Background: Birth asphyxia is one of the important causes of neonatal morbidity and mortality, accounting up to 30% of neonatal death in Nepal. It is also an important cause of long term neurological disability and impairment. Thompson encephalopathy score is a clinical score which can be used to assess the newborn with hypoxic ischemic encephalopathy for the prognosis and their neurodevelopmental outcome. The aim of the study was to assess the role of Thompson score in predicting the early outcome of neonates with birth asphyxia. Methods: A prospective study was conducted from May 2019 to April 2020 in Nepal Medical College. All the term babies during the period with Apgar score of less than seven at five minutes were considered to have birth asphyxia and included in the study. Neurological examination was done on first, second and third day using HIE score proposed by Thompson and severity of hypoxic ischemic encephalopathy was classified accordingly. Outcome was measured as normal, morbidity with encephalopathy, seizure, organ dysfunction and death. Results: Out of 391 newborn admitted to neonatal unit, 84 (21.4%) had birth asphyxia. Mild Thompson score on day 1,2,3 were 49(58.3%), 49 (58.3%), 51(60.7%); moderate Thompson score on day 1,2,3 were 21 (25%), 21 (25%), 18(21.4%) and severe Thompson score on day 1, 2, 3 were 14 (16.7%), 14 (16.7%), 15(17.9%) respectively. Out of 14 babies who had severe Thompson score on day 1, 11(91.7%) expired and 3 (16.7%) developed encephalopathy. Conclusions: There was strong correlation of severity of Thompson score with the outcome. Keywords: Birth asphyxia; hypoxic ischemic encephalopathy; thompson score

Bacterial endocarditis in neonates is a rare. Generally neonates who develop endocarditis have required the invasive intensive care monitoring necessary for the support and treatment of a high-risk nursery population.  Neonatal Infective endocarditis is usually reported as a fatal disease. With early diagnosis and treatment we can change prognosis to better side.

Various scoring system have been developed and are becoming essential part of Pediatric and other critical care units. The Pediatric department wants to introduce Pediatric Index of Mortality-2 (PIM 2) as a predictive scoring system in Pediatric critical care unit of Nepal Medical College Teaching Hospital (NMCTH). This was a prospective cohort study done in Pediatric Intensive Care Unit (PICU) of NMCTH. Study was done from August 2017 to December 2018. All cases admitted in ICU were taken consecutively from term newborn to 14 yrs of age. PIM 2 scoring system was done in all patients. PIM 2 performed well in terms of discrimination with area under curve for PIM 2 scor e was 0.809 with 95% Confidence Interval of 0.0709 to 0.910 and Standard Error of 0.051. Good calibration was observed across deciles of risk as measured by Hosmer-Lemeshow goodness of fit test with P value of 0.163, chi-square value of 11.752 (8). Mortality observed in our PICU was 28.4% with standardized mortality ratio of 1. PIM 2 scoring system performed well in our PICU.

Background: Hyperbilirubinemia is a common problem in neonates. Phototherapy and exchange transfusion are the primary treatment modalities. Less known, but one of the potential complications of phototherapy is hypocalcemia. Most of the neonates with hypocalcemia are asymptomatic. Though asymptomatic, treatment should be initiated immediately when serum calcium level is reduced. This study was conducted to detect the incidence of hypocalcemia in jaundiced neonates receiving phototherapy.Methods: It is a hospital-based cross-sectional study conducted from May 2020 to December 2020 in the neonatal intensive care unit of Nepal Medical College Teaching Hospital. A total of 128 full-term neonates with jaundice and a normal serum calcium level before initiating phototherapy were enrolled in the study. Serum calcium level was measured before starting conventional phototherapy and after 48 hours of continuous phototherapy.Results: Hyperbilirubinemia was present in 23.3% of neonates admitted to the neonatal unit. Hypocalcemia was seen in 26 (20.3%) of term jaundiced neonates receiving phototherapy. Signs of hypocalcemia were present only in 3 (2.3%) neonates.Conclusions: Hypocalcemia is a common complication of phototherapy. Serum calcium levels should be monitored in all the full-term neonates receiving phototherapy. Keywords: Hyperbilirubinemia; hypocalcemia; phototherapy