Background: Neonatal sepsis is one of the major causes of neonatal morbidity and mortality in developing countries like Nepal. In order to lower the morbidity and mortality of newborns in Neonatal Intensive Care Unit (NICU), it is essential to study the bacteriological profile and antibiotic sensitivity. Objective: This study aims to study the common bacteriological profile and their antibiotics susceptibility pattern in the NICU of medical college of western Nepal. Methodology: A descriptive cross-sectional study was conducted in NICU of Devdaha Medical College and Research Institute, Nepal among all blood culture positive neonates admitted between April 2020 to September 2020. Convenient sampling was done. All clinically suspected neonates were identified and laboratory data including bacteriological profile and antibiotic sensitivity were recorded and analyzed using Statistical Package for the Social Sciences (SPSS) version 20. Results: Among 215 neonates admitted in the NICU, 45 (20.9%) had culture positive sepsis. Most isolates were early onset sepsis (62.22%) and low birth weight (57.78%). The majority of isolates were Gram positive, predominantly Staphylococcus aureus (37.78%). Staphylococcus aureus showed higher resistance to Cloxacillin (57.1%) and had higher sensitivity to Vancomycin and Linezolid (100%). Similarly, Gram negative isolates, Escherichia coli and Klebsiella sps, showed higher resistance to Ceftriaxone (100%) and Cefoperazone and were highly sensitive to Imipenem (100%) and Colistin (100%). Conclusion: Staphylococcus aureus was the most common organism causing neonatal sepsis in current study with increasing resistance to commonly used Cloxacillin and Ampicillin and highly sensitive to Vancomycin and Linezolid. There is higher risk of emergence of antibiotic resistance. Thus, rational use of empirical antibiotics is necessary to prevent drug resistant sepsis.

Background: As documented in many studies, anterior shoulder dislocation can be effectively immobilized in both external and internal rotation positions, with favorable outcomes. However, controversy exists about the superiority of the technique of immobilization to achieve the reduced rate of redislocation. We conducted this study to assess the functional outcome of immobilization of shoulder in external rotation position after relocation in patients with acute anterior shoulder dislocation. Methods: This is hospital based cross-sectional study in total of 36 patients of primary anterior dislocation of shoulder. They were managed with closed reduction and immobilization in external rotation position and followed up for up to twelve months. Functional outcome (including re-dislocation rate) during each follow-up visit was assessed by using ROWE Score. Results: The mean age of the participants was 29.6±7.9 years (range: 17-44 years). Of them, 89.9% were male; and 55.6% were involved in risky jobs. Similarly, 50% of them sustained injury due to slip and fall, 72.2% presented to the hospital within 12 hours; and 69.4% had their right side involved. All the patients were compliant with treatment regime; 77.8% tolerated the brace well and the redislocation rate was 8.3%. ROWE score was found to be significantly increased between subsequent follow-up visits (p<0.05), except between six months and 12 months (p>0.05). Overall, ROWE score varied significantly across the total follow-up period (p<0.05). Conclusions: Immobilization in external rotation position in traumatic anterior shoulder dislocation was a simple and easy method of conservative treatment with good patient compliance, less incidence of re-dislocation and good functional outcome.