Early Outcome of Neonates Admitted with Meconium Aspiration Syndrome.

BACKGROUND: Meconium aspiration syndrome is one of the commonest cause of respiratory distress in neonates. The incidence is still high in developing world. This study aims to study the clinical characteristics and early outcome of neonates admitted for meconium aspiration syndrome. METHODS: This was a cross-sectional descriptive study done among neonates admitted to the neonatal Intensive Care Unit with a diagnosis of Meconium Aspiration syndrome. Relevant epidemiological, clinical and laboratory data were obtained. The early outcome of those neonate was studied. RESULTS: Out of 140 neonates with a mean birth weight of 2865 + 543 grams,73.6% were male, of which 76.4% were referred cases while 23.6% were inborn. Of them 69.3% had history of thin type of meconium while 30.7% had thick type of meconium during delivery. Of all mothers, 74.3% were primigravida, 4.3% had intrapartum fever of unknown source,11.4% suffered from urinary tract infection while 2.8% had hypertension. Premature rupture of membrane had occurred among 7.9% and oligohydramnios was found in 10%. Half of them (50.7%) had spontaneous vaginal delivery, 44.3% had caesarian section, while 4.8% had assisted delivery. Around one third of the neonates (37.1%) were given supplemental oxygen via nasal prongs, 25.7% via head box, 27.1% via continuous positive airway pressure and 10% intubated. Around half of the neonates (42.1%) had no complications. Complication noted were sepsis, birth asphyxia, seizures and polycythemia in 35%, 14.3%, 5.7% and 2.9% respectively. Mortality occurred among 5.0% of them. CONCLUSIONS: Meconium aspiration syndrome is one of the commonest cause of respiratory distress in a neonate which is associated with common maternal risk factors especially in primigravida which included Urinary tract infection, hypertension and oligohydramnios.

Scrub Typhus among Febrile Children in a Tertiary Care Center of Central Nepal: A Descriptive Cross-sectional Study.

INTRODUCTION: Scrub typhus is a mite borne infectious disease caused by Orientia tsutsugamushi, obligate intracellular bacteria, transmitted by chigger mites. Scrub typhus is an emerging febrile illness with clinical suspicion being the only key to diagnosis. This study was conducted to find out the prevalence of Scrub typhus among febrile children in a tertiary care center of central Nepal. METHODS: A descriptive cross-sectional study was conducted from January 2018 to December 2019 in the pediatric inpatients of a tertiary care hospital after obtaining ethical clearance from Institutional Review Committee of Institute (Reference number 2020-105). Convenient sampling method was used. Data was analyzed using Statistical Packages for the Social Science version 16. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. RESULTS: Out of 1024 febrile patients, prevalence of scrub typhus among febrile children was 55 (5.37%) (3.66-7.08 at 90% Confidence Interval). Of 55 patients, mean age was 9.2 years with 52 (94.6%) of cases diagnosed between July to November. Among 55 patients, other symptoms were vomiting 33 (60%), headache 22 (40%), abdominal pain 19 (34.5%), cough 15 (27.3%), nausea (25.5%), seizure 11 (20 %), and dyspnea 6 (10.9%). Major clinical signs was lymphadenopathy 29 (52.7%). Major complication noted was meningitis 11 (20%). CONCLUSIONS: The prevalence of scrub typhus is considerably high during July to November so it should be considered as a differential diagnosis of fever particularly in this period.

Association of Iron Deficiency Anemia with Febrile Seizure in Children in a Tertiary Care Hospital.

BACKGROUND: Febrile seizure is the most common cause of seizure in children. Iron deficiency, by lowering seizure threshold, is proposed to be one of the risk factors for febrile seizure. Many studies have been done to determine the association of iron deficiency anemia with febrile seizure but the results are controversial. Hence, the present study was conducted to evaluate the association of iron deficiency anemia with febrile seizure in Nepalese children. METHODS: A prospective age and sex matched case control study was performed in 68 cases of febrile seizures and 68 controls of febrile illness without seizure after calculating the sample size. The study was conducted from October 21, 2019 to October 20, 2020 in Pediatric ward and intensive care unit of College of Medical Sciences, Bharatpur, Nepal after obtaining ethical clearance from institutional review committee. Data entry was done in statistical packages for the social science version 20. RESULTS: Mean of haematological parameters (haemoglobin and mean corpuscular volume) as well as mean of serum iron, ferritin and transferrin saturation were significantly less and total iron binding capacity was significantly high in cases as compared to controls (P <0.05). Iron deficiency anemia was significantly associated with cases (59.7%), with odds ratio of 2.5 (95% confidence interval =1.24 - 5.01) as compared to control (40.3%) (P <0.05). CONCLUSIONS: Iron deficiency anemia may be considered one of the risk factors for febrile seizure in children. Hence, Children with febrile seizure should be investigated and treated for Iron deficiency anemia.