Highlights 2019: fresh focus on health

Contribution towardsFresh focus on health: Highlights 2019 photography competition open for submissions.Palmer J.Lancet. 2019 Jun 8;393(10188):2284-2285. doi: 10.1016/S0140-6736(19)31258-9. Epub 2019 Jun 6https://www.ncbi.nlm.nih.gov/pubmed/3118001

Prevalence of migraine and tension‐type headache among undergraduate medical students of Kathmandu Valley: A cross‐sectional study

Abstract Background Headache is the most prevalent neurological symptom which can be of a serious condition, as in brain tumor, but mostly it is a benign condition that includes primary headache such as migraine or tension‐type headache (TTH). Migraine reoccurs frequently and is more severe but owing to the high prevalence of TTH, however, impaired quality of life due to TTH is greater than that of migraine at the population level. Medical students are constantly subjected to stress and in such a condition, it was necessary to find out the burden of headache among medical students. This cross‐sectional study done among medical students aims to generate some data and literature which will change the outlook of stakeholders towards headache disorders among medical students. Methods This cross‐sectional study is based upon Headache Screening Questionnaire—English Version questionnaire based upon the ICHD‐3 beta criteria. Medical students of Kathmandu valley were sampled by using convenient sampling and data were collected. Data were refined in Microsoft Excel and imported to SPSS 20 for analysis. Results A total of 352 individuals were part of this study, out of which 229 (65.1%) were males and 123 (34.9%) were females with a mean age of 21.72 ±  1.601 years (mean ± SD). Prevalence of migraine and TTH was found to be 15.3% (95% confidence interval [CI]: 11.7%–19.3%) and 40.3% (95% CI: 34.9–45.2), respectively. Through multivariate binomial regression, it was observed that the odds of being diagnosed with migraine increased with age (adjusted odds ratio [AOR] = 1.266 [1.013–1.583], p = 0.038), females had twice the odds of experiencing migraine headaches compared to males (AOR = 2.119 [1.074–4.180], p = 0.03), and medical students who stayed at the hostel were at lesser odds of experiencing migraine headache (AOR = 2.772 [1.501–5.118], p = 0.01). Conclusion Prevalence of migraine and TTH among undergraduate medical students was found to be 15.3% and 40.3%, respectively

Knowledge, Awareness, and Attitude Regarding Dental Implants among Dental Interns

Introduction: Implant therapy is an elective dental procedure of dental rehabilitative treatment. Objective of this study was to assess the knowledge, awareness, and attitude of dental interns of Nepal toward dental implants and to see associations of the responses with gender and geographic location of dental college. Methods: It was conducted from June 2016 to June 2017 after taking ethical clearance and approval from the research committee. The sample included the interns who were present at the time of the survey. Data collection was done through a cross-sectional questionnaire survey, during clinical postings of the interns at all the dental colleges of Nepal, supervised and monitored by the investigators themselves; coded and entered in Microsoft Excel 2013 and statistical analysis was done by SPSS. Results: A majority of the interns said they are moderately well informed about dental implants 141 (50.36%); main advantage of dental implants is they are conservative 164 (58.6%); most important factor for implant success is case selection 143 (51.07%); the longevity of dental implants is 10-20yrs, 162 (57.85%), 188 (67.14%) agreed that they were not provided with sufficient information and 191 (68.21%) stated that they need more information; 180 (64.3%) felt the difficulty encountered while placing implants is average and 229 (81.78%) stated that they need more hygiene care than natural teeth.  Conclusions: A majority of interns have knowledge regarding dental implants, but the percentage of those who gave unsatisfactory answers is also large. They have a positive attitude towards gaining more information through various means

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

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

Factors affecting Nepalese rural dwellers’ choice of first-contact health facility: a cross-sectional survey

# Background Despite significant progress in Nepal's health indicators over the past three decades, regional disparities in public health centre (PHC) provision and accessibility remain severe. It has been reported that rural dwellers prefer and place more trust in outreach centres (ORCs) run by the Dhulikhel Hospital. However, the reasons behind this remain unclear. This cross-sectional survey study examined the determinants of Nepal's rural dwellers' choices of first-contact health facility by collecting the data of 1,098 adults. # Methods The differences were tested, and then binary logistic regression was performed to analyse first-contact health facility decision-making. # Results Sex, education level, importance of health care satisfaction, importance of free health care, diagnosis of hypertension, diagnosis of diabetes, insurance coverage, savings, community-level cooperation, and distance to the health facility were significant factors affecting the choice of the first-contact health facility. Most significantly, people who were unconcerned about receiving free health care were 19.417 times more likely to use ORCs. Additionally, it was observed that rural dwellers perceived ORCs as providing higher quality health care. # Conclusions The government must promote cooperation between PHCs and ORCs, as it is essential to understand consumer demand, supply-side issues, and institutional aspects of health care in rural areas to achieve universal access to health care

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

Reproducibility and relative validity of food group intake in a food frequency questionnaire developed for Nepalese diet

<p>We developed a food frequency questionnaire (FFQ) designed to measure the dietary practices of adult Nepalese. The present study examined the validity and reproducibility of the FFQ. To evaluate the reproducibility of the FFQ, 116 subjects completed two 115-item FFQ across a four-month interval. Six 24-h dietary recalls were collected (1 each month) to assess the validity of the FFQ. Seven major food groups and 23 subgroups were clustered from the FFQ based on macronutrient composition. Spearman correlation coefficients evaluating reproducibility for all food groups were greater than 0.5, with the exceptions of oil. The correlations varied from 0.41 (oil) to 0.81 (vegetables). All crude spearman coefficients for validity were greater than 0.5 except for dairy products, pizzas/pastas and sausage/burgers. The FFQ was found to be reliable and valid for ranking the intake of food groups for Nepalese dietary intake.</p