Background: Autism spectrum disorder (ASD) is a neurological disorder which usually appears before the age of 3. Several genetic or environmental factors may be involved in onset of Autism Spectrum Disorder. Objectives: To fi nd relationship of Autism Spectrum Disorder with different maternal factors and events during pregnancy. Methodology: This is a retrospective case control study with total of 104 children of age 3-15 years as a sample, 52 were cases and 52 were controls. The study unit was selected from the database of Autism Care Nepal (ACN) for cases and questionnaire was designed based on the probable risk factors of Autism Spectrum Disorder from existing literature. Controls were chosen from schools, questionnaire being fi lled by asking questions to the mothers of the child with same age group as the cases, similar socio-economic background and intellectually normal. Results: There were 78.8% males and 21.1% females among cases and 53.8% were male and 46.1% were female among controls which show male predominance among cases. Among various maternal risk factors, the maternal second hand smoking (P value: 0.04) and maternal respiratory tract infection (P value: 0.04) were found to be statistically signifi cant. Regarding neonatal factors, birth asphyxia (P value: 0.003), delayed cry (P value: 0.000) and neonatal jaundice (P value: 0.05) were found to be statistically signifi cant. Conclusion: We found association of maternal second hand smoking, respiratory tract infection and among neonatal factors, birth asphyxia, delayed cry and neonatal jaundice to be associated with Autism Spectrum Disorder.

Scrub typhus is a rickettsial zoonosis caused by Orientia tsutsugamushi which can cause focal or disseminated vasculitis & perivasculitis in various body systems. It is endemic in many parts of Nepal & has been neglected & under-detected. We clinically assessed six patients from a intensive care unit in a tertiary hospital in Nepal that tested positive for scrub typhus using IgM ELISA & analyzed their profiles. Out of six patients, three were male & three were female with a mean age of 44.6 years. All six patients had chief complaints of fever & myalgia. Four patients presented with eschar. Three patients presented with septic shock while one presented with septicemia and meningoencephalitis. Only one patient had elevated white cell counts. Four out of six patients had transaminitis. Thrombocytopenia was present in two patients. Hypoalbuminemia was present in three patients. All cases tested negative for dengue, malaria, brucella, Leptospira, leishmania, salmonella & tuberculosis. This study points out the need for raising the index of suspicion & early screening of scrub typhus in patients with fever & laboratory findings of liver dysfunction or thrombocytopenia even with normal white cell counts.