Background Meningitis is a serious infection. Little is known about the bacterial agents and their antibacterial sensitivity in Nepalese children. Objectives To study bacteriological agents, clinical profile and immediate outcome in patients admitted to children’s ward of Patan Hospital with meningitis. Methods Prospective observational study conducted in paediatric ward of Patan Hospital. All the children admitted to the ward, with the diagnosis of culture proven bacterial meningitis’ on discharge were eligible. Results Out of 7,751 children, 296 (3.8%) had meningitis. This was a group ranging from neonates to adolescents aged 18 years. Only 13 (4.4%) of cerebrospinal fluid samples taken from them yielded positive culture reports. The organisms were pneumococcus (6), Haemophilus influenza ‘b’ (3), ?-hemolytic Streptococcus (1), ?-hemolytic Streptococcus (1), N. meningitides (1) and Pseudomonas (1). Whereas Haemophilus influenza ‘b’ was isolated from young infants, pneumococci were found in the young as well as the old. Fever, vomiting, high leukocyte count with left shift were all commonly present. All but one had cerebrospinal fluid pleocytosis. Low sugar and high protein was found in most specimens. Neuroimaging was done in six children of which three were abnormal (all young infants and pneumococci cases). Ceftriaxone was given to all but one child. Everybody recovered but three had complications – profound hearing loss and cortical atrophy with subdural collection in pneumococcal and septic arthritis with persistence of fever in Haemophilus influenzae ‘b’ meningitis. Conclusion The present study corroborates most of the epidemiological and clinical features of acute bacterial meningitis and sheds light on the causative agents of bacterial meningitis in Nepalese children. http://dx.doi.org/10.3126/kumj.v9i1.6260 Kathmandu Univ Med J 2011;9(1):36-40

Introduction: Postgraduate specialization is perceived as essential for success with high competition for enrolment. The reasons how medical students choose their postgraduate specialty are complex. Understanding the factors that influence career choice helps in workforce planning. So, we tried to identify the specialty preferred by postgraduate students and the factors that influenced these choices in a post graduate institution.Methods: A cross-sectional observational study was conducted in National Academy of Medical Sciences. All the postgraduate students of batch 2011 AD were enrolled for the study. The responses were rated on a five point Likert scale.Results: Significant gender preference was observed in specialties. General Surgery, Internal Medicine and Orthopedics were chosen by male students (P-Values, respectively, 0.001, 0.033 and 0.000) while Obstetrics and Gynecology and Ophthalmology being chosen by female students (P-Values, respectively, 0.000 and 0.006). Significant difference was observed between male and female student responses to the factor – scope in future (P – value 0.042), between married and unmarried students to the factor – workload flexibility (P – value 0.011), students who tried to go abroad versus who didn’t, for the factor – Illness of self/family/friend (P – value 0.016), and between those who worked in rural area versus those who didn’t, to the factor – Influence of friends/ seniors (P – value 0.038).Conclusions: Various factors affect the choices for preferred specialty. Policy makers should look at the needs of the nation, and ensure that specialty postgraduate education programs reflect those needs. Keywords: career choices; likert scale; medical education; postgraduate specialty. | PubMed