A STUDY ON ORAL HEALTH KNOWLEDGE, ATTITUDE AND PRACTICE AMONG POPULATION OF SISWANI JAHADA VDC IN BIRATNAGAR CITY, NEPAL - A QUESTIONNAIRE SURVEY

The study is aimed to evaluate oral hygiene practice, knowledge and attitude among population of Siswani Jahada VDC in Biratnagar city, Nepal. This is a cross sectional study which included 1280 population selected by random sampling method. The consent for the participation was obtained verbally. A pre-tested close- ended questionnaire was used for the study.The result of this study show that 98.35% had habit of cleaning their teeth while very few numbers 1.6% were not cleaning teeth. It was seen that 62.3% brushed their teeth using toothbrush and tooth paste. 94.9% brushed only once a day, 33% brush twice a day while 25 1.9% brushes more than twice per day. Of 62.96% who used the brush, 41.7% participants change their brush in every 1-3 months, 33.1% change every six months and 25% change only after it worn out. Surprisingly, 70.76% of the respondents were aware of using fluoridated toothpaste and only 29.2% were not using it. 31.5% of the participants reported that they had suffered from some form of dental problem and 17.1% consulted the trained dentist and pain was the main factor for them to visit the dentist. 48.2% participants feel that dental caries is the most common dental disease, major factor being irregular brushing followed by consuming more sweets. Results of this study prove that oral hygiene habits, oral health awareness and knowledge level among population of siswani jahada VDC is satisfactory and need to be improved

Treatments for intracranial hypertension in acute brain-injured patients: grading, timing, and association with outcome. Data from the SYNAPSE-ICU study

Purpose: Uncertainties remain about the safety and efficacy of therapies for managing intracranial hypertension in acute brain injured (ABI) patients. This study aims to describe the therapeutical approaches used in ABI, with/without intracranial pressure (ICP) monitoring, among different pathologies and across different countries, and their association with six months mortality and neurological outcome. Methods: A preplanned subanalysis of the SYNAPSE-ICU study, a multicentre, prospective, international, observational cohort study, describing the ICP treatment, graded according to Therapy Intensity Level (TIL) scale, in patients with ABI during the first week of intensive care unit (ICU) admission. Results: 2320 patients were included in the analysis. The median age was 55 (I-III quartiles = 39-69) years, and 800 (34.5%) were female. During the first week from ICU admission, no-basic TIL was used in 382 (16.5%) patients, mild-moderate in 1643 (70.8%), and extreme in 295 cases (eTIL, 12.7%). Patients who received eTIL were younger (median age 49 (I-III quartiles = 35-62) vs 56 (40-69) years, p < 0.001), with less cardiovascular pre-injury comorbidities (859 (44%) vs 90 (31.4%), p < 0.001), with more episodes of neuroworsening (160 (56.1%) vs 653 (33.3%), p < 0.001), and were more frequently monitored with an ICP device (221 (74.9%) vs 1037 (51.2%), p < 0.001). Considerable variability in the frequency of use and type of eTIL adopted was observed between centres and countries. At six months, patients who received no-basic TIL had an increased risk of mortality (Hazard ratio, HR = 1.612, 95% Confidence Interval, CI = 1.243-2.091, p < 0.001) compared to patients who received eTIL. No difference was observed when comparing mild-moderate TIL with eTIL (HR = 1.017, 95% CI = 0.823-1.257, p = 0.873). No significant association between the use of TIL and neurological outcome was observed. Conclusions: During the first week of ICU admission, therapies to control high ICP are frequently used, especially mild-moderate TIL. In selected patients, the use of aggressive strategies can have a beneficial effect on six months mortality but not on neurological outcome