Background: Anemia and acute lower respiratory tract infections are persistent and pervasive public health problems. Objective-To determine the relation of iron deficiency anemia with lower respiratory tract infection. Methods: The study included 82 diagnosed cases of acute lower respiratory tract infection in infants and children of age 6 months to 5 years. Detailed history and physical examination was done according to predesigned proforma. Laboratory investigations like complete blood count, red blood cell morphology and serum ferritin was carried out. Data was statistically analyzed. Results: Out of 82 cases, 34 cases were iron deficiency positive. Among 82 cases, majority of them were below 24 months. Gender wise, male population was higher compared to female. Sixty one percent of the cases belonged to middle class and 39% belonged to lower class. Cough was present in all acute lower respiratory tract infection patients followed by fast breathing, fever, chest in drawing, noisy breathing, poor feeding and the least of all was bluish discoloration of face/lips. The overall mean temperature, pulse rate and respiratory rate were 100.36

Background & Objectives: Neonatal period is a vulnerable time in which the newborn has to adapt to a totally new environment and is susceptible to many problems, which may even be life threatening. Every year, millions of neonates are born and a large proportion of them are admitted to the neonatal intensive care unit (NICU) for various indications. It is found that neonatal mortality rate is decreasing in Nepal but at a slower pace than infant and child mortality. In order to improve neonatal outcome, it is crucial to identify the areas where health care can be improved. Therefore, this study was conducted to identify the clinical profile, pattern of diseases and common causes of mortality and morbidity in neonates admitted to neonatology unit.Materials & Methods: A retrospective study was conducted at neonatology unit of BPKIHS, from January 2014 to December 2014. A total of 1009 neonates (both inborn and out-born) were admitted to neonatology division during the study period. Data was collected from the hospital record section. Ethical clearance was taken from the institutional ethical committee before the initiation of the study. Data was entered and descriptive analysis was done by using SPSS 20.0.Results: Total of 1009 neonates were admitted in neonatology unit. Among them, 349(34.5%) cases were admitted due neonatal sepsis, 236 (23.3%) due to prematurity and 233 (23.1%) with birth asphyxia. Among birth asphyxia, 102(43.7%) were in HIE III, 34.3% and 21.8% in HIE II and HIE I, respectively. The overall mortality was 47 (4.7%) during hospital stay.Conclusion: Sepsis, prematurity and birth asphyxia were major causes for admission in NICU. All these etiologies are preventable up to some extent and, if detected earlier, can be effectively treated in order to reduce morbidity and mortalityJCMS Nepal. 2015;11(3):20-24.

Background & Objectives: Anemia is a global health problem. About 40% of the world's population suffers from anemia and adolescence is one of the most vulnerable age group. Hence the objective of the study was to determine prevalence and distribution of anemia among adolescent girls in eastern part of Nepal.Materials & Methods: This cross sectional study was conducted in a Government School of Dharan over a period of one year. There were total 433 participants, whose clinical and demographic profile were recorded and analyzed. Hemoglobin estimation was done by using cyanmethaemoglobin method and anemia was defined as per WHO cut-off.Results: The overall prevalence of anemia was found to be 51.3%. Prevalence was significantly more in pre-menarche age and undernourished girls (p<0.05). However factors like diet (vegetarian/non-vegetarian), worm infestation and parental education did not have a significant impact on occurrence of anemia.Conclusion: Anemia is the major health problem among adolescent girls in eastern part Nepal with high prevalence rate and nutrition is one of the leading causative factors for anemia.JCMS Nepal. 2016;12(1):19-22.

Background Typhoid fever is an endemic disease in many low-income and middle-income countries. The 2018 WHO position paper recommends that countries should consider typhoid vaccination in high-risk groups and for outbreak control. To address the typhoid vaccine supply and demand gap, a typhoid Vi polysaccharide-diphtheria toxoid (Vi-DT) conjugate vaccine development effort was undertaken to achieve WHO prequalification and contribute to the global supply of typhoid conjugate vaccine. The main aim of this study was to show immune non-inferiority of the Vi-DT vaccine compared with the WHO prequalified Vi polysaccharide-tetanus toxoid (Vi-TT) conjugate vaccine (Typbar TCV; Bharat Biotech India, Hyderabad, India) in participants of various ages from an endemic country. Methods We did an observer-blind, active-controlled, randomised, non-inferiority, phase 3 trial at four hospitals in Kathmandu, Dhulikhel, Dharan, and Nepalgunj in Nepal. Eligible participants were healthy individuals aged 6 months to 45 years for whom informed consent was obtained, were willing to follow the study procedures and were available for the duration of the study. Patients with an acute or chronic illness that could interfere with interpretation of the study endpoints, or who were involved in any other clinical trial were excluded. Participants were randomly assigned (1:1:1:1) by block randomisation (block size of four and eight), stratified by age (6 months to <2 years, 2 years to <18 years, and 18 years to 45 years), into one of four groups (A-D). Participants in groups A-C received a single dose (25 μg; 0•5 mL) of Vi-DT test vaccine via intramuscular injection from one of three good manufacturing practice lots (group A received lot 1, group B received lot 2, and group C received lot 3), and those in group D received a single dose (25 μg; 0•5 mL) of the Vi-TT vaccine via intramuscular injection. All participants, site staff (except for those who administered the study vaccines), and those assessing the outcomes were masked to group assignment. The co-primary endpoints were: (1) non-inferiority of immunogenicity of the Vi-DT vaccine (pooled groups A-C) versus the Vi-TT vaccine (group D), measured by the anti-Vi IgG seroconversion rate at 4 weeks after vaccination; and(2) the lot-to-lot consistency of the Vi-DT vaccine, measured by immune equivalence of the anti-Vi IgG geometric mean titre (GMT) at 4 weeks after receipt of the three Vi-DT vaccine lots (lot 1 vs lot 2, lot 1 vs lot 3, and lot 2 vs lot 3). Non-inferiority of the Vi-DT vaccine compared with the Vi-TT vaccine was shown if the lower limit of the 97•5% CI for the difference between the seroconversion rates in Vi-DT vaccine groups A-C combined versus Vi-TT vaccine group D was above the predefined non-inferiority margin of -10%. Lot-to-lot immune equivalence was shown if the upper and lower bounds of the two-sided 99•17% CI around the GMT ratio for each pairwise lot-to-lot comparison was between 0•67 and 1•50, which is the predefined equivalence margin recommended by WHO. The co-pri...

Introduction: With the development of advanced technologies in neonatal intensive care worldwide, survival rates of newborns, particularly low birth weight and premature babies are higher. This has led to longer duration of hospital stay predisposing these babies to hospital-acquired infections (HAIs). Hence it is one of the main cause of morbidity and mortality in the neonatal intensive care unit (NICU).