Background: Respiratory distress is one of the most common reasons for admission in Neonatal Intensive Care Unit. However, studies of newborn admitted with respiratory distress in our setup are limited. This study aims to look for incidence of neonatal respiratory distress in our setup, to analyze the common causes of respiratory distress and to determine possible strategic plan needed for better clinical outcome.Methods: A cross sectional study was conducted from March 2013 to December 2014 in Nepal Medical College and Teaching Hospital. Data of all the neonates with respiratory distress admitted during this period were analyzed.Results: Total 317 (13.4%) neonates were admitted to Neonatal Intensive Care Unit during the study period.109 neonates developed respiratory distress comprising 34.3% of all Neonatal Intensive Care Unit admissions. Incidence of neonatal respiratory distress was 4.6%. The common causes of respiratory distress in our study were meconium aspiration syndrome in 21.1%, septicemia in 16.5%, transient tachypnea of newborn in 15.5%, pneumonia in 14.6%, birth asphyxia and hyaline membrane disease were in each 11.9% of the neonates. Caesarean section was the most common predisposing factor associated with the development of transient tachypnea of newborn in 82.3% newborns (p=.001). The overall mortality rate due to respiratory distress was 12.8%.Conclusions: Meconium aspiration syndrome, septicemia and hyaline membrane disease are the most important causes of respiratory distress in our setup. Good obstetric care, proper training of health care personnel in neonatal resuscitation and early recognition of potential risk factors of respiratory distress will be helpful.

Background: Child malnutrition is the single biggest contributor to under-five morbidity and mortality. Objectives: To assess the prevalence and types of malnutrition in children below 60 months of age, attending outpatient department at Nepal medical college teaching hospital in Attarkhel, Kathmandu, Nepal. Methods: A prospective study was carried out in five hundred and twelve children below 60 months of age from September 2010 to April 2011. Children detailed history, sex, weight were recorded and length/height were measured using standard technique. The length /height and weight were plotted on WHO centiles curves.1 The malnutrition were graded according to WHO classification. Result: Out of 512 children, according to WHO based on weight for age assessment , 148 (28.9%) were undernourished .Subsequently, in weight for height analysis, 73 (14.2%) were wasted and in height for age assessment, 64 (12.5%) were stunted. The present study also shows , 59 (11.5%), 50 (9.80%) and 14 (2.7%) children with acute, chronic and acute on chronic malnutrition. Conclusion: This study revealed that a high prevalence of undernutrition exists in Nepalese children. Overall, 28.9% children were undernourished. Illiteracy, large family size, not exclusively breast feeding, delayed weaning and low socio-economic status are the major risk factors for malnutrition.

Introduction: This retrospective study was undertaken to analyze the disease pattern in the Pediatric ward in a Medical College. After analyzing the data, our study would emphasize on the prevention and the management modality of the most prevalent diseases in the community. Methodology: This study was carried out retrospectively for one year from January 2008 - December 2008 on the basis of age and sex and the frequency of disease according to the system involved. Results: A total number of 453 patients were admitted during the study period. There were 267(59%) male and 186(41%) female children. Less than five years age group accounted for 180(39.7%) excluding the neonate. In the study period, respiratory tract infections were the commonest cause of admission in all age group 198(43.7%), gastrointestinal including diarrhoeal diseases were 112(24.7%), enteric fever comprised of 22(5%), and other disease comprised of about 143(31.5%) of the total admissions. CNS diseases comprised of 43(9%) of which 7(16%) were meningitis and meningoencephalitis, 26(60%) of the total CNS cases were due to febrile convulsion. Respiratory diseases were found to be the major cause of morbidity in children. Conclusion: Children under five years age being the most common age group amongst all, with infection being the most predominant cause of Pediatric morbidity, the WHO/UNICEF algorithm for Integrated Management of Childhood Illness (IMCI) is specifically suited for the developing country like ours. Key words: Paediatric Inpatient; Morbidity; IMCI DOI: 10.3126/jnps.v31i1.3262J Nep Paedtr Soc 2010;31(1):25-29

Recurrent pneumonia usually occurs due to an underlying disorder that negatively affects local or systemic defence mechanisms. The aim of this study was to find out the prevalence and risk factors associated with recurrent pneumonia in children and to determine possible strategic plan needed for better clinical outcome. Children between 2 months to 15 years old who had a history of 2 or more episodes of pneumonia per year, or 3 or more episodes in a life time were investigated prospectively at Nepal Medical College Teaching Hospital. Out of 653 children admitted for pneumonia, 74 (11.3 %%) met the criteria for recurrent pneumonia. Among 74 children with recurrent pneumonia, underlying risk factors was demonstrated in 65 patients (87.8%). Most common underlying diseases were aspiration syndrome in 21.6% patients, congenital heart disease in 13.5% patients and bronchial asthma in 12.1% children. No predisposing illness could be demonstrated in 12.1% patients. Approximately 1 in 9 children with pneumonia in our hospital had recurrent pneumonia. Aspiration syndrome was the most common underlying illnesses for undiagnosed recurrent pneumonia in children.

Pulmonary leiomyoma are uncommonly encountered benign mesenchymal neoplasms in children, usually found in immunosuppressed individuals in association with human immunodeficiency virus or Ebstein-Barr virus infection. We describe an interesting case of a 4-year-old immunocompetent girl who presented with pleural effusion and lung collapse secondary to endobronchial leiomyoma. She underwent a left thoracotomy and a left pneumonectomy for excision of the bronchial mass.

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