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Dual Antiepileptics Induced Stevens-Johnson Syndrome: A Case Report
(Nepal Medical Association, 2020) Nakarmi, Prami; Raut, Sumit; Manandhar, Siddhartha; Shrestha, Abhash
Abstract: Stevens-Johnson syndrome and Toxic Epidermal Necrolysis are acute mucocutaneous reactions hallmark of which is widespread necrosis and detachment of epidermis. SJS/TEN fall under the single disease spectrum with an incidence rate of 1.0 to 6.0 per 1000000 and 0.4 to 1.2 per 1000000 respectively. Here, we present a case of a 46 years female who developed a generalized erythematous rash over her body, 26 days after being exposed to phenytoin and sodium valproate. Given the strong association between SJS and antiepileptic drugs, and the usual presentation being within the first eight weeks of exposure to susceptible medications; we diagnosed her with SJS. Phenytoin and sodium valproate was withdrawn and she was managed with antihistamines and corticosteroids. She improved significantly within 15 days of our intervention. The mortality rates for SJS and TEN are up to 10% and 30-50% respectively. Early identification of SJS, discontinuation of triggering medicines, and prompt initiation of supportive therapy improve the prognosis.
Knuckle Pigmentation as an Early Cutaneous Sign of Vitamin B12 Deficiency: A Case Report
(Nepal Medical Association, 2020) Srivastava, Ankita; Choudhary, Sanjiv
Abstracts: Vitamin B12 deficiency can present with variable hematological, neuropsychiatric, and mucocutaneous changes. Hyperpigmentation, specifically involving the knuckles has been described in vitamin B12 deficiency, but usually,these patients are symptomatic with systemic manifestations like megaloblastic anemia, pancytopenia, or neurological deficits. Here, we are reporting a case of nutritional vitamin B12 deficiency, who presented with isolated knuckle pigmentation and was successfully treated with oral therapy. This case also highlights the importance of recognizing this cutaneous sign as an early marker of vitamin B12 deficiency; thereby enabling the clinician to treat the disease before it leads to irreversible neurological complications.
Medical Induction for Mid trimester Abortion: A Hospital-based Descriptive Cross-sectional Study
(Nepal Medical Association, 2020) Sharma, Jyotshna; Tiwari, Sanjeeb; Pokhrel, Manoj; Lama, Lhakpa
Abstract: Introduction: Second trimester abortion is known as termination of pregnancy from 13- 28 weeks of gestation which can be further divided into early second trimester as 13-22 weeks and late as 23-28 weeks. In our study we have limited up to early second trimester. We intend to see the success rate of combination of mifepristone and misoprostol for medical induction, median time required for expulsion, complication and need of dilation and evacuation in some cases. This study also aims to give a review of current literature in mid trimester abortion with respect to efficacy, complication and also to provide evidencebase recommendation for safe regimens for mid trimester pregnancy termination. Methods: This was hospital-based descriptive cross-sectional study conducted among 40 pregnant women at second trimester admitted for termination of pregnancy in Kathmandu medical collage teaching hospital for the period of six month. Ethical approval was taken from the Institutional Review Committee of Kathmandu Medical College (Ref: 2207202002). Convenient sampling was done. All the pregnant women who need to terminate their pregnancy at second trimester (13-22 weeks) were admitted at Kathmandu Medical College Teaching hospital for termination of pregnancy were included in the study. Results: Among the 40 women, who had termination of pregnancy at second trimester 37 (92.5%) had successful medical termination whereas 3 (7.5%) needed dilatation and evacuation. Conclusions: The combination of Mifepristone and Misoprostol have excellent result for termination of pregnancy if appropriately used after evaluating the patient with minimal complications.
Study of Oxygen Saturation by Pulse Oximetry and Arterial Blood Gas in ICU Patients: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2020) Rauniyar, Nabin; Pujari, Shyam; Shrestha, Pradeep
Abstract: Introduction: Pulse oximetery is expected to be an indirect estimation of arterial oxygen saturation. However, there often are gaps between SpO2 and SaO2. This study aims to study on arterial oxygen saturation measured by pulse oximetry and arterial blood gas among patients admitted in intensive care unit. Methods: It was a hospital-based descriptive cross-sectional study in which 101 patients meeting inclusion criteria were studied. SpO2 and SaO2 were measured simultaneously. MeanÂ±SD of SpO2 and SaO2 with accuracy, sensitivity and specificity were measured. Results: According to SpO2 values, out of 101 patients, 26 (25.7%) were hypoxemic and 75 (74.25%) were nonâ€“hypoxemic. The meanÂ±SD of SaO2 and SpO2 were 93.22Â±7.84% and 92.85Â±6.33% respectively. In 21 patients with SpO2<90%, the meanÂ±SD SaO2 and SpO2 were 91.63Â±4.92 and 87.42Â±2.29 respectively. In 5 patients with SpO2 < 80%, the mean Â± SD of SaO2 and SpO2 were: 63.40Â±3.43 and 71.80Â±4.28, respectively. In nonâ€“hypoxemic group based on SpO2 values, the meanÂ±SD of SpO2 and SaO2 were 95.773Â±2.19% and 95.654Â±3.01%, respectively. The agreement rate of SpO2 and SaO2 was 83.2%, and sensitivity and specificity of PO were 84.6% and 83%, respectively. Conclusions: Pulse Oximetry has high accuracy in estimating oxygen saturation with sp02>90% and can be used instead of arterial blood gas.
Patterns of Rheumatic Heart Disease and Treatment Practices at Tertiary Care Center in Nepal: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2020) Nepal, Rajesh; Bista, Madhab; Dhungana, Sahadeb Prasad
Abstract: Introduction: Rheumatic heart disease is a sequel of rheumatic fever which causes heart valve damage. This study was conducted to look at the pattern of valve lesions and treatment practices in patients with rheumatic heart disease. Methods: A cross-sectional study conducted at the tertiary care center with a diagnosis of rheumatic heart disease from July 2018 to January 2020 by convenient sampling. Ethical clearance was obtained from the Institutional Review Committee (ref no. 55/2018). Data were analyzed by using Statistical package for social sciences version 20. Results: Out of 600 patients, 428 (71.3%) were female. The mean age was 44.24Â±14.24 years. The isolated mitral valve was affected in 280 (46.6%). Dual involvement of mitral and aortic valve was present in 294 (49%). Only 14 (2.3%) had involvement of isolated aortic valve involvement. Overall, mitral stenosis was the most common abnormality 508 (84.6%) followed by mitral regurgitation 418 (69.6%), aortic regurgitation 320 (53.3%), and aortic stenosis 63 (10.5%). Assessment of the severity of lesions showed that 247 (41.2%) patients had severe mitral stenosis, 119 (19.8%) severe mitral regurgitation, 14 (2.3%) severe aortic stenosis, and 11 (1.8%) severe aortic regurgitation. Majority 493 (82.2%) were treated with medical therapies. Surgical procedures were performed in 51 (8.5%). The use of anticoagulation was in 212 (35.3%) of eligible patients. Conclusions: Mitral valve was affected commonly both in isolation and combination. The majority of patients who were eligible for cardiac interventions were treated medically with suboptimal use of anticoagulation and secondary prophylaxis.
Miller Dieker Syndrome as a Cause of Refractory Seizures
(Nepal Paediatric Society (JNPS), 2014) Pati, Sananda; De, Sangita; Nag, Sankha Subhra; Nayek, Kaustav
Abstract Miller-Dieker syndrome is a genetic deletion syndrome characterized by neuronal migration disorder lissencephaly where the exterior of the brain is abnormally smooth with fewer folds and grooves and characteristic facial dysmorphism. A one year old boy born presented to our emergency with severe respiratory distress and recurrent convulsions. A diagnosis of Miller Diecker syndrome was made consistent with typical clinical features and investigations. The child was managed symptomatically, however the seizures remained refractory and the child succumbed on day three of admission. Diagnosis of rare diseases like this is necessary not only for management but also for predicting recurrence in the family and genetic counselling.
Methylmalonic Acidemia – Cause of Recurrent Neonatal Death and Its Social Implications
(Nepal Paediatric Society (JNPS), 2014) Madhavi, Vasikarla; Sharma, Deepak Kumar; Murki, Srinivas; Pratap, Tejo
Abstract: Mr and Mrs R, non-consanguineous couple had history of all their children during neonatal period. First two neonates were normal at birth, then presented with lethargy, vomiting and decreased acceptance of feeds. Both the babies expired after birth without being investigated for cause of death. The third neonate was investigated for inborn error of metabolism and found to be affected with methylmalonic acidemia. The couple departed away inspite of extensive counselling. In the fourth pregnancy antenatally fetus was diagnosed as carrier case of methylmalonic acidemia and short chain fatty acid oxidase deficiency. The fourth baby was normal and was in follow up till one year age.
Left Lung Agenesis with Bicuspid Aortic Valve
(Nepal Paediatric Society (JNPS), 2014) Taran, Shachi Jain; Kumar, Ravindra; Lodha, Manish
Abstract: Agenesis of the lung is an extremely rare congenital anomaly representing failure of development of the primitive lung bud. Here we are presenting a case of left lung agenesis with bicuspid aortic valve in a 17 year old girl who came with the complaints of backache only. The diagnosis was made on the basis of CECT and 2D Echocardiography.
Congenital Tuberculosis
(Nepal Paediatric Society (JNPS), 2014) Chatterjee, Nandita
Abstract: 2 month old baby presented with huge hepato-splenomegaly, ascites & pallor, , born to a mother suffering from fever and backache since last 4 months. Hypo-echoic shadows in liver, spleen and abdominal lymph nodes on USG & CT-scan and acute-on-chronic inflammation of liver by FNAC suggested Congenital Tuberculosis. Investigations in mother revealed Pulmonary Tuberculosis & Caries Spine, confirming the diagnosis of Congenital Tuberculosis in the baby.
Cervical Lymphadenitis Due to Nodular Fasciitis in a Child
(Nepal Paediatric Society (JNPS), 2014) Kanik, Ali; Eliacik, Kayi; Ince, Tolga; Bayol, Umit; Helvacı, Mehmet
Abstract: Nodular fasciitis is a benign, reactive proliferation of fibroblasts in the subcutaneous tissues. It usually affects the trunk and upper extremities, and rarely the head and neck region of young adults. It is rare among children and the histologic findings may incorrectly suggest malignant lesions. We describe a two-year-old girl that referred to our clinic with complaints of fever and swelling on the right side of neck and diagnosed as lymphadenitis clinically. Cervical lymphadenitis due to nodular fasciitis is a rarity. We emphasize that nodular fasciitis needs to be included in the differential diagnoses of neck lymphadenitis during childhood.
Ataxia Telangiectasia: Case Report from a Rural Hospital in Nepal and Current Management Recommendation
(Nepal Paediatric Society (JNPS), 2014) George, Susan Mary; Mathews, MC
Abstract: It is important though challenging to make accurate diagnosis of neurodegenerative conditions in children and initiate the right treatment. A 14 years old boy presented with deterioration in speech, mobility and performance of daily activities and frequent chest infections over four years. Aided ataxic gait, dysarthria, stooped posture, generalised hypotonia and weakness and ocular telangiectasia were noted. We present a case of Ataxia telangiectasia from a rural hospital in Nepal.
Health Co-morbidities and Early Marriage in Women of a Rural Area of Nepal: A Descriptive Cross-Sectional Study
(Nepal Medical Association, 2020) Manandhar, Naresh; Joshi, Sunil Kumar
Abstract: Introduction: Early marriage is defined as the marriage of a young person less than 18 years. Early marriage is more prevalent in South Asia as more than half of all child marriage occurs here. Thirtyseven percent of girls in Nepal marry before age 18 years. This study was done to find out the health consequences of early marriage in women of a rural area of Nepal. Methods: A descriptive cross-sectional study was conducted from 10th to 15th Feb 2020 February in 358 women from Panauti, Kavrepalchowk. The convenient sampling method was used. Ethical approval was taken from the Institutional Review Committee. Economic status was assessed by using Kuppuswamyâ€™s socioeconomic scale. The collected data were analyzed using the Statistical Package for Social Science version 20. Point estimate at 95% confidence interval was calculated along with frequency and proportion for binary data. Results: The prevalence of early marriage was 187 (52.2%) (47.03 to 57.37 at 95% confidence interval). One hundred sixteen (62%) early marriage women had gynecological problems followed by depression problem 85 (45.5%) and miscarriage 32 (17.1%). The mean age of marriage was 17.2 years. The majority, i.e. 167 (89.3%) of respondents who married earlier were Hindu by religion. Early marriage was observed in 104 (55.6 %) of illiterate women. Conclusions: The prevalence of early marriage was high. Early married women had a lower level of socio-economic status, lower level of education, which harmed the participants' health status.
Functional Outcomes of Capitellum Fractures Treated by Open Reduction and Internal Fixation with Herbert Screw: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2020) K.C., Kapil Mani; Acharya, Parimal; Marahatta, Suman Babu; Sigdel, Arun; K C, Amuda; Dahal, Sudip Chandra
Abstract: Introduction: Based on the complex intra-articular nature of capitellum fractures, it has been sometimes difficult to formulate a universally accepted method of surgical treatment. The purpose of this study is to present the functional outcomes of capitellum fractures after fixation with Herbert screw including the safety and tips of the surgical approach. Methods: This descriptive cross-sectional study was done from December 2014 to November 2019. Ethical approval was taken. The study included 22 capitellum fractures treated by open reduction and internal fixation with Herbert screws either lateral or anterolateral approach. Functional outcomes were assessed with Mayo elbow performance index scores at the latest follow-up visit. Convenient sampling was done. Data entry was done using the Statistical Package for the Social Sciences (version16.0). Results: Out of 22 surgeries, the average time to unite the fracture was 11.13Â±1.20 weeks (range 9 to 15). The mean range of movement for flexion and extension was 138.41Â±8.22 degree while the mean supination and pronation range was 161.59Â±6.79 degree. The average time of follow-up in this series was 37.45Â±9.43 weeks (range 22 to 58 weeks). Similarly, the mean Mayo elbow performance index score at the latest follow-up was 90.22Â±8.65 (range 70 to 100). Conclusions: Careful assessment and radiological evaluation, anatomical reduction, and stable fixation with Herbert screws maintaining the minimal damage to the articular cartilage can maximize the functional outcomes and minimize the incidence of complications.
Information about COVID-19 among Selected Population of Eastern Nepal: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2020) Chapagain, Kumud; Rauniyar, Gajendra Prasad; Pokharel, Rais; Bhattarai, Abhisekh
Abstract: Introduction: Rapid spread of COVID-19 has become a major concern worldwide. Strong adherence to preventive measures can help to break the chain of the spread of coronavirus. We conducted this study to find out the extent of information general people of Eastern Nepal have regarding COVID-19 and their attitude and practice towards preventing its spread. Methods: A descriptive cross-sectional online study was done among the people of Eastern Nepal on knowledge, attitude, and practice related to COVID-19 from May 1st to May 15th after obtaining ethical clearance from the ethical review board (ERB) (ref no. 319/2020 P). A 20 item survey instrument was adapted using WHO course materials on an emerging COVID-19. A convenience sample method was used. Data were collected and entered in Statistical Packages for Social Services version 11.5. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Among 1069 respondents, the correct answer on the COVID-19 related knowledge questionnaire was 958 (89.61%), 487 (93.11%) were health professionals, and 471 (86.26%) non-health professionals. Preventive measures were strictly followed by 1044 (97.66%) participants. A wrong perception about the disease was present in 390 (36.48%). Health ministry website 356 (33.30%) followed by news media 309 (29%) was the major source of information among the people. Conclusions: Knowledge regarding COVID-19 among people the selected population of eastern is satisfactory which was similar to other studies done. However, people still have misperceptions regarding the disease and do not strictly follow the preventive measures.
Dental Practice during COVID-19 in Nepal: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2020) Humagain, Manoj; Humagain, Rashmi; Rokaya, Dinesh
Abstract: Introduction: Currently, coronavirus disease (COVID-19) has become pandemic and spread globally. In Nepal, the number of COVID-19 is increasing day-by-day. This research was done to find out the impact of COVID-19 on dentists, patients, and dental practice in Nepal. Methods: This study is a cross-sectional study conducted using an online survey from May 10 to17, 2020. A questionnaire was designed and uploaded in Freeonlinesurveys.com. Following ethical approval, the questionnaire was distributed among 500 dentists, and 406 dentists participated in the study. The survey link was dispersed to the Nepali dentists through social media and e-mail, and the results of the responses were received online. The questionnaire consisted of a total of 34 closed-ended questions containing three parts; demographic details, knowledge of dentists on COVID-19, and the impact of COVID-19 on dentists, patients, and dental treatments. Results: It showed that majority of the participants were females 243 (60%) of the age group 25-29 years with the clinic as the workplace. Patients receive dental treatments only from 40 (10%) of the dentist. A high number of dentists: 284 (70%) were severely affected by the financial burden and were not receiving a salary during this lockdown. About 349(86%) of the dentist think they should do regular dental treatments, but only 101 (25%) think the dentist should do only dental emergency treatments for COVID-19 infected cases. Conclusions: Dentists, patients, and dental practice are severely affected by the COVID-19.The majority of the dentists have faced financial burdens. The dental treatments should be done with high standards of care and infection control following proper recommendations.
Knowledge, Attitude and Practices among Mothers of Children 6 to 24 months of Age Regarding Complementary Feeding
(Nepal Medical Association, 2020) Shrestha, Sabina; Pokhrel, Manoj; Mathema, Smriti
Abstract: Introduction: Complementary foods fill the gap between the total nutritional needs of the child and the amounts provided by breast milk. Inappropriate feeding practices are a major cause of the onset of malnutrition in young children. The objective of this study was to assess the knowledge, attitude, and practices of mothers of children between 6 to 24 months of age regarding complementary feeding. Methods: This Knowledge, Attitude, and Practice Study was conducted among 250 mothers in Kathmandu Medical College and Teaching Hospital from June 2019 to November 2019 after obtaining ethical approval from the institutional review committee (Ref no. 150320199). Convenient sampling method was applied. The mothers of children between 6 to 24 months were interviewed using a structured questionnaire to ascertain the knowledge, attitude, and practices regarding complementary feeding. Statistical analysis was done using SPSS version 20. Results: Two hundred and fifty mothers were interviewed. 151 (60.4%) mothers knew initiation of breastfeeding soon after birth and 179 (71.6%) were knowledgeable about exclusive breastfeeding for 6 months. 161 (64.4%) mothers knew the proper age of initiating complementary feeding but only 139 (55.6%) mothers practiced it. Early initiation of complementary feeding was done by 87 (34.8%) mothers while 24 (9.6%) mothers delayed it beyond 6 months. Conclusions: There was a gap in knowledge and practice among mothers regarding adequate age of initiation of complementary feeding, complementary foods, preparation, and practices.
Interpersonal Violence during the COVID-19 Lockdown Period in Nepal: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2020) Ghimire, Calvin; Acharya, Sajan; Shrestha, Carmina; KC, Prabhat; Singh, Swarndeep; Sharma, Pawan
Abstract: Introduction: The government issued a country-wide lockdown in Nepal as a measure to curb the spread of COVID-19 pandemic. This has resulted in various difficult experiences which includes financial loss, separation from loved ones, grief, uncertainty over disease status and loss of freedom. During these stressful situations, interpersonal violence is likely to be aggravated. To avoid the occurrence of adverse events such as impulsive acts, homicide, or suicide, it is important to identify high-risk individuals. Methods: This is a descriptive cross-sectional, questionnaire-based, online survey by convenience sampling. The prevalence of different types of interpersonal violence with socio-demographic factors, substance use, and overall mental wellbeing was assessed by using descriptive statistical tests. Results: Out of total 556 participants included in the analysis, 50.9% (283) were male and 48.7% (271) were female. There were 100 (18.0%) participants who reported being a victim of interpersonal violence and 101 (18.2%) participants who reported being a perpetrator during the lockdown. The victims of violence were more likely to be living with their spouse alone. The victims and perpetrators were also more likely to have increased alcohol and tobacco use. More number of victims and perpetrators had lower mental wellbeing scores on the WHO wellbeing index. Conclusions: There was prevalence of interpersonal violence during the COVID-19 lockdown. In addition to the fear regarding pandemic, victims have to face domestic violence placing them at a double injustice. Identification of vulnerable groups and proper management of survivors must be prioritized given the unanimous consensus on the rise of interpersonal violence during periods of heightened stress.
Mental Wellbeing during the Lockdown Period following the COVID-19 Pandemic in Nepal: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2020) Shrestha, Carmina; Ghimire, Calvin; Acharya, Sajan; KC, Prabhat; Singh, Swarndeep; Sharma, Pawan
Abstract: Introduction: COVID-19 pandemic has profoundly affected all aspects of society, including mental and physical health. Often missed is the fact that the pandemic is occurring against the backdrop of a very high prevalence of mental health issues. Protecting the mental health of people and healthcare workers is important for long-term positive health outcomes and proper control of the outbreak. Methods: This is a descriptive cross-sectional, questionnaire-based, online survey by convenience sampling. Ethical approval was obtained from the institutional review committee of Nepal Health Research Council (reference no. 2467). Open access, pre-validated questionnaires were used. Participants with significantly poor Mental wellbeing were identified using the WHO well-being index threshold score. Descriptive statistical analysis was carried out. Results: Five hundred and fifty-six participants were included in the analysis. Forty percent of the participants reported a WHO well-being index score of below 13, indicative of poor mental wellbeing and a need for further assessment for depression. Poor Mental wellbeing was more prevalent among participants less than 30 years of age, female gender, never married, diagnosed mental disorder, living alone and those using informal sources for COVID-19 related information. More participants with lower sleep quality score and higher perceived stress score reported poor Mental wellbeing. Conclusions: Combating this challenge requires integration across disciplines. One potential part of the solution is psychological intervention teams. An emerging positive connotation to the pandemic is that it needs to be harnessed as a tool for improving health facilities, community participation, and fighting misinformation.
Functional Outcome Estimation of Bimalleolar Ankle Fractures Treated by Open Reduction and Internal Fixation at a Tertiary Care Center: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2020) Dwivedi, Rajeev; Karki, Ankit; Bhattarai, Roshan; Rijal, Badri
Abstract: Introduction: Ankle fractures account for about 9% of all fractures in adults. Open reduction and internal fixation is the preferred treatment for such injuries. However, surgery is not free of complications, and outcomes following surgery are not always satisfactory. Therefore, this study aimed to estimate the functional outcomes of bimalleolar ankle fractures treated by open reduction and internal fixation. Methods: This descriptive, cross-sectional study was carried out at a tertiary care center in the western region of Nepal among the patients with bimalleolar ankle fractures from March 2017 to August 2020 after approval from the Institutional review committee. Convenience sampling was done to reach the sample size. Twenty-nine cases were included in the study. Data were recorded in proforma and data analysis was done in the statistical package for social sciences (SPSS 16.0). The American Orthopedic Foot and Ankle Society (AOFAS) ankle-handfoot score was used to assess the final outcome. Results: At the final evaluation mean AOFAS ankle-handfoot score score was 89.86 (Â±7.95). According to the AOFAS ankle-hindfoot score, there were 19 excellent (65.51%), six good (20.68%), and four fair (13.79%) results. Complications in the form of superficial infection were seen in four (13.79%) cases. Conclusions: Functional outcomes following surgical treatment of bimalleolar ankle fractures are mostly excellent to good and complications following surgery are few, therefore, surgery is a better option of treatment in bimalleolar ankle fractures.
Prevalence of Tracheoesophageal Anomaly Cases among Neonates Undergoing Surgery in a Tertiary Care Childrenâ€™s Hospital
(Nepal Medical Association, 2020) Basnet, Bal Mukunda; Simkhada, Prashant; Thapa, Anupama; Singh, Rajkumar
Abstract: Introduction: Tracheo-oesophageal anomaly is the abnormal communication between trachea and oesophagus. The most common type of tracheo-oesophageal anomaly is oesophageal atreasia with distal tracheo oesophageal fistula. Tracheo-oesophageal anomaly is a common neonatal problem requiring an urgent surgery. Tracheo-oesophageal anomaly can be diagnosed as an isolated malformation or as part of polymalformative syndrome with possible vertebrae anomalies also known as Vacterl syndrome. The aim of the study is to find out the prevalence of tracheo-oesophageal anomaly cases among neonates undergoing surgery in a tertiary care childrens hospital in Nepal. Methods: This is a descriptive cross sectional study conducted in a tertiary care childrenâ€™s hospital in Nepal taking into account the medical records from period of 01 Jan, 2018 to Dec 31, 2019. Study population included the infants undergoing operative procedure in the operation theatre of Kanti Childrenâ€™s Hospital. The calculated sample size was 306. Data was collected by retrospective chart review technique and listed in performa. Consecutive sampling technique was used. Thus collected data was entered in SPSS version 20 and necessary calculations were done. Results: The prevalence of tracheo-oesophageal anomalies was found out to be 30 (9.8%) at 95% confidence interval. The most common problem, with which infants were brought to Kanti Childrenâ€™s Hospital, that required urgent neonatal surgical intervention was anorectal malformation constituting 94 (30.72%) of the surgeries followed by intestinal obstruction 76 (24.84%) which included duodenal atresia, jujunal atresia and ileal atresia. Conclusions: Tracheo-oesophageal anomaly constitutes a major portion of neonatal disease condition requiring surgery in Nepal.

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