Background Intensive care units (ICU) are essential healthcare facility for life threatening conditions. Bacterial contamination of objects/instruments in ICU is an important source of nosocomial infections. This study is aimed to determine the level of bacterial contamination of instruments/objects which are commonly touched by healthcare workers and frequently come in contact with the neonates. Methods This hospital based prospective study was conducted in neonatal intensive care unit (NICU) of Manipal Teaching Hospital, Pokhara, Nepal. A total of 146 samples collected from surfaces of incubators, radiant warmers, suction tips, ventilators, stethoscopes, door handles, weighing machines, mothers’ beds, phototherapy beds, laryngoscope, telephone sets, blood pressure machine, etc. formed the material of the study. Isolation, identification and antibiotic susceptibility of the bacterial isolates was performed by standard techniques. Blood culture isolates from NICU patients during the study period were compared with the environmental isolates. Results Out of 146 samples, bacterial growth was observed in 109. A total of 119 bacterial isolates were retrieved from 109 samples. Three common potential pathogens isolated were Escherichia coli (n = 27), Klebsiella species (n = 21) and Staphylococcus aureus (n = 18). Majority of E. coli and Klebsiella isolates were from incubators, suction tips and mothers’ beds. Majority of S. aureus isolates were cultured from radiant warmers. Among S. aureus isolates, 33.3% (6/18) were methicillin resistant. Majority of the bacterial isolates were susceptible to gentamicin and amikacin. Common potential pathogens isolated from blood culture of NICU patients were S. aureus and Klebsiella species. Conclusion High degree of bacterial contamination of objects/instruments in NICU was recorded. Isolation of potential pathogens like E. coli, Klebsiella species and S. aureus is a major threat of nosocomial infections. Blood culture data of NICU reflects possibility of nosocomial infections from contaminated sites. Gentamicin and amikacin may be used for empirical therapy in suspected cases of nosocomial infections in NICU.

Background

BackgroundSkin diseases in children contribute to significant morbidity and psychological distress. Infective dermatoses are one of the major dermatoses in children. Low socioeconomic status, overcrowding and poor personal hygiene has been linked to skin diseases. ObjectiveTo find out the prevalence of infectious skin disease in children, rate of transmissible skin disease and association of sociodemographic factors and personal hygiene on infective childhood dermatoses. MethodThis was a cross-sectional study conducted in the Pediatric and Dermatology Department, Manipal Teaching Hospital, Pokhara, Nepal. A total of 226 patients were examined over a period of one year. Relation of sociodemographics, crowding and personal hygiene on skin disease were assessed. ResultThe most common category was Infections and Infestations (51.3%) followed by Dermatitis (27.9%) . Transmissible skin disease was seen in 49.6%. Low socioeconomic status and overcrowding were associated with increased risk for infective dermatoses. ConclusionSkin disease in children constitutes a public health problem. Improving the socioeconomic status and personal hygiene can help to reduce the incidence of skin disease in children.

Backgroud Simian crease is usually associated with some chromosomal anomalies and syndromes but it is also seen in some populations without any chromosomal defects. Objective To see the incidence of simian crease in children without chromosomal anomalies and to detect the Ethnic group variations. Methods A prospective study in children attending the paediatric outpatient department of Manipal Teaching Hospital, Pokhara. –2,067 children were screened randomly from the 1st June 2007 to the 31st December 2007. Palm crease and axial triradius angle were detected in every child. Axial Triradius angle was compared between those who have simian crease to those who do not simian crease.Children who were found with simian crease underwent IQ testing. The exclusion criteria were children with Down syndrome, other chromosomal and minor anomalies, plus or any other chronic disease condition. Results 2,067children (1,084 boys & 983 girls) were screened. Among them four were cases of Down syndrome so were excluded from the study. Finally total of 2,063 (1,082 boys & 981 girls) were the study group. There were a total 14 ethnic groups who attended the outpatient department of Manipal Hospital during a seven months period. Among the seven ethnic groups Brahaman, Gurung, Tamang, Lama, Newar, Chettri and Dalit had single palmar crease. The incidence of simian crease was14.6%.This incidence was highly significant (p<0001) in Lama population (71.2%). In these seven ethnic groups axial triradius angle was compared between those who had simian crease and with those who did not have simian crease. Comparisons were made statistically and found to be significant. ConclusionIncidence of simian crease in Nepalese children was 14.6% and was observed only in certain ethnic groups. It was significantly high in the Lama population (71.2%0.http://dx.doi.org/10.3126/kumj.v8i4.6241 Kathmandu Univ Med J 2010;8(4):410-14

Background: Snake bite is a widely distributed and neglected condition with a significant mortality. Medically significant snakes are: Elapidae, which are mainly neurotoxic and Viperidae, which are hemotoxic. Most studies on snake bites are done in Terai belt of Nepal and this is a first study of its kind in children in western region of Nepal. Methods: This was a 7 year retrospective study in Pediatric unit of Manipal Teaching Hospital, Pokhara, Nepal. Relevant data from all cases of snake bite in children up to 18 years of age was collected in a structured proforma and analyzed. Results: Among the 39 cases of Snake bites; it was more in boys (M: F=1.16:1), from rural areas (62%) and was more common during monsoon (64%). The commonest site of bite was foot (64%). Snakes were identifiable in only 23% of the cases. Local swelling (77%) and pain (74%) were common clinical features. Coagulation profile was deranged in 80% of the patients, hematuria was observed in 13% patients and 15% patients had thrombocytopenia. Most of the snakes were hemotoxic (77%) and only 1 case (2.5%) was neurotoxic. Only 44% of the patients received polyvalent anti-snake venom and blood products were required in 51% of the patients. Most patients improved (75%) and the case fatality rate was 2.5%. Conclusion: Most snakes found in mountainous region of Nepal are hemotoxic and lead to deranged coagulation profile. Mortality is low in hemotoxic as compared to neurotoxic envenomations. Nepal Journal of Medical Sciences | Volume 02 | Number 02 | July-December 2013 | Page 119-124 DOI: http://dx.doi.org/10.3126/njms.v2i2.8954