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ele-colleaguography - Adjunct to Intraoperative Time Out for Safe Laparoscopic Cholecystectomy
(Kathmandu University, 2024) Laudari, U; Chaudhary, A; Chaudhary, A; Thapa, PB
ABSTRACT Laparoscopic cholecystectomy is a common surgical procedure, and strategies for preventing biliovascular injury include intraoperative time-out and intraoperative cholangiography. However, the feasibility of intraoperative cholangiography is limited in certain regions due to cost and training constraints. This article introduces the concept of “Tele-colleaguography” as an adjunct to intraoperative time-out during laparoscopic cholecystectomy, particularly in low-resource settings. Tele- colleaguography, a term coined to signify remote consultation with senior surgeons using video applications like WhatsApp and Viber, presents a potential solution to prevent bile duct injuries. The viewpoint discusses the potential benefits of Tele- colleaguography, and the role of modern technology such as 5G, and references key studies that support this approach. KEY WORDS Intraoperative time-outs, Laparoscopic cholecystectomy, Tele-colleaguography
Assessment of Hand Hygiene Knowledge among Residents and Nursing staffs at Nobel Medical College Teaching Hospital, Biratnagar Authors
(Nepal Paediatric Society (JNPS), 2018) Yadav, Sunil Kumar; Giri, Arun
Abstract: Introduction: Hand hygiene is a very simple and cost-effective procedure to prevent cross-transmission of microorganisms. The compliance of residents and nursing staffs with hand hygiene guidelines seems to be vital in preventing disease transmission among patients. The objective of the study was to assess the knowledge of residents and nursing staffs with regard to hand hygiene. Material and Methods: This was an institution based descriptive cross-sectional study conducted among 55 respondents (29 nursing staffs and 26 resident doctors) of department of paediatrics, Nobel Medical College in Biratnagar, Nepal. Knowledge was assessed using WHO hand hygiene questionnaire for health care workers. Chi square test was used to compare the percentage of correct responses between resident doctors and nursing staffs. A p value of <0.05 was considered significant. Results: Among 26 resident doctors and 29 nursing staffs who participated in the study, 30.7% of resident doctors and 55.1% of nursing staffs had received formal training in hand hygiene in the last three years. Only 9% of participants (5 out of 55) had good knowledge regarding hand hygiene. Conclusions: The knowledge regarding hand hygiene is limited among the study population. The study recommends the need for emphasizing hand hygiene component in the preservice as well as in-service training programs of doctors and nurses.
Prevalence and Knowledge on Obesity Among School Going Adolescents of Kaski, Nepal
(Nepal Paediatric Society (JNPS), 2018) Pandey, Apsara; Sapkota, Sony
Abstract: Introduction: Childhood obesity has now been recognized as a global health problem because of its devastating consequences and prevalence at uncontrollable rate worldwide. The objective of this study was to determine prevalence of obesity and find out the knowledge on obesity among school going adolescents. Material and Methods: This descriptive cross-sectional study was conducted among adolescents of two private schools of Kaski district. Altogether 120 adolescent students were selected using census method. Height and weight were measured with standard scale and BMI was calculated. Self-administered structured questionnaire was used to assess knowledge. Descriptive statistics and Chi-square test at 0.05 significance level was used to analyze data. Results: The mean age of adolescents was 15.1 years and 50% of them were male. The prevalence of obesity among adolescents was 3.3%. Seventy five percent of the adolescents had knowledge regarding meaning of obesity and 59.2% had mentioned high calorie intake as a risk factor of obesity. Likewise, 52.5% adolescents stated Diabetes mellitus as consequence of obesity. Ninety eight percent mentioned regular exercise as a preventive measure of obesity. More than three fourth (78.3%) of the adolescents had inadequate knowledge regarding obesity. Male adolescents had significantly higher knowledge than female adolescents (p=0.00). Conclusion: Even though very few adolescents had obesity, there were adolescents with overweight which were at more risk for getting obesity. Adolescents have inadequate knowledge regarding obesity.
Orbital Compression Syndrome in a Child with Sickle Cell Anaemia: A Case Report And Review of Literature Authors
(Nepal Paediatric Society (JNPS), 2018) Panda, Prateek Kumar
Abstract: Vaso-occlusive crises in sickle cell disease commonly involve bone marrow of the long bones and vertebrae. Involvement of bones with less marrow space, including the bones of the orbit, is reported rarely in the literature. The present case is a six year old boy, a known case of sickle cell disease, who presented with acute onset right upper and lower eyelid swelling, restriction of extraocular movement and pain. USG orbit showed a retro-orbital haemorrhage compressing on the orbit, probably due to orbital bone infarction. The child was managed successfully with red blood cell transfusion and intravenous antibiotics, without steroids and surgical intervention. This report highlights the importance of maintaining a high index of suspicion in patients with known sickle cell disease presenting with pain, orbital swelling and restriction of ocular movement. Timely red blood cell transfusion only may be sufficient for uneventful recovery, without steroids or surgical intervention. Expedient diagnosis of orbital compression syndrome in children with sickle cell disease is crucial because this is a potentially sight-threatening entity.
Microbial Resistance Caused by Antibiotic Prophylaxis with Amoxicillin in a Male Infant with Vesicoureteral Reflux
(Nepal Paediatric Society (JNPS), 2018) Taniguchi, Kazuto; Kii, Sakumo; Oka, Masafumi; Uemichi, Kazuyasu
Abstract: Vesicoureteral reflux is a common condition in infants with urinary tract infection. Although antibiotic prophylaxis to prevent recurrent urinary tract infection is widely performed, its effectiveness remains controversial. Herein we report a seven- month-old boy with vesicoureteral reflux. Antibiotic prophylaxis with amoxicillin caused microbial resistance accompanied by recurrent urinary tract infection. Subsequent antibiotic prophylaxis with sulfamethoxazole-trimethoprim was effective until spontaneous remission of vesicoureteral reflux occurred. Sulfamethoxazole-trimethoprim, but not amoxicillin, should be considered as an agent for antibiotic prophylaxis in infants with vesicoureteral reflux.
Chronic Recurrent Multifocal Osteomyelitis: An Unusual Cause of “Aches and Pains”
(Nepal Paediatric Society (JNPS), 2018) Jamal, Ahmad; John, Biju; Awariwar, Mahesh; Dalal, Shamsher; Singh, Daljit
Abstract: Children are often brought to the paediatric out-patient department with non specific aches and pains. Though the majority of them have only a benign diagnosis, some may harbour rare conditions like chronic recurrent multifocal osteomyelitis (CRMO). Case: We describe a 11 year old girl who presented with migratory pain across various parts of hip and lower limbs without any significant signs. After six months of OPD visits, she was diagnosed to have CRMO following an incidental X-ray which led to a musculoskeletal MRI. Conclusion: CRMO is a rare auto-inflammatory disorder which must be kept in mind when encountering a relatively healthy child with poorly defined limb pains along with paucity of signs.
An Early Presentation of a Genomic Variant of Mucopolysaccharidoses II in a Female Newborn Baby
(Nepal Paediatric Society (JNPS), 2018) Ritesh; Singh, Harsh Mohinder
Abstract: Mucopolysaccharidoses II is a X-linked genetic disorder caused by the deficiency of lysosomal enzyme Iduronate sulfate sulfatase due to mutations of Iduronate 2-sulfatase (IDS) gene which results in accumulation of intralysosomal glycosaminoglycan. X inactivation and gene alterations are known to cause this entity in a female child. We report an unusual case of missense mutation of IDS gene in heterozygous variant with dominant expression in a female neonate presented in early newborn period with incurable severity. X- linked recessive (heterozygous) missense mutation of Exon 8 in IDS gene confirmed a case of Mucopolysaccharidoses II by Sanger sequencing.
The Development and Validation of Questionnaire on Autism Spectrum Disorders and its Association With Plastic-Based Food Contact Materials
(Nepal Paediatric Society (JNPS), 2018) Nor, Zaleha Md; Isa, Zaleha Md; Yusof, Siti Norbayah; Ghazi, Hasanain Faisal; Jaafar, Mohd. Hasni
Abstract: Introduction: Autism is a neuropsychiatric disorder. Multiple factors have been identified as causes of autism spectrum disorder. Many studies indicated genetic as the main risk factor, but environmental risk factors are also seen as contributing factors. Exposure to environmental pollutants such as endocrine disrupting chemicals (EDCs) can occur as early as in the mother’s womb. The main concern of EDCs in food packaging are Bisphenol A (BPA) and phthalates. The objectives of this study are to develop and validate a questionnaire for the assessment of habitual usage of plastic- based food contact materials (FCM) as a proxy for exposure to this group of EDCs. Material and Methods: The questionnaire developed by organising a focus group discussion among experts. An interview-guided pilot study was then done to 250 respondents for construct validation process. In the validation process, test-retest study for reliability, Cronbach alpha for internal consistency, exploratory factor analysis and confirmatory factor analysis were done. Results: The questionnaire achieved kappa value ranged between 0.800 to 0.900 for knowledge, 0.610 to 0.815 for perception and 0.607 to 1.000 for self-care product section. Cronbach alpha value ranged between 0.600 to 0.780. Conclusions: Exploratory and confirmatory factor analysis approved the final model for phase one consisting of four domains with total of 13 items and final model for phase two consists of three domains with total of nine items.
Study of Congenital Anomalies of the Kidneys and Urinary Tract in Neonates
(Nepal Paediatric Society (JNPS), 2018) Chougule, Akshaya; Purkayastha, Jayashree; Lewis, Leslie; Aiyappa, Gourav; Barche, Apurv
Abstract: Introduction: Congenital anomalies of the kidneys and urinary tract (CAKUT) comprise various structural malformations that result from defects in morphogenesis of the kidney and/or urinary tract. In most cases, CAKUT are associated with infant mortality and morbidity in older children and adults. Hence this study was undertaken to follow up antenatally diagnosed cases of CAKUT and see their outcome in the first six months of life. Material and Methods: An observational follow up study was conducted in the department of Paediatrics in a tertiary care hospital. All inborn neonates, whose antenatal anomaly scans showed the presence of CAKUT were included in the study. Abdominal ultrasound (USG) were done on day three of life for all these neonates and those whose day three USGs showed presence of CAKUT were followed up over a period of six months and outcome was assessed. Results: CAKUT was more common among males. Hydronephrosis was the most common CAKUT in antenatal scans. Anomalies of the renal collecting system formed 93.9% of all CAKUT detected on antenatal anomaly scan and 57.4% of these resolved by six months of age. Abnormalities of the renal collecting system together formed 93.9% of all antenatally diagnosed CAKUT and were more common than abnormalities of the renal parenchyma which formed 6.1%. Postnatal resolution on day three USG was seen in seven out of 22 (31.8%) cases of antenatally diagnosed mild hydronephrosis irrespective of their site. Out of the 28 antenatally diagnosed hydronephrosis, 11 (39.3%) resolved at some point during the follow up period of six months. Conclusions: Antenatally diagnosed CAKUT were more common among male foetuses. On day three scan, 29.2% of CAKUT showed resolution. Hydronephrosis remained the most common antenatally as well as postnatally detected CAKUT. Anomalies of renal collecting system were better detected by antenatal scans than anomalies of renal parenchyma
Spectrum of Influenza B Viral Infection in Indian Children: A Tertiary Centre Experience Authors
(Nepal Paediatric Society (JNPS), 2018) Kini, Sandesh; Y, Ramesh Bhat; Handattu, Koushik; Kousika, Phalguna; Thunga, Chennakeshava
Abstract: Introduction: Influenza viral infection in children can range from subclinical illness to multi system involvement. The morbidity associated with influenza B viral infection is often overlooked. India being the second most populous country, accounts for 20% of global childhood deaths from respiratory infections. There is paucity of data on the clinical features and complications of influenza B viral infections in children from the Indian subcontinent. Our objective was to study the clinical profile, seasonality, complications and outcome associated with Influenza B viral infection in children < 18 years of age. Material and Methods: We conducted a retrospective observational study at a tertiary care hospital in South India. Children less than 18 years of age admitted to our paediatric unit were included in the study. We reviewed the case sheets of 56 patients who tested positive for influenza B virus during the study period and recorded their clinical and laboratory data. Throat swab obtained from cases were tested by RT-PCR. The illness was classified as upper respiratory tract infection, pneumonia and severe pneumonia. Outcome measures analysed were- mortality, need for oxygen supplementation or assisted ventilation, duration of oxygen support, duration of ICU/ hospital stay and time for defervescence following initiation of oseltamivir therapy. Results: The mean age of the study population was 6.98 years. Majority of the affected children were > 5 years of age in the school going category with a male to female ratio of 3:2. The diagnosis based on clinical and radiological findings included upper respiratory tract infection (URTI) in 44 (78.5%) cases followed by pneumonia in 11(19.6%) and severe pneumonia in one (1.7%) child. The peak incidence was in the month of March. Malnutrition was the most common risk factor affecting 22 (39.3%) cases followed by history of asthma in eight (14.3%). Three children required oxygen supplementation at admission. The median duration of hospital stay was seven days. The median duration for defervescence following initiation of oseltamivir therapy was 24 hours. Mortality was recorded in one infant who died of acute respiratory distress syndrome. Conclusions: Influenza B virus should be screened in all children having underlying high risk medical condition, presenting with pneumonia or upper respiratory tract infection. Oseltamivir therapy should be initiated early in the management of influenza B viral infections to prevent complications.
Prevalence of Asthma, Eczema and Allergic Rhinitis Symptoms in School Children of Kathmandu Valley: Results of a Questionnaire Survey
(Nepal Paediatric Society (JNPS), 2018) Sharma, Arun Kumar; Basnet, Sudha; Thapa, Surya B
Abstract: Introduction: Asthma is the most common chronic disease in children. This study was performed to determine the prevalence of asthma, eczema and allergic rhino-conjunctivitis symptoms in school children of Kathmandu. Methods: This questionnaire-based survey was conducted from December 2009 to August 2010 in 13 schools of Kathmandu among children aged six to seven years and 13 to 14 years based on questions adapted from International Study on Asthma and Allergies in Children (ISAAC) and translated into Nepali. Data were analysed using SPSS and prevalence of self-reported asthma-like symptoms, eczema and allergic rhinitis were assessed. Results: The questionnaire was distributed to 8269 children with a response rate of 68.54%. About 7.5% replied positively for "ever wheezed” (8.1% in older and 6.4% in young children) and 5.2% reported, "current wheeze" (4.2% in younger and 5.8% in older children). Boys had more frequent wheezing than girls in both age groups (p < 0.05). More children had nocturnal cough not associated with cold or chest infection (16.0%) and exercise-induced symptoms (9.4%). The overall prevalence of eczema was 6.2%; younger children (7.2%) reporting symptoms more commonly than older children (5.6%). The reported prevalence of allergic rhinitis was 28.2% (31.2% in older as compared to 22.9% in younger children). Allergic symptoms like “current wheeze”, “eczema” and “allergic rhinitis” were frequently reported together. Conclusion: Asthma, eczema and allergic rhinitis are common in school children of Kathmandu. A multi-centre study across all ecological zones in both rural and urban settings including video questionnaire will more accurately estimate asthma prevalence and its trends in school children of Nepal.
Evaluation of the Prescription Pattern of Antimicrobial Agents in Hospitalised Paediatric Patients in a Tertiary Care Hospital of Kathmandu, Nepal
(Nepal Paediatric Society (JNPS), 2018) Khadka, Anjan; Rayamajhi, Heleena; Shrestha, Shova
Abstract Introduction: Infectious diseases are one of the most frequent reasons for hospital admission for children and antimicrobials are commonly used to treat them. There is higher prevalence of irrational prescriptions of antimicrobials in such population. This study was conducted to survey the pattern of antimicrobial prescription in Paediatric inpatient. Material and Methods: This was retrospective, descriptive, observational study. The data was collected from prescription records. The paediatric population included in the study was categorised into three age groups. A total of 87 prescriptions were studied and the information was recorded in performa. Data were recorded in MS Excel and Graph Pad Prism version 6 was used for analysis. Results: The number of male child was outnumbered by female child. The average age of the patient on antimicrobial prescription was 5.34 ± 2.18 years. The mean duration of hospital stay was 6.17 ± 2.01 days. The common indications for antimicrobial prescriptions were upper respiratory tract infections, diarrhoeal illness, urinary tract infections, enteric fever, etc. The antimicrobials prescription rate was 1.33. Oral route was found to be commonly used than parenteral route. The generic prescription rate was 33.6%. The most common drug prescribed was ceftriaxone followed by amoxicillin + clavulanic acid, ciprofloxacin, metronidazole and amikacin. The 62.5% of antimicrobials were prescribed from National Essential List of Medicines. Conclusion: This study highlights the prescription pattern of antimicrobial agents in hospitalised Paediatric population in a tertiary care hospital.
The Evolving Role of Biologics in Otorhinolaryngology: Innovations, Applications, and Future Perspectives
(Kathmandu University, 2024) Shrestha, BL
ABSTRACT The introduction of biologics into otorhinolaryngology has marked a significant shift in the management of complex and chronic ENT (Ear, Nose and Throat) conditions. This review delves into the mechanisms, clinical applications, and evidence supporting the use of biologics in treating disorders such as chronic rhinosinusitis, allergic rhinitis, head and neck cancer, and autoimmune inner ear disease. By examining current research and clinical trials, this article provides an in-depth analysis of the transformative impact of biologics and discusses future directions in this rapidly advancing field. KEY WORDS Biologics, chronic rhinosinusitis, Ear, Nose and Throat
Mirror Ear: A Rare Case of Polyotia
(Kathmandu University, 2024) Amatya, N; Shrestha, BL; Karmacharya, S; Sapkota, N; Subba, S
ABSTRACT Polyotia is an anomaly of the external auricle in which the accessory auricle is large enough to closely resemble an additional pinna rather than a skin remnant and cartilage. Polyotia, also known as mirror ear or accessory ear, is a type of ear anomaly in the tragus area, but the term refers to substantial anomalies which resemble an accessory ear, unlike a pre-auricular tag. It is an extremely rare condition and to date, less than 30 cases of polyotia have been reported according to a review of the literature. A variety of theories has been proposed for development of such abnormal external auricle. We report two cases of polyotia which presented to Dhulikhel Hospital ENT OPD that was successfully corrected surgically. An 8-year-old boy and a 14-year-old boy presented with a large accessory anomalous auricle on left and right ear respectively. The accessory auricle was composed of an elastic cartilaginous component covered with skin and was positioned anteriorly to the original auricle in both the cases. The anomaly was not as large as the patient’s external auricle, rather it mirrored the external auricle. On the opposite ear both the cases presented with pre- auricular skin tag. Surgical correction was done by dissecting the skin free from the duplicated cartilage via an incision along the free edge of the helix the duplicated cartilage was contoured to fill the pre-tragal hollow and the tragus reconstructed with a free cartilage graft. KEY WORDS Accessory auricle, Accessory ear, Duplicated pinna, Mirror ear, Polyotia
Vesicovaginal Fistula Following Trauma
(Kathmandu University, 2024) Shrestha, S; Dangal, G; Karki, A; Pradhan, HK; Shrestha, R; Bhattachan, K; Sah, S
ABSTRACT Vesicovaginal Fistula (VVF) is an abnormal communication between the bladder and vagina. The major causes of vesicovaginal fistula in developing countries are associated with obstructed labour whereas in developed countries, vesicovaginal fistula results from pelvic surgeries. Rarely vesicovaginal fistula may result due to direct trauma to the pelvis. This is a case of 17 years female who presented with the history of fall from tree 5 years back, sustained genital injury and complained of involuntary leakage of urine one month after the incident. She underwent fistula repair with vaginal approach using Latzko technique. KEY WORDS Vesicovaginal fistula, Trauma, Transvaginal
An Unusual Presentation of Fatal Acute Haemorrhagic Pancreatitis in a Young Adult
(Kathmandu University, 2024) Naveen, A; Sahu, MR; Padhi, KS; Sharma, M; Sahu, SS; Mohanty, MK
ABSTRACT Acute haemorrhagic pancreatitis is a medical emergency and the most severe form of Acute Pancreatitis. It is characterized by severe epigastric pain that radiates to the back and is associated with vomiting. If not diagnosed and managed promptly, it may result in sudden, unexpected, unexplained deaths which fall within the medicolegal domain. In such cases, the role of an autopsy is of paramount importance to determine the cause of death. Here we report a young adult, who presented to the local hospital with vague abdominal discomfort and vomiting following alcohol intake and referred to our tertiary care center for further management. But he was received dead on arrival at our hospital. The diagnosis of acute haemorrhagic pancreatitis was made only after the post mortem examination. Awareness of the physicians about the unusual symptoms in acute haemorrhagic pancreatitis and the need for pancreas examination at autopsy of all sudden deaths is emphasised. KEY WORDS Acute pancreatitis, Autopsy, Autolysis, Haemorrhagic pancreatitis, Sudden death, Young adult
Nail Changes Following Valproate Therapy
(Kathmandu University, 2024) Shrestha, S; Pandey, A; Pathak, R
ABSTRACT Valproic acid is a widely prescribed medication for seizure disorders, mood disorders, and migraines. The adverse effects involving nails following the use of sodium valproate are rare. The nail changes reported so far include onycholysis, onychomadesis, the roughness of the nail, brownish-yellow discoloration, and a transverse yellow band. These changes are independent of the age of the patients, dose, and duration of medication. The nail changes are reversible following the discontinuation of the medication. KEY WORDS Onycholysis, Onychomadesis, Nail discoloration, Valproic acid
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
Cone-Beam Computed Tomographic Study of the Internal Anatomy of Lower Anterior Teeth
(Kathmandu University, 2024) Nepal, M; Chakradhar, A; Pradhan, SP; Khadka, J; Tripathi, R; Bali, H
ABSTRACT Background A thorough knowledge of the root and canal morphology and their possible variations are essential for successful endodontic treatment. Methods like staining and clearing techniques, cross sectional method can provide precise information on root canal systems, however, these methods are invasive. Cone-beam computed tomography (CBCT) is the 3-dimensional scans of the maxillofacial skeleton that best visualizes canal morphology and helps in identifying additional canals and roots in vivo. Objective To investigate the root canal configuration of mandibular anterior teeth using Cone- beam computed tomography. Method A total of 2910 CBCT images, comprising 970 central incisors, lateral incisors, and canines each from 485 patients were assessed. The following assessments were made: (1) The number of roots and root canals (2) Canal configuration according to Vertucci’s classification (3) Bilateral occurrences for variations. Also, the gender and age of patients were noted. Result The study revealed mandibular anterior teeth predominantly had 1 root with Type I (79.79%, 77.11%, 91.34%) canal configuration followed by type III (20.2%, 22.67%, 5.15%) in central, lateral and canine respectively. Almost 90% incisors had symmetry in the canal configurations. No statistical correlation was found between the gender and root canal configurations. Type III canal configurations in canines were present more in elder age group. Conclusion Clinicians must be aware that each tooth may display a different number of roots and types of canal configurations. During endodontic treatment, presuming lower anterior teeth with single root and single canal may lead to missed canals and consequently, treatment failure. KEY WORDS Cone-beam computed tomography, Internal anatomy, Mandibular anterior teeth
Assessment of Oral Health and Nutritional Status of School Teachers in Dharamshala City, Himachal Pradesh
(Kathmandu University, 2024) Gurung, D; Bhardwaj, VK; Fotedar, S; Thakur, AS; Vashisth, S
ABSTRACT Background Nutrition is associated with oral health and any changes in dietary habits have impacted nutritional profiles which in turn influences oral health status. Objective To assess the oral health and nutritional status among school teachers in Dharamshala city, Himachal Pradesh. Method A descriptive cross-sectional study was undertaken with interviews and documented using a structured and adapted WHO proforma. The oral health was assessed by using WHO oral assessment form 2013 (by tooth surfaces) and the nutritional status by using five day dietary recall and scored according to dental health dietary score. The dental health dietary scores included food group scores (FGS), nutritional evaluation score (NES), decay promoting potential scores (DPPS) for all five days. Result Almost, two third of the school teachers in both types of schools had an excellent Food Group Score (FGS) on all five days of dietary recalls. The mean total Decay Promoting Potential Score (DPPS) was 23.33±3.20 (minute). Approximately one- third of the teachers in both types of schools had DPPS scores within the “watch out” zone of dietary recall, ranging 15 or more on each day. The mean DMFT was 3.79±2.52 with mean total decayed teeth as 1.35±2.03. Similarly, the mean DMFS was 9.68±7.95 with the mean total decayed surfaces as 1.81±2.94. Conclusion The frequency of essential food groups remained consistent throughout the five- day dietary recall period. Carbohydrates formed the primary component whereas proteins were frequently missing from the diets. Frequent absence of protein intake in diet increased loss of attachment. KEY WORDS Nutritional status, Oral health status, WHO oral assessment for adults

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