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Background: Coronavirus Disease 2019 is global pandemic having high morbidity and mortality. It is thought that COVID-19 can predispose high thrombus burden and lead to Acute Coronary Syndrome. The aim of this study was to compare the symptoms, angiographic characteristics and procedural outcome in COVID-19 positive and COVID-19 negative patient undergoing percutaneous coronary intervention for acute coronary syndrome. Methods: All the data of 121 patients who were admitted at Chitwan Medical College on April 2020 to September 2020, suffering from acute coronary syndrome who underwent PCI were collected and compared with COVID-19 positive and negative patients using SPSS version 22. The categorical variables were presented as numbers or percentages (%) and continuous variables were presented as mean ± standard deviation. Results: Patient suffering with acute coronary syndrome with concurrent COVID-19 infections have more symptoms of fever (27.3% Vs 0.9%) and cough (27.3% Vs 2.8%, complications (45.5% Vs 7.3%), Mortality (36.4% Vs 0.9%), multi vessels thrombosis (27.3% Vs 2.8%) glycoprotein IIb/IIIa inhibitors use (27.3% Vs 0.14%) than non-COVID infection. Conclusions: Patient with acute coronary syndrome with concurrent COVID-19 infections have high complication rate, multivessel thrombosis and death.

Background: Electrical injury and its consequences after exposure to electric shock has been associated with an increased risk of developing immediate and delayed cardiac arrhythmias. The aim of this study was to evaluate the prevalence of cardiac arrhythmias and different symptoms in patient with high voltage and low voltage electrical injury. Methods: All 50 consecutive patients who were admitted in Chitwan Medical College from April 2018 to March 2020 were prospectively studied. Patients were categorized into high and low voltage injury group and their variables were compared. Results: The mean age of the patients was 32.3±10.4 years among them 41 (82%) were male. Patients who sustain high voltage electrical injury (>1000V) were 18 (36%) and low voltage injury (

Background: Dengue fever is one of the most common tropical diseases caused by an arbo­virus. This virus is a member of genus Flavivirus and flaviviradae family, is transmitted by bite of Aedes aegypti mosquito. Its outbreak is being reported from different parts of the world including Nepal. This disease is prevalent throughout Nepal mostly in terai regions. The aim was to study the epidemiological and clinical spectrum of dengue fever at tertiary care hos­pital in Chitwan. Methods: This study was a hospital based prospective study where a total of 241 patients di­agnosed with dengue fever were assessed. This study was carried out from September 2019 to February 2020. Data was entered on predesigned proforma and analyzed by using SPSS version 16.0. Mean and standard deviations was calculated for continuous variables and frequencies for categorical variables. Results: More than half (56%) of the dengue patients belonged to the age group of 25-44 years. Out of 241 patients, 61.4% were males. Apart from fever the other common symptoms were ret­roorbital pain/headache comprising around 80% of patients. The mean duration of hospital stay in our study was 3.86 days. Approximately 72% (173) patients had leucopenia and 8.7% (21) had severe thrombocytopenia(

Purpose This study aimed to determine whether complete dentures improve the oral health-related quality of life (OHRQoL) of edentulous patients, and to assess any associations related to age, gender, and OHRQoL. Material and methods Hundred edentulous patients who required conventional complete denture treatment were selected for this study. The following inclusion criteria were established: edentulous in both jaws with no previous history of denture treatment and no significant medical history. The patients were selected who satisfied the criteria associated with the class I prosthodoctic diagnostic index. OHRQoL of the patients were assessed twice, once pre treatment (at the first visit) and once post treatment (8 weeks post insertion of dentures) using an instrument called OHIP-EDENT-N. Significant differences in the OHIP-EDENT-N scores between pre treatment and post treatment were calculated using the Wilcoxon Signed-Rank test. Gender differences were assessed using the Mann–Whitney test. Results After provision of new complete dentures, all domains of the OHIP-EDENT-N showed significant improvements except physical pain and social disability. Conclusions The results of this study indicated that conventional complete denture improved the OHRQoL of edentulous patients.

Introduction: The dental implant has now become a routine treatment for oral rehabilitation. The treatment planning and positioning of implants is greatly dependent upon the clinicians’ understanding of the alveolar architecture of the maxilla and mandible. In the esthetic zone, the implants therapy can be successful only if it is in harmony with the surrounding tissues. Objectives: To study the labial osseous wall thickness of the anterior maxillary bone at various sites apical to the cemento-enamel junction using the cone beam computed tomography (CBCT). Materials and Methods: Cone beam tomographic scans of 150 Nepalese adults (70 females and 80 males) were obtained from the Oral Radiology Unit, Kantipur Dental College Teaching Hospital & Research Center. CBCT scans were carried out by trained technicians using CS 9300 (Carestream Dental, Atlanta, GA, USA). In the CBCT images, distances between the CEJ and alveolar crest (AC) as well as the labial bone thickness at different levels (at the crest, 1mm, 3mm and 5 mm) were measured for central incisor (CI), lateral incisor (LI), and canine (C). Results: It showed that the average distance between CEJ and crest of CI, LI, and C were 1.98±0.84 mm, 2.09±0.83 mm, and 2.12±1.20 mm, respectively. Only 3.3% of the CI, 10.7% of the LI, and 13.3% of the C showed a thick labial bone (1–2 mm) at the crestal level. At the 1 mm level, 75.3% of the CI, 64.5% of LI, and 70% C showed a very thin bony wall. Similarly, none showed very thick bony wall (>2mm). The thickness level was significant at the crest and at 5 mm level. The highest bone thickness of LI was found at the 1 mm level. In addition, there was also significant difference in different levels of LIs. The mean distance between the CEJ and the AC for the CI and the C was significantly higher in males than females. Conclusion: The labial bone in the anterior maxilla is inherently thin, with more than 80% of the sites showing less than 1 mm. The results of this study may be useful for the implant planning in the esthetic zone and it is recommended tissue augmentation (soft and hard) to achieve esthetic emergence profile.

Background: Denture adhesives play an important role in the retention of removal dentures. This research aimed to study the knowledge and attitude (K&A) of Nepalese dental interns in various Universities/ dental colleges towards adhesives for removal denture (ARDs). Materials and Methods: A survey was conducted among the dental interns of various colleges in Nepal. Pearson’s Chi-square test was carried out to compare the various variables among the Universities/ dental colleges. Rating scale was used for testing the K&A towards denture adhesives. Results: It was found that 86.5% of the dental interns had adequate K&A on ARDs, 87.8% responded that ARD is beneficial for dentures and 95.5% agreed that dentists should regularly inform regarding ARDs to all denture patients. Conclusion: Most of the Nepalese dental interns of various Universities/ dental colleges possessed acceptable K&A on ARDs.

Background: Urinary tract infection (UTI) is characterized by pathological invasion of the urinary tract by microorganisms. Majorities of organisms causing UTI are gram negative bacteria, most common of which is E. coli. Urine culture and sensitivity test is used to isolate the organism and to identify the susceptible drug of choice for appropriate treatment. This hospital-based study was carried out to analyze the spectrum and antibiotic susceptibility of microorganisms causing UTI. Methods: A retrospective study was done to analyze the results of urine culture and sensitivity test done at Chitwan Medical College Teaching Hospital over a period of two and half years. Standard guideline and protocol were used to collect the urine sample and to perform the test. Data analysis was done using SPSS version 21.0. Result: Out of 12, 925 urine samples submitted for culture and sensitivity test during the study period, bacterial pathogens were isolated from 3, 173 (24.54%) samples, which was significantly higher among females (28%) than the males (17%). The most common organism isolated on the culture was E. coli (68.5%) followed by Klebsiella (18.4%). Sensitivity of the uropathogens was seen highest with colistin (79.2%) followed by teicoplanin (64.58%), Aztreonam (63.25%) and Ni­trofurantoin (61.16%). Most common antibiotics that showed resistance to the microorganisms in this study were Ampicillin (60.93%), Cotrimoxazole (53.72%), Cefixime (40.57%) and Levofloxacin (32.93%). Conclusions: This study has found a usual pattern of UTI with higher prevalence among females and E. coli being the most common organism. Nitrofurantoin has been found to have a good sus­ceptibility for the treatment of UTI.

Background: Urinary tract infection (UTI) is characterized by pathological invasion of the urinary tract by microorganisms. Majorities of organisms causing UTI are gram negative bacteria, most common of which is E. coli. Urine culture and sensitivity test is used to isolate the organism and to identify the susceptible drug of choice for appropriate treatment. This hospital-based study was carried out to analyze the spectrum and antibiotic susceptibility of microorganisms causing UTI. Methods: A retrospective study was done to analyze the results of urine culture and sensitivity test done at Chitwan Medical College Teaching Hospital over a period of two and half years. Standard guideline and protocol were used to collect the urine sample and to perform the test. Data analysis was done using SPSS version 21.0. Result: Out of 12, 925 urine samples submitted for culture and sensitivity test during the study period, bacterial pathogens were isolated from 3, 173 (24.54%) samples, which was significantly higher among females (28%) than the males (17%). The most common organism isolated on the culture was E. coli (68.5%) followed by Klebsiella (18.4%). Sensitivity of the uropathogens was seen highest with colistin (79.2%) followed by teicoplanin (64.58%), Aztreonam (63.25%) and Ni­trofurantoin (61.16%). Most common antibiotics that showed resistance to the microorganisms in this study were Ampicillin (60.93%), Cotrimoxazole (53.72%), Cefixime (40.57%) and Levofloxacin (32.93%). Conclusions: This study has found a usual pattern of UTI with higher prevalence among females and E. coli being the most common organism. Nitrofurantoin has been found to have a good sus­ceptibility for the treatment of UTI.

Transportation infrastructure has remained a critical component of a country's economic and social growth. The need for new roads and upkeep of current roads is quite strong, particularly in emerging nations, as they are directly related to overall development. This is a plea for a paradigm shift in the way roads are constructed. Recent research have shed light on the need of greening and sustainable transportation, which can expedite the process of rescuing the world from additional severe situations. One of the most effective approaches to solve this issue is by the substitution or replacement of pavement layers with non-natural materials. Numerous studies have been conducted to determine the feasibility of employing different alternative materials in road building, especially recycled trash. The objective of this study is to assess the environmental implications of alternative materials such as waste plastics in road building and to demonstrate their viability. This is accomplished by evaluating several environmental effect criteria such as global warming potential, carbon footprint, and cost. The comparison of these materials demonstrates their use in pavement construction and their distinct limitations when used on a wide scale. This will result in more efficient, inexpensive, and sustainable pavement design and construction. Current practice of recycled waste plastics includes 7 major types: polyethylene terephthalate (PETE), high-density polyethylene (HDPE), polyvinyl chloride (PVC), low-density polyethylene (LDPE), polypropylene (PP), polystyrene (PS), and others such as acrylonitrile butadiene styrene (ABS), ethylene vinyl acetate (EVA), polycarbonate (PC), and polyurethane (PU).

Introduction Awareness about dental implants is increasing among dental patients, which demands a higher level of competence for dental students. So, the objective of this study was to assess the knowledge and perception of undergraduate dental students about dental implants. Materials and methods This cross-sectional questionnaire-based survey was conducted after taking ethical clearance and approval from the Institutional Review Committee of B.P. Koirala Institute of Health Sciences and informed consent from each dental college of Nepal. The sample included all those students who were present at the time of survey. Data collection were carried out during the academic schedules of the colleges, supervised, and monitored by the investigators themselves. Collected data were coded, entered in Microsoft excel 2013 and descriptive analysis was carried out. Results A majority of the total (54.6%) and 59.2% of 5th year respondents perceived to be moderately well-informed about dental implants. The main advantage of dental implants was thought to be longevity by 53.1% of total and 48.4% of 5th year students; only 27.6% of the total and 42.2% of 5th year students said the main advantage of dental implants is they are more conservative than other tooth-replacement modalities. Highest percentage of the total respondents (31.9%) said most important factor for implant success to be implant type and material, whereas 59.8% of 5th year students said case selection. Those who felt dental implants require additional oral hygiene maintenance and care by the patient and dentist were 58.4% of total and 75.1% of 5th year students. Over two-thirds (67.5%) of total thought that economic feasibility will limit use of dental implants in Nepal. The difficulty encountered to place implants was perceived to be average by 56.8% of total and 58.1% of 5th year. There were differences in the perception and knowledge at different academic levels, but not as expected. Conclusions It could not be concluded that knowledge about dental implants increased with increase in academic level. Even at the late-clinical year a majority of students gave unsatisfactory responses.

Introduction: The purpose of this study was to identify and compare aerobic microorganisms adhering to polished and tissue surfaces of temporary removable partial dentures at 24hrs and at one week of dentures in use. Materials and methods: A total of 31 patients visiting the department of Prosthodontics for temporary removable partial dentures without any known systemic and oral diseases were included in the study. Dentures were fabricated according to the standard prosthodontic procedures accepted in the department. Each patient was examined twice, once after 24hrs of denture insertion, and then at oneweek of use wherein plaque samples were collected from the polished surface and the tissue surface. The samples were taken to the microbiology lab for microbiological investigations within half an hour of sample collection and different microorganisms were identified. Results: Microorganisms identified at 24 hours from polished and tissue surfaces of the dentures were same in type and not significantly different in frequency of isolation. They were Streptococcus spp., Staphylococcus spp., Acinetobacteranitratus, Enterobacter cloacae, Pseudomonas aeruginosa, Citrobacterfreundii and Candida albicans. Those identified at one week of dentures in use, from the two surfaces were same in type but three new types of microorganisms, Klebsiella pneumonia, Escherichia coli, and Proteus vulgaris were also found. There was a significant difference in the isolation frequency of Staphylococcus spp. from the two surfaces. Conclusion: Same types of microorganisms adhere to both the surfaces but significant differences may occur in frequency of isolation. With time dentures favour colonization of new microorganisms.

Objectives of this study were to see the types of aerobic microorganisms present in the saliva of Complete Denture wearing patients and to see any change in isolation frequency and types of microorganisms at 1-week of dentures in use. Materials and Methods: Ethical clearance from the institutional ethical committee and written consent from the patients were taken. All the patients were assessed by taking a detailed history and clinical examination which were recorded in the pre-designed proforma. Standard procedures accepted in the Department of Prosthodontics and in the Department of Microbiology were performed. Each patient were examined twice, once at 24hrs of denture insertion and then at 1-week of dentures in use. A micropippet was used to collect the resting saliva from the floor of the mouth and was diluted in 1ml of normal saline in a sterile vial and was immediately taken to the microbiology lab for culture within half an hour of sample collection. Result: Microorganisms identified at 24hrs of Complete Denture insertion were Streptococcus spp. (n=35), Staphylococcus spp. (n=15), Klebsiella pneumonia (n=5), Acinetobacter anitratus (n=5), Enterobacter cloacae (n=4), Citrobacter freundii (n=4), Pseudomonas aeruginosa (n=1) and Proteus vulgaris (n=1). Two new microorganisms were isolated at 1-week, Escherichia coli (n=1) and Candida albicans (n=2). Frequency of isolation of the gram negative bacteria increased at 1-week except for Proteus vulgaris. Conclusion: Use of Complete Denture favours colonization of some microorganisms which appear in saliva of patients.

Objectives: Acute kidney injury is one of the most common cause of hospitalization in developing countries. Causes of AKI are multifactorial. Most of AKI are community acquired. The objective of the study was to identify the clinical profile and outcome of acute kidney disease. Subject and Methodology: 30 patients from Chitwan Medical College outpatient clinic were included in the study from November 2014 to April 2015. A brief history and clinical examinations were taken from all patients along with laboratory tests for Renal function tests, urine output, metabolic parameters and hematological profile. Results: 19 males (63.3% and 11 females (36.7%) were studied. The main causes for AKI were sepsis (46.6%) followed by hepatic causes (16.6%), gastroenteritis (10%) and others (10.2%). Out of 30 patients, 19 recovered (63.3%) and were discharged and 11(36.7%) died. Most of the deaths were in injury (37.5%) and failure (42.8%) stages of RIFLE criteria. Out of 19 recovered 16(84.21%) patients did not need any renal replacement therapy whereas 3(15.8%) patients had to undergo hemodialysis. Conclusion: Early identification of kidney injury may lead to lesser renal replacement therapy and better prognosis. However late presentations of AKI have higher hospital mortality rate.

Objectives: Vitamin D deficiency is being studied all over the world and is a global health problem. Recent studies haveshown that Vitamin D may have a significant role in reducing the incidence of autoimmune diseases. This study was conducted to find out the level of Vitamin D in patients with thyroid disorders and compare Vitamin D levels in Anti Tpo positive and negative patients. Subject and Methodology: 60 patients from Chitwan Medical College outpatient clinic were included in the study from February to May 2016. A brief history and clinical examinations were taken from all patients along with laboratory tests for thyroid functions, TPO antibody level of 25(OH) Vitamin D3 level and Serum Calcium level. Results: Both patients of hypothyroidism (autoimmune and nonautoimmune) had severe Vitamin D deficiency. Most of the hyperthyroid cases had Vitamin D insufficiency. Anti TPO positive and negative patients both had Vitamin D deficiency. Conclusion: Our study shows there is significant Vitamin D deficiency in hypothyroidism and hyperthyroidism irrespective of its autoimmunity. This study certainly encourages us to screen Vitamin D and supplement Vitamin D to all thyroid disorders patients.

Purpose To assess the reliability and to validate the translated Nepalese version of the Oral Health Impact Profile (OHIP-EDENT-N) in Nepalese edentulous subjects. Materials and Methods The international guidelines for translation and cross-cultural adaption of OHIP-EDENT were followed, and a Nepalese version of the questionnaire was adapted for this study. Eighty-eight completely edentulous subjects were then selected for the study and completed their responses for the questionnaire. The reliability of the OHIP-EDENT-N was evaluated using internal consistency. Validity was assessed as construct and convergent validity. Construct validity was determined using exploratory factor analysis (EFA). The correlation between OHIP-EDENT-N subscale scores and the global question was investigated to test the convergent validity. Results Cronbach's alpha for the total score of OHIP-EDENT-N was 0.78. Construct validity was assessed by factor analysis: 70.196% of the variance was accountable to five factors extracted from the factor analysis. Factor loadings above 0.40 were noted for all items. In terms of convergent validity, significant correlations could be established between OHIP-EDENT-N and global questions. Conclusions This study has been able to establish the reliability and validity of the OHIP-EDENT-N, and OHIP-EDENT-N can be a considered a reliable tool to assess the oral health related quality of life in the Nepalese edentulous population.

Implant therapy is an elective dental procedure of dental rehabilitative treatment. Objective of this study was to assess the knowledge, awareness, and attitude of dental interns of Nepal toward dental implants and to see associations of the responses with gender and geographic location of dental college.It was conducted from June 2016 to June 2017 after taking ethical clearance and approval from the research committee. The sample included the interns who were present at the time of the survey. Data collection was done through a cross-sectional questionnaire survey, during clinical postings of the interns at all the dental colleges of Nepal, supervised and monitored by the investigators themselves; coded and entered in Microsoft Excel 2013 and statistical analysis was done by SPSS 20 version.A majority of the interns said they are moderately well informed about dental implants 141 (50.36%); main advantage of dental implants is they are conservative 164 (58.6%); most important factor for implant success is case selection 143 (51.07%); the longevity of dental implants is 10-20yrs, 162 (57.85%), 188 (67.14%) agreed that they were not provided with sufficient information and 191 (68.21%) stated that they need more information; 180 (64.3%) felt the difficulty encountered while placing implants is average and 229 (81.78%) stated that they need more hygiene care than natural teeth. There were major differences in the mindset to some other questions. Significant associations were seen with the location of college for some responses.A majority of interns have knowledge regarding dental implants, but the percentage of those who gave unsatisfactory answers is also large. They have a positive attitude towards gaining more information through various means.

Objectives. This study was conducted to know the preferred source and perceived need of more information about dental implants by the undergraduate students of Nepal and their association with academic levels and gender. Materials and Methods. It was conducted in all the dental colleges of Nepal from June 2016 to June 2017 after taking ethical clearance and approval from the research committee of BPKIHS. It included all those who were present at the time of survey. Data collection was done through a cross-sectional questionnaire survey during the academic schedule of the colleges, supervised and monitored by the investigators themselves. The collected data were coded and entered in Microsoft excel 2013, and statistical analysis was done by SPSS 20 version. Result. A majority of the respondents agreed that they were not provided with sufficient information about implant treatment procedures during their BDS program (65.3%), would like more to be provided in the curriculum (95.1%), and would like to get additional reliable information from dental consultants and specialists (40.7%) and training on it from fellowship programs conducted by universities (39.2%). Significant association was seen between the responses and academic levels. Conclusion. Undergraduate dental students of Nepal want more information about dental implants through various means.

Purpose.Closed hollow bulb obturators are used for the rehabilitation of postmaxillectomy patients. However, the time consuming process, complexity of fabrication, water leakage, and discoloration are notable disadvantages of this technique. This paper describes a clinical report of fabricating closed hollow bulb obturator using a single flask and one time processing method for an acquired maxillary defect. Hard thermoplastic resin sheet has been used for the fabrication of hollow bulb part of the obturator.Method.After fabrication of master cast conventionally, bulb and lid part of the defect were formed separately and joined by autopolymerizing acrylic resin to form one sized smaller hollow body. During packing procedure, the defect area was loaded with heat polymerizing acrylic resin and then previously fabricated smaller hollow body was adapted over it. The whole area was then loaded with heat cure acrylic. Further processes were carried out conventionally.Conclusion.This technique uses single flask which reduces laboratory time and makes the procedure simple. The thickness of hollow bulb can be controlled and light weight closed hollow bulb prosthesis can be fabricated. It also minimizes the disadvantages of closed hollow bulb obturator such as water leakage, bacterial infection, and discoloration.

The pleomorphic adenoma of lacrimal gland presents as a painless, progressive, slowly growing supero-temporal swelling with variable proptosis. This tumor is usually found in adults and extremely rare in teenage. We report a case of a 15-year-old boy with pleomorphic adenoma of lacrimal gland which mimicked pseudotumor of orbit due to its presentation as an orbital inflammatory disease and the age distribution. Neuroimaging also suggested pseudotumor and oral steroid was started. But, there was no improvement on steroids and ultrasound guided Fine Needle Aspiration Cytology (FNAC) was performed which suggested Pleomorphic adenoma of the lacrimal gland. En-bloc excision of the mass through antero-lateral orbitotomy was done with satisfactory final outcome The histopathological evaluation was consistent with pleomorphic adenoma of the lacrimal gland. Keywords: lacrimal gland pleomorphic adenoma; orbitotomy; proptosis; pseudotumor.

Introduction: Dental implants are considered one of the best treatment options for completely or partially edentulous patients. But due to lack of knowledge and education many patients especially in the region of underdeveloped or developing countries do not opt for this. In current study the knowledge, attitude and awareness about dental implants was studied in a referral center and its outreach centers in Nepal. Purpose: To determine the status of knowledge, attitude and awareness about dental implants in a tertiary care hospital and its outreach centers. Materials and Methods: 192 patients were asked about dental implants using a standard questionnaire. Their response were recorded and analyzed statistically. Results: Among the respondents 52.6% were aware of implant therapy, however in specific knowledge only 24.5% could attribute the jaw as site for implant placement. It was also found that rather than dental professionals (17.7%), friends and acquaintances (30.2%) play a role in awareness. Conclusion: Within the limitations of this study limited knowledge and awareness about dental implants was noticed and role of dentists for the information is lacking in our part of world.

Background: Trabeculectomy is the standard surgical procedure for management of glaucoma. Objective: To compare the outcome of triangular and rectangular scleral flaps in trabeculectomy. Materials and methods: This study was carried out in the Department of Ophthalmology, BPKIHS, Dharan, over a period of one year. A total of 22 patients undergoing trabeculectomy were randomized to undergo either trabeculectomy with triangular scleral flap (Group A= 11 eyes) or trabeculectomy with rectangular flap (Group B =11 eyes). Outcome measurement: The parameters studied were intraocular pressure (IOP), anterior chamber depth (ACD), bleb characteristics and surgical complications. Statistics: P value of