The features of hospital wastewater (HWW) are identical to domestic wastewater in general, but a subset of HWW includes toxic, nonbiodegradable, infectious contaminants. The hospital effluents include a wide range of chemicals utilized in medical, laboratory, and study settings, as well as patient excreta. Antibiotics, lipid inhibitors, among other medications and their metabolites are among the wastes. This book will help in understanding through the case studies from around the globe how to deal with HWW effectively, as well as help Governments to modify laws relating to it.ISBN: 9781789062618 (paperback)ISBN: 9781789062625 (eBook)ISBN: 9781789062632 (ePUB)
Introduction: Many sick neonates admitted to neonatal intensive care unit (NICU) require mechanical ventilation but it is associated with various complications and the outcome of neonates is unpredictable. This study aims to identify the indications for mechanical ventilation, complications, co-morbid conditions and outcome of those neonates in terms of survival.Materials and Methods: Retrospective observational study of all neonates who underwent mechanical ventilation from 1 January 2014 to 31 December 2014 in NICU, Tribhuvan University Teaching Hospital. Medical records of the patients were retrieved from hospital record section to collect the relevant data.Results: One-third of admitted neonates in NICU required mechanical ventilation (MV). Commonest indication was severe respiratory distress (70%) followed by perinatal asphyxia (12%) and recurrent apnea (8%). Disease pattern were sepsis (37.2%), RDS of prematurity (17.6%), perinatal asphyxia (11.7%), meconium aspiration syndrome (9.8%), apnea of prematurity (7.8%) and congenital pneumonia (4%). Hospital acquired sepsis was a major complication occurring in 47% patients on mechanical ventilation. Survival rate among neonates on MV was 33%. Survival was better with increasing birth weight and gestational age. Survival was 100% in congenital pneumonia, 50% in perinatal asphyxia, 50% in recurrent apnea, 26% in sepsis, 20% in MAS and 0% in RDS of prematurity.Conclusion: Survival rate of neonates on mechanical ventilation in NICU was 33%. Sepsis was a major problem in NICU, which must be addressed to improve outcome.J Nepal Paediatr Soc 2015; 35(3): 218-223.
Chest X-Ray findings of unilateral lung or lobar collapse with a shift of mediastinal shift towards the affectedside may prompt differential diagnoses of suspected foreign body aspiration, mucus plug occlusion, andbronchial mass lesions. We must also consider the rare condition of pulmonary agenesis. It is one of therare congenital abnormalities in the development of the lungs in which there is complete absence of alung. We report a three month old child with right sided pulmonary aplasia.Key words: Agenesis lung; pulmonary aplasia; congenital abnormalityDOI: 10.3126/jnps.v30i2.2645J. Nepal Paediatr. Soc. May-August, 2010 Vol 30(2) 116-118
The relationship between corporate culture and organizational performance is intricate and influential. Corporate culture encompasses shared values, beliefs and behaviours within a company, shaping its identity. A positive and aligned culture can enhance employee engagement, teamwork, and innovation, ultimately driving organizational success. Effective leadership plays a pivotal role in cultivating a healthy corporate culture, fostering employee satisfaction and commitment. Organisations that prioritize a cohesive and positive culture often experience improved productivity, adaptability, and long-term viability in the competitive business landscape. Understanding and nurturing the interplay between corporate culture and orgainsational performance is crucial for sustained success. However the study discovered that researches on the subject matter remain inconclusive as there are various variables of culture that are yet to be fully explored in research. Therefore, the study recommended that management of organisation should endeavour to establish an acceptable and well appreciated culture by members in order to enhance continuous success and development.
Introduction: Preterm birth is a major determinant of neonatal mortality and morbidity and has long-term adverse consequences for health. The objectives of this study were to find the demographic characteristics and clinical course of preterm babies admitted at Neonatal Unit of TU Teaching Hospital. Materials and Methods: A retrospective study was done by collecting data from labour room, NICU and by reviewing medical records of all preterm babies admitted to NICU in 2011. Results: There were total of 266 preterm deliveries in TUTH in the year 2011. About 45% of them required NICU admission. Ninety five babies were included in the study. Most common cause of premature delivery was maternal pregnancy induced hypertension (26%). Other causes were preterm premature rupture of membrane (24%) and in 25% of cases the cause was unknown. There were 10 (10.5%) severe preterm babies with mean weight 1.4 ± 0.3 kg, 27 (28.5 %) moderate preterm babies with mean weight 1.8 ± 0.4 kg and 58 (61%) late preterm babies with mean weight 2.2 ± 0.5 kg. Respiratory distress syndrome (RDS) was seen in 32% babies, hyperbilirubinemia in 40% babies, sepsis occurred in 37% and NEC in 4%. Hypothermia was seen in 10.5% and hypoglycemia in 5% babies. Apnea of prematurity was seen in 7% babies. Mechanical ventilation was required in 7% babies. The overall mortality was 12%. The main causes of death were respiratory distress syndrome and sepsis. The mean duration of stay was 10.2±8.8days. The survival rate of severe preterm babies was 80%, moderate preterm babies was 78% while that of late preterm was 95%. Conclusion: The main causes of morbidities in preterm babies were respiratory distress, hyperbilirubinemia and sepsis. Respiratory distress syndrome and sepsis were the predominant causes of mortality in these babies.DOI: http://dx.doi.org/10.3126/jnps.v33i3.9200 J. Nepal Paediatr. Soc. 2013;33(3):201-205
BACKGROUND Respiratory syncytial virus (RSV) infection is an important cause of hospitalization and death in young children. The majority of deaths (99%) occur in low- and lower-middle-income countries (LMICs). Vaccines against RSV infection are underway. To obtain access to RSV interventions, LMICs depend on support from Gavi, the Vaccine Alliance. To identify future vaccine target populations, information on children with severe RSV infection is required. However, there is a lack of individual patient-level clinical data on instances of life-threatening RSV infection in LMICs. The RSV GOLD III-ICU Network study aims to describe clinical, demographic and socioeconomic characteristics of children with life-threatening RSV infection in Gavi-eligible countries. METHODS The RSV GOLD-III-ICU Network study is an international, prospective, observational multicenter study and will be conducted in 10 Gavi-eligible countries at pediatric intensive care units and high-dependency units (PICUs/HDUs) during local viral respiratory seasons for 2 years. Children younger than 2 years of age with respiratory symptoms fulfilling the World Health Organization (WHO) extended severe acute respiratory infection (SARI) case definition will be tested for RSV using a molecular point-of-care (POC) diagnostic device. Patient characteristics will be collected through a questionnaire. Mortality rates of children admitted to the PICU and/or HDU will be calculated. DISCUSSION This multicenter descriptive study will provide a better understanding of the characteristics and mortality rates of children younger than 2 years with RSV infection admitted to the PICU/HDU in LMICs. These results will contribute to knowledge on global disease burden and awareness of RSV and will directly guide decision makers in their efforts to implement future RSV prevention strategies. TRIAL REGISTRATION NUMBER NL9519, May 27, 2021.
Kikuchi-Fujimoto Disease (KFD) is a rare benign, condition of necrotising histiocytic lymphadenitis. In this case report, we discuss a case of 10 year old male patient who presented with a fever, rash and generalised lymphadenopathy that was not attributable to the more common causes. Axillary lymph node biopsy confirmed the diagnosis of KFD. Treatment with prednisolone improved his symptoms but after six months he had recurrence of his symptoms. He was investigated again and finally met diagnostic criteria for SLE. This case report highlights importance of close follow up in a child with KFD.
Abstract The features of hospital wastewater (HWW) are identical to domestic wastewater in general, but a subset of HWW includes toxic, nonbiodegradable, infectious contaminants. The hospital effluents include a wide range of chemicals utilized in medical, laboratory, and study settings, as well as patient excreta. Antibiotics, lipid inhibitors, among other medications and their metabolites are among the wastes. This book will help in understanding through the case studies from around the globe how to deal with HWW effectively, as well as help Governments to modify laws relating to it. ISBN: 9781789062618 (paperback) ISBN: 9781789062625 (eBook) ISBN: 9781789062632 (ePUB)
Abstract Background Respiratory syncytial virus (RSV) infection is an important cause of hospitalization and death in young children. The majority of deaths (99%) occur in low- and lower-middle-income countries (LMICs). Vaccines against RSV infection are underway. To obtain access to RSV interventions, LMICs depend on support from Gavi, the Vaccine Alliance. To identify future vaccine target populations, information on children with severe RSV infection is required. However, there is a lack of individual patient-level clinical data on instances of life-threatening RSV infection in LMICs. The RSV GOLD III—ICU Network study aims to describe clinical, demographic and socioeconomic characteristics of children with life-threatening RSV infection in Gavi-eligible countries. Methods The RSV GOLD-III—ICU Network study is an international, prospective, observational multicenter study and will be conducted in 10 Gavi-eligible countries at pediatric intensive care units and high-dependency units (PICUs/HDUs) during local viral respiratory seasons for 2 years. Children younger than 2 years of age with respiratory symptoms fulfilling the World Health Organization (WHO) “extended severe acute respiratory infection (SARI)” case definition will be tested for RSV using a molecular point-of-care (POC) diagnostic device. Patient characteristics will be collected through a questionnaire. Mortality rates of children admitted to the PICU and/or HDU will be calculated. Discussion This multicenter descriptive study will provide a better understanding of the characteristics and mortality rates of children younger than 2 years with RSV infection admitted to the PICU/HDU in LMICs. These results will contribute to knowledge on global disease burden and awareness of RSV and will directly guide decision makers in their efforts to implement future RSV prevention strategies. Trial registration number: NL9519, May 27, 2021
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