Kanti Children's Hospital

Background: Hepatitis A virus (HAV) infection remains an important cause of acute viral hepatitis among children in low- and middle-income countries. Improvements in sanitation and socioeconomic conditions have resulted in a shift in HAV epidemiology toward older age groups, leading to an increasing proportion of symptomatic disease. However, contemporary data on the clinical spectrum and complications of pediatric hepatitis A in Nepal remain limited. This study aimed to evaluate the clinico-epidemiological profile, laboratory characteristics, complications, and outcomes of hepatitis A infection among children in a tertiary care center in Nepal and to identify factors associated with complications. Methods: A prospective observational study was conducted among children aged ≤ 14 years with serologically confirmed hepatitis A infection attending the inpatient and outpatient pediatric services at Kanti Children’s Hospital between April 2025 and March 2026. Demographic, epidemiological, clinical, laboratory, ultrasonographic, complication, and outcome data were collected using a structured proforma. Factors associated with complications were analyzed using Fisher’s exact test, with p value < 0.05 considered statistically significant. Results: A total of 137 children were enrolled, with a mean age of 7.01 ± 3.42 years; 66.4% were male. The majority of cases occurred in children aged 5–10 years (45.3%). Most children belonged to lower-middle and lower socioeconomic strata, and 90.5% of households reported no water treatment practices. None of the enrolled children had received hepatitis A vaccination. Cases peaked during the monsoon season (40.1%). Jaundice (87.6%), abdominal pain (81.8%), and fever (78.8%) were the most common presenting symptoms, while hepatomegaly was observed in 69.3% of children. Gallbladder wall thickening (81.8%) was the most frequent ultrasonographic finding. Acute liver failure occurred in 13.1% of patients, hepatic encephalopathy in 6.6%, and mortality was 1.5%. Total bilirubin > 10 mg/dL (p = 0.021) and prolonged activated partial thromboplastin time (aPTT) > 45 seconds (p < 0.001) were significantly associated with complications. Conclusions: Hepatitis A infection continues to impose a substantial clinical and public health burden among children in Nepal, particularly among unvaccinated children from lower socioeconomic backgrounds with inadequate water sanitation practices. Although outcomes were generally favorable, severe complications including acute liver failure were observed. Elevated bilirubin and prolonged aPTT may serve as indicators of complications in children with hepatitis A infection. Strengthening preventive strategies including safe water access, sanitation measures, and consideration of hepatitis A vaccination may help reduce disease burden.

Child rights are a core component of human rights, yet child abuse and neglect remain underrecognized and represent a public health concern in Nepal. This study assessed the knowledge, awareness and attitudes of doctors, nurses and other healthcare professionals involved in childcare regarding child abuse and neglect and examined training adequacy and application in practice. A descriptive cross-sectional study was conducted among 370 healthcare professionals. Data were collected between September and November 2024 using a structured, pretested questionnaire and analysed using SPSS version 20 with descriptive and inferential statistics. The results showed that 56.2% of participants had a high level of knowledge of child abuse, while 87.3% demonstrated positive attitudes toward child protection. Practical application was limited: Only 13.5% had ever reported a suspected case, 5.1% felt confident in recognizing abuse and standardized screening tools were used by 36.5%. Training was significantly associated with positive attitudes (p = 0.001), and higher knowledge correlated with favourable attitudes (p = 0.001). Despite good knowledge and attitudes, gaps persist in confidence, reporting and implementation. Strengthening training, standardized screening, reporting awareness and interprofessional collaboration are essential to improve child protection practice in Nepal.

The term “Virtual Autism (VA)” has recently gained popularity and is often understood as Autism Spectrum Disorder (ASD) caused by excessive screen exposure. However, this condition is neither virtual nor autism. It involves certain developmental features that may resemble ASD, but does not meet the criteria for an autism diagnosis. The use of VA can create unnecessary stress, confusion, and stigma for families of newly diagnosed children. To address this concern, a more neutral, hopeful, and scientifically appropriate term, “Screen-induced Developmental Deviation (SiDD)” is proposed. SiDD is a proposed construct describing atypical neurodevelopmental trajectories associated with excessive or developmentally inappropriate screen exposure. This terminology is self-explanatory and avoids both over-sensitizing and underestimating the relationship between screen exposure and developmental outcomes. Early identification of SiDD followed by decrease or cessation of screen time and affective parent child interaction can lead to improvement in developmental outcome.

Background: Pelviureteric junction obstruction(PUJO) is the commonest cause of antenatal hydronephrosis. Majority of antenatal hydronephrosis resolve with watchful observation in postnatal period. Amongst them, very few will require intervention in infancy. Anderson- Hynes pyeloplasty is considered as standard procedure for PUJO. This study aimed toevaluate and assess the outcome of this procedure in an infant with severe hydronephrosis secondary to PUJO. Methods: A retrospective review of all infants with moderate to severe hydronephrosis due to PUJO who underwent Anderson-Hynes Pyeloplasty between Baisakh 2079 to Chaitra 2080 (2 years) was evaluated. Different demographic data including age and sex of patient, side of surgery, ultrasound grading of hydronephrosis, total operative time, their hospital stay, outcome and complications were assessed. Results: Total 26 infants (17 boys and 9 girls) with PUJO underwent Anderson-Hynes Pyeloplasty with a mean age of 6.35 months (1 month to 11 months). 87.8 minutes was the mean operative time period. 3.75 days (3 days to 5 days) was mean hospital stay.Major complications include anastomotic stricture in one infant and one case had recurrent UTI. Postoperative ultrasound and DTPA scan were obtained after 6 months postoperatively, which showed improved renal function in DTPA in 24 patients (92.4%). Conclusion: Anderson-Hynes Pyeloplasty is the gold standard procedure in PUJO. Its implication in infant age group is also safe. For better outcome, patient selection and refinement technique should be pursued.

Artificial intelligence (AI) chatbots are considered a potential resource for dental education. However, there is still a lack of adequate knowledge regarding the trustworthiness, validity, and utility of the content on these platforms, and its application in dental education is still understudied. A set of Multiple-Choice Questions (MCQs) consisting of 100 questions related to removable complete denture prosthodontics were formulated. Two AI models, DeepSeek-V3 and ChatGPT-4o, were used to deliver the queries. First, accuracy of the generated answers was assessed. Subsequently, two reviewers assessed the LLM (Large Language Model) usefulness and reliability of the responses using modified 5-point Likert scales. McNemar test was done to test the difference between ChatGPT-o4 and DeepSeek-V3 in determining accuracy of scores. The Wilcoxon sign rank test was done to determine the difference between reliability and usefulness between the two AI tools. The Chi square test was used to determine the proportional differences between type of questions and accuracy of scores (α = 0.05). The accuracy of the responses was 59