Detection of Pyuria by Microscopic Urinalysis as a Marker of Pediatric Urinary Tract Infection

Globally, different diagnostic tests of urinary tract infection (UTI) are in clinical practices. A reliable test can increase the efficiency of the healthcare system, especially in a developing country like Nepal, reducing cost and time. Thus, we accessed the possibility of pyuria detected by microscopic urinalysis as a marker of pediatric UTI. The prospective study was conducted fromJuly2014 to January 2015 at Alka hospital, Lalitpur. Microscopic urinalysis of 353clean-catch urine samples was done by the wet mount method, followed by urine culture by a semi-quantitative method. We confirmed 64 (18.1%) UTI cases by culture, the gold standard for UTI diagnosis. Fever was the most common clinical manifestation in UTI cases. The sensitivity, specificity, positive predictive value and negative predictive value of pyuria detected by microscopic urinalysis to identify UTI were 50%, 70.9%, 27.6% and 86.5% respectively. In 318 febrile cases, the sensitivity, specificity, positive predictive value and negative predictive value of pyuria detected by microscopic urinalysis to identify UTI were 73.2%, 72.6%, 28.3% and 94.8% respectively. The findings suggest pyuria detected by microscopic urinalysis as not a worth while marker of pediatric UTI. But it is a trust worthy marker in febrile pediatric cases

A Comparative study to measure the horizontal condylar guidance obtained by protrusive interocclusal records and panoramic radiographic images in completely edentulous patients

Background &amp; Objectives:The study was conducted with objective to compare the horizontal condylar guidance (HCG) obtained by protrusive interocclusal records and panoramic radiographic images in completely edentulous patients.Materials &amp; Methods:The horizontal condylar guidance was measured in 25 completely edentulous patients by protrusive interocclusal records using zinc oxide eugenol paste through a face bow transfer (HanauTM Spring bow, Whip Mix Corporation, USA) to a semi-adjustable articulator (HanauTM Wide-Vue Articulator, Whip Mix Corporation, USA).  In the same patients, HCG was traced in the panoramic radiograph. The angles formed by the intersection of two lines: Frankfurt’s horizontal plane and posterior slope of articular eminence was measured using protractor to represent the horizontal condylar guidance angle on each side.Results:The mean difference between the horizontal condylar guidance angles values obtained using protrusive interocclusal record and panoramic radiograph was 2.68 degrees and 3.40 degrees for the right and the left side respectively, with the panoramic radiograph values being higher. This difference between the values was found to be highly significant between the two methods for the right side (t = 2.70, p = 0.012) and left side (t = 3.69, p = 0.001). A significant positive correlation was found between the horizontal condylar guidance obtained from protrusive interocclusal record and panoramic radiograph for the right (r = 0.643, p = 0.001) and left sides (r = 0.622, p = 0.001) separately.Conclusion:The panoramic radiographic tracing can be used to calculate the mean horizontal condylar guidance in the completely edentulous patients and these values can be used to programme semi-adjustable articulators avoiding the cumbersome process of obtaining protrusive interocclusal records.</p

Prosthetic Rehabilitation of Maxillectomy Patient with Post-Surgical Obturator: A Case Report

Case description: A 60 year old female patient presented to Department of Prosthodontics, CODS, BPKIHS, Dharan with a chief complain of loose obturator. History revealed that patient had undergone partial maxillectomy for squamous cell carcinoma 7 years back. The patient also has been wearing obturator which was loose when the patient reported to the department. On examination, the site of surgery was the maxillary right buccal sulcus area and a part of the hard palate including teeth number 11, 12, 13, 14, 15, 16, 17. The presented defect situation corresponded to a Class I situation (resection performed along the palatalmidline) according to the Aramany classification of defects. The surgical site showed complete healing. A hollow-bulb obturator was fabricated for rehabilitation of the defect. Conclusion: The extensive surgical procedures necessary to eradicate cancer of the head and neck and to prevent local recurrence or regional metastasis often leave extremely large physical defects which present almost insurmountable surgical difficulties in restoring acceptable function or esthetics. The prosthesis rehabilitated the patient in terms of function by providing better masticatory efficiency, phonetics by adding resonance to the voice, hence improving the clarity of speech and also improved the esthetics of the patient. DOI: http://dx.doi.org/10.3126/jcmsn.v10i4.12976 JCMS Nepal 2014; 10(4):32-36</p

Custom Ocular Prosthesis for Enucleated Eye: A Case Report

The unfortunate loss or absence of an eye may be caused by a congenital defect, irreparable trauma, tumor, sympathetic ophthalmia, or the need for histologic confirmation of a suspected diagnosis. Early rehabilitation with suitable prosthesis is recommended to ease the mind of the afflicted. An ocular prosthesis is a maxillofacial prosthesis that artificially replaces an eye missing as a result of trauma, surgery, or congenital absence. A custom ocular prosthesis has advantage of close adaptation to the tissue bed, provides maximum comfort and restores full physiological function to the accessory organs of the eye. </p

Preferred Source and Perceived Need of More Information about Dental Implants by the Undergraduate Dental Students of Nepal: All Nepal Survey

Objectives. This study was conducted to know the preferred source and perceived need of more information about dental implants by the undergraduate students of Nepal and their association with academic levels and gender. Materials and Methods. It was conducted in all the dental colleges of Nepal from June 2016 to June 2017 after taking ethical clearance and approval from the research committee of BPKIHS. It included all those who were present at the time of survey. Data collection was done through a cross-sectional questionnaire survey during the academic schedule of the colleges, supervised and monitored by the investigators themselves. The collected data were coded and entered in Microsoft excel 2013, and statistical analysis was done by SPSS 20 version. Result. A majority of the respondents agreed that they were not provided with sufficient information about implant treatment procedures during their BDS program (65.3%), would like more to be provided in the curriculum (95.1%), and would like to get additional reliable information from dental consultants and specialists (40.7%) and training on it from fellowship programs conducted by universities (39.2%). Significant association was seen between the responses and academic levels. Conclusion. Undergraduate dental students of Nepal want more information about dental implants through various means

Biliary atresia and posterior fossa bleed: Chance or causality. A case report and review of the literature

Key Clinical Message A newborn with a rare form of biliary atresia had posterior fossa bleed and subarachnoid hemorrhage despite vitamin K prophylaxis, indicating biliary atresia is a causality rather than chance. Abstract Biliary atresia frequently causes surgical jaundice, resulting in delayed vitamin K deficiency. We report a 28‐day‐old newborn diagnosed with a rare form of biliary atresia presented with an unusual association of posterior fossa bleed and subarachnoid hemorrhage despite vitamin K prophylaxis. Thus, biliary atresia remains causality rather than chance

Fabrication of Closed Hollow Bulb Obturator Using Thermoplastic Resin Material

Purpose. Closed hollow bulb obturators are used for the rehabilitation of postmaxillectomy patients. However, the time consuming process, complexity of fabrication, water leakage, and discoloration are notable disadvantages of this technique. This paper describes a clinical report of fabricating closed hollow bulb obturator using a single flask and one time processing method for an acquired maxillary defect. Hard thermoplastic resin sheet has been used for the fabrication of hollow bulb part of the obturator. Method. After fabrication of master cast conventionally, bulb and lid part of the defect were formed separately and joined by autopolymerizing acrylic resin to form one sized smaller hollow body. During packing procedure, the defect area was loaded with heat polymerizing acrylic resin and then previously fabricated smaller hollow body was adapted over it. The whole area was then loaded with heat cure acrylic. Further processes were carried out conventionally. Conclusion. This technique uses single flask which reduces laboratory time and makes the procedure simple. The thickness of hollow bulb can be controlled and light weight closed hollow bulb prosthesis can be fabricated. It also minimizes the disadvantages of closed hollow bulb obturator such as water leakage, bacterial infection, and discoloration