BackgroundEmergence of Extended-spectrum beta-lactamase producing Escherichia coli causing urinary tract infections (UTI) among pediatric patients is an increasing problem worldwide. However, very little is known about pediatric urinary tract infections and antimicrobial resistance trend from Nepal. This study was conducted to assess the current antibiotic resistance rate and ESBL production among uropathogenic Escherichia coli in pediatric patients of a tertiary care teaching hospital of Nepal.MethodsA total of 5,484 urinary tract specimens from children suspected with UTI attending a teaching hospital of Nepal over a period of one year were processed for the isolation of bacterial pathogens and their antimicrobial susceptibility testing. Escherichia coli (n = 739), the predominant isolate in pediatric UTI, was further selected for the detection of ESBL-production by phenotypic combination disk diffusion test.ResultsIncidence of urinary tract infection among pediatric patients was found to be 19.68% and E coli (68.4%) was leading pathogen involved. Out of 739 E coli isolates, 64.9% were multidrug resistant (MDR) and 5% were extensively drug resistant (XDR). Extended spectrum beta lactamase (ESBL) was detected in 288 (38.9%) of the E coli isolates.ConclusionAlarming rate of drug resistance among pediatric uropathogens and high rate of ESBL-producing E. coli was observed. It is extremely necessary to routinely investigate the drug resistance among all isolates and formulate strict antibiotics prescription policy in our country.

Introduction: Neurocysticercosis (NCC) is common in developing countries including Nepal. Clinical presentations vary depending on the CT scan findings of head. Adequate information of NCC in children from Western Nepal is lacking. This study was conducted with an objective of evaluating the most common clinical and radiological picture in children suffering from NCC at a tertiary care teaching hospital in Western Nepal. Methods: Hospital records of all pediatric inpatients, admitted from 16th June 2010 to 15th December 2012, consistent with the diagnosis of Neurocysticercosis were reviewed.Results: Among the 217 patients that either presented seizure or other neurological deficit, 49 were diagnosed as Neurocysticercosis. Their age varied between 2.6 years and 14 years with the mean age of 10.6 years and the peak age of 12 years among diagnosed inpatients. It also showed slight male predominance with the ratio of male and female being 1.22:1. Sorted based on geographical distribution, the maximum of 14 (28.6%) patients were from Kaski district, closely followed by Tanahun district with 13 (26.5%). 38 (77.5%) of the presentations were seizures, partial seizures being most common. 44 (89.8%) of the lesions were single, with 20 (40.8%) predominantly residing in the parietal region, 30 (61.22%) were in transitional stage. However, number of lesions discovered from CT scan of head showed no significance in association with seizure types (p=0.84). In addition, perilesional edema and scolex within the lesion were noted in 67.34% and 18.36% of the cases respectively._______________________________________________________________________________________Keywords: clinico-radiological profile; neurocysticercosis; pediatric population._______________________________________________________________________________________

ABSTRACT:Introduction: There has been a decreasing trend in malnutrition (stunting, wasting, and under-weight) in Nepal from 2001 till 2016 according to Nepal demographic health survey 2016. We tried to study whether these national survey data equally reflect the nutritional status of children visiting hospitals in the capital city of our country. The objective of the study was to evaluate the nutritional status of children less than five years of age brought to a hospital in Kathmandu. Methods: Anthropometric measurements (height/length and weight), other demographic details, and morbidity of all children, six months to five years of age, visiting the hospital over the period of three months were collected from the out-patient register. Height-for-age, weight-for-height, and weight-for-age were calculated and expressed as standard deviation units as compared to the median of reference data taken from WHO Multicentre Growth Reference Study Group (2007). Association between morbidity and various anthropometric values were calculated. Results: A total of 424 children were included in the study. There were 2.1% severely stunted, 8% stunted, 2.8% tall, and 1.7% very tall children. Similarly, 6.4% were severely wasted, 14.4% wasted, 4.7% severely underweight, and 12.3% under-weight. The anthropometric values were significantly associated with morbidity (acute Vs chronic) but not associated with whether they were from within Kathmandu or form outside, and individual morbidity. Conclusion: Wasting and severe wasting in under five children from and nearby Kathmandu of Nepal is higher while stunting and severe stunting is lower as compared to previous National reports.