scholarly journals A Study of Clinical Profile and Neutrophil-Lymphocyte Ratio in Clinical Outcome of Covid 19 Patients: Tertiary Care Centre in Bangalore

2021 ◽  
Vol 6 (09) ◽  
pp. 525-529
Author(s):  
Mamatha Tittamegalapalya Ramalingaiah ◽  
Jeetendra Kumar Jogihalli Mood ◽  
Vinutha Bagalur Srinivas Murthy ◽  
Virender Singh
Keyword(s):  
Clinical Outcome ◽  
Tertiary Care ◽  
Clinical Profile ◽  
World Health ◽  
Severe Illness ◽  
P Value ◽  
Common Symptom ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Corona Virus

Introduction: Corona virus disease is ongoing global pandemic, caused by severe acute respiratory distress syndrome corona virus 2 (SARS-Cov2). The virus was first identified in Wuhan, China in December 2019. The World Health Organization declared the virus a Public Health Emergency of International Concern on 30 January 2020, and later a pandemic on 11 March 2020.The severity of COVID-19 symptoms can range from asymptomatic milder forms to life-threatening. Severe illness is more likely in elderly patients and also in patients with co morbid conditions. Disease can transmit through air contaminated by droplets and small airborne particles. Aims: we aimed to know the clinical profile of covid 19 patients and also to co relate the neutrophil-lymphocyte ratio with clinical outcome of the disease. Materials and methods: This Prospective study was conducted in Patients admitted from August 2020 to October 2020. COVID-19 infection was diagnosed by RT-PCR and rapid antigen test (RAT) technique. Patients demographic data, clinical history was collected. Clinical assessment was performed. Laboratory investigations was sent. Patients were followed during the hospital stay. Appropriate statistical analysis was used Results: Males were commonly affected than females. Mean age of the patient was 61years. Diabetes was the most common co morbid condition. Fever was the most common symptom followed by cough, breathlessness. Neutrophil-lymphocyte ratio was elevated in intubated patients than in patients maintaining room air saturation, which was statistically significant (p value 0.001). Conclusion: Neutrophil-lymphocyte ratio (NLR) can be used as reliable, early marker for the disease progression of covid 19 disease.

scholarly journals Clinico-epidemiological Profile and Outcomes of COVID-19 Patients Admitted in Jawaharlal Nehru Medical College and Hospital: A Retrospective Study

2021 ◽  
Author(s):  
Syed Haider Mehdi Husaini ◽  
Shaad Abqari ◽  
Obaid Ahmad Siddiqui ◽  
Abu Nadeem ◽  
. Urfi ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Uttar Pradesh ◽  
P Value ◽  
Common Symptom ◽  
Duration Of Stay ◽  
Medical College ◽  
Males And Females ◽  
Jawaharlal Nehru

Introduction: Coronavirus Disease-2019 (COVID-19) has taken the world by storm since its detection in China. The pandemic swept across the globe and affected India. The presence or absence of co-morbidities may determine the clinical outcome. Clinical manifestations include cough, fever and dyspnoea mainly. Aim: To elucidate epidemiological findings, clinical features, co-morbidities of COVID-19 disease and clinical outcomes in first 500 COVID-19 patients admitted at a tertiary care teaching hospital in Northern India. Materials and Methods: The retrospective observational study was conducted at Jawaharlal Nehru Medical College and Hospital (JNMCH), Aligarh Muslim University, Aligarh, Uttar Pradesh, India, from 21st April to 27th October 2020 on first 500 Reverse Transcription- Polymerase Chain Reaction (RT-PCR)/Rapid Antigen or TruNatBeta positive patients. During January to March 2021 period data was collected and analysed. Data was analysed for epidemiological parameters, symptoms and clinical hospital outcomes of patients. Data was analysed using Statistical Package for the Social Sciences (SPSS) version 21.0 IBM and p-value <0.05 was taken as significant. Results: Out of total patients, 284 (56.80%) and 216 (43.20%) were males and females respectively and 11.12% of females were pregnant. Difference in mean ages of males and females was significant (p-value <0.001). The results show that 434 patients (86.80%) recovered fully and were discharged (more males were discharged), whereas 47 (9.40%) patients died. Out of total 500 patients 75.60% patients stayed in the hospital for more than 72 hours and 24.40% stayed for less than 72 hours. The mean age of patients who stayed for less than 72 hours was 48.85±17.93 as compared (44.23±17.45) to those who stayed for more than 72 hours and the difference was significant (p-value=0.012). Most common symptom was fever (58%) followed by cough (32%) and dyspnoea (31%). The association between the duration of stay and clinical outcome was significant (p-value <0.001). Conclusion: Gender, advancing age, duration of stay and associated co-morbidities appear to play role in infection and outcome of COVID-19

scholarly journals A STUDY ON EFFECTS OF MENTAL HEALTH ON CHILDREN AND ADOLESCENT DURING COVID-19 PANDEMIC IN A TERTIARY CARE CENTER – AN ONLINE STUDY

2021 ◽  
Vol 5 (6) ◽  
Author(s):  
Darshan Yallappa Jotibannad ◽  
Kalagi Amit Kumar ◽  
Vijayaraj N
Keyword(s):  
Public Health ◽  
Care Center ◽  
Tertiary Care ◽  
World Health ◽  
Psychological State ◽  
P Value ◽  
Global Public Health ◽  
Impact Of Event Scale ◽  
Event Scale ◽  
Corona Virus

Background: A new corona virus was subsequently identified and was temporarily named the 2019 new corona virus. On 30th January 2020, the World Health Organization (WHO) announced that the emergence of a replacement corona virus (2019-nCoV) was a public health emergency of international concern. Infectious diseases became one among the main threats to global public health within the twenty first century; such diseases impact both physical health and psychological state. PTSD in youth is common and debilitating. In contrast to adult PTSD, relatively little is understood about the neurobiology of paediatric PTSD. This study is an effort to explore the Assessment of suspected covid 19 children for perceived levels of stress during covid 19 outbreaks. Methods: The information required for the study was obtained through online means. Consent was obtained orally over phone before proceeding with the study. The questionnaire consisted of demographics variables and the questionnaire was shared online via Whatsapp and/or other means. The questionnaire was given in English. The Children’s Impact of Event Scale (CRIES 13) was used and the questions were multiple choice question (MCQ) type with 1 best response. In case of the patient not having an appropriate phone they were interviewed over the phone and the collected data was statistically analysed to ascertain any significance and association between each variable. Results: Out of 54 children, two of them were found to have a score of 30 on CRIES ScaleConclusion: The findings of the study suggest that paediatric PTSD is almost identical to adult PTSD, which has significant p value. It is necessary to recognise the initial psychological impact of the pandemic on children and help them receive immediate attention. Keywords: Covid 19 pandemic, PTSD, CRIES, children’s, DSM -5

scholarly journals Time to negative PCR in various disease categories of COVID-19 infection in Pakistani population

2021 ◽  
Vol 38 (1) ◽  
Author(s):  
Kaleem Ullah Toori ◽  
Asma Chaudhry ◽  
Muhammad Arsalan Qureshi
Keyword(s):  
Disease Severity ◽  
Virus Disease ◽  
World Health ◽  
P Value ◽  
Common Symptom ◽  
Cross Sectional ◽  
Pakistani Population ◽  
Corona Virus ◽  
Co Morbidity ◽  
Epidemiological Characteristics

Objectives: To identify association of epidemiological characteristics, presence of underlying pre-morbidities and disease severity with time to first negative PCR in Corona virus disease 2019. Methods: Total 842 Corona Virus Real Time Polymerase-Chain-Reaction positive patients were included in this cross-sectional study. Patients were admitted to Department of Medicine at KRL Hospital Islamabad from April to August 2020. Age, gender, symptoms, pre-morbidities and disease severity were recorded. Outcome (recovered versus died) was documented. World Health Organization categories to classify disease severity (asymptomatic, mild, moderate and severe) were used. Time to negative PCR was documented as time between first positive PCR to first negative PCR. Results: The mean age of patients was 39.04 ± 11.32 years with 99.8% being males. Majority of patients (78.4%) were asymptomatic. Amongst symptoms, fever was the most common symptom. Diabetes mellitus and hypertension were the most commonly recorded co-morbidity. Mean time to negative PCR was 8.8 ± 3.1 days. A large proportion of patients recovered (99.9%). Significant positive correlation (p value < 0.05) was found between age, gender, presence of underlying pre-morbidities and disease severity categories with time to first negative PCR. Conclusion: The underlying epidemiological factors, pre-morbidities and disease severity are associated with time to negative PCR and hence affect frequency of recovery samples. doi: https://doi.org/10.12669/pjms.38.1.4476 How to cite this:Toori KU, Chaudhry A, Qureshi MA. Time to negative PCR in various disease categories of COVID-19 infection in Pakistani population. Pak J Med Sci. 2022;38(1):---------. doi: https://doi.org/10.12669/pjms.38.1.4476 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals The Neutrophil Lymphocyte Ratio (NLR), Platelet Lymphocyte Ratio (PLR) and routine hematological parameters of COVID-19 Patient : A perspective of the Indian scenario from a frontline pilot study of 32 COVID-19 cases in a Tertiary Care Institute of North India

2020 ◽  
Author(s):  
Neema Tiwari ◽  
Devajit Nath ◽  
Jyotsna Madan ◽  
Savitri Singh ◽  
Prashant Bajpai ◽  
...  
Keyword(s):  
Hematological Parameters ◽  
Tertiary Care ◽  
North India ◽  
World Health ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Platelet Lymphocyte Ratio ◽  
Significant Difference ◽  
Indian Scenario

Introduction The coronavirus disease 2019(COVID-19) is caused by the virus SARS-CoV-2 and is declared as a global pandemic by the World Health Organization (WHO). Various hematological parameters alteration has been documented in the Chinese literature in SARS-Cov-2 infection. However, there is a need for research to evaluate the pattern of the hematological parameters of COVID-19 patients in the Indian population. Aims & Objectives: The objective of the study is to see the Neutrophil-Lymphocyte Ratio (NLR), Platelet Lymphocyte Ratio (PLR), and other hematological parameters alteration of COVID-19 patients along with their clinical course in the Indian scenario. Methods: A single-center prospective study of 32 patients with laboratory-confirmed COVID-19 admitted to Super Speciality Pediatric Hospital & Post Graduate Teaching Institute NOIDA, from March to April, were enrolled for the study. The demographic data, the clinical status of the patients during admission and follow up, baseline, and follow up hematological findings were recorded. Statistical analysis of the data was carried out, and relevant findings were presented. Results: Demographic characterization shows a mean age of 37.7 years, male (41.9%), female (58.1%)with the majority of patients are mildly symptomatic to asymptomatic(93%). The CBC values and NLR, PLR at baseline between the male and the female patients, are not showing any statistically significant difference as the 95% C.I. A statistically significant increment in the lab parameters is observed in follow-up visits. Conclusion: The majority of the patients are younger and have mild clinical presentation with female predominance. Pediatric cases have mild symptomology. Baseline CBC findings show mild neutrophilia, lymphopenia, eosinopenia, and normal to mild thrombocytopenia. An increase in CBC parameters, NLR was noted in follow up cases. Anemia was not noted in baseline CBC and in the follow-up group. A onetime PLR is not indicative of disease progression. Key words: Corona virus,COVID-19,CBC,NLR,PLR

The Neutrophil Lymphocyte Ratio (NLR), Platelet Lymphocyte Ratio (PLR) and routine hematological parameters of COVID-19 Patient: A perspective of the Indian scenario from a frontline pilot study of 32 COVID-19 cases in a Tertiary Care Institute of North India. (Preprint)

2020 ◽  
Author(s):  
Neema Tiwari ◽  
Devajit Nath ◽  
Jyotsna Madan ◽  
Savitri Singh ◽  
Prashant Bajpai ◽  
...  
Keyword(s):  
Hematological Parameters ◽  
Tertiary Care ◽  
North India ◽  
World Health ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Platelet Lymphocyte Ratio ◽  
Significant Difference ◽  
Indian Scenario

BACKGROUND The corona virus disease 2019(COVID-19) is caused by the virus SARS-CoV-2 and is declared as a global pandemic by World Health Organization (WHO). Various hematological parameters alteration has been documented in the Chinese literature in SARS-Cov-2 infection. However, there is a need for research to evaluate the pattern of the hematological parameters of COVID-19 patients in the Indian population. OBJECTIVE The objective of the study is to see the Neutrophil-Lymphocyte Ratio (NLR), Platelet Lymphocyte Ratio (PLR), and other hematological parameters alteration of COVID-19 patients along with their clinical course in the Indian scenario. METHODS A single-center prospective study of 32 patients with laboratory-confirmed COVID-19 admitted to Super Speciality Pediatric Hospital & Post Graduate Teaching Institute NOIDA, from March to April, were enrolled for the study. The demographic date, the clinical status of the patients during admission and follow up, baseline, and follow up hematological findings were recorded. Statistical analysis of the data was carried out, and relevant findings were presented. RESULTS Demographic characterization shows a mean age of 37.7 years, male (41.9%),female (58.1%)with majority patients are mildly symptomatic to asymptomatic(93%). The CBC values and NLR, PLR at baseline between the male and the female patients, are not showing any statistically significant difference as the 95% C.I. A statistically significant increment in the lab parameters is observed in follow-up visits. CONCLUSIONS Majority of the patients are younger and have mild clinical presentation with female predominance. Pediatric cases have mild symptomology. Baseline CBC findings show mild neutrophilia, lymphopenia, eosinopenia and normal to mild thrombocytopenia. An increase in CBC parameters, NLR was noted in follow up cases. Anemia was not noted in baseline CBC andin follow up group. A onetime PLR is not indicative of disease progression. CLINICALTRIAL NA

scholarly journals Clinical profile of patients presenting with inhalational organophosphorus poisoning in central India: a retrospective study

2020 ◽  
Vol 7 (8) ◽  
pp. 3047
Author(s):  
Sachin Divekar ◽  
Sandeep M. Bhelkar ◽  
Prabhakar Hiwarkar ◽  
Monika Masare
Keyword(s):  
Emergency Department ◽  
Pupil Size ◽  
Statistical Significance ◽  
Tertiary Care ◽  
Clinical Profile ◽  
Nausea And Vomiting ◽  
World Health ◽  
Common Symptom ◽  
Chemical Safety ◽  
Organophosphorus Poisoning

Background: World Health Organisation (WHO) report through International Programme on Chemical Safety (IPCS), poisoning is a significant global public health problem. According to WHO data, in 2012 an estimated 193,460 people died worldwide from unintentional poisoning. Intentional and unintentional pesticide poisoning has been acknowledged as a serious problem in many countries, including India, Limited literature available on clinical profile of organophosphorus poisoning cases, with this background present study was attempted. Objective of the study was to know the clinical presentation of OP poisoning cases admitted in tertiary care hospital.Methods: A retrospective record based observational study was conducted.Results: A total of 535 patients presented in the emergency department with the clinical features of OP poisoning. Mean age of the persons presenting in the emergency was 33.3±10.1 years. Nausea and vomiting is the most commoner symptom reported by 60.7% of patients followed by giddinesss (41.3%), loose motion (28.2%) and secretions (9.5%). Signs like abnormal pupil size, fasciculations and inability to neck holding were common with 23.55% 19.3% and 21.1% respectively. Statistical significance was found between Serum acetylcholine esterase level and outcome of patients (p<0.01). 96.1% received treatment less than half an hours. 18 patients required ventilator and among these 13 were died.Conclusions: Majority of the patients were of young age with males outnumbering females. Nausea and vomiting was the most common symptom reported by the patients while abnormal pupil size was the most common sign observed at the emergency department.

scholarly journals The role of neutrophil/lymphocyte ratio in predicting the severity of sepsis in a tertiary care hospital in South India: a retrospective study

2020 ◽  
Vol 8 (5) ◽  
pp. 1624
Author(s):  
Alfy Ann George ◽  
Teju P. Thomas ◽  
Abdul Gaffoor
Keyword(s):  
Tertiary Care ◽  
Clinical Manifestations ◽  
Organ Involvement ◽  
P Value ◽  
Risk Category ◽  
Care Hospital ◽  
Chi Square ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio

Background: Sepsis, a syndrome of dysregulated host response to infection leading to life-threatening organ dysfunction, is having a substantial burden in health system. The outcome in sepsis is often time dependent. None of the clinical manifestations nor the age-old markers like ESR, CRP, etc. have proven diagnostic or prognostic of sepsis. This study aims to assess the role of neutrophil: lymphocyte ratio (NLR) in assessing the severity of sepsis within the initial 24 hrs of admission.Methods: Authors did a retrospective observational study in 208 sepsis patients admitted in the MDICU. The NLR was calculated and the study population was grouped into those with an NLR of more than or equal to 5 and those with less than 5. The patients were also grouped based on the number of organs impaired due to sepsis. The association between these groups were then assessed.Results: 46 patients (60.5%) with single organ involvement had NLR <5; 30 patients (39.5%) had NLR >5; 27 patients (42.2%) with two organ involvement had NLR <5 and 37 patients (57.8%) had NLR >5. Among patients with more than two organ involvement, 8 patients (21.6%) had NLR <5 and 29 patients (78.4%) had NLR >5. It was found that there is statistically significant association between increase in number of organs involved and NLR more than 5. The chi square test value was 15.691 with a p value was less than 0.001.Conclusions: In the current study, we have evaluated the role of NLR in sepsis. NLR calculated on the day of admission is a simple parameter that helps to stratify patients into severe risk category. A significant association was found with higher NLR and the number of organs impairment in sepsis.

Prediction of Troponin elevation in Non- ST Acute Coronary Syndrome Patients presenting to The Emergency Department Using Neutrophil-lymphocyte ratio

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Sarah Mohamed Mahmoud ◽  
Bassam Sobhy ◽  
Ramy Raymond
Keyword(s):  
Emergency Department ◽  
Acute Coronary Syndrome ◽  
Complete Blood Count ◽  
P Value ◽  
Troponin Elevation ◽  
Positive Group ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Coronary Syndrome

Abstract Background The neutrophil–lymphocyte ratio (NLR) is considered an independent predictor of mortality and myocardial infarction (MI) in stable coronary artery disease (SCAD). Also NLR have prognostic value in patients with acute coronary syndromes (ACSs). However the diagnostic power of NLR in patients suspected of ACS is still under study Objective is to determine the ability of neutrophil-lymphocyte ratio to predict troponin elevation in patients presenting to emergency department with acute coronary syndrome Material and Methods From June 2018 to March 2019, 100 patients were enrolled who presented to the ER with NST-ACS. Patients were divided into 2 groups based upon the troponin positivity in the 12- to 24-hour follow-up. Baseline Complete blood count with calculation of NLR is done Results The study population was divided into 2 groups: troponin- negative group (n = 50) and troponin-positive group (n = 50). Mean age was 55.8 ± 11.3. 77% of the patients were male. No significance difference in the level of hemoglobin, WBCs and platelets between the 2 groups. The neutrophil count was significantly higher in the troponin-positive group (p &lt; 0.001). The median admission. NLR was significantly higher in the troponin-positive group (2 vs. 3.9, P &lt; 0.001). A cutoff point of 3.4 for NLR measured on admission had 84% sensitivity and 84% specificity in predicting follow-up troponin positivity. A highly significant correlation was found between NLR and level of troponin change (p value &lt;0.01) Conclusion NLR can be used as a diagnostic tool in the differentiation of patients with acute coronary syndrome. NLR is a non-expensive, simple and available parameter that can be used in diagnosis of NSTEMI.

Fetomaternal Outcome of Pregnancy with COVID-19: An Observational Study in Tertiary Care Hospitals of Pakistan

2021 ◽  
Vol 15 (6) ◽  
pp. 1903-1906
Author(s):  
Nabila Khan ◽  
Zahra Wasim ◽  
Aesha Sadaf Rizwan ◽  
Afshan Ahmad ◽  
Muhammad Tahir ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Negative Impact ◽  
Heart Defects ◽  
Tertiary Care ◽  
World Health ◽  
Observational Research ◽  
Military Hospital ◽  
Corona Virus ◽  
Study Results ◽  
The World

Background: The new corona virus first appeared in Wuhan, China in December 2019 and has since spread around the world to other countries. The World Health Organization believes that this new CoV-19 epidemic is a public health emergency of international concern (PHEIC) on January 30, 2020Worldwide.The mortality rate of this viral infection ranges from 2% in Pakistan to 14.4% in Italy. Lympopenia, elevated transminase, proteinuria, increased LDH, and C-reactive protein levels are all common laboratory findings in the early stages of the disease. Covid patients have experienced a variety of complications, including extreme pneumonia, ARDS, heart defects, sepsis and septic shock, and respiratory tract super infection. Methodology: This retrospective observational research study was carried out at the Gynecology Unit of MardanMedical Complex, Mardan and Combined Military Hospital, Risalpur for 06 months duration from April 2020 to September 2020. In a pre-constructed data collection form, biochemical and radiological parameters of medical history, test results, symptoms, pregnancy, and neonatal outcomes were noted. Patients treated in an outpatient setting were not included in the study. Results: There were 121 patients in total, with mean age of 27 having standard deviation ± 5, having range 19-40 years. 48.3% pregnant women reported their first pregnancy(primigravida). 51.3% of SARS-Cov-2 were in their 3rd trimester while 34.7% were in their 35-40 weeks of gestational age. Common complications are gestational hypertension (PIH) (16 cases), hypothyroidism (14 cases) and gestational diabetes (GDM) 9 cases. More than half (53%) of patients are asymptomatic. Common symptoms are cough (22%) and fever (11%). The incidence of multiple organ failure was 2% as shown in table 01. Lymphopenia was common (84%). A CT scan of 24 patients showed bilateral invasion. Conclusion: COVID-19 has a negative impact on the foetus, according to our results. Although pregnant women do not seem to be more vulnerable to COVID-19 complications than non-pregnant adults, previous research has suggested that pregnant women could be at higher risk for negative pregnancy outcomes such as preterm birth, foetal pain and respiration, symptoms, and LBW in a newborn baby. Keywords: Corona virus, COVID-19, Pregnancy, Outcome.

scholarly journals Clinical outcome of infants younger than two months in children ward of a tertiary care hospital, Nepal

2016 ◽  
Vol 3 (2) ◽  
pp. 15-18
Author(s):  
Ganesh Shah ◽  
Dinesh Dharel ◽  
Anish K Shah ◽  
Bikal Sapkota ◽  
Asmita Bhattarai
Keyword(s):  
Blood Culture ◽  
Clinical Outcome ◽  
Skin Infection ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Facility ◽  
Clinical Profile ◽  
Care Hospital ◽  
Young Infants ◽  
Level Hospital

 Introductions: Newborn and young infants are most vulnerable for preventable deaths, particularly in developing countries. This study was conducted to see the clinical profile and outcome of infants less than two months of age admitted in children ward of Patan Hospital.Methods: This descriptive retrospective study was conducted at Patan Hospital, over 12 months from April 2014 to March 2015. Hospital records of all admitted infants aged less than two months were reviewed. The demographic characteristics, clinical profile and clinical outcome were descriptively analyzed.Results: Out of 2062 admissions in children ward, 614 (29.8%) were infants aged less than two months, out of which 482 were neonates less than 28 days. Among these neonates, 114 were inborn. Out of 436 infections, blood culture was positive in 37 (8.9%). There were 4 (0.04%) deaths, 4 (0.04%) referral and 22 (0.25%) left against medical advice. Infection 436 (436) was the commonest cause of illness, of which neonatal sepsis was 163 (37.4%), pneumonia 130 (30%) staphylococcal skin infection 39 (8.7%) and UTI 34 (7.8%). There were 71 (11.6%) cases of neonatal hyperbilirubinemia. Blood culture was positive in 55 (9%) with CONS being the commonest organism isolated; 19 (51.3%).Conclusions: Children ward contributes significantly to the care of sick infants less than two months of age, especially out born ones, requiring neonatal care facility in tertiary level hospital of Nepal. As most admissions are for infection, followed by hyperbilirubinemia, pediatrics wards need to be equipped and staffed accordingly to meet the need of sick young infants.Journal of Patan Academy of Health  Sciences. 2016 Dec;3(2):15-18

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