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Browsing by Author "Upadhyay, S"

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    An Experience of Pediatric Upper and Lower Gastrointestinal Endoscopy in a Tertiary Center
    (Kathmandu University, 2017) Upadhyay, S; Sharma, A
    ABSTRACT Background Although upper gastrointestinal endoscopy and colonoscopy is considered to be a gold standard in the diagnosis of many pediatric gastrointestinal disorders, there is limited data about its utility from our country. This important diagnostic tool is underutilized. Objective The objective of this study is to report the common indications, endoscopic findings and complications of pediatric upper gastrointestinal endoscopy and colonoscopy in a tertiary center to increase awareness amongst pediatricians. Methods This descriptive cross-sectional study was conducted in children undergoing upper gastrointestinal endoscopy and colonoscopy for various indications in a tertiary center from November 2014 to October 2016 (24 months). Results We performed 192 endoscopies during this period. Upper gastrointestinal endoscopy 158 and Colonoscopy 34. Mean age of patients was 10.2 years (range 6 months to 16 years) and 140(72.9%) patients were under 10 years of age. Common indications of UGI endoscopy were recurrent abdominal pain (67%), acute abdominal pain (12.6%), recurrent vomiting (8.0%), upper GI bleed (4.4%), failure to thrive (3.1%) and caustic ingestion (2.5%). An abnormality was detected in 128(81%) patients. Antral gastritis (55%) was the most common diagnosis. Thirty two percent of children with RAP had chronic moderate to severe gastritis and were positive for H. pylori in Giemsa stain on histopathological examination. Common indications of colonoscopy were Lower GI bleed and chronic diarrhea. Out of 22 patients who underwent colonoscopy for lower GI bleed, 18(82%) patients had rectal polyp and underwent snare polypectomy. Out of 12 patients who were evaluated for chronic diarrhea, 7(20%) were diagnosed to have cow’s milk protein allergy and 5(15%) patients had inflammatory bowel disease. An abnormality was detected in 30(88%) patients. All children received sedation/ analgesia and tolerated the procedure well. Conclusion Upper gastrointestinal endoscopy and colonoscopy are safe procedure in children. The awareness about its diagnostic and therapeutic role should be raised amongst pediatricians in developing countries. There is also a need to develop training programs of pediatric gastroenterology and pediatric endoscopic suites in developing countries so that children may benefit from this state of the art diagnostic modality. KEY WORDS Colonoscopy, pediatric, upper gastrointestinal endoscopy
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    Assessing the Relationship of Maternal Factors and Family Income with Early Childhood Caries: A Hospital Based Study
    (Kathmandu University, 2017) Upadhyay, S; Dahal, S
    ABSTRACT Background Earlychildhood caries (ECC) is a multifactorial disease. Maternal factors and family income has major influence on the caries status of children. Objective To assess the relationship of maternal factors and family income with early childhood caries among children attending Pediatric Dentistry department of Dhulikhel Hospital. Method A cross sectional study was conducted among 239 children of age 3 to 6 years attending Pediatric Dentistry department of Dhulikhel Hospital, Kavre, Nepal. Age of child, mother’s occupational status,educational level and family income were recorded. Oral examination of child was done to record decayed, missing, filled teeth (dmft). Descriptive analysis was done to observe the caries experience. Chi - square test was used to assess the relationship of caries experience with occupational status, education of mother and family income. Result The mean decayed, missing, filled teeth of the children was7.04±4.10. There was no significant relationship of early childhood caries with occupational status of mother (p=0.675), education of mother (p=0.140) and family income (p=0.158). Conclusion There was no relationship of maternal factors and family income with early childhood caries when surveyed among the children visiting Pediatric Dentistry department of Dhulikhel hospital. KEY WORDS Early childhood caries, Income, Mother’s education
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    Developing tool and Measuring Integration Characteristics of Basic Science Curriculum to Improve Curriculum Integration
    (Kathmandu University, 2018) Maharjan, BR; Bhandary, S; Upadhyay, S; Ghimire, S; Shrestha, I; Joshi, M; Vaidya, S; Pradhan, P
    ABSTRACT Background Integrated curriculum enhances students’ learning and the retention of knowledge. At Patan Academy of Health Sciences, integrated organ system based curriculum is used with Problem Based Learning as the principle teaching learning method to foster students’ learning. In addition, other approaches of integration were under taken such as integrated assessment; logical arrangement teaching learning methods (lectures and practicals); joint effort of faculty in curriculum planning and delivery; conducive environment to foster hidden curriculum. This study describes the perception of faculty and students on integration characteristics of Basic Science curriculum. Objective To measure the integration characteristics of Basic Science Curriculum. Method Tool was developed to measure integration characteristics of Basic Science Curriculum and ensure whether such planned integration has been achieved. Mixed method was used to measure the perception of the integration characteristics i) quantitatively by questionnaire survey to faculty and students ii) qualitatively by in-depth interview of students. Result Both faculty and students perceived that all the blocks in Basic Science was well integrated in the quantitative questionnaire survey. But, in the in-depth interview, students perceived integration of curriculum in organ system blocks were better integrated compared to Principle of Human Biology blocks where fundamentals of basic science disciplines were delivered. Students reflected that Problem Based Learning not only integrated Basic Science disciplines but also with clinical sciences and the social context. But, students perceived that Community Health Sciences curriculum was not so well integrated with Basic Science subjects. Conclusion Overall, this study showed that planned integration in Basic Science curriculum was successfully executed during curriculum implementation. KEY WORDS Basic Science, Integration characteristic, Integrated curriculum, PBL
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    Emergence Time and Sequence of Primary Teeth in a Sample of Nepalese Children
    (Kathmandu University, 2022) Upadhyay, S; Deoju, R; Mahanta, SK; Shrestha, R
    ABSTRACT Background Primary teeth emergence is an important milestone in children and timing of emergence varies among populations. Objective To determine the emergence time and sequence of primary teeth in a sample of Nepalese children visiting Dhulikhel Hospital. Method A descriptive cross-sectional study was conducted in children of 5 months to 4 years visiting Dhulikhel Hospital. The emergence of incisal tip to incisal margin for incisors and canines, cusp tip to occlusal margin of molars visible were recorded along with age in months and gender. Descriptive statistics was done to calculate the mean age of emergence of each tooth with standard deviation. Unpaired t-test was used to assess the difference between the mean age of emergence of teeth between right and left sides and between boys and girls. Result The first teeth to emerge was mandibular central incisor at the age of 9.37 ± 1.42 months and the last one was maxillary second molar at the age of 32.91 ± 6.39 months. There was no significant difference in the mean emergence time between the maxillary and mandibular jaws, between right and left sides of jaws and between boys and girls except for primary maxillary right central incisor and mandibular right second molar which was found to be emerged early in girls. Conclusion The emergence time and sequence of primary teeth observed in the present study can be used as a baseline data for the children of Kavre district. KEY WORDS Emergence, Eruption, Nepalese children, Primary teeth
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    Hypochlorite Accident in a Pediatric Patient
    (Kathmandu University, 2024) Bhandari, A; Shrestha, R; Upadhyay, S; Upadhyaya, C; Shrestha, N
    ABSTRACT Sodium hypochlorite (NaOCl), the most used irrigation solution is a reducing agent that is a clear, yellowish solution. Since hypochlorite is one of the most commonly used solutions in dental procedures, accidents are common. The report describes a case of sodium hypochlorite accidentally being injected into a 10-year-old girl instead of local anesthesia who was appointed for a pulpotomy procedure. The accident was followed by prompt management, which included a thorough lavage with a mixture of normal saline and local anesthetic injection. She was later kept under oral antibiotics and was followed routinely to find a well-healed region. KEY WORDS Accidental, Flushing, Hypochlorite, Injection
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    Knowledge of Emergency Management of Avulsed Teeth Among General Dentists in Kathmandu
    (Kathmandu University, 2012) Upadhyay, S; Rokaya, D; Upadhyaya, C
    ABSTRACT Background An avulsed permanent tooth is one of the most emergency situations in dentistry. Dentists handling the situation should have adequate knowledge in this field. Objective To assess the level of knowledge of emergency management of avulsed teeth among general dentists in Kathmandu. Methods A questionnaire containing 10 close ended questions about emergency management of avulsed teeth was distributed among 102 general dental practitioners working in different private dental hospitals and clinics of Kathmandu. The dental hospital and clinics were randomly selected. This cross sectional study was conducted between January 2012 to February 2012. Data were entered into SPSS 11.5. Descriptive analysis was carried out to assess the frequency. Results General dentists of Kathmandu did not have adequate knowledge about emergency management of avulsed teeth. Conclusion An education program should be conducted to increase the knowledge of general dentists in the management of traumatic injuries to teeth. KEY WORDS Avulsion, emergency, general dentists, replantation
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    Permanent Teeth Emergence Time and Sequence in Children of Kavre District, Nepal
    (Kathmandu University, 2016) Upadhyay, S; Shrestha, R; Shrestha, D; Poudyal, S
    ABSTRACT Background Population specific standards on the timing and sequence of emergence of permanent teeth are essential in planning dental care for children. There is only a single study on the emergence of permanent teeth in Nepalese children. Objective To determine the standards for permanent teeth emergence time and sequence in children of Kavre district, Nepal. Method A descriptive cross sectional study was conducted in 623 children of age 5 to 14 years from six different schools of Kavre district. The number of permanent tooth erupted except third molar was recorded along with age and gender. Data were analysed using SPSS 20.0. Descriptive statistics was used to determine the number and percentage of permanent teeth emerged at different ages and the mean age of emergence of each tooth. Student ‘t’ test was used to determine the inter jaw differences in the mean age of emergence of each tooth. Result The study population constituted 50.7% boys and 49.3% girls of the total sample. The first tooth to emerge was mandibular first molar, whereas maxillary second molar tended to be the last to emerge in both the genders. Though in general, mandibular teeth tended to precede the corresponding maxillary teeth in emergence but significantly only mandibular central, lateral and second premolar emerged earlier than maxillary.( p ≤ 0.05) Conclusion This study can be used as a reference data for clinical and academic purpose especially for the children of Kavre district, Nepal. KEY WORDS Emergence sequence, emergence time, permanent teeth
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    Translation and Validation of Oral Health-Related Early Childhood Quality of Life Tool for Nepalese Preschool Children
    (Kathmandu University, 2021) Upadhyay, S; Mathur, VP; Dhillon, JK; Poudyal, S
    ABSTRACT Background Early childhood caries (ECC) in preschool children debilitate their quality of life affecting oral function, appearance and social well-being. A tool for measuring oral health-related quality of life for preschoolers may help in making clinical decisions and assist policy makers in planning and management of health programs in the country. Objective To translate oral health-related early childhood quality of life (OH-ECQoL) tool into Nepali language and test its validity and reliability. Method OH-ECQoL was translated into Nepali language by two Nepalese professional translators which was back translated by professional English translator. This was sent to three independent advisors to see the appropriateness of translation. Pilot testing was done in 20 parents and questionnaire was finalized after needed corrections. Final version was introduced to the 118 parents of children aged 24- 71 months. Caries status was recorded for all children participating in the study. Concurrent, construct, discriminant validity and internal consistency reliability, test -retest reliability were evaluated. Result OH-ECQoL scores and perception of parents for general and oral health of their children was significant (at 0.01 level). There was significant difference in OH-ECQoL scores between no ECC and severe ECC groups and moderate and severe ECC groups (at 0.05 level). There was also a significant correlation between child impact section and family impact section (at 0.01 level). Cronbach’s alpha was 0.891 demonstrating good internal consistency. Intra class coefficient was 0.963 suggesting excellent test- retest reliability. Ninety-one (77.1%) children had severe ECC and 40(33.9%) parents were from upper middle class. Conclusion The Nepali version of OH-ECQoL is a valid and reliable tool for assessing the oral health-related early childhood quality of life in children of Nepal. KEY WORDS Early childhood caries, Oral health-related quality of life, Preschool children

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