Background: Urine collection in children especially in new born is a great challenge. A wide range of clinical interventions for urine collection is described in the literature, including non-invasive and invasive methods. Mid-stream urine collection is considered the most appropriate technique for older children. Here we are testing a method for obtaining mid- stream urine sample in newborns.Objective: To test a technique of urine collection for obtaining mid-stream urine sample in newborns.Method: A prospective feasibility study of a technique of urine sample collection based on bladder and lumbar stimulation maneuvers done in 100 newborns of less than 28 days of life over a period of one month. The main variable was the success rate in obtaining a midstream urine sample collection within four minutes and secondary variables were time required to obtain the sample and associated complications.Results: Mid- stream urine sample was collected successfully in 91% of babies. Mean time required for urine collection was 59.7 seconds with standard deviation of 46.4 seconds and median time was 47 seconds. No untoward complication other than controlled crying was seen.Conclusion: This is a quick and safe technique for mid-stream urine sample collection in newborn with high success rate and minimal discomfort.Journal of Kathmandu Medical CollegeVol. 5, No. 3, Issue 17, Jul.-Sep., 2016, Page: 82-84

Introduction: Perinatal asphyxia is one of the major causes of perinatal and early neonatal mortality in developing countries. The main objective of this study was to observe the prevalence of perinatal asphyxia in babies born at Kathmandu Medical College Teaching Hospital. Methods: This was a descriptive cross-sectional study conducted at Kathmandu Medical College Teaching Hospital over six month period (January to June 2019). All preterm, term and post term babies delivered at Kathmandu Medical College Teaching Hospital were included. Ethical clearance was received from Institutional Review Committee of Kathmandu Medical College (Ref.:2812201808). Convenient sampling method was applied. Data analysis was done in Statistical Package for Social Sciences (SPSS 18), point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: A total of 1284 babies delivered over six months period were enrolled in this study and 47 (3.66 %) babies were asphyxiated, at 95% Confidence Interval (2.64%-4.68%). The mean birth weight of asphyxiated babies was 2759.75±65 grams and gestational age was 37.57±2 weeks. Among asphyxiated babies, 15 (32%) babies were normal, 15 (32%) babies were in Hypoxic Ischemic Encephalopathy stage I, 14 (30%) were in stage II and 3 (6%) were in stage III. Twenty Three (49%) asphyxiated babies had antenatal risk factors and all 47 babies had intrapartum risk factors leading to asphyxia. Conclusions: Prevalence of perinatal asphyxia was lower compared to that of other similar tertiary care hospitals. Perinatal asphyxia remains a major cause of neonatal morbidity and mortality.

Potter sequence is a rare congenital malformation that primarily affects male fetuses and is characterized by pulmonary hypoplasia, skeletal malformation, and kidney abnormalities. The pressure of the uterine wall due to oligohydramnios leads to an unusual facial appearance, abnormal limbsor limbs in abnormal positions or contractures. The fetus generally dies soon after birth due to respiratory insufficiency. We presented a male baby of 35 wks gestation with birth weight 1200gms delivered by primi mother. She had severe oligohydramnios and virtually there was no liquor during birth. The baby had severe perinatal depression at birth requiring resuscitation. Multiple congenital anomalies like absence of left eye, congenital cataract on the right eye, right-sided choanal atresia, micrognathia, low set ears, beaked nose, bilateral clubbed foot with hip deformity were noted. After 2 hours of life,baby developed fast breathing and cyanosis and died due to respiratory failure.

Introduction: Neonatal sepsis is the most important cause of morbidity and mortality among lowbirth weight and preterm babies in developing countries. The main objective of this study is to findthe level of micro-Erythrocyte sedimentation rate in neonatal sepsis. Methods: This is a descriptive cross-sectional study conducted at the neonatal unit over six monthsperiod (November 2019 to April 2020). All preterm, term and post-term babies with neonatal sepsisdelivered at Kathmandu Medical College Teaching Hospital were enrolled. Ethical clearance wasreceived from the Institutional Review Committee of Kathmandu Medical College (Ref: 181020191).Convenient sampling method was applied and statistical analysis was done with Statistical packagefor social sciences 19 version. Results: Out of 75 babies, confirm sepsis is 13 (17.3%), probable sepsis is 40 (53.4%) and suspectedsepsis is 22 (29.2%). Micro-Erythrocyte sedimentation level is elevated (≥15mm in 1st hr) in 25 (33.3%)babies with a mean micro-Erythrocyte sedimentation level 9.32±5.4 (2-18) mm in 1st hr. The elevatedmicro- Erythrocyte sedimentation level was seen in relation to sepsis types and C-reactive protein. Conclusions: The bedside micro-Erythrocyte sedimentation level aids in the diagnosis of neonatalsepsis.

Infantile hypotonia or floppy infant is a diagnostic challenge when it presents with other presenting complaints such as fever, cough or diarrhea. Many times the hypotonia goes unnoticed when other symptom covers the hypotonia and child continues to receive the treatment for other symptoms. We report a rare case from Nepal of infantile Pompe disease who presented with the history of fever and cough in the recent earthquake disaster camp at remote part of Sindhupalchowk, Nepal. He was being treated as a case of pneumonia.Pompe disease can be diagnosed clinically by taking detailed history and correlating the clinical findings during the presentation with other symptoms. In our case the normal respiratory rate, reduced Spo 2 and presence of crackles dominated the hypotonia and was mistreated as pneumonia. High index of suspicion is necessary in diagnosing Pompe disease. KEY WORDSDevelopmental delay, hypertrophic cardiomyopathy, hypotonia, normal respiratory rate, pompe disease