Background: Perinatal asphyxia (PNA) is one of the most important causes of perinatal mortality and morbidity which can be preventable and managable.Objectives: The purpose of the study was to determine the prevalence of perinatal asphyxia and to explore the factors influencing or related to the development of the PNA.Materials and Methods: It is a cross-sectional study conducted in the neonatal unit of department of pediatrics, KYAMC hospital from January 2015 to December 2016. Two hundred eleven neonates admitted in neonatal unit including SCABU were enrolled in the study considering inclusion criteria. Necessary information about sociodemography, peri-natal history (including antepartum, intrapartum and fetal risk factors) were collected by detailed history taking on a pre-designed questionnaire. Clinical examinations and outcomes were also recorded. We used Student's t-test and ?2-test to determine the association of PNA with various risk factors.Results: The male to female ratio was 1.6:1. The mean age of the neonates during admission time was 3.66 (±5.506) days (in PNA 1.8±2.803 days and in normal group 6.11±7.047 days). The overall prevalence of PNA was 56.9% (120); male 60.8% (73) and female 39.2% (47). Identified significant materno-fetal risk factors were maternal young age (p= .038), low socioeconomic condition (p = .000,) primiparity (p = .003), muconium stained amniotic fluid (p = .004), obstructed labour (p = .019), low birth weight (p = .009) and home vaginal delivery by local dai and midwives (p = .017). Serious neonatal complications noted among the asphyxiated babies were hypoxic ischemic encephalopathy with convulsion, neonatal jaundice, septicemia, transient tachypnoea of neonate, hypoglycemia, respiratory distress syndrome, caput succedaneum and feeding problem.Conclusions: Findings of this study highlight the need for the better obstetrical care and awareness of the possible presence of the risk factors of PNA among mothers and fetus, so that the occurrence and worsening of PNA could be prevented or at least appropriately managed. It can reduce the high incidence of morbidity and mortality due to birth asphyxia.KYAMC Journal Vol. 8, No.-1, Jul 2017, Page 43-48

Infections due to multidrug resistant E.coli range from uncomplicated urinary tract infections to life-threatening sepsis. A retrospective study was conducted to determine the patterns of antimicrobial susceptibility in 173 (12.84%) Escherichia coli strains isolated from 1347 clinical specimens of different types. Isolation and identification of E.coli were done as per routine laboratory protocol directed by Cheesbrough1. The isolation rate of E.coli was 48.57% in stool followed by 17.68% in urine, 25% in wound swabs, and 15.38% in tracheal aspirate etc. Among the 173 isolates 102 (59%) were from males and 71 (41%) were from females. Patients were classified into five age groups: 0-15, 16-30, 31-45, 46-60 and >60 years. E.coli was found highest number in females (13.9%) of age range 31-45 years and in males (22%) belonged to age group of over 60 years. Antimicrobial susceptibility testing by the disk diffusion method was conducted for 22 different antibiotics. The majority of isolated E.coli were highly sensitive to Imipenem (98.18%), Meropenem (97.37%), Amikacin (91.67%), Amoxiclav (80%), Ceftazidime (73.33%), and Gentamycin (71.76%). The antibiotics Tobramycin and Azithromycin were found as moderately sensitive against E.coli with the susceptibility rate of 52.5% and 50% respectively. The isolates show low degree of susceptibility to Penicillin G (9.52%), Carbenicillin (10%), Erythromycin (19.48%), Amoxycillin (19.59%), and Ampicillin (25%). These findings have clinical and epidemiological significance and provide a benchmark for future studies on the pattern of susceptibility of clinical isolates of E.coli in this region as well as may help the clinician to prescribe the right empirical treatment.KYAMC Journal Vol. 7, No.-1, Jul 2016, Page 681-686

Hypothyroidism is a common disorder of the endocrine system in which the

Introduction: Addison's disease is a relatively rare endocrine condition requiring life-long glucocorticoid and mineralcorticoid replacement therapy. Women with Addison's disease may have a reduced parity. Addisonian crises, a rare but life-threatening event in pregnant women, may accompany stressful conditions such as labor, puerperium, infection, hyperemesis gravidarum or surgery.Case Presentation: This is a case report of previously healthy 24-year-old nulliparous woman presented with a history of fatigue, fever, diarrhoea and skin darkening. She had pale conjunctiva, low blood pressure, tachycardia, some dehydration, hyperpigmentation of palmer creases, knuckles, buccal mucosa and face. Her serum cortisol was low and rapid ACTH stimulation test with Synacthen showed a poor cortisol response. Patient was immediately managed with IV steroid and later dicharged with oral steroid. After 6 months she became pregnant and the steroid therapy was regulated to avoid adrenal crisis during pregnancy. The patient underwent to caesarean section at 38th week and gave birth to a normal baby.Conclusion: Addisonian crisis represents an endocrine emergency that requires a correct diagnosis with prompt and appropriate salt and steroid replacements to save the patient. Though Addison's disease in women is a risk factor for an adverse pregnancy outcome, it is believed that appropriately treated patients can expect to have uneventful pregnancies of normal duration and without fetal compromise.KYAMC Journal Vol. 7, No.-2, Jan 2017, Page 814-817

Background: In late presentation of cases there is dilemma whether to wait for osteotomy later or do open reduction on arrival. The purpose of this prospective multicentric study is to evaluate the functional outcome of open reduction and internal fixation (ORIF) with crossed Kirschner wires fixation and early joint motion in the late presentation of supracondylar fractures in children.Methods: A total of 21 children, with an average delay of 22.5 days, with displaced type III Gartland supracondylar fracture, were treated by ORIF with crossed Kirschner wires fixation and early joint motion. Average follow-up was 12 months.Results: Flynn's criteria were used to evaluate the outcome. All of them had more functional range of motion of the injured elbow than the published reports.Conclusions: Most of the surgeons in the developing world prefer ORIF for optimal results. Thus it appears to be justifiable to go for ORIF with K-wires even in the late presentation of supracondylar fractures. The overall results are encouraging. However, the small number of cases and lack of control group are the limitations of this study. The study is ongoing and so the full report with more cases will be presented later.KYAMC Journal Vol. 7, No.-2, Jan 2017, Page 745-749