Introduction: The unmet need for family planning is a very useful tool in measuring and predicting the contraceptive needs of a population. Seventeen percent of all married women would prefer to avoid pregnancy but are not using any form of family planning. In less developed countries, about one forth of pregnancies is unintended. Objective: To determine the level of unmet need for family planning and evaluate the factors that influences the unmet needs in Married Women of Reproductive Age (MRWA). Methods: A cross-sectional study of 410 women attending the immunization clinic of B.P.Koirala Institute of Health Sciences, a teaching hospital in Dharan was carried out over 3 months. Results: MRWA had 22%, 15% and 8% unmet needs for family planning, spacing and limiting births respectively. Health concerns and side effects (30.5%), husband and family opposition (14%), uncertainty about child bearing (12.2%) and inconvenience (10%) were among the major constraints to the use of contraception. Unmet need has significant association between parity & education. Age and family type had no significant effect on unmet needs. Conclusion: In spite of high level of awareness about family planning method, a significant level of unmet need exists among women of reproductive age.

Background: Preterm deliveries of babies weighing less than 1500 grams (VLBW, very low birth weight) are of major concern because of maximum perinatal morbidity and mortality found in this group. VLBW babies overload the neonatal intensive care unit (NICU) and their mortality contributes significantly to neonatal and infant mortality. Objectives: To study the common maternal risk factors associated with VLBW births. To study the morbidity and mortality patterns of VLBW babies. Methods: This was a hospital based retrospective study done in NICU of BP Koirala Institute of Health Sciences. Data were collected from medical records of VLBW babies admitted in NICU over a period of three years (13 April 2005 to 12 April 2008). Data were analyzed with SPSS 10.0 software. Results: Data of 140 VLBW babies were analyzed. Mean birth weight was 1188.9 (±212.78), 10.7% were home deliveries, 24.3% were twins, 31.4% required active resuscitation at birth and 46.4% were exposed to antenatal steroid. Common maternal risk factors associated with premature deliveries were inadequate antenatal check up (ANC) visits (95.7%), twin pregnancy (24.3%), antepartum hemorrhage (APH, 28.6%), premature rupture of membrane (23.6%), pregnancy induced hypertension (12.9%), bad obstetric history (12.9%) and maternal age less than 20 years (8.6%). Common morbidities among VLBW babies were clinical sepsis (77.1%), non physiological hyperbilirubinemia (73.6%), apnea (48.6%), shock (42.9%), hypoglycemia(39.3%), anemia (29.3%), hyaline membrane disease (HMD, 21.4%), patent ductus arteriosus (15.0%), severe hypothermia (12.1%), culture proven sepsis (15.7%), retinopathy of prematurity (5.7%), and bronchopulmonary dysplasia (3.6%). Overall survival was 54.3% and major causes of death were HMD (51.0%) and sepsis (34.7%). Median durations of hospital stay were 17.5 days for survivors and five days for expired cases.Conclusion: Increasing the coverage of ANC visits, early diagnosis and treatment of APH and pregnancy induced hypertension, discouraging the childbirth at too young age, early diagnosis and treatment of acute infections and chronic medical diseases in mothers are important measures to decrease the burden of VLBW births. Common morbidities in VLBW babies are sepsis, HMD, apnea, hyperbilirubinemia, patent ductus arteriosus, shock, anemia, hypoglycemia, hypothermia and hypocalcemia. Common causes death of VLBW babies are HMD and sepsis. Overall survival of VLBW babies in our settings is less. More numbers of well equipped NICUs and services like surfactant therapy are needed to improve survival of VLBW infants in our set up. Key words: Maternal risk factors, Morbidity, Mortality, Very low birth weight.   doi: 10.3126/jnps.v29i2.2040 J. Nepal Paediatr. Soc. Vol 29, No. 2, pp.59-66

Background: Cheiloscopy is a forensic investigation technique that deals with the identification based on lip traces. Based upon the research, it was established that the arrangement of lines on the red part of human lips is unique for each human being. Objectives: To analyze and compare quadrant wise and sex wise predilection of lip print pattern. Methods: A total of 200 (18-25 years) Nepalese undergraduate students of BPKIHS were selected. Thin layer of lip-stick was applied on the lips of these sub-jects. The hinged por-tion of a folded paper was inserted between the lips and the sub-jects were asked to press their lips onto it. Only middle 10 mm of both upper and lower lips were taken as study area. The lip prints, thus obtained were stud-ied on the basis of Tsuchihashi's classification. Chi square test was used to analyze and compare the lip print patterns in all the quadrants of males and females, with the level of significance p<0.05. Results: Type I pattern was predominant in all the four quadrants among males (62%, 56%, 54%, 57% in first, second, third and fourth quadrants respectively). In female also type I was predominant in 2 nd , 3 rd and 4 th quadrant (40%, 45%, 51% respectively) whereas in 1 st( right upper) quadrant type II pattern was predominant (37%). Conclusion: Lip print pattern can be used as an additional tool for personal identification and sex determination. Further work on the subject can help to make cheiloscopy a practical reality in the forensic identification process.

BackgroundUrinary screening tests for early detection of renal diseases in asymptomatic school children and adolescents are important in the detection of silent renal diseases.ObjectivesThe purpose of the study was to determine the prevalence of occult renal diseases by dipstick test (reagent strips) in asymptomatic Nepalese children.Patients and MethodsA total of 2,243 school children, aged 5–15 years, were screened for urinary abnormalities using dipstick test screening. The children who tested positive in the first screening were re-tested after 2–4 weeks.ResultsIn the first screening, 123 children (5.5%) tested positive for isolated hematuria and proteinuria and for combined hematuria and proteinuria. Of these children, 16 (0.71%) cases tested positive in a second screening. Subsequently, 1 child from the secondary screening group was lost to follow up, 5 tested normal and 10 revealed abnormalities. Glomerulonephritis was the most commonly detected disorder (50%).ConclusionsUrinary screening was found to be useful in identifying occult renal diseases in asymptomatic children. Urinary screening would therefore not only help in early detection but also in the prevention of the deterioration of renal function later in life.

Objectives: The present study was undertaken to study the incidence, etiological factor, and days of onset, clinical types and biochemical abnormalities in babies having neonatal seizures. Materials and Methods: This is a retrospective, observational hospital based study. Ninety neonates, who developed seizures before 28 days of life and admitted to neonatal intensive care unit and nursery with neonatal seizure, were evaluated for incidence, etiological factor, clinical types and biochemical abnormalities found in neonatal seizure. The variables were analysed using Chi-Square and student t-test. Results: The incidence of neonatal seizure was 10.3/ 1000 live births. The seizures were common in male babies. 65 (72.2%) neonates were born to multiparous women while 35 (38%) were born to primigravidas. In birth asphyxia (n= 40), the most common type of seizure observed was subtle seizure 20 (50%), followed by focal clonic 10 (25%) and multifocal clonic 5 (12.5%). Tonic type of seizure was observed in 3 (7.5%) and myoclonic in 2 (5%). Meningitis and septicaemia was the second most common cause of neonatal seizure observed in our study. Among metabolic abnormalities hypoglycaemia was found in 20 (22%) and hypocalcaemia in 10 (11%). Conclusion: The commonest cause of seizure was birth asphyxia presenting within 72 hours of life. Among infection septicaemia and meningitis was the most common cause leading to neonatal seizure. Among biochemical abnormalities the most common cause of seizure observed in our study was hypoglycaemia and hypocalcaemia. Subtle seizures were the commonest type of seizure observed in this study.