Journal of Universal College of Medical Sciences

MDR Tuberculosis - A Global Threat

Maruti Sawadkar — 2019-05-30

N/A

Breast Feeding and Weight Loss Pattern in Term Neonates During First 72 Hours of Life: A Cross Sectional Observational Study

Badri Kumar Gupta — 2019-05-30

DOI: https://doi.org/10.3126/jucms.v6i2.22467

Introduction: Healthy, full term, exclusively breastfed infants are expected to lose weight in the first days following birth. There are conflicting opinions about what constitutes a normal neonatal weight loss. This study was conducted to establish the reference weight loss pattern in exclusively breastfed neonates.

Materials and methods: A cross sectional observational study was conducted at a tertiary care hospital of western Nepal for a period of 12 months. All babies delivered were recruited. Newborns with birthweight of > 2500 grams without any congenital anomalies and Apgar score >7/10 were finally included for analysis. Breast feeding was started as soon as possible and all newborns were fed within 6 hours of life. If breast feeding was not possible within first 2 hours of life, expressed breast milk (EBM) or formula feeding was initiated as recommended. Data was analyzed showing distribution and frequency of various parameters like initiation of breastfeeding, weight of babies at different time intervals and weight loss patterns.

Results: Out of 1000 babies subjected to analysis, majority were males (n= 517, 51.7%). The average time of initiation of breast feeding was less than 6 hours. The weight loss pattern in babies was 7.1% at 72 hours of life.

Conclusion: Breast feeding was initiated as soon as possible in all healthy term neonates. The average weight loss pattern in all term healthy newborns were almost similar.

Keywords: Breast feeding, weight loss pattern, initiation of breast feeding

Anterior Interhemispheric Approach in Craniopharyngiomas : Personal Experience of Operative Technique and Results

Jaideep Chandra — 2019-05-30

Introduction: Removal of intracranial supra-sellar masses continues to be a surgical challenge. Various approaches have been used by different authors with varying results. Anterior basal interhemispheric approach is most suitable with better results than other approaches for craniopharyngiomas

Materials and methods: Fifteen patients with large craniopharyngiomas having third ventricular and or retro or supra-sellar extensions or reaching the interpeduncular cisterns were operated by this approach, over a period of seven years since the first use of this approach at our institute. The data of patients opearated by this approach were then retrospectively analysed. There were eleven males and four females with five patients in the pediatric age group. Follow up range was from 2 to 83 months with a mean of 21.6 months.

Results: Total excision was achieved in seven (46.6%) and near total excision in another seven (46.6%), partial excision was done in only one (6.66%). Seven patients with total excision were disease free at mean follow up of 6.8 months. There was asymptomatic recurrence in two (13.33%) patient with near total excision at 11 and 63 months respectively and were given radiotherapy post-operatively. All patients were symptom free except one with diabetes insipidus (DI) and one mortality, and one with post operative visual deterioration.

Conclusion: Anterior basal interhemispheric approach is a useful alternative to other transcranial approaches in the management of the craniopharyngiomas. It has the advantage of being a midline approach and displays the tumour brain interface better.

Keywords: Intracranial, transcranial, craniopharyngiomas

A Comparative Study of Endoscopic Versus Otomicroscopic Myringoplasty

Bishow Tulachan — 2019-05-30

DOI: https://doi.org/10.3126/jucms.v6i2.22469

Introduction: Myringoplasty is one of the common surgical procedures done for closure of perforated tympanic membrane. Traditionally, it used to be performed with the help of operating microscope, however, the rigid endoscopes are being popular nowadays. So, we are comparing the success of graft uptake between endoscopic versus otomicroscopic myringoplasty.

Materials and methods: This is a prospective, comparative and randomized study done in the Department of Otorhinolaryngology and Head and Neck Surgery (ORL-HNS), Universal College of Medical Sciences-Teaching Hospital (UCMS-TH), Bhairahawa, Nepal. The study duration was for 18 months (1st December 2015 to 31st May 2017). There were 60 patients with age range of 12-60 years. All the patients fulfilling the inclusion criteria were included. Patients were randomized into Group A (endoscopic) and Group B (otomicroscopic).

Results: Patient's age ranged from 12-60 years. The mean ± standard deviation (S.D) of age (years) between two groups was 27.07 ± 11.96 years and 27.20 ± 9.65 years respectively. There were 33.33% male and 66.67% female patients in group A and 43.33% male and 56.67% female patients in group B. The graft uptake success rate was 93.33% in group A and 90% in group B. Statistically no significant difference was observed in graft success and failure rates between two groups (p =0.640).

Conclusion: Comparatively the rate of graft uptake was higher in endoscopic group without statistical significance. Thus, endoscopic myringoplasty can be a good alternative of microscopic myringoplasty.

Keywords: Chronic otitis media, endoscopic, myringoplasty, otomicroscope

Prevalence of Helicobacter Pylori Infection in Patients with Portal Hypertension

Shatdal Chaudhary — 2019-05-30

DOI: https://doi.org/10.3126/jucms.v6i2.22470

Introduction: Helicobacter pylori (H. pylori) is a microaerophile gram-negative bacillus which is found mainly on the surface of mucous membrane of the prepyloric part of the stomach. It is found to be infecting approximately 50% of world population. In patients with liver cirrhosis, the prevalence of H. pylori is variable. A high incidence of H. pylori colonization has been found in portal hypertension; especially in those with gastric erosion. This study was done to find out the prevalence of H. pylori infection in patients with portal hypertension at Universal College of Medical Sciences Teaching Hospital, Nepal.

Materials and methods: It was a hospital based cross sectional observational study. All the consecutive patients aged more than 16 years, presented with portal hypertension who fulfilled the inclusion criteria were included in the study. The study period was from 1st September 2015 to 31st August 2016. The upper gastrointestinal endoscopy was done in all cases and mucosal biopsy was taken. H. pylori infection was diagnosed by using rapid urease test.

Results: During the study period, 71 patients fulfilled the inclusion criteria and were included in the analysis. The majority of the patients 21 (29.6%) were between 51-60 years age group. There were more male (78.9%) then female (21.1%). The mean age of study population was 50.85 ± 12.47 years. Among the study population, rapid urease test was positive in 70.4% (n=50) patients.

Conclusion: The prevalence of H. pylori infection was seen in 70.4% of the patients suffering with portal hypertension.

Keywords: Chronic liver disease, Helicobacter pylori, portal hypertension, rapid urease test

The Use of Arm Span and Knee Height for Estimation of Stature among Nepalese Medical Students

Niraj Pandey — 2019-05-30

DOI: https://doi.org/10.3126/jucms.v6i2.22471

Introduction: Height is a significant parameter for growth and development of an individual. Arm span and knee height measurement are useful when accurate measurement for stature is unobtainable. Studies have shown that the relationship between stature and arm span varies with age and population. Thus, the aim of the present study was to analyze the correlation between stature and two measurements; the arms span and knee height of medical students of Kathmandu Medical College Public Limited, Kathmandu, Nepal.

Materials and methods: This is a descriptive study. A total two hundred medical students, presently studying at Kathmandu Medical College, aged between eighteen and twenty eight years were randomly selected as the subjects for the present study. Among them, seventy six were females and one hundred twenty four were males. Arm span and knee height was measured by flexible steel tape and height was taken by stadiometer. The collected data were tabulated and SPSS 20 was used to perform analysis.

Results: There is statistically strong correlation (r) between height and arm span (r=0.858, =0.736; r=0.849,=0.720, p<0.01 for males and females respectively) while knee height too has shown a similar relationship (r=0.882, =0.778, r=0.819,=0.670, p<0.01 for males and females respectively).

Conclusion: This present study revealed that both arm-span and knee height can be used in estimation of the height of both males and females. The regression equations so derived can be used in cadavers or an amputee or bed ridden patients with fairly accurate results. This can be helpful in medico- legal cases as well as in study of anthropology.

Keywords: arm span, knee height, anthropometry, stature

Spectrum of Lesions in Urinary Bladder- A Histopathological Study

Anita Shah — 2019-05-30

DOI: https://doi.org/10.3126/jucms.v6i2.22473

Introduction: The lesions of urinary bladder both non-neoplastic and neoplastic pose a common source of both morbidity and mortality. An accurate diagnosis of these lesions requires cystoscopy which allows a direct visualization of the bladder mucosa and biopsies of suspected lesions. Urinary bladder cancer is sixth most common cancer worldwide and represents a heterogeneous group of neoplasms. The current study aimed to study the different bladder lesions and its clinical features to detect it in early stage and as a mainstay option in the diagnosis and follow up.

Materials and methods: This was a retrospective analysis of biopsies of urinary bladder submitted to the department of pathology over a period of 12 months. The study was approved by the institutional review board of the Universal College of Medical Sciences (UCMS-TH). All the urinary bladder biopsies received in the department were included in the study whereas autolysis of specimen and inadequate biopsies were excluded.

Results: Among the 36 cases of urinary bladder lesions, the majority (35.36%) were in age group 61-70 years (22.33%). The patients had combination of lower urinary tract symptoms, the commonest being hematuria. 30.55% had non-neoplastic lesions and 69.55% had neoplastic lesion. Among non- neoplastic cases, 5.55% had chronic granulomatous inflammation. Most common neoplastic lesions was infiltrating urothelial carcinoma (n=6) followed by non- invasive urothelial neoplasia (n=5).

Conclusion: A variety of lesions occur in urinary bladder and is commonly encountered by pathologist. Hematuria was commonest symptom and the clinicians investigated these patients further, which led to discovery of the urothelial tumors. Identification of these patients has an important impact on prognosis as well as on therapeutic approach.

Keywords: Histopathology, infiltrating urothelial carcinoma, urinary bladder

Sonographic Imaging and Cytological Changes in Thyroid in Patients with Breast Carcinoma

Manisha Shrestha — 2019-05-30

DOI: https://doi.org/10.3126/jucms.v6i2.22503

Introduction: The association between thyroid disorders and breast cancer is debated. A possible relationship between breast carcinoma and thyroid disorders have been suggested considering the fact that the breast malignancy may alter endocrine homeostasis. A prospective cross sectional study in breast cancer patients was performed to evaluate the association of breast cancer with thyroid disorders. Ultrasonography and cytological changes in thyroid gland were evaluated.

Materials and methods: The study included 30 consecutive newly diagnosed breast cancer patients between the age group of 30 to 60 years. The study had a control group of 20 age matched patients from the same geographical area with no breast or thyroid disease and no malignancy. The presence of thyroid disease was examined by using well defined diagnostic criteria of ultrasonography. The observations on ultrasound were correlated with cytological assessment in breast cancer patients only.

Results: Results were analyzed statistically by Fischer's exact probability test, Pearson correlation coefficient and unpaired student 'T' test. Sonographically nodular thyroid was observed in 50% of breast cancer patients as compared to 10% in control group (p<0.002). Majority of patients had solitary and solid echo texture thyroid nodules. There was a direct correlation between the stage of breast cancer and total thyroid volume. All thyroid nodules were cytologically benign (adenomatous/ colloid nodular goiter) on cytological evaluation.

Conclusion: It is concluded that an increased preponderance of thyroid disorders exist in patients with breast cancer.

Keywords: Ultrasonography, cytology, thyroid, breast carcinoma

Sexual Dimorphism in Distribution of Hair on The Phalanges of Hand of Undergraduate Medical Students of Nepalgunj Medical College, Nepal

Laxmi Bhattarai — 2019-05-30

DOI: https://doi.org/10.3126/jucms.v6i2.22476

Introduction: This study was conducted to evaluate different hair patterns on the dorsal aspect of phalanges of both hands and compare it between males and females.

Materials and methods: The present study was carried out in 300 undergraduate medical students (males and females 150 each) of Nepalgunj Medical College, Nepalgunj, Nepal. Distribution of phalangeal hair was observed by using hand lens under adequate light. Data was collected on proximal, middle and distal phalanges according to modified scheme of Burnstein classification.

Results: Statistical analysis showed that there was significant difference (p=0.000) in the average value of different patterns in distribution of hair on proximal phalanges of both hands. The most common pattern between both sexes is 1-2-3-4-5 (67%) but frequency is slightly less in females (56%) as compared to males (78%). In case of middle phalanges, result showed that there is significant difference (p=0.665) in the average value. The most common pattern between both the sexes is 3-4-5 (23%). Result also revealed that hair on middle phalanges is absent in 53.33% female and 35.33% males.

Conclusion: This study was carried out using standard anthropometric method. Hence, this result is useful because of their anthropological significance and is recommended to forensic experts in deciding sex, nationalism and race.

Keywords: Distribution of hair, proximal and middle phalanges, hair patterns

Antimicrobial Susceptibilty Profile of Urinary Tract Infection: A Single Centre Hospital Based Study From Nepal

Sulochana Khatiwada — 2019-05-30

DOI: https://doi.org/10.3126/jucms.v6i2.22477

Introduction: Urinary tract infection (UTI) is amongst the most common bacterial infections. Identification of causative organism and their in-vitro susceptibility test is essential for the successful treatment of a patient. The study was done to determine different bacterial species causing UTI and their antimicrobial susceptibility profile.

Materials and methods: A total of 332 urine samples from patients attending both inpatient and outpatient departments of UCMS-TH were included in this study. Samples were subjected to culture and sensitivity test with the use of standard bacteriological techniques as described by American Society for Microbiology (ASM).

Results Twenty three percent of the total urine samples showed significant bacterial growth. Thirteen different bacterial species were isolated. Among these, Escherichia coli (50.6%) was the most predominant one followed by Klebsiella species (15.6%), Staphylococcus aureus (7.8%) and others. Majority of bacteria isolated was found to be sensitive to imipenem (82%) followed by nitrofurantoin (78%), gentamicin (63.8%) and others.

Conclusion: UTI is a commonly encountered case in general practice. Females are commonly affected than males. Majority of bacterial isolates were found resistant towards commonly used first line antimicrobial agents. This type of study should be continued to determine the changing pattern of microbial flora and their antibiogram.

Keywords: Antimicrobial susceptibility profile, urinary tract infection, Nepal.

Prevalence of Iron Deficiency Anemia in Anemic Patients: A Hospital Based Study

Satyendra Kumar Mishra — 2019-05-30

DOI: https://doi.org/10.3126/jucms.v6i2.22494

Introduction: In developing countries like Nepal, iron deficiency anemia (IDA) is one of the major concern. The high rate incidence has been related to insufficient iron intake, accompanied by chronic intestinal blood loss due to parasitic and malarial infections. Therefore, a study was conducted to evaluate the prevalence of IDA in anemic patients of Universal College of Medical Sciences-Teaching Hospital (UCMS-TH), South Western region, Nepal.

Material and Method It was a hospital based cross sectional study comprised of 100 anemic patients. Their detailed medical history and lab investigations, focusing on hematological parameters were documented. Peripheral smear examination and serum ferritin estimation were done to observe red cell morphology and iron status respectively.

Results: This study revealed that out of 100 anemic patients, 35% were that of IDA. The most affected age group was 21-40 years with frequency 42.55%. IDA was more common in females (42.85%) than in male (21.62%). Out of 100 anemic patients, microcytic hypochromic anemia was predominant in 47% followed by macrocytic anemia (31%) and then normocytic normochromic anemia (22%). Out of 47 microcytic hypochromic anemic patients, 12 had normal serum ferritin. There was a statistical significant difference in Hb (p=0.011), MCV (p=0.0001), MCH (p=0.0001), MCHC (p=0.0001) and serum ferritin (p=0.0001) among all types of anemia. There was a statistical significant positive correlation of ferritin with Hemoglobin (0.257, p= 0.01), MCV (0.772, p= 0.0001), MCH (0.741, p=0.0001) and MCHC (0.494, p=0.0001).

Conclusion: The peripheral smear in conjunction with serum ferritin estimation needs to be included for susceptible individuals to screen the IDA and other types of anemia.

Keywords: Anemia, ferritin, iron deficiency anemia, peripheral smear

Awareness Regarding Vesicovaginal Fistula among Women Residing in A Municipality of Kapilvastu

Saraj Gurung — 2019-05-30

DOI: https://doi.org/10.3126/jucms.v6i2.22495

Introduction: Vesicovaginal fistula (VVF) is one of the most distressing maternal morbidities. It is a physically and socially disabling obstetric complication that affects many women annually. It has a devastating social, economic and psychological effect on the health and well-being of the affected women. The aim of the study was to find out awareness regarding vesicovaginal fistula among women.

Material and Method: Descriptive study design was used for the study to find out awareness regarding vesicovaginal fistula. Hundred women were selected as the study sample by non purposive and snow ball sampling technique. Pretested semi structured interview schedule was used for data collection and analyzed by using descriptive and inferential statistics.

Results: The findings of the study revealed that 81% and 100% of women knew that delivery by non skilled and wetting under garments is risk factor and symptom of VVF. 82% and 73% of women knew that VVF is preventable and curable respectively. 58% of women had knowledge that women can become pregnant in case of VVF and 47 % knew that VVF can be reoccurred. Out of 73 women, 23% knew that surgery as the treatment of VVF. Forty nine percentage of women had answered regarding family and social misbehave and depression (5%) being social consequences of VVF. Seventy percentage of women answered that cervicitis is complication of VVF.

Conclusion: Based on the findings of the study half of the women had low knowledge regarding VVF. So, it is recommended to organize continue awareness program to the women regarding VVF.

Keywords: Awareness, vesicovaginal fistula, community

Knowledge Regarding Assessment of High Risk Neonates among Nurses Working in Selected Hospitals of Rupandehi

Anuja Kachapati — 2019-05-30

DOI: https://doi.org/10.3126/jucms.v6i2.22496

Introduction: There is need of early assessment and high quality nursing care for high risk neonates to reduce morbidity and mortality. Knowledge assessment is the pivotal step in assessing the status of patients' care given by the nurses. Researcher sought to assess level of knowledge regarding care of high risk neonates among nurses in selected hospitals in outreach Nepal.

Materials and methods: A descriptive cross-sectional study was conducted to find out the knowledge regarding assessment of high risk neonates among fifty five nurses selected through non probability enumerative method. The data was collected by using self- administered semi-structured knowledge questionnaire and was analyzed by using descriptive and inferential statistics with SPSS software version 16.

Results: The findings of the study revealed that more than half (58.18%) of the nurses had high level of knowledge regarding assessment of high risk neonates.

Conclusion Based on the study findings, it is concluded that more than half of the respondents in the study had high level of knowledge regarding assessment of high risk neonates. Beside this, the respondents have good knowledge pertaining to predisposing factors, diagnostic tools, initial clinical assessment, preventive measures, management of high risk neonates and definition of preterm, post-term, low birth weight neonates. Respondents had low level of knowledge for clinical characteristics of small for gestational age neonates as well as clinical parameters of high risk neonates. Hence, there is utmost need to give in-service education to the nurses in order to achieve the quest to improve their knowledge relating to care of high risk neonates.

Keywords: Assessment of high risk neonates, knowledge, nurses

Misoprostol Versus Oxytocin for Induction of Labour at Term and Post Term Pregnancy of Primigravida

Malati Tripathi — 2019-05-30

DOI: https://doi.org/10.3126/jucms.v6i2.22497

Introduction: To compare effectiveness and safety of sublingually administered misoprostol and intravenously infused 10 units of oxytocin for labor induction at term and post term pregnant women in Gandaki Medical College Teaching Hospital (GMCTH).

Materials and methods: This is a prospective study conducted in Department of Obstetrics and Gynaecology in Gandaki Medical College and performed on 120 patients of primigravida with cephalic presentation at term and post-term pregnancy. Patients were given 50µg sublingual misoprostol 6 hourly (two doses) and 5 units of oxytocin in 500ml RL started from 10 drops up to 60 drops till effective contraction occur with maximum of 10 units oxytocin. Maternal and fetal outcomes were observed. Collected data were analyzed using SPSS and MS Excel.

Results: There were no significant differences between the groups concerning time duration between inductions to delivery time, indications of caesarean section, different modes of delivery and for the Apgar score at one and five minutes.

Conclusion: Both oxytocin and misoprostol are effective and safe for induction of labour.

Keywords: Induction of labour, maternal outcome, misoprostol, neonatal outcome, oxytocin

Prevalence of Deviated Nasal Septum among Nepalese Preclinical Students at Kathmandu Medical College Teaching Hospital, Nepal

Nripendra Tiwari — 2019-05-30

DOI: https://doi.org/10.3126/jucms.v6i2.22498

Introduction: The fragile nature of the nasal septum and other bony structures makes them prone to fragmentation and destruction. Deviated nasal septum persists in adult stage of life giving rise to anatomical, psychological and cosmetic consequences. There are many consequences of deviated nasal septum like nasal obstruction, mouth breathing, headache and asymmetry of face. The amount of airflow and resistance to it in the nasal cavity with deviated nasal septum are quite different from person to person. Our study is focused on the prevalence of deviated nasal septum.

Materials and methods: This was a cross-sectional observational study conducted among 300 individuals from Nepalese preclinical students studying at Kathmandu Medical College Teaching Hospital (KMCTH). Prevalence of deviated nasal septum in males and females were determined affecting symmetry of the face.

Results: The prevalence of deviated nasal septum was found to be 53% (159) of total study population. The left sided nasal septal deviation was found to be more in male 33.33% (50) than that of female 29.33% (44).The asymmetry of the face was observed in 55% (165) of total study population. However, asymmetry of face was observed more in male 58.66% (88) than in female 51.33% (77).

Conclusion The deviated nasal septum and asymmetry of the face were remarkably prevalent among Nepalese preclinical students studying at Kathmandu Medical College Teaching Hospital. The prevalence of deviated nasal septum and asymmetry of face was found significantly greater in male than in female (p< 0.05).

Keywords: Asymmetry of face, lower anterior crowding of dentition of lower jaw, deviated nasal septum (DNS)

Transition of Assessment Tools in Medical Education

Khushbu Adhikari — 2019-05-30

DOI: https://doi.org/10.3126/jucms.v6i2.22499

Medical education is on an advancement in recent years in Nepal. Our ultimate goal as a medical educationist is to produce a confident “Medical Graduate” who are capable to provide health care to the people belonging to different regions of our country. The curriculum for the medical program helps us achieve this goal. The effectiveness of the curriculum taught is assessed by various methods. There are two types of assessment namely formative and summative assessment. Of the various competencies expected out of an undergraduate only few are assessed in the routine internal and summative assessment examinations. The first and second generation tools such as viva voce and structured essay type questions evaluate the clinical reasoning without addressing other competencies such as social skills. The inadequacy in these assessment methods can hinder our way to achieving our goal. Social skills like communication skills, attitude, professionalism, leadership qualities, and skills of healing patients rather than just treating the disease is to be emphasized and addressed. Hence, third generation assessment like 360 degree assessment, experiential assessment, and portfolio can help us achieve our goal of creating efficient medical graduates which incorporates assessment of social skills as well.

Keywords: Competency, formative assessment, portfolio assessment, summative assessment

Medical Ethics in Clinical Practice in Nepal: Challenges and Way Forward

Shristi Raut — 2019-05-30

DOI: https://doi.org/10.3126/jucms.v6i2.22500

Ethics for health care professional have many components. Among them, medical ethics is one of the important but neglected component which deals with issues related to confidentiality, beneficence and non-maleficence between health care providers and stake holders. Four basic principles of medical ethics are autonomy, justice, beneficence and non- maleficence which form the foundation of ethical clinical practice. The level of knowledge on medical ethics that medical students receive during the training is meagre and inadequate. In recent years, clinical practice has become more challenging. This is primarily due to increased opposition, aggression and violence against medical professionals at health care settings. As a result, the gap between clinicians and patients is increasing leading to diminishing trust and real/perceived allegations. In addition, the widening gap between doctors and patients has provided a space for middle men/broker to meddle, oppose and flare up the violence against treatment providers. Doctors and other medical professionals have been increasingly facing such challenges leading to circumspection in their practice, despondence, psychosocial trauma and depression. There is an urgent need of incorporation of medical ethics in undergraduate curriculum and independent hospital ethics committee consisting of experts from the hospital and outside to monitor and provide rational reasons to minimize such challenges.

Keywords: Medical ethics, doctor-patient relationship, hospital ethics committee, codes of conduct

Traumatic Diaphragmatic Hernia: Anaesthetic Consideration

Raghu Nandan Khadgaray — 2019-05-30

DOI: https://doi.org/10.3126/jucms.v6i2.22501

Any type of trauma may lead to diaphragmatic hernia with blunt forces accounting for majority. Diaphragmatic hernias require a high level of suspicion to detect. Brain, pelvis, long bones, liver, spleen, and aorta are some other organs that can be severely damaged and need different anesthetic management. Gastric decompression, pre-oxygenation, rapid sequence induction and mechanical ventilation with low tidal volume after intubation were used in anesthetic management for thoracotomy and repair. Traumatic diaphragmatic hernia can be life threatening as it may compromise cardiorespiratory function.

Keywords: Anesthesia, diaphragmatic hernia, thoracotomy

An Insight into Anatomical Variations in Maxillary Molars: A Case Series

Manisha Nepal — 2019-05-30

DOI: https://doi.org/10.3126/jucms.v6i2.22502

The aim of this article is to show different anatomic complexities of the root canal system related to maxillary molars. Maxillary molars are presumed to have only three roots with three canals but this is not always the case, it might present with different variations. Some of the anatomical variations such as, mesiobuccal2 (MB2) canals in maxillary 1st and 2nd molars, two rooted maxillary 1st and 2nd molar, one rooted maxillary 2nd molar, C-shaped upper 2nd molar and maxillary 2nd molar with extra palatal root are reported in this case series. Hence, in treating each tooth every dentist must keep foresight that complex anatomy occurs often enough to be considered normal and manage them accordingly.

Keywords: Anatomical variations, extra palatal root, maxillary molars, mesiobuccal