Journal Issue: Volume 14: No 2, Issue 54, APR-JUN, 2016
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Volume
Number
Issue Date
2016
Journal Title
Journal ISSN
1812-2027
Journal Volume
Articles
Eruption Pattern of Dentition and Its Medico-legal Significance
(Kathmandu University, 2016) Karki, RK
ABSTRACT
Background
The eruption pattern of temporary and permanent teeth are fairly constant with
the growing age. So the age determination of an individual by examination of teeth
is one of the accepted methods in legal system. A review of the literature shows
there are differences in eruption pattern between different populations mainly due
to variations in the constitutions and environment, so highlighting the importance of
this study to the Nepalese population.
Objective
To assess the eruption age of temporary and permanent teeth in Nepalese population
and compared the eruption age with other groups.
Method
This cross-sectional study, included 450 subjects, aged between six months to 25
years selected by simple random sampling method. The determinant variable such
as age and number of teeth was recorded.
Result
Eruption of temporary and permanent teeth is slightly delayed in Nepalese population
compared with others. First temporary tooth to erupt is lower central Incisor at
around eight months and last to erupt is second molar at around 28 months. For
permanent tooth, first molar erupts at around seven years and second molar erupts
by 14 years. Eruption of third molar (wisdom tooth) varies from 18 to 25 years.
Conclusion
This study provides a model data on eruption age of teeth which is first study of
its kind in Nepal. The findings of this study will help as a reference data for optimal
use in clinical, academic and research activities especially in Nepalese population.
Medico legally it helps in estimation of age along with other parameters.
KEY WORDS
Age, eruption, permanent teeth, temporary teeth
Incidence and Risk Factors of Surgical Site Infections in Kathmandu University Hospital, Kavre, Nepal
(Kathmandu University, 2016) Shrestha, S; Wenju, P; Shrestha, R; Karmacharya, RM
ABSTRACT
Background
Surgical site infections (SSI) are the common nosocomial infection in surgical patients,
and are a significant source of postoperative morbidity resulting in increased hospital
stay, morbidity and cost.
Objective
The objective of this study was to obtain the incidence of SSI and determine various
risks factors influencing the SSI rate with special reference to the National Nosocomial
Infections Surveillance System risk index in Kathmandu University Hospital, Kavre,
Nepal.
Method
Six hundred and thirty eight patients who underwent various surgeries in Dhulikhel
Hospital, Kathmandu University Hospital during a three-month period were included.
Using a pre designed questionnaire with follow up to 30 days and in orthopedic
cases, where metal implants were used as internal fixation devices, with follow up to
90 days data were collected. Infected cases were identified using Centre for Disease
Control and Prevention definition for surgical site infections. Swabs were obtained
from wounds and were processed without delay using standard microbiological
methods.
Result
Overall SSI rate was 2.6%. The most common pathogen isolated was Escherichia coli
(5 isolates, 29.4 %). The SSI rate was 0.0% for clean wounds, 2.9%, 15.3% and 18.7%
for clean-contaminated, contaminated and dirty wounds respectively. Increased
incidence of surgical site infections were associated with higher grades of wound,
emergency surgeries, American Society of Anesthesiologists score >2 and increased
in National Nosocomial Infections Surveillance System risk index.
Conclusion
The incidence of SSI in this study meets the standard of center for disease prevention
and control. Increases in surgical wound class, National Nosocomial Infections
Surveillance System risk index, American Society of Anesthesiologist score >2 and
emergency surgeries were associated with increased SSI rates.
KEY WORDS
National Nosocomial Infections Surveillance System (NNIS) risk index, Surgical site
infection, wound class
Estimation of Causes of Death in Suburban Nepal Using Verbal Autopsy
(Kathmandu University, 2016) Ide, N; Fitzpatrick, AL; Flaxman, AD; Koju, R; Tamrakar, D; Hernandez, B
ABSTRACT
Background
Nepal is in the midst of a disease transition, including a rapid increase of non-
communicable diseases. In order for health policy makers and planners to make
informed programmatic and funding decisions, they need up to date and accurate
data regarding cause of death throughout the country. Methods of improving cause
of death reporting in Nepal are urgently required.
Objective
We sought to validate SmartVA-Analyze, an application which computer certifies
verbal autopsies, to evaluate it as a method for collecting mortality data in Nepal.
Method
We conducted a medical record review of mortality cases at Dhulikhel Hospital,
Kathmandu University Hospital. Cases with a verifiable underlying cause of death
were used as gold standard reference cases. Verbal autopsies were conducted with
caregivers of 48 gold standard cases.
Result
Of the 66 adult gold standard mortality cases reviewed, 76% were caused by cancer,
cirrhosis, cardiovascular disease, COPD or injury. When assessing concordance
between cause of death from verbal autopsy vs. gold standards, we found an overall
agreement (Kappa) of 0.50. Kappa based on broader ICD-10 categories was 0.69.
Cause-Specific Mortality Fraction Accuracy was 0.625, and disease specific measures
of concordance varied widely, with sensitivities ranging from 0-100%.
Conclusion
Ongoing, countrywide mortality data collection is crucial for evidence-based priority
setting in Nepal. Though not valid for all causes, we found SmartVA-Analyze to
provide useful general cause of death data, particularly in settings where death
certification is unavailable.
KEY WORDS
Cause of death, death certification, Nepal, SmartVA, verbal autopsy
Prevalence of Sensory Neuropathy in Type 2 Diabetes Mellitus and Its Correlation with Duration of Disease
(Kathmandu University, 2016) Karki, DB; Yadava, SK; Pant, S; Thusa, N; Dangol, E; Ghimire, S
ABSTRACT
Background
Peripheral neuropathy is one of the most common and distressing late complication
of diabetes mellitus. Ignorance of the complications may develop foot ulcers and
gangrene requiring amputation.
Objective
The main objective of this study is to find out the prevalence of sensory neuropathy
in type 2 diabetes mellitus and to compare it with the duration of disease.
Method
Two hundred seventy one patients with type 2 diabetes mellitus of both gender
age 30 years and above willing to participate were included in this study. Patients
having hypothyroidism, rheumatoid arthritis, B12 deficiency, cerebrovascular
disease, chronic musculoskeletal disease, Parkinson’s disease, alcohol abuse, chronic
renal or liver failure and cancer were excluded from the study. Touch, pin prick and
vibration sensation were tested. Vibration perception threshold was recorded from
six different sites of the sole of each foot using Biothesiometer.
Result
Two hundreds seventy one type 2 diabetic outpatients were studied. The mean age
was 59.81±22.85 years. The overall prevalence of diabetic sensory neuropathy in the
study population was 58.70%. A rising trend of diabetic sensory neuropathy with
increasing age and duration of diabetes was observed. Neuropathy was found more
in patients having urinary microalbuminuria. Burning and pins and needles sensation
were most common symptoms.
Conclusion
The overall prevalence of diabetic sensory neuropathy in the study population was
58.70% (mean age 59.81±22.85 yrs), and its prevalence increased with duration
of diabetes and increasing age. Its prevalence was found more in patients having
microalbuminuria.
KEY WORDS
Biothesiometer, sensory neuropathy, type 2 diabetes mellitus