Nepal paediatric society clinical guidance for management of sepsis and septic shock in the paediatric intensive care units in Nepal

Justification: Sepsis is a major cause of morbidity and mortality in Nepal. There is a lack of standardisation in the management of severe sepsis and septic shock. Additionally, international guidelines may not be completely applicable to resource limited countries like Nepal. Objective: Create a collaborative standardised protocol for management of severe sepsis and septic shock for Nepal based on evidence and local resources. Process / Methods: Paediatricians representing various paediatric intensive care units all over Nepal gathered to discuss clinical practice and delivery of care of sepsis and septic shock under the aegis of Nepal Paediatric Society. After three meetings and several iterations a standardised protocol and algorithm was developed by modifying the existing Surviving Sepsis Guidelines to suit local experience and resources. Recommendations: Paediatric sepsis and septic shock definitions and management in the early hours of presentation are outlined in text and flow diagram format to simplify and standardise delivery of care to children in the paediatric intensive care setting. These are guidelines and may need to be modified as necessary depending on the resources availability and lack thereof. It is recommended to analyse data moving forward and revise every few years in the advent of additional data

Protection of Right to Education, and Prohibition on Discrimination within ECHR

This thesis examines the case law of European court of Human Rights (ECtHR) regarding protection of right to education and prohibition on discrimination in getting education within the European Convention on Human Rights (ECHR). As the ECtHR articulated, it considers any applicable international law while interpreting the Convention provisions, and it regularly refers to various regional instruments. To determine the elements of discrimination, this thesis examines the European framework for non-discrimination. This thesis will focus on Roma children regarding the discrimination in getting education and access to educational institution by analysing related case law. This is the main issue to analyse in the thesis; nevertheless, to build the structure of this thesis coherently, the thesis will define the concept of "right to education" and "discrimination," as well as explain how courts assess cases of educational violations according to various elements that hinder access to education. Roma has been known as one of the largest vulnerable groups of the Europe who has been facing constant violation of their rights and has been the victim of discrimination in several fields. Among them, exclusion from education is one of those fields. Exclusion from education takes the form such as refusal from enrolment in school, placing Roma in special school or classes where there are only Roma people, anti-Roma sentiment which impact ethnic segregation. Whatever the cause, it is unacceptable from a perspective of human rights for there to be any ethnic segregation. Thus, this thesis aims to analyses what are the grounds of discrimination under ECHR, how those grounds affect the individual rights to education, and how court interprets the ground of discrimination through cases. Furthermore, in this thesis, the part of parental right will be discussed as it has been stated in a same Article where right to education (Article 2 Protocol 1) has been mentioned. There are several occurrences where parents have filed the case on behalf of their children violation on right to education, as well as regarding violation of their parental rights. Accordingly, the thesis looks at the cases to find out what grounds the court determines that there has been a violation regarding parental rights and how it influences parents' objections to matters pertaining to their child's education. Finally, the thesis concludes by examining the role of non-state actors in safeguarding the educational rights of Roma children and ensuring they do not face discrimination in their pursuit of an education

Challenges of implementing the Paediatric Surviving Sepsis Campaign International Guidelines 2020 in resource-limited settings: A real-world view beyond the academia.

The Surviving Sepsis Campaign International Guidelines for the Management of Septic Shock and Sepsis-associated Organ Dysfunction in Children was released in 2020 and is intended for use in all global settings that care for children with sepsis. However, practitioners managing children with sep sis in resource-limited settings (RLS) face several challenges and disease patterns not experienced by those in resource-rich settings. Based upon our collective experience from RLS, we aimed to reflect on the difficulties of implementing the international guidelines. We believe there is an urgent need for more evidence from RLS on feasible, efficacious approaches to the management of sepsis and septic shock that could be included in future context-specific guidelines