Introduction: Birth asphyxia is defined by the World Health Organization "the failure to initiate and sustain breathing at birth." The WHO has estimated that 4 million babies die during the neonatal period every year and 99% of these deaths occur in low-income and middle income countries. Three major causes account for over three quarters of these deaths, serious infection (28%) complication of preterm birth (26%) and birth asphyxia (23%). This estimation implies that birth asphyxia is the cause of around one million neonatal deaths each year. One of the present challenges is the lack of a gold standard for accurately defining birth asphyxia. Because of same reason the incidence of birth asphyxia is difficult to quantify. Objective: The aim of this study was to assess the prevalence of birth asphyxia, identify the common obstetric and neonatal risk factors, and study the cause of death. Methodology: All babies born in Dhulikhel Hospital (DH) from Jan 2007 to Oct 2009 with a diagnosis of birth asphyxia (5 min Apgar < 7 and those with no spontaneous respirations after birth) were included in the study (n=102). Clinical information was collected retrospectively from maternal records (maternal age, gravida, type of delivery, presence of meconium, induced or spontaneous labour, and pregnancy complications). The NICU records provided additional information about new born infant (birth asphyxia, stages of birth asphyxia, birth weight, sex and subsequent mortality). Results: Among the 3784 live births there were 102 babies with birth asphyxia prevalence of 26.9/1000 live births. Babies with Hypoxic ischemic encephalopathy (HIE) Stage 1 had a very good outcome but HIE III was associated with a poor outcome. Males, primipara and pregnancies with complications were associated with a higher rate of birth asphyxia. Septicaemia, necrotizing enterocolitis, preterm delivery, convulsion and, pneumothorax were associated with higher mortality and morbidity. Conclusion: Birth asphyxia was one of the commonest causes of admission and mortality in NICU. Babies with HIE Stage III had a very poor prognosis. Birth asphyxia combined with other morbidities was associated with a higher mortality. Sepsis is the commonest morbidity in cases of birth asphyxia. Maternal gravida, pregnancy complication with PROM, meconium, APH, emergency caesarean section, preterm and male sex were the risk factors for birth asphyxia. Key words: Birth asphyxia; HIE; Neonatal sepsisDOI: 10.3126/jnps.v30i3.3916J Nep Paedtr Soc 2010;30(3):141-146

Introduction: Acute encephalitis syndrome (AES) is a constellation of clinical signs and or symptoms i.e. acute fever with acute change in mental status. AES may be present as encephalitis, meningoencephalitis or meningitis. It can be associated with severe complication, including impaired consciousness, seizure, limb paresis or death. Materials and Methods: Study consisted of retrospective analysis of hospital records of children up to 16 years of age admitted with diagnosis of AES in the department of Paediatrics

In low‐ and middle‐income countries (LMIC), growth impairment is common; however, the trajectory of growth over the course of the first month has not been well characterised. To describe newborn growth trajectory and predictors of growth impairment, we assessed growth frequently over the first 30 days among infants born ≥2000 g in Guinea‐Bissau, Nepal, Pakistan and Uganda. In this cohort of 741 infants, the mean birth weight was 3036 ± 424 g. For 721 (98%) infants, weight loss occurred for a median of 2 days (interquartile range, 1–4) following birth until weight nadir was reached 5.9 ± 4.3% below birth weight. At 30 days of age, the mean weight was 3934 ± 592 g. The prevalence of being underweight at 30 days ranged from 5% in Uganda to 31% in Pakistan. Of those underweight at 30 days of age, 56 (59%) had not been low birth weight (LBW), and 48 (50%) had reached weight nadir subsequent to 4 days of age. Male sex (relative risk [RR] 2.73 [1.58, 3.57]), LBW (RR 6.41 [4.67, 8.81]), maternal primiparity (1.74 [1.20, 2.51]) and reaching weight nadir subsequent to 4 days of age (RR 5.03 [3.46, 7.31]) were highly predictive of being underweight at 30 days of age. In this LMIC cohort, country of birth, male sex, LBW and maternal primiparity increased the risk of impaired growth, as did the modifiable factor of delayed initiation of growth. Interventions tailored to infants with modifiable risk factors could reduce the burden of growth impairment in LMIC.

In Nepal, in the fiscal year 2014/2015, a total of 32,109 (0-28) days' infants were treated at health facilities and PHC / ORC clinics. 1 The birth of a baby is supposed to be a happy event, but for parents with a infant in the NICU, it is marked by fear, sadness, guilt and anger. 2 Many infants admitted to the NICU are born premature and have low birth weight or a medical conditions that requires intensive medical and nursing care, sometimes for several months following birth. So, the need of proper information, support, comfort, assurance, and proximity are very important to be addressed while planning a nursing care plan. Parents experience communication with the NICU staff as essential to the management of their situation. 4 When parents receive information, they feel less anxious and have a better relationship with staff.5 It is very important that nurses should provide the concrete information in order to better understand parents' need for support and try to meet their expectations, resulting in improved nursing care in neonatal intensive care units. 6 If nurses provide emotional support to parents, promote family presence and participation in the NICU and can create a welcoming environment for families which is a part of the family-centered care. 7 Assurance to parents in the NICU can enhance nursing communication and allow nurses to incorporate parents needs into families care plan. Nurses play an important role in helping parents by developing therapeutic relationship, providing accurate and proper information, emotional support, giving assurance, providing comfort and allowing parents to provide care to neonates under supervision in Neonatal Intensive Care Unit (NICU). The objective of the study was to assess the perception of mothers needs and nurses felt needs on nursing care provided by nurses to their neonates in the NICU. Materials & Methods: This was descriptive cross-sectional study conducted in 21 NICU nurses and 69 mothers whose neonates were admitted in the NICU. Data were collected for a period of six months. Data were gathered using opinion-survey Likert scale and were analyzed using descriptive-analytical methods. Results: Subscales related to family needs, the mean score (± SD) of mothers in information was 37.7 ± 3.8, in comfort 32.1±2.8, in support 38.8±3.4, in assurance 31.2±2.2, in proximity 21.7±2.8. Mean score on care provided by nurses to their neonates in information need 39.0±3.6, in comfort 31.5±2.9, in support 38.8±4.1, in assurance 30.2±3.0, in proximity 21.1±2.4. There was no statistical difference shown in the study. The study shows positive correlation between mother's perceived need and nurses felt needs. Conclusion: According to the study findings, nurses don't put subjective assumption over mothers need. So, to develop nursing care plan, it is important to understand the needs perceived by the mothers.