Background: Child rearing practices and family environment determine the health of newborn. Harmful newborn care practices are the risk factors for late onset neonatal sepsis. The objective was to identify newborn practices related to breast feeding, cord care, hygiene of newborn and thermal care practice at home of admitted neonates with diagnosis Late Onset Neonatal Sepsis in pediatric unit of B.P. Koirala Institute of Health Sciences tertiary center in eastern Nepal.Methods: Descriptive cross sectional study was carried out from December 2014 to January 2015 using consecutive sampling. Semi structured, pretested questionnaire was used to interview 40 mothers. Data were analyzed using SPSS 20, descriptive and inferential statistics were used.Results: Initiation of breastfeeding within one hour of delivery was practiced by only 40% of mother. Among neonates, 65% were given colostrum, 25% were given pre lacteal feed, and 45% were given formula milk and animal milk. Mustard oil was used to care umbilical cord by 72.5 %. Hand washing was practiced by 62.5 % before touching the baby. Application of kajal (52.5%) in eyes and use of mustard oil (95%) for massaging newborn was common. For thermal care, burning charcoal (75%) was mostly used. The study revealed association between newborn care and mother education, per capita income of family and family type (p =0.012, p= 0.012, p=0.039) respectively. Conclusions: Majority of practices in breast feeding and thermal care were good however in cord care and newborn hygiene practices was poor which stresses the need for the promotion of health education program to mothers by health care facilities. Keywords: LONS; newborn care; practice

More travellers are making swift ascents to higher altitudes without sufficient acclimatization or pharmaceutical prophylaxis as road connectivity develops in the Himalayan region of Nepal. Our study connects ascent rate with prevalence and severity of acute mountain sickness (AMS) among patients admitted to the emergency ward of the Mustang district hospital in Nepal. A register-based, cross-sectional study was conducted between June 2018 and June 2019 to explore associations of Lake Louise scores with ascent profile, sociodemographic characteristics, and comorbidities using chi-square test, t-test, and Bayesian logistic regression. Of 105 patients, incidence of AMS was 74%, of which 61%, 36%, and 3% were mild, moderate, and severe cases, respectively. In the Bayesian-ordered logistic model of AMS severity, ascent rate (odds ratio 3.13) and smoking (odds ratio 0.16) were significant at a 99% credible interval. Based on the model-derived counterfactual, the risk of developing moderate or severe AMS for a middle-aged, non-smoking male traveling from Pokhara to Muktinath (2978m altitude gain) in a single day is twice that of making the ascent in three days. Ascent rate was strongly associated with the likelihood of developing severe AMS among travellers with AMS symptoms visiting Mustang Hospital’s Emergency Ward.

Introduction: Heel prick is one of the commonest procedures carried out in the hospitalised newborns. Pain is a subjective experience for which the neonates, infants and children respond with behavioural reactions. Applying hot pack to the skin surface causes proximal blood vessels to dilate due to the raised temperature which may decrease the pain perception in neonates. We intended to study the effect of heel warming during heel prick in perception of pain in neonates. Method: An experimental study was conducted among neonates admitted in paediatric wards of BPKIHS. Total 92 participants undergoing heel prick/stick were selected by consecutive sampling technique and allocated randomly to experimental group and control group. Warmer was applied to the heel of the baby for three to five minutes which provided the baby’s heel with the warmth of 38°C to 40°C prior to heel stick in experimental group only. Newborn’s pain level was assessed in both experimental and control group through The Neonatal Infant Pain Scale (NIPS). Mann Whitney test was used to compare means of pain score between experimental and control groups. Results: The mean pain score among experimental group was 1.39 and in control group was 2.20. Experimental group showed significantly lower pain (p < 0.001) compared to the control group. Application of warmth before heel stick caused reduction in pain. Conclusions: The findings suggest that heat application prior to heel stick is effective in reducing pain in newborns.

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Background Vaccination is the most effective method to prevent the spread of infectious diseases and helps reduce mortality rate and economic costs associated with the pandemic. Despite these advantages, misinformation on vaccine safety and efficacy can lead to increased hesitation towards vaccination. This study reports the incidence of adverse events following Covishield vaccination, their associated factors, medication used for their management, and attitudes about vaccine safety. Methods A cross-sectional study was conducted from the sample of Covishield-vaccinated individuals from a secondary hospital, two primary health centres, and 36 health posts in eastern Nepal. Individuals (n = 602) were randomly sampled from a population (n = 1013) who had received the first dose of Covishield, namely frontline workers and other high-risk populations. The second-round follow-up had 516 participants. Association of incidence and severity of post-vaccination events with socio-demographic variables, comorbidity status, and medication use were estimated. Results Among the 79.9% of participants who reported adverse events after receiving the first dose, two-thirds of complaints were mild (67.4%, 95% CI 63.2–71.6) with the most common complaint being pain at the injection site (86.5%). Paracetamol or its combination with NSAIDs were used in the majority of cases (95.2%). After the second dose, only 31.2% (95% CI 27.2–35.2) reported adverse events, the overwhelming majority of which were mild (95.7%) and required a lower frequency of medication (7.5% vs. 26.0%). Adverse event following immunization were significantly associated with being 18–30 years old (χ2 = 16.9, df = 3, p < 0.001) and female gender (χ2 = 5.2, df = 1, p < 0.05). Prior to the first dose, 86.0% of participants (95% CI 83.3–88.8%) perceived the vaccine to be safe, and 96.0% recommended the vaccine post-vaccination, while 96.8% were interested in receiving the second dose. AEFI severity was negatively associated with vaccine recommendation to the peers (odds-ratio 0.062, p < 0.05) following the first dose, whereas, the optimistic pre-vaccination perception was associated with positive vaccine recommendation post-vaccination (odds-ratio 28.658, p < 0.01). Conclusions Overall, vaccination-associated events were mild and majority were managed with paracetamol or its combination. Effective counselling about adverse events before vaccination should be prioritized to reduce hesitation and fear.