Introduction: Acute respiratory infection is a leading cause of morbidity and mortality in under 5 children in developing countries. There are various modifiable risk factors associated with Acute Respiratory Tract Infection (ARI). Hence, identification of associated risk factors for ARI may be helpful to reduce the burden of disease. The aims of this study were to study the risk factors for ARI in under five hospitalized children and to correlate risk factors with ARI related morbidity. It was a hospital-based prospective study. Materials and Methods: Children of less than 5 years admitted in ward with diagnosis of ARI were enrolled in the study as cases. Control included children under 5 years of age attending to Well Baby Clinic, Immunization Clinic and siblings or relatives under 5 years who came with patients in the Paediatric outpatient department of the same institution during the same period. Various risk factors, demographic and clinical data of each child were recorded in a pre-designed proforma of both groups. Results: A total of 200 cases and 200 controls were enrolled. The various risk factors associated with ARI on stepwise logistic regression were male gender, rural residency, overcrowding, history of ARI in any family member within two weeks and undernutrition. The statistically insignificant risk factors were infancy, economic status, illiterate parents, cooking fuel other than LPG, low birth weight, prematurity, lack of exclusive breast feeding, vitamin A deficiency and incomplete immunization. Conclusion: The various risk factors for ARI identified in this study were male gender, rural residency, overcrowding, history of ARI in any family member within two weeks and undernutrition.

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Angiofibromas, located in any other sites than nasopharynx are unusual. Cardiac angiofibromas are a very rare cardiac tumours in comparison to rhabdomyomas which are the commonest in the children. We report a right ventricular tumour in a10 year old girl which was excised under cardiopulmonary bypass successfully and diagnosed as angiofibroma on histopathology. Journal of College of Medical Sciences-Nepal, 2012, Vol-8, No-4, 51-54 DOI: http://dx.doi.org/10.3126/jcmsn.v8i4.8702

Background: Nephrotic Syndrome is the clinical manifestation of glomerular diseases associated with heavy (nephrotic range) proteinuria. This study   was done to compare biochemical bone markers in nephrotic children on steroid therapy and the linear growth velocity in children with nephrotic syndrome receiving steroid with that of  known available reference standard for children of same age and sex groups Methods: A hospital based comparative study   was conducted in the Department of Pediatrics, College Of Medical Sciences, Bharatpur, Nepal among 40 Study group and 40 Comparatvie group by taking the data from 2014 to 2018.   Results: We found that in study   group, the Mean Vitamin D of patients was 12.6293 ± 3.4974 which was low. Present study  found that in Study   group, the Mean serum Ca (Mean± SD.) of patients was 6.8000 ± .9672. In comparative group, the Mean serum Ca (Mean± SD.) of patients was 9.6907 ± .9218. Difference of Mean serum Ca vs. group was statistically significant (p<0.0001). Conclusions: We found that the Mean albumin significant lower in study   group compared to comparative group but total cholesterolsignificant higher in study   group. Vitamin D and calcium were low in Study   group which was statistically significant.

IntroductionNeonatal septicemia is one of the commonest causes of neonatal morbidity and mortality worldwide. C-Reactive Protein (CRP) is an acute phase reactant that can be expected to fall quickly after efficientelimination of microbial stimulus due to its short half-life. CRP levels may sufficiently reflect the balancebetween microbes and immune system of the neonate for monitoring the effect of antibiotic treatmentand for guiding the duration of antibiotic therapy. MethodsA prospective study conducted in ninety neonates admitted with suspected neonatal sepsis during oneyear in tertiary care hospital in the department of pediatrics, College of Medical Sciences, Bharatpur,Nepal from October 2013 to September 2014. CRP was estimated within 24–72 hours of admission.Then neonates were assigned to one of 3 groups according to CRP levels. Infection unlikely group,infection likely group with two subgroups- CRP guided therapy and 7 days antibiotic therapy. ResultsOut of 90 cases of suspected neonatal septicaemia antibiotics were stopped in ≤7 days in 61 cases(67.8%). In 25 out of 30 cases (27.8%) of neonatal septicaemia, antibiotics were stopped after 72 hoursof initiation. In group II, antibiotics could be stopped in five days in 4 cases and remaining 26 casesantibiotics were given for 7 days. In group III, antibiotics could be stopped in 7 days in one case andremaining 29 cases antibiotics were given more than 7 days. ConclusionsCRP has a high negative predictive value 96-100% and can be used as a marker of neonatal sepsis toreduce duration of antibiotics.

Congenital tuberculosis is a rare disease. It usually presents with respiratory distress, fever and organomegaly. We report a case of congenital tuberculosis presenting with ascites only.DOI: http://dx.doi.org/10.3126/jcmsn.v10i1.12766 Journal of College of Medical Sciences-Nepal, 2014, Vol.10(1); 37-40

Aims: In the present study acute leukemic children were studied to determine the incidence and principal site of infection, correlation with absolute neutrophil count, causative organisms and to standardize the initial empirical anti microbial therapy. Materials and methods: A total 40 children in the age group 6 month to 12 year with acute leukemia relapse were included in this study. A total 82 infectious episodes including 61 febrile episodes were investigated for infectious etiology. Results: We found that the frequency of infections increased significantly with the degree of immunocompromisation specially neutropenia (ANC < 500/cmm). The skin and soft tissue was the commonest site of infection (26.83%), followed by respiratory tract (21.95%). Staphylococcus nonhemolytic coagulase-negative (34%), followed by Klebsiella (17%) were the most common organisms isolated from blood. Staphylococcus non-hemolytic coagulase-negative was also the commonest isolate (26%) from other sites of infection. Most strains were sensitive to Cloxacillin, cephalosporin and aminoglycosides. Conclusion: For the treatment of febrile episodes, empirical use of beta-lactamase resistant penicillin e.g. Cloxacillin or cephalosporin combined with an aminoglycosides with a broad spectrum antifungal like fluconazole in selective cases at the first sign of infection is recommended. Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-1, 40-47 DOI: http://dx.doi.org/10.3126/jcmsn.v9i1.9672

<p>Serial samples demonstrate recurrent loci with copy number alterations for each patient.</p>