Viral and Atypical Bacterial Detection in Young Nepalese Children Hospitalized with Severe Pneumonia

Respiratory viruses are an important cause of respiratory tract infections in children but are underrecognized as a cause of pneumonia hospitalization in low-income settings. Previously, we detected at least one of seven respiratory viruses by PCR in 30% of young Nepalese children hospitalized with severe pneumonia over a period of 36 months.

Association of Antibody-Dependent Neutrophil Phagocytosis With Distinct Antibody Glycosylation Profiles Following Typhoid Vaccination

Typhoid Vi-conjugate vaccines (Vi-TCV) have been developed to control typhoid fever in children in endemic regions. Previously, in a human challenge model of typhoid, Vi-TCV was administered prior to deliberate ingestion of Salmonella Typhi by healthy adult volunteers in the UK. Vi-specific antibody-dependent neutrophil phagocytosis (ADNP) was associated with protection against enteric fever in this model, but it is not known if ADNP is induced by vaccination of children. We measured ADNP in a cohort of Nepalese children receiving a Vi-TCV in a field study to investigate whether functional antibody responses were also present in children in an endemic setting. Furthermore, we investigated relationships between the functional antibody measures and other properties of the antibody response, including Vi-IgG and IgA titres, and Fc region glycosylation. Antibody-dependent neutrophil phagocytosis significantly increased in children aged 9 months to 15 years between the day of vaccination and 28 days following administration of Vi-TCV (D28). The magnitude of ADNP was also comparable with the levels of ADNP induced by plasma from vaccinated UK adults. Neither IgG nor IgA antibody titres significantly correlated with ADNP scores at D28; however, increased vaccine-induced ADNP was associated with decreased levels of IgG1 sialylation. These data suggest that vaccination with Vi-TCV produces functional antibody responses in children, which associate with specific glycosylation patterns of the Fc region.

Different Risk Factors for Erosive Tooth Wear in Rural and Urban Nepal: A National Study

Background: Erosive tooth wear (ETW) is of growing concern, but data on ETW among Nepalese children are scarce. The main aim of the study was to investigate the prevalence and severity of ETW among Nepalese schoolchildren. We also aimed to analyse the risk indicators for ETW according to location (rural/urban) and the role of obesity in the risk for ETW. Methods: This national study was conducted among 5–15-year-old Nepalese schoolchildren from different regions. Altogether, 1137 out of 1151 schoolchildren participated in both a clinical examination and a survey. ETW was recorded using the Basic Erosive Wear Examination. Results: The prevalence of ETW was 65%. One-fifth of the examined subjects were in need of preventive or restorative treatment. Living in an urban area and studying in a private school were protective factors for ETW, whereas consuming fruits frequently and using charcoal for tooth cleaning increased the odds for ETW. Central obesity was the strongest risk indicator for ETW among urban residents. Conclusions: ETW of low severity is common among Nepalese children and adolescents. Socio-demographic factors influence the prevalence of ETW in Nepal and there seems to be different factors that play a role in the ETW process according to location of residence.

Age estimation based on appearance of pisiform bone in selected Nepalese children of Gandaki Province Nepal

Background: Age estimation is based on general physical examination, radiological examination of bones and dental examination. The appearance of ossification center of pisiform bone is one of the important evidence for estimating age among young children between nine to 13 years. The objective of this study is to estimate the age of appearance of pisiform among the Nepalese children. Materials and methods: It is a cross sectional descriptive study conducted at the department of Radiology, Pokhara Academy of Health Sciences, Western Regional Hospital on the month of July 2020. The Antero posterior view of X Rays of either hand (left or right) including the carpal bones of the patients aged seven to 15 years of 183 Nepalese children archived at the department of Radiology were taken as samples. The X rays were checked for the appearance or non appearance of Pisiform and the age of appearance analysed. Results: One hundred and twenty seven (69.40%) of total 183 cases were males and 56 (30.60%) were females. The minimum age of appearance of pisiform was 9 years in females and 10 years in males. All the subjects had pisiform bone appeared at the age of 13 years and above. Conclusion: The minimum age of appearance of Pisiform in the study subjects was 9 years in females and 10 years in males. All the cases have pisiform ossified at the age of 13 years and above.

A Sonographic Study of Kidney Dimensions Among Nepalese Children

Introduction: Any variations in shape or size of either one or both kidneys may indicate sign of its pathology. The study was aimed to determine normal values for renal dimensions among Nepalese children. Methods: This was a cross-sectional study of the renal dimensions among 211 children. The length, breadth and thickness of kidneys were measured by computerised in built calliper in centimetre by using ultrasound and volume of the kidney was calculated. Results: The mean values of length, breadth, thickness and volume were 7.05 ± 1.80 cm, 2.95 ± 0.48 cm, 1.35 ± 0.15 cm and 15.09 ± 5.91 cc for right kidneys respectively; and 7.36 ± 1.89 cm, 2.98 ± 1.89 cm, 1.35 ± 0.18 cm and 15.98 ± 6.44 cc for left kidneys respectively. The mean values for length, breadth, thickness and volume of right kidney was 7.57 ± 1.99 cm, 3.11 ± 0.46 cm, 1.38 ± 0.14 cm and 17.38 ± 6.20 cc among boys respectively; and 6.50 ± 1.39 cm, 2.78 ± 0.44 cm, 1.31 ± 0.17 cm and 12.69 ± 4.43 cc among girls respectively. Similarly, these values for length, breadth, thickness and volume of left kidneys were 7.91 ± 2.04 cm, 3.13 ± 0.49 cm, 1.39 ± 0.18 cm and 18.46 ± 6.89 cc among boys respectively; and 6.78 ± 1.52 cm, 2.83 ± 0.45 cm, 1.31 ± 0.17 cm and 13.38 ± 4.73 cc among girls respectively. Conclusions: It was concluded that mean values for renal length and volume was found to be higher on left side than right side in all age groups. These values for renal breadth and thickness were observed almost same on both sides in all age groups. All measurements of renal dimensions were found significantly higher among boys than girls on both sides. This study has provided the reference values for renal sizes among Nepalese children.

Anthropometric Assessment of Nepali Children Institutionalized in Orphanages

Nepal is among the world’s poorest countries, and it is the third-poorest country in the South Asian region. Asia has the largest number of orphans in the world; in Nepal there are around 13,281 orphan children. The objective of this study is to evaluate the growth status of institutionalized children in Nepal through the analyses of anthropometric measures. The sample was Nepalese children aged 4 to 17, obtained from two different orphanages: in the first one, children with physical and mental disabilities coexist with children without any conditions. In the second one, there were no subjects with disabilities. Significant evidence of an association between mental and physical disability in institutionalized children and undernutrition (wasting and stunting) was found in this study. There is also weak but significant evidence of a relationship between underweight and being male. The study could help reaching a better understanding of growth status of institutionalized children in Nepal.

Mean Leeway space in Nepalese children attending a tertiary care hospital, Bhaktapur: A radiographic evaluation

Background: Leeway space becomes important during the change of dentition and occlusal development. Objectives: The study was designed to measure the mean leeway space of maxilla and mandible of Nepalese children using Orthopantomogram radiographs and also to compare the difference between mean leeway space in male and female children. Methodology: After ethical approval, 270 OPG (Orthopantomogram) radiographs of age groups 6-12 years Nepalese children exhibiting mixed dentition were selected for the study after following the inclusion and exclusion criteria by convenience sampling method. A digital measurement in the OPG software was used to measure the mesiodistal width of deciduous canine and molars along with permanent canine and premolars in all quadrants. Results: The mean leeway space on maxilla was seen to be (0.86 ±1.97mm) while for mandible was (2.45± 1.85 mm).The leeway space in both maxilla and mandible was seen to be more in females (0.87 ± 1.87 mm) and (2.52 ± 1.85 mm) than in males (0.85 ± 2 mm) and (2.40 ± 1.90mm)respectively. Conclusion: The mean leeway space in Nepalese children was found to be less than the standard “Leeway space of Nance” which could be due to population tooth crown differences and various environmental factors. Further studies could be recommended in the future both radiographically and clinically for obtaining a standardized leeway space for Nepalese population.