatal sepsis. Objectives: This study aims to compare two different cord care regimens (dry cord care versus chlorhexidine cord care) on their cord separation time and the incidence of omphalitis. Methodology: This is a comparative observational study conducted at the Neonatal unit of Kathmandu Medical College over a three months period (August 2019 to October 2019). All newborn babies born between 37 to 42 weeks of gestation were enrolled. Randomization for dry cord care and chlorhexidine cord care group was done via computer generated numbers. Statistical package for social sciences 19 version was used for statistical analysis. Results: Among 514 term babies, 256 babies were included in the dry cord care group while 258 babies were enrolled in the chlorhexidine cord care group. The two groups had similar baseline characteristics. The mean cord separation time in the dry cord care group was 7.70±1.2 days (range 3-15 days), whereas in the chlorhexidine group, it was 7.77±1.4 days (range 4-18 days). Conclusion: There was no significant difference between the cord separation times in dry and chlorhexidine cord care regimens. Both dry cord care and chlorhexidine cord care regimens were found to be safe and effective.

Background Low birth weight is a common problem in neonates.The ponderal index (PI) is a simple anthropometric measurement that is used to diagnose impaired fetal growth. PI = Weight (GM)/Length (CM) 3 × 100. The value of ponderal index Objectives To determine the ponderal index of the low birth weight babies and to classify them accordingly. Methods A descriptive cross sectional study which was carried out in Paediatrics Department of Kathmandu Medical College Teaching Hospital from July 2020 to September 2020. Ethical clearance was taken from the Institutional Review Committee. The study population consisted of low birth weight neonates on any period of gestation. Informed written consent was taken from the parents. Babies with congenital malformations were excluded. The sample size was 212 neonates. The eligible babies were examined after birth. Birth weight and the length were taken by standard weighing machine and infantometer. For perinatal factors, interview of parents were taken using the designed proforma. Results A total of 210 low birth weight babies fulfilling the inclusion criteria were enrolled in this study.105 (49.5%) mothers were primiparous. 116 (54.7%) babies were born vaginally. 111 (52.4%) babies were males. A total of 111 (52.3%) babies were premature. The mean birth weight of the babies was 2052±352 gms (1050–2490 gms) and the mean gestational age was 35±2 weeks (28–42 weeks). Out of 212 babies, ninety-nine babies (46.7%) had a low ponderal index ( 170 babies (80.2%) had no postnatal complications, 15 babies had neonatal sepsis, 10 babies had respiratory distress syndrome, 6 babies had hypoxic-ischemic encephalopathy (4 babies stage I HIE, 2 babies Stage II HIE), 8 babies had transient tachypnea of newborn, 3 babies had hypoglycemia and 2 babies had polycythemia. Conclusions Ponderal index is a simple and effective tool to identify wasting. In this study, nearly 46.7% of the low birth weight babies were disproportionate at birth.

Guillain-Barré syndrome is the most common cause of acute fl accid paralysis in healthy infants and children. It has an annual incidence of 0.6 to 2.4 cases per 100,000 population and occurs at all ages and in both sexes. The incidence is lower in children ranging from 0.38 to 0.91 cases per 100,000 in the studies and most of these cases ranging from four years to 18 years of age. Hence, the true incidence is even lesser in child younger than four years. We report a case of an early presentation of Guillain-Barré syndrome in child who was also a case of atypical febrile seizure under sodium valproate. Keeping in mind all the possibilities of acute onset weakness including orthopedic problems, possible side effect of valproate and possible new seizure, treatment was started early solely based on history and physical examination later confirmed by laboratory investigations.Journal of Kathmandu Medical College Vol. 6, No. 1, 2017, page: 35-37

Background: Urine collection in children especially in new born is a great challenge. A wide range of clinical interventions for urine collection is described in the literature, including non-invasive and invasive methods. Mid-stream urine collection is considered the most appropriate technique for older children. Here we are testing a method for obtaining mid- stream urine sample in newborns.Objective: To test a technique of urine collection for obtaining mid-stream urine sample in newborns.Method: A prospective feasibility study of a technique of urine sample collection based on bladder and lumbar stimulation maneuvers done in 100 newborns of less than 28 days of life over a period of one month. The main variable was the success rate in obtaining a midstream urine sample collection within four minutes and secondary variables were time required to obtain the sample and associated complications.Results: Mid- stream urine sample was collected successfully in 91% of babies. Mean time required for urine collection was 59.7 seconds with standard deviation of 46.4 seconds and median time was 47 seconds. No untoward complication other than controlled crying was seen.Conclusion: This is a quick and safe technique for mid-stream urine sample collection in newborn with high success rate and minimal discomfort.Journal of Kathmandu Medical CollegeVol. 5, No. 3, Issue 17, Jul.-Sep., 2016, Page: 82-84

Gross haematuria is uncommon in the fi rst month of life and etiologies of haematuria in the newborn is different from those in older children. we reported a six days old term male baby who was brought by parents with isolated complain of red colored urine for one day and his mother had culture positive urinary tract infection prior to delivery. The baby was diagnosed to have culture positive urinary tract infection. Our fi ndings suggest the diversity of clinical presentation of urinary tract infection in neonates and also some relationship between the history of urinary tract infection in mother and occurrence of urinary tract infection in neonate.

Infantile spasm constitutes 2% of childhood epilepsies but 25% of epilepsy with onset in the first year of life. The rate of infantile spasm is estimated to be 2.5-6.0 cases per 10,000 live births. Its prevalence rate is 1.5-2.0 cases per 10,000 children aged 10 years or younger. Ninety percent of infantile spasms begin in infants younger than 12 months with a peak onset at age 4-6 months. We report a case of 45 days old male child who had onset of flexor spasms since one month of age which is an unusual age of onset of West syndrome. The symptoms were initially thought as a simple startle response by the mother. This is a rare case because of its age of onset and lack of typical electroencephalographic features. Although the electroencephalography showed abnormal pattern suggesting seizure disorder, the frequently encountered pattern of hypsarrhythmia seen in children with infantile spasm was not seen in this case. It was difficult to assess developmental regression in a month old child who in subsequent visits had some degree of developmental delay. Hence fulfilling two of the three criterias for the diagnosis.

Lymphoma is the third common malignancy of childhood, presenting with rapidly or slowly growing mass, systemic B symptoms (fever, night sweats and weight loss), hepatomegaly and splenomegaly. Here, we report an eight year old male child who presented with fever, dyspnoea and weight loss of three kilograms over the last month; had right pleural effusion and was investigated for both infectious and non-infectious causes and later was diagnosed as Non-Hodgkin lymphoma. It emphasizes the importance of high suspicion, especially in the presence of haemorrhagic pleural fluid, to differentiate it from other common causes of pleural effusion in childhood.DOI: http://dx.doi.org/10.3126/jkmc.v3i3.12250Journal of Kathmandu Medical CollegeVol. 3, No. 3, Issue 9, Jul.-Sep., 2014, Page: 126-128