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Introduction: Frenum attachments are fold of mucous membrane attaching the lips to alveolar mucosa and underlying periosteum. Aberrant location of attachment of maxillary labial frenum poses many clinical problems such as mucogingival problems and midline diastema. Objective: The study was performed to assess the variations in morphology of maxillary labial frenum in a sample of Newari children of Bhaktapur, Nepal. Methods: A descriptive cross-sectional study was performed enrolling 340 Newari children residing in Bhaktapur from August 14, 2020 to March 30, 2021. The study comprised both genders within age group of 6 to 16 years. The frenal attachment was recorded according to Mirko and Sewerin classification. The data was analysed with Statistical Package for the Social Sciences version 16 using descriptive statistics. Results: In total, 340 Newari children participated in this study. The mucosal type was observed in 204 (60%) of the participants followed by gingival type 101 (29.7%). More than 80% of the participants had simple frenum (283, 83.2%). The frenum with nodule was present in 25 (7.4%) and frenum with appendix in 22 (6.5%) of study participants. Frenum with appendix was mostly present in males 18 (10.1%) than females 4 (2.5%). Conclusion: Within the Newari children, the mucosal type of maxillary labial frenum was more prevalent followed by gingival type. The simple frenum was the most common type on basis of morphology.

Background: Hepatitis B is a serious public health problem and dental healthcare workers (HCW) are at a greater risk of acquiring the infection. The main aim of this study was to as­sess the knowledge, attitude, and hepatitis B vaccination status of dental HCW at a tertiary dental hospital. Methods: A cross-sectional study was carried out among all dental HCW and their knowledge lev­el, attitude, and vaccine uptake were measured. Factors associated with the receipt of full hepatitis B vaccination was assessed using Pearson’s chi-square test. The data was analyzed using Statistical Package for the Social Sciences version 23. Results: Out of the total 254 dental HCW, 207 responded to the survey signifying a response rate of 81.5%. The mean age of the participants was 25.6±5.4 years. A majority of the participants were female (156; 75.4%), unmarried (169; 81.6%), and dental students (117; 56.5%). Most participants had a fair knowledge (117; 56.5%) and a positive attitude regarding Hepatitis B virus (189; 91.3%). However, the uptake of full dose of hepatitis B vaccine was only 41.5%. Dental HCW’s age, marital status, educational attainment, and type of dental HCW were associated with receipt of full vac­cination (all p-value

Background: Mouth opening is an everyday activity which plays a vital role for mastication and speech. Restricted mouth opening may be associated with musculoskeletal disorder or some pathology in the masticatory system or due to orofacial infections and trauma, as well as chronic condition such as disorders of the temporomandibular joint and tumors. So, den­tist are concerned about their patient’s ability to open the mouth for oral examination and dental procedures. This study was aimed to measure the maximum mouth opening among the Newari children of Bhaktapur. Methods: A descriptive cross-sectional study was conducted among the Newari school children of Bhaktapur with a sample size of 250 subjects. Descriptive statistical analysis was done using SPSS version 16. Results: Among the participants, one hundred and nineteen (47.6%) were male while 131 (52.4%) were female. The mean maximum mouth opening seen in male was 41.61 ± 6.21mm and in female was 40.22 ± 5.85 mm. The mean maximum mouth opening in 3 to 5 years age group was 33.19 ± 4.24 mm, 6 to 8 years age group was 37.92 ± 4.34 mm, 9 to 11 years age group was 43.47 ± 4.73 mm, and 12 to 14 years age group was 45.30 ± 3.99 mm. Mouth opening differences among differ­ent gender was compared which showed male had wider mouth opening but the difference was not statistically significant. Conclusions: The maximum mouth opening in boys was slightly large than girls. The base line data was achieved in our study which needs to be validated further by conducting study in larger population.

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.

Background: Smokeless tobacco use is prevalent in Nepal, and various Smokeless tobacco products are widely available in the country. Areca nut chewing habit is common in Nepal especially in the Terai region adjoining India. This study was aimed to assess the Smokeless Tobacco use and betel nut chewing among adolescents of Bhaktapur and to assess their knowledge about Oral Submucous Fibrosis (OSMF). Methods: Cross-sectional study was performed among adolescents (age group 10-18) years studying in high schools and colleges in Bhaktapur. Random sampling methods was carried out to select 400 adolescents after taking written consent for questionnaire. Descriptive statistical analysis was done using SPSS version 16. Results: Among 400 adolescents, only 24 (6%) admitted to using smokeless tobacco and tobacco based products. One hundred sixty-two (40.5%) participants had experienced betel nut chewing where the most common form was betel nut alone. Sixty one (37.8%) of them had tried at special traditional functions. OSMF was never heard before among 392 (98%) of participants. Conclusions: Smokeless tobacco usage was seen to be less among the participants but areca nut chewing was comparatively high. Traditional functions and predominant usage of betel nut chewing at home emphasizes the need for awareness of harmful effect of betel nut chewing in any forms to be reinforced at one’s home and community. Knowledge about OSMF was seen to be scanty in the adolescents.

Background: Understanding the association between morphological aspects in the primary dentition and its transition to the permanent dentition provides the possibility of predicting the final permanent occlusion. Study on the occlusal characteristics in deciduous dentition in Nepalese population is limited. This study was aimed to assess the occlusal characteristics and spacing in primary dentition in preschool children. Methods: The cross-sectional study was conducted among 432 preschool children around Kathmandu valley after getting permission from Institutional Review Committee of Kath­mandu Medical College and Teaching Hospital. Each child fulfilling the inclusion criteria was enrolled on the study only after their assent and their parent’s consent. The primary molar relation, canine relation, overjet, overbite was assessed using Foster and Hamilton criteria with the teeth in centric occlusion. Primate and physiological spaces were assessed. Data was collected and analysis was done in SPSS version 16. Results: Among the participants, (51.9%) were male and (48.1%) female. Primate spaces was seen to be absent on157 (36.3%) children. Physiological space was seen among 190 (44%) children. Flush terminal plane molar relationship was more prevalent among 294 (68%) chil­dren. Class I canine relationship was found in 257(59.5%) children. Ideal overjet was seen in 333 (77.1%) children and ideal overbite was seen among 337(78%) children. Conclusions: Favorable characteristics traits were seen in the studied population yet longi­tudinal studies are recommended to predict the possible outcome in permanent dentition.

Achievement of a high dose of drug in the tumor while minimizing its systemic side effects is one of the important features of an improved drug delivery system. Thus, developing responsive carriers for site-specific delivery of chemotherapeutic agents has become a main goal of research efforts. One of the known hallmarks of cancerous tumors is hypoxia, which offers a target for selective drug delivery. The stimuli-sensitive micellar system developed by us, (PEG-azobenzene-PEI-DOPE (PAPD) has proven to be effective in vitro. The proposed construct developed, PAPD, contains an azobenzene group as a hypoxia-sensitive moiety that triggers the shedding of the PEG layer from the nanoparticle surface under conditions of hypoxia to improve cellular uptake. Using microfluidics, we show significantly improved cellular association and penetration under hypoxia in both single cells and in a 3D tumor model. Employing an in vivo model, we demonstrate slower tumor growth that did not induce systemic side effects, including weight loss in an experimental animal model, when compared to the free drug treatment. This complex-in-nature but simple-in-design system for the simultaneous delivery of siRNA to silence the P-glycoprotein and doxorubicin with active tumor targeting and proven therapeutic efficacy represents a universal platform for the delivery of other hydrophobic chemotherapeutic agents and siRNA molecules which can be further modified.

Aim: To explore the dental caries and periodontal disease and oral hygiene practice among the females in Chepang ethnic group. Methods: Questionnaire were developed regarding socio-behavioral aspects in the prevention and control of dental caries and periodontal diseases at an individual and population level; and mechanical and chemical plaque control in the simultaneous management of gingivitis and dental caries. Data were collected and analyzed. Results: Total 104 female patients were interviewed with their mean age of 30.1±12.7 (range: 11-70) years. 85.6% showed the regular brushing and 96.2% used the tooth brush and paste. 79% of the female brushes twice daily. Periodontal index and DMFT index showed good results. Conclusions: Despite of tooth brushing practice the prevalence of periodontal disease and DMFT were significant. This could be associated with many other factors. Education and motivation of the population is required to improve the oral hygiene, oral hygiene measures and to refrain from habits. Keywords: Caries, Chepang female, DMFT, Periodontal Index

Herpes zoster infection, commonly known as Shingles, is caused by reactivation of the Varicella-Zoster virus which may have remained latent in the dorsal root ganglia. It is characterized by prodromal symptoms of unilateral deep aching, burning pain followed by a maculopapular rash, vesicular eruptions, ulcers, and scab formations over the affected nerve distribution. The ophthalmic branch of the trigeminal nerve is more commonly involved in herpes zoster infection than maxillary and mandibular branches; in particular, the maxillary involvement is rare. This is a case report of herpes zoster infection in a 65-years-old male patient involving the maxillary division of the trigeminal nerve. This case highlights the importance of early diagnosis and prompt use of antivirals in managing orofacial infection in dental practice.

Background: Injury to a young child’s teeth and face is a traumatic experience for the child and parents. Prompt and effective action on traumatized teeth significantly increases the likelihood of a positive treatment outcome. Adequate knowledge of school teachers in emergency situation arising during school hours can prove to be a boon for the child’soral health.Objectives: To assess the knowledge of school teachers of Bhaktapur about emergency management of dental trauma and also to measure the relationship between socio demographic characteristic of teachers and knowledge about dental emergencies.Methods: The cross sectional study was conducted among 424 schools teachers of Bhaktapur district from September 2014 to March 2015. Simple random sampling was done to select the schools. Questionnaire was distributed among the teachers after taking their informed written consent. Data was collected and sent for statistical evaluation. Frequenciesand percentage were calculated. Chi-square and Fisher’s Exact test were applied.Results: Nearly one third (32.2%) teachers who had information on dental trauma knew the proper management of displaced teeth (p=0.01). Statistically significant difference was found among those who had fi rst aid training and proper management of displaced teeth (p=0.04). Teachers who had experienced dental trauma in their students were only confident of managing displacement of traumatized teeth (p=0.02).Conclusion: Knowledge of the school teachers in Bhaktapur was seen to be inadequate for emergency management of fracture and avulsed tooth.

Pharmaceutical products often have drawbacks of unacceptable taste and palatability which makes it quite difficult for oral administration to some special populations like pediatrics and geriatrics. To curb this issue different approaches like coating, granulation, extrusion, inclusion complexation, ion-exchange resins, etc for taste masking are employed and among them use of lipids have drawn special attention of researchers. Lipids have a lower melting point which is ideal for incorporating drugs in some of these methods like hot-melt extrusion, melt granulation, spray drying/congealing and emulsification. Lipids play a significant role as a barrier to sustain the release of drugs and biocompatible nature of lipids increases their acceptability by the human body. Further, lipids provide vast opportunities of altering pharmacokinetics of the active ingredients by modulating release profiles. In taste sensors, also known as electronic tongue or e-tongue, lipids are used in preparing taste sensing membranes which are subsequently used in preparing taste sensors. Lipid membrane taste sensors have been widely used in assessing taste and palatability of pharmaceutical and food formulations. This review explores applications of lipids in masking the bitter taste in pharmaceutical formulations and significant role of lipids in evaluation of taste and palatability.

Recently, it has been discovered that the PEG layer on nanoparticle surface can create steric hindrance, preventing efficient cellular uptake of PEGylated nanoparticles. Thus, it would be ideal to have a nanoparticle system that sheds the PEG layer upon reaching the tumor microenvironment. Hypoxia, which is a hallmark of cancerous tumors, can be used as a trigger to shed the PEG layer from the nanoparticle surface. In this study, a hypoxia-sensitive PEG-azobenzene-PEI-DOPE (PAPD) construct, with an azobenzene group as a hypoxia-sensitive moiety, was prepared. The feasibility of co-delivering Doxorubicin (Dox) and anti-P-gp siRNA (siPgp) using the PAPD nanoparticles was evaluated in monolayers of the Adriamycin-resistant human ovarian cancer cell line, A2780 ADR, and in 3D spheroids of the multidrug-resistant human breast cancer cell line, MCF7 ADR. Under hypoxic conditions, the PAPD nanoparticles showed up to a 60% increase in cellular uptake by monolayers and a significantly greater tumor penetration in a spheroid model. siPgp, when delivered using PAPD nanoparticles, showed up to a 60% P-gp downregulation under hypoxic conditions. The combination of siPgp and Dox delivered using PAPD nanoparticles led to an 80% cytotoxicity in cell monolayers and 20% cytotoxicity in spheroids under hypoxic conditions. In this research, a novel hypoxia-sensitive nanoparticle system was developed that demonstrated improved delivery of an encapsulated cargo and augmented cytotoxicity on multidrug-resistant cancer cells under hypoxic conditions.

Intrinsic properties that result in therapeutic activity of molecules are also the cause of many limitations for their application. Low physicochemical stability, premature inactivation in vivo, poor absorption, distribution, metabolism, and excretion (ADME), nonspecific toxicity, and poor water solubility are critical properties of such chemicals that significantly impact the potential for therapeutic efficacy. Improving these features has long been recognized as a way to develop more effective therapeutics or increase the potential of the existing ones. However, directly improving the ADME through chemical modifications of a molecule is limited since most of the small-molecule therapeutics have a very small number of groups that allow alterations without impeding the activity. Nano-sized polymeric micelles can solubilize the lipophilic drugs in their hydrophobic core, thus dramatically increase the drug concentration in aqueous environments. In addition to encapsulation and protection of the therapeutic molecules, specific delivery of a drug only where and when it is needed is one of the most significant promises for nanotechnology-based drug carriers, i.e., nanomedicines. Furthermore, these nanomedicines can be formulated to selectively respond to various specific internal or external triggers. The resulting stimuli-sensitive or ‘smart,’ drug delivery systems can undergo specific physicochemical changes that are abrupt and act as triggers to switch on particular functions of the system such as drug release. Hence, high therapeutic concentrations of the drugs can be achieved locally at their site of action. This chapter focuses on polymeric micelles as an important class of stimuli-sensitive nanomedicines.

Identity and Access Management (IAM) and Single Sign on (SSO) are two security concepts that are related to each other. IAM governs the user access in an organization whereas SSO facilitates the user by authenticating to one centralized application and not having to re-authenticate when trying to access other applications. This paper addresses the different benefits that an IAM and SSO tool can provide to reduce the security risk within an organization. Since, authentication and authorization are one of the major concerns in the cyber security; this paper analyzes common problems that are faced during authentication and authorization. We have also analyzed prior researches that have been done in the IAM and SSO space along with conducting a survey to understand the different issues and benefits of IAM and SSO. From the survey that has been conducted, we have addressed different issues when implementing IAM and SSO solutions along with understanding the architecture, in which these solutions have been deployed into. The surveys conducted have been compared with prior researches done in IAM and SSO space to understand the benefits that the solution provides. The results from the survey have been analyzed to provide the best practices when implementing IAM and SSO solutions along with the benefits provided by the solution.

Introduction: Anaemia is a pathologic deficiency in oxygen-carrying haemoglobin in red blood cells which may be the result of genetic diseases, infections and deficiency of several nutrients. Nepal is one of the developing countries where anaemia is one of the most serious public health problems. So, a study was planned to evaluate the prevalence of anaemia among children under five years in tertiary care hospital of Nepal. Methods: A cross-sectional study was carried out from August 2011 to January 2012 using a structured questionnaire interview and observation. The children were divided into three groups: group I (0-1 years), group II (>1-3 years), group III (>3-5 years). Anaemia was assessed using haemoglobin measurement in gram in decilitre on Sysmex KX -21 (automated haematology analyzer). The severity of anaemia were grouped as follows: severe anaemia, < 7.0 g/dL; moderate anaemia, 7.0 to 8.9 g/dL; and mild anaemia, 9.0 to 10.9 g/dL as per WHO classification. Stool test was also carried out to assess worm infestation. Data were analysed using SPSS 11.5. Results: There were 208 children among which 52.9 % were male while 47.10 % were female. The overall prevalence of anaemia was found to be 49.5% of which 43.3% had mild, 15.8% had moderate and 0.5% had severe anaemia. Out of 20 children in group I, 70 % were anaemic. Among the 94 each in group II and group III, children suffering from anaemia were 51% and 43% respectively. The stool investigations showed that 5.3 % children suffered from worm infestations. Conclusions: prevalence of anaemia was seen in 49.5% of children below five years age group and the diet and worm infestations didn’t affect it.doi: http://dx.doi.org/10.3126/mjsbh.v13i1.12998