Introduction: The burden of malnutrition is of significant concern in Nepal. The objectives of this study are to classify the nutritional status in children admitted in nutritional rehabilitation home of Pokhara Academy of Health Sciences and to relate the demographic characteristics and the effectiveness of the nutritional intervention measures on status of malnutrition which can help in the policy formulation to tackle the burden of malnutrition. Materials and Methods: This is a hospital based retrospective study in which total of 238 children with malnutrition admitted in nutritional rehabilitation home of Pokhara Academy of Health Sciences during July 2014 to July 2018 were followed. The socio-demographic factors and nutritional status were analyzed at admission and at discharge using the available record. Data was analyzed using SPSS 16. Results: Out of 238 malnourished children, 167(70.2%) were cases of moderate acute malnutrition and 76(29.8%) were cases of severe acute malnutrition. The mean weight at admission was 7.18±1.73 kg, mean weight at discharge was 7.82±1.82 kg and mean weight increased after nutritional intervention was 0.62 kg±0.40. The average weight gain in severe acute malnutrition was 4.7gm/kg/day. A statistically significant difference was obtained between mean weight (p=0.00, t= - 24.62) of children at admission and discharge. There was significant statistical difference between mean weight gain (p<0.05, t= -3.1) in severe acute malnutrition (0.76±0.49 kg) and in moderate acute malnutrition (0.59±0.34 kg). Conclusion: Nutritional rehabilitation homes are effective in improving the nutritional status of undernourished children, more effective in severe acute malnutrition. However it is important to reassess the management protocol to meet the intake targets so that the rate of weight gain is improved.
Introduction: Iron deficiency anemia (IDA) is the most common anemia worldwide. It adversely affects the physical growth, cognition, behavior and the immune status of infants and children. There are limited number of studies in Nepal analyzing its prevalence, risk factors and diagnosis in pediatric population. Restriction of analgesics intake, increased intake of iron rich food and deworming are important determinants in the disease management. Methods: Hospital based prospective comparative study was conducted in the Department of Pediatrics in Manipal Teaching Hospital from December 2014 to December 2016 enrolling all children aged 6 months to 5 years with anemia. Demographic profile, clinical features and information regarding risk factors were noted along with detailed physical examination. Iron profile was done to confirm diagnosis of IDA. Data was analyzed using SPSS 21. Results: Out of 168 anemic children, 110 (65.45%) children were diagnosed as IDA. Dietary factors, pica and intake of analgesics/antipyretics were major risk factors. Serum iron, serum ferritin, transferrin saturation were low whereas total iron binding capacity was high in IDA. Conclusion: Iron deficiency anemia is a common, preventable and easily treatable disease which has potentially serious consequences if not treated. Non compliance to exclusive breastfeeding in the first 6 months of life, introduction of cow’s/buffalo’s milk in the first year, pica and rampant use of analgesics/antipyretics are major risk factors.
Introduction: Laparoscopic cholecystectomy is the choice of operation for symptomatic gallstones. Gallstone and bile spillage can occur during laparoscopic cholecystectomy during dissection by cautery or due to perforation of gall bladder by grasper. The complication of spilt stone and bile may range from simple superficial surgical site infection, adhesion, obstruction, abscess formation to none. Methods: This study was conducted at Western Regional Hospital (WRH), Pokhara from July 2015 to December 2016. A total of one hundred and twenty patients who underwent laparoscopic cholecystectomy were included. All patients’ age, sex, pre-operative ultrasound findings, intra operative spillage of stone and bile and post-operative superficial surgical site infection were noted. Statistical analysis was done using Microsoft Excel software and SPSS-21. Result obtained from the study was discussed with reference to current world literature. Results: Out of one hundred and twenty patients, one hundred and nine were female and eleven were male with mean age of 42.68 years. Spillage of stones and bile occurred in twelve patients (10%). Spillage of stone and bile was common with multiple stones. Only four patients (one male and three females) developed superficial port site infection (3.3%). Two patients among spillage and two among non spillage developed superficial surgical site infection (p<0.05). Most common organism was Staphylococcus aureus followed by Escherichia coli. Conclusion: The incidence of split stone or bile is 10 % and is common with multiple gallstones. The chance of superficial surgical site infection is more in male patients and with spillage of stone and bile.
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