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Abstract Background Forensic anthropological examinations help in identification of unidentified human remains. This study aims to establish population-specific standards for age estimation from the sternal ends of left fourth ribs in the Nepalese population. A quantitative, observational study was conducted on 387 Nepalese deceased (106 females, 281 males) between November 2021 and March 2023. Left fourth ribs were collected, macerated and examined for the study. The variables examined included pit depth, pit shape, rim and wall configurations and rib phase. Results Pit depth significantly predicted age, β = 0.642, t(385) = 16.42, p

Background: Forensic anthropological examinations help in identification of unidentified human remains. This study aims to establish population-specific standards for age estimation from the sternal ends of left fourth ribs in the Nepalese population. A quantitative, observational study was conducted on 387 Nepalese deceased (106 females, 281 males) between November 2021 and March 2023. Left fourth ribs were collected, macerated and examined for the study. The variables examined included pit depth, pit shape, rim and wall configurations and rib phase. Results: Pit depth significantly predicted age, β = 0.642, t(385) = 16.42, p < 0.001. Pit depth also explained a significant proportion of variance in age, R2 = 0.41, F(1, 385) = 269.54, p < 0.001. The age estimates from pit depth stage were 7–36 (stage 0), 7–49 (stage 1), 16–51 (stage 2), 10–58 (stage 3), 22–70 (stage 4) and 32–81 (stage 5). Age estimates for pit shape were 17–20 (stage 0), 13–48 (stage 2), 15–55 (stage 3), 24–68 (stage 4) and 39–82 (stage 5). Age estimates for rim and wall configurations were 17–20 (stage 0), 13–47 (stage 2), 17–53 (stage 3), 24–68 (stage 4) and 40–82 (stage 5). Similarly, age estimates for rib phase were 17–20 (phase 0), 18–20 (phase 1), 13–46 (phase 2), 18–50 (phase 3), 23–60 (phase 4), 32–71 (phase 5), 50–76 (phase 6), 44–81 (phase 7) and 62–85 (phase 8). The study also examined the use of transitional analysis to develop posterior probability distributions for estimation of age using rib phases. Conclusion: This study found significant differences in the age estimates from previous studies and shows the importance of developing population-specific models for use in forensic anthropology. [ABSTRACT FROM AUTHOR]

Background: Cricoid cartilage is crucial during endotracheal intubation, yet its dimensions in the Nepali population remain uncharacterized. This study aimed to measure cricoid cartilage dimensions in adult Nepalese. Methods: A total of 105 cadavers (75 males, 30 females) were dissected at *** Medical Campus, Nepal. Measurements of outer and inner transverse and anteroposterior diameters, as well as heights of the cricoid arch and lamina, were taken using digital vernier calipers. Statistical analyses included gender comparisons and correlations with age. Results: The mean age of the 105 cadavers studied was 34.11 years (SD = 12.08). The measurements of outer anteroposterior diameter, outer transverse diameter, inner anteroposterior diameter, inner transverse diameter, arch height and lamina height were respectively 22mm (SD=4), 21mm (SD=4), 18mm (SD=3), 17mm (SD=3), 9mm (SD=3) and 24mm (SD=4). Inner AP (p = 0.009) and inner TR (p = 0.021) measurements correlated significantly with age. Males had significantly larger cricoid cartilage dimensions than females (p < 0.001). Conclusions: This study provided essential data for selecting appropriately sized endotracheal tubes in Nepalese patients, reducing airway complications. It underscored the need to tailor medical devices to local anatomical variations, supporting advancements in biomechanical modeling and medical research.

Introduction: Mandibular premolars are considered an enigma in dentistry because of their variability in anatomical and morphological features making it difficult to treat endodontically. This study was conducted to determine the root and canal morphology of mandibular premolars in the Nepalese population by using cone beam computed tomography imaging. Methods: One hundred and thirty-four cone beam computed tomography images of the Nepalese population were collected by convenience sampling method from April 1 to August 31, 2022 in Bir Hospital, Kathmandu, Nepal. A total of 536 premolars (268 mandibular first premolars and 268 mandibular second premolars) were evaluated by two examiners (one endodontist and one oral radiologist). Canal configuration was classified according to Vertucci’s classification. Results: In mandibular premolar teeth, the majority had one root followed by two roots and fused roots. The most common configuration in mandibular premolars was Vertucci’s type I (83.88% and 96.65% in the first and second premolar respectively) followed by type V (9.89%) in the first premolar and type III (1.86%) in the second premolar. Vertucci’s type VII (0.37%), C-shaped configuration (1.46%), and an unusual configuration (0.37%) were observed in the first premolar. In mandibular first premolars, males showed more variation than females; while in second premolars, females showed more variation than males. Conclusions: Mandibular premolar teeth showed variation in root and canal morphology with one root and Vertucci’s type I in the majority of the cases.

Introduction The prevalence of tinnitus is increasing in younger adult rapidly. It is increasing mainly because of increased daily noise levels due to the unrestrained usage of recreational devices like mobile phones, MP3s, iPods, and other personal stereos. The aim of this study is to describe awareness and experience of tinnitus among younger adult with respect to the existence, cause, effects, and management. Methods A descriptive cross-sectional study was conducted in 205 young adult Nepalese population between the age ranges between 20 and 40 years through online survey mode. Statistical analyses were carried out using SPSS 25.0 software. Data were analyzed using the descriptive statistics. Results Result showed more than half of the participants (59.2%) were aware about the existence of tinnitus; however, only 16.1% of participants were aware about the effect of tinnitus. The incidence of tinnitus was found to be high (11.71%) in Nepalese population. Conclusion Even though most of the participants were found to be aware about existence of tinnitus, most of them were not aware about the effect of tinnitus and its cause. This result has implications for audiologist who are involved in hearing health care program across the various age groups. As per this study, since most of the participants pointed to the Internet as their source of awareness, that could be further tapped on to provide awareness in these age groups. [ABSTRACT FROM AUTHOR]

Introduction: Hypertension and Diabetes are two major risk factors for atherosclerotic disease. Carotid artery intima media thickness(cIMT) is considered a reliable surrogate measure for diagnosing subclinical atherosclerosis, its progression and regression. Paucity of available data regarding mean value of cIMT highlights the importance of defining the cut off value of cIMT in a specified population. Very limited studies have been done on sonographic evaluation of mean cIMT and carotid artery injury in hypertension and diabetes in Nepalese population. This study, therefore aims to determine mean cIMT in Nepalese population and to analyze effect of Hypertension and diabetes on cIMT. Methods: Cross-sectional hospital based study was conducted within the period of 18 months. B-mode ultrasound was used to measure cIMT in bilateral common carotid arteries. Comparison of mean cIMT was done amongst healthy, hypertensive and diabetes with hypertensive patients. Duration of disease was also considered. Data analysis was done with “R” analytical study. Results were expressed as mean ± standard deviation. Results: Total1005 (508 female and 497 male) adult patients with age range of 30 to 85 years were assessed. Among these 329(32.74%) were healthy adults, 341(33.93%) were hypertensive and 335(33.33%) were diabetes with hypertensive patients. The mean cIMT in cases was more than controls (P < 0.001) bilaterally with diabetes having an additive effect. There was also positive correlation of measured value with duration of disease and age of patients. Conclusion: The present study found that mean cIMT in cases was more than controls. There is an additional effect of Diabetes on cIMT in hypertensive patient. Age and duration of disease can accelerate atherosclerosis.

Background: Presence of lumbosacral transitional vertebra may lead to number of clinical consequences because of failure to correctly number the problematic vertebra and also has been associated with low back pain. Different studies done at different part of the world have shown wide range of prevalence of lumbosacral transitional vertebra. Aims and Objective: This hospital based cross sectional observational study was undertaken to determine the prevalence of lumbosacral transitional vertebra among the Nepalese population. Materials and Methods: Plain radiographs (anteroposterior and lateral views of lumbosacral spine and KUB radiographs) of 947 patients (646 with lumbosacral spine and 301 with KUB radiographs) done from August 2015 to July 2016 and meeting inclusion criteria were retrospectively analyzed for the presence of lumbosacral transitional vertebra. Results: The overall prevalence of lumbosacral transitional vertebra was 14.7% with prevalence of 16.3% in patients with lumbosacral radiographs and 11.3% in patients with KUB radiographs and was statistically significant. Prevalence of sacralization was higher than lumbarization (11.9% Vs 2.7%). Lumbosacral transitional vertebra was more common in females than in males with Castellvi type I being most common and type IV least common. Conclusion: The overall prevalence of lumbosacral transitional vertebra in the studied Nepalese population was 14.7% with significantly higher prevalence in patients with lumbosacral radiographs than with KUB radiographs.

Background & Objectives: Mesio-distal tooth size-arch length discrepancy is one of the major sources of malocclusion. Accurate prediction of space required for unerupted tooth can help in early interception of developing malocclusion. Various methods has been proposed for prediction of mesio-distal tooth size however accuracy of such methods in population groups other than that on which these methods are based remains questionable. The aims and objectives of this study were to test the reliability of Moyer’s and Tanaka Johnston mixed dentition analysis in Nepalese population, to construct prediction tables for Nepalese population if these methods were found not reliable.Materials & Methods: Study models of 77 subjects (31 males,46 females) fulfilling the inclusion criteria were retrieved from department archive. Tooth dimensions were measured using electronic digital caliper. Moyer’s and Tanaka and Jhonston methods were applied to predict the mesio- distal tooth size of canines and premolars. The predicted values were compared with the actual mesio-distal mesio-distal size. A regression equation based on actual canine and premolar mesio-distal dimensions and sum of mandibular permanent incisors was also developed.Results: Independent t-test showed that there was no significant difference between mesio-distal tooth size in males and females. Paired t-test showed that there was no difference in mesio-distal tooth size between right and left sides of the arch. Tanaka – Johnston analysis overestimated the mesio-distal size in both males and females. Moyer’s method at 75% overestimated the mesio-distal size in male and female and the difference were statistically significant while at 50% it underestimated the tooth size in females.Conclusion: Moyer’s and Tanaka and Jhonston method of mesio-distal size prediction are inaccurate when applied in Nepalese population. A new regression equation to predict the size of tooth has been presented.

CORRECTION: The conclusion on the PDF of this article was replaced on 17th April 2016. The corrected PDF is now available by clicking on the link below.Background & Objectives: Ectopic Left ventricular diastolic dysfunction is now well established as a cause of left sided heart failure and as a powerful predictor of cardiovascular events. It is attributed mostly to systemic hypertension. The objective of the study was to determine the prevalence of left ventricular diastolic dysfunction in recently diagnosed hypertensives in Nepalese population using echocardiography. Materials & Methods: Two-dimensional echocardiography was performed on 120 newly diagnosed patients of systemic hypertension. Transmitral Doppler indexes of diastolic function, Valsalva maneuver applied to the same mitral inflow pattern, pulsed tissue Doppler of the mitral annulus, deceleration time, isovolumic relaxation time and pulmonary venous flow pattern.Results: The age of the patients in our study ranged from 20 to 84 years with mean age of 50years±14.13 years (standard deviation) and male:female ratio being 1.35:1. Hypertensive patients were highest in age group 45-64 years followed by 25-44 years in both the genders. Majority of the patients had stage 1 hypertension (44.16%) followed by stage 2 HTN in 34.17% and pre-hypertension in 21.67%. The majority of the patients in our study had Grade 1 LVDD (66.67%), 10.83% patients had Grade II LVDD, only 2.50% had non-restrictive Grade III LVDD and none had LVDD-IV. Stage II hypertensives had more LVDD(I+II+III): 39/41-95.12% than stage I hypertensives(39/53-73.58%) and pre-hypertensives (8/26-30.77%). The association between stages of systemic HTN and LVDD was found to be highly statistically significant (p=0.002). Conclusion: Our study showed that left ventricular diastolic dysfunction is a common entity in Nepalese population with systemic hypertension.JCMS Nepal. 2016;12(1):14-18.

Background & Objectives:Sarcoidosis is a multi-system granulomatous disorder of unknown origin.The frequency and the clinical presentation of sarcoidosis vary among the geographical regions. This study is a retrospective analysis of the sarcoidosis patients diagnosed in Nepalese population. The aim of this study was to find the prevalence of sarcoidosis in Nepalese population which has high prevalence of tuberculosis and to understand the clinical profiles and ethnic differences.Materials & Methods:A retrospective chart analysis was done in all the patients from January first, 2005 to December 31st, 2010 who had abnormal chest radiograph and who were diagnosed with sarcoidosis. The study was done at Nepal Medical College Teaching Hospital and Everest Nursing Home.Results:A Forty two patients were diagnosed to have sarcoidosis over a five year period, of which 23/42 (55.0%) were females and 19/42 (45%) were males. The mean age was 36 years with minimum age being 18 years and maximum 72 years. As far as Ethnicity is concerned, 15/42 (36.0%)were Brahmins,08/42(19.0%) were Marwadi, and 07/42(17.0%) were Chhetri. The most common presenting symptom was cough 19/42 (45.0%).Out of the 42 patients, eight were being treated for pulmonary tuberculosis. Most common radiographic findings were bilateral hilar lymphadenopathy 15/42 (36.0%).Conclusion:Sarcoidosis is common in Nepal and should be considered in the differential diagnosis before treating the patient empirically for tuberculosis.

Establishing the identity of the deceased becomes essential when highly decomposed bodies, mutilated body parts or skeletal remains are recovered from mass fatality sites. In these situations, estimation of stature along with other parameters such as age, sex and race/ethnicity becomes important to establish the biological profile of the deceased. Following the Maoist insurgency in Nepal, there have been numerous discoveries of unidentified human remains in mass graves or otherwise. No systemic studies and anthropological data on the Nepalese population however, is available posing problems in anthropologic evaluation of the remains. The sample of the present study consisted of 200 autopsied cases (148 males and 52 female adult cadavers). During the autopsy, the scalp was reflected after giving a coronal incision extending from one mastoid to the other exposing the cranium in each case. Maximum cranial length (MCL), maximum cranial breadth (MCB), bi-zygomatic breadth (BZB), minimum frontal breadth (MFB) and length of parietal chord (PC) were then measured. Stature was measured as the length of the body from head to heel in centimeters with the heel, buttocks, back of the shoulders and the head in contact with the autopsy table. Linear and stepwise multiple regression models were derived for estimation of stature from cranial measurements. Univariate, bivariate and multivariate regression models show statistically significant correlation between stature and the cranial measurements. The present study opines that the stature estimation from cranial dimensions using multivariate linear regression models is more accurate than those of the univariate and bivariate regression models. This study presents a rare data from Nepalese population that show typical Asian features and thus, is significant from anthropologic and genetic point of view. The study observations further contribute a baseline data bank for forensic pathologists and specialists. [ABSTRACT FROM AUTHOR]

Objective: To establish the Steiner's cephalometric norms for a Nepalese population, compare the gender and inter-racial variations in dentoskeletal and soft tissue structures, and to test the null hypothesis that there are no racial differences in cephalometric measurements between Nepalese, Caucasians and other populations. Design: Prospective, cross-sectional study. Subjects and methods: One hundred and twenty lateral cephalograms of Nepalese subjects aged 16-21 years with class I normal occlusion and balanced facial aesthetics were selected. The cephalometric variables were measured. An independent one sample t test was used to compare the Steiner's ideal values with Indo-Aryan Nepalese means and independent t test to compare Japanese means with Mongoloid Nepalese means and Mongoloids with Aryans. Entra-investigator error was assessed with Lin's concordance method and the reliability of aesthetic evaluation of the photographs was tested with Cronbach's alpha. Results.' Nepalese Mongoloid males possessed more protrusive lips (Z angle mean difference, 8°; P<0.001) than the Indo- Aryan males. Mongoloid females had more protrusive mandible (SNB angle mean difference, 3.7°; P<0.001), greater class 11 skeletal bases (SND angle mean difference, 3.5°; P<0.001), longer SL length (mean difference, 5.6 mm; P<0.01), more proclined upper incisors (UI-NA mean difference, 6°; P<0.01) and a more protrusive lower lip (lower lip-S line mean difference, 0.9 mm; P=0.003), lower lip-E line (2.0 mm; P<0.001) and Z angle (4,40; P<0.001), than the Endo-Aryan females. Differences between the Nepalese sample and published Caucasian and Japanese norms are also described. Conclusions: Differences in the cephalometric values exist between the two ethnic groups in Nepal, as well as between our Nepalese sample and published Caucasians and Japanese norms. The norms published in this article will be useful when planning orthodontic treatment in Mongoloid and Indo-Aryan individuals. [ABSTRACT FROM AUTHOR]