Introduction: Birth asphyxia is a serious clinical problem worldwide. It claims approximately 9 million deaths each year. It can lead to serious neurological sequaele, such as cerebral palsy, mental retardation, and epilepsy. Methods: All babies admitted in College of Medical Sciences Teaching Hospital, Chiwan, Nepal, NICU from January 2013 to December 2013 with a diagnosis of birth asphyxia (5 min Apgar<7 or those with no spontaneous respirations after birth) were included in the study (n=125). This was a descriptive observational study. Clinical information was collected (gravida, hour at presentation, mode of delivery, sex of baby, gestational age of the baby, requirement of resuscitation). Neonates were admitted to NICU, observed for complications and managed as per hospital protocol. Results: Among the 722 neonates admitted to NICU, 125 had perinatal asphyxia (17.3%). Babies with Hypoxic ischemic encephalopathy(HIE) Grade I had a very good outcome but HIE III was associated with a poor outcome. Outborn neonates had higher grades of perinatal asphyxia as compared to inborns (p=0.018). Term gestation, Males and Multigravida were associated with a higher rate of birth asphyxia. 22.4% neonates were delivered via caesarean section and 74.4% required bag and mask ventilation at birth. Conclusions: Birth asphyxia was one of the commonest causes of admission NICU. Babies with HIE Grade III had a very poor prognosis. Outborn neonates with birth asphyxia had a higher mortality. Males were frequently affected than females.  Keywords: birth asphyxia; HIE; mortality; measurement.

Introduction: Acute febrile encephalopathy is a common and severe neurological syndrome that is associated with significant morbidity and mortality in children. The etiologies differ according to geographical regions and appropriate and efficient protocols for investigations and management requires proper understanding of various potential etiologies. Material and Methods: In this prospective observational study, 54 children of one month to 14 years presenting to the College of Medical Sciences, Bharatpur, Nepal with acute onset of fever with altered sensorium were clinically evaluated and investigated. Clinical examinations included temperature, pulse rate, heart rate, blood pressure, coma severity by GCS, respiratory pattern and detail systemic and CNS examination. Etiology of acute febrile encephalopathy was based on clinical history, examination and relevant laboratory investigations. Results: The incidence of acute febrile encephalopathy was 5.5% of the total hospital admissions. There were 35(64.8%) boys and 19(35.2%) girls. The maximum number of children 24(44.4%) were within the age group of one to five years of age. The most common presenting complains besides fever and altered sensorium were seizures and vomiting which was present in 59.3% and 46.3% of children respectively. Signs of meningeal irritation, hypertonia, brisk deep tendon reflexes and extensor plantar response was present in 50%, 24%, 29.6%, and 44.4% respectively. The diagnosis based on clinical findings and laboratory investigations were viral encephalitis 34(63%), bacterial meningitis 12(22.2%), cerebral malaria 4(7.4), enteric encephalopathy 3(5.6%) and hepatic encephalopathy 1(1.9%). Conclusion: Viral encephalitis and bacterial meningitis are the most common cause of acute febrile encephalopathy. Preventive strategies can be undertaken to decrease the incidence.

IntroductionLow Birth weight is one of the most sensitive and reliable predictors of health and also an essential determinant of mortality, morbidity and disability in infancy and childhood. Globally, about one sixth of all newborns are low birth weight (LBW<2500 grams), which is the single most important underlying risk factors for neonatal deaths. It is estimated that 18 million babies are born with Low Birth Weight and half of them are born in south Asia. Over three –quarters of newborns death in Nepal occur in LBW babies. The estimates of prevalence of LBW in Nepal have ranged from 14% in community based studies to 32% in hospital based ones, overall being 27%. Objectives were to study the various socioeconomic and maternal reproductive factors related to low birth weight babies in Central regional part of Nepal.Material and MethodsCross-sectional and observational study was undertaken from October 2012 to September 2014 comprising of 350 singleton live born baby admitted in NICU of Tertiary Care Teaching Hospital, Chitwan.ResultsThe common risks factors for LBW were significantly associated with low socio- economic status, maternal age, maternal education, occupation of mother, maternal smoking, maternal alcohol intake, number of ANC visit with significant p-value of <0.05.ConclusionLBW mostly associated with maternal factors can be addressed directly by improving the socioeconomic factors (maternal age, educational level and economic status) and health status of pregnant women by supplementations, family planning services and female education.