Profile of children with cerebral palsy at a tertiary hospital in eastern Nepal.

BACKGROUND: The clinical spectrum of Cerebral palsy (CP) can differ in various places depending upon knowledge of the people and resources for prevention, diagnosis and management. Although studied extensively in high-resource countries, adequate data related to CP from resource-constraint settings are lacking. This study aims to describe the profile of children with CP at a tertiary care center in eastern Nepal. METHODS: This was a hospital-based cross-sectional descriptive study done from 2017 to 2018. Children 6 months to 15 years who presented with CP were enrolled and their clinical details recorded and described. RESULTS: Amongst 110 children with CP, 74.54% were male. Majority (76.36%) were 5 years or below with the median age being 3(2.00-4.75) years. Children with spastic quadriplegia (44.44%) and Gross Motor Function Classification System level III (41.81%) were most common. Etiologically, perinatal factors (64.54%) like perinatal asphyxia (35.45%) and prematurity (20.90%) and postnatal infections (25.45%) were common. The common comorbidities were intellectual disability (71.81%) and epilepsy (66.36%). The main treatment modalities were: antiepileptics (59.09%) and centre-based physiotherapy sessions (35.45%). School education was provided in 23.07% with special education in 11.53%. CONCLUSIONS: This study describes the profile of CP at our centre in eastern Nepal. Predominance of perinatal complications and postnatal infections points towards the urgent need to further improve the perinatal and neonatal health care delivery system and practices.

Patterns of Injury and Mortality in Pediatric Patients Attending Emergency Department in a Tertiary Care Center in Eastern Nepal.

INTRODUCTION: Trauma is a major and increasing global health concern in the recent world. It is now the leading cause of death among people less than 18 years old. The aim of this study is to analyze all injuries from trauma-related causes among children and adolescents under 18 years old of age. METHODS: This is a retrospective cross sectional study done in Emergency Department of B.P. Koirala Institute of Health Sciences. Patients aged less than 16 years were included with history of trauma from January 1st 2013 to 31st December 2013.The details of patient were taken from computerized medical records of the hospital. The demographic data, pattern of injury, mode of injury, diagnosis and outcomes were tabulated in Microsoft Excel. RESULTS: Total 3958 pediatrics patient were enrolled in this study with Male: Female=3.6:1 and Mean age 9.6±3.2 years. The common modes of injury were fall injury 2596 (65.6%) and RTAs 1176 (29.7%). Whereas the commonest patters were Fractures 1385 (35%) and Soft Tissue Injuries 784 (19.8%). CONCLUSIONS: Fall Injury and Road Traffic Accidents are major and serious problem for children in Low Income countries like Nepal.