Developmental anomalies affecting the morphology of teeth – a review

Introduction: The development of tooth is a complex process wherein there is series of interactions between the ectoderm and ectomesenchyme. The role of genes in determining the shape and form of a specific tooth has already been defined, the alterations in which can lead to a variety of anomalies in regards to number, size, form, shape, structure, etc. Objective: To review the literature on the developmental anomalies of teeth. Literature review: The developmental anomalies affecting the morphology exists in both deciduous & permanent dentition and shows various forms such as gemination, fusion, concrescence, dilacerations, dens evaginatus, dens invaginatus, enamel pearls, taurodontism or peg laterals. These anomalies have clinical significance concerning esthetics, malocclusion and more importantly predisposing the development of dental caries and periodontal diseases. Conclusion: Knowledge of various diagnostic criteria for identification of these developmental anomalies is significant for early diagnosis and pertinent treatment

GIANT CELLS AND GIANT CELL LESIONS OF ORAL CAVITY- A REVIEW

Giant cells are large mononucleated or multinucleated cells that are seen in a variety of physiological as well as pathological conditions. Multinucleated giant cells (MGCs) are important mediators of tissue remodeling and repair and also for removal of foreign materials and various pathogens.  The commonly encountered giant cells arise from monocyte precursors, formed due to different mechanisms. Depending upon the mechanism of their formation these cells assume distinctly variable phenotypes.  The giant cell lesions of oral cavity have been classified on the basis of etio-pathogenesis, the presence of which at times being pathognomic. We attempt to review the basic information regarding the mechanism of formation and morphology of giant cells and its significance in the associated giant cell lesions. Also we have tried to describe the clinical, histopathological and immunohistochemical aspects of various giant cell lesions of the oral cavity

Adolescents with disabilities and caregivers experience of COVID-19 in rural Nepal

Introduction: Intersecting vulnerabilities of disability, low socio-economic status, marginalization, and age indicate that adolescents with disabilities in low-and middle-income countries were uniquely affected by the COVID-19 pandemic. Yet, there has been limited research about their experience. We conducted participatory research with adolescents with disabilities in rural, hilly Nepal to explore their experience of the pandemic and inform understanding about how they can be supported in future pandemics and humanitarian emergencies. Methods: We used qualitative methods, purposively sampling adolescents with different severe impairments from two rural, hilly areas of Nepal. We collected data through semi-structured interviews with five girls and seven boys between the age of 11 and 17 years old. Interviews used inclusive, participatory, and arts-based methods to engage adolescents, support discussions and enable them to choose what they would like to discuss. We also conducted semi-structured interviews with 11 caregivers. Results: We found that adolescents with disabilities and their families experienced social exclusion and social isolation because of COVID-19 mitigation measures, and some experienced social stigma due to misconceptions about transmission of COVID-19 and perceived increased vulnerability of adolescents with disabilities to COVID-19. Adolescents who remained connected with their peers throughout lockdown had a more positive experience of the pandemic than those who were isolated from friends. They became disconnected because they moved away from those they could communicate with, or they had moved to live with relatives who lived in a remote, rural area. We found that caregivers were particularly fearful and anxious about accessing health care if the adolescent they cared for became ill. Caregivers also worried about protecting adolescents from COVID-19 if they themselves got ill, and about the likelihood that the adolescent would be neglected if the caregiver died. Conclusion: Contextually specific research with adolescents with disabilities to explore their experience of the pandemic is necessary to capture how intersecting vulnerabilities can adversely affect particular groups, such as those with disabilities. The participation of adolescents with disabilities and their caregivers in the development of stigma mitigation initiatives and strategies to meet their needs in future emergencies is necessary to enable an informed and inclusive response

Demographic profile of patient with acute watery diarrhea during monsoon 2022: Patan Hospital, Nepal

Introduction: Diarrhea is the passage of three or more loose or liquid stools per day or more. Acute watery diarrhea is a major public health problem worldwide.  In Nepal, diarrhea is among the top 10 inpatient morbidity. This study’s objective is to monitor demographic characteristics and laboratory findings of stool specimens of diarrhea. Method: This is a cross-sectional descriptive study done at Patan Hospital. Ethical approval was taken from the Ethical committee. Data for Monsoon 2022 (June to September 2022) were collected from the Patan Hospital record system. Cases from within the Lalitpur district were included. Result: Out of 119 cases, 50(42%) were male and 69(58%) were female. The mean age±SD was 33.28±25.38 (p=0.083) with maximum cases observed during June and a peak observed during the fourth week of June. Out of 119, 4(3.3%) were stool culture positive. Two cases of Vibrio cholera, one case of Shigella sonnei, and one case of Salmonella parathypi B were isolated. In the etiological profile, 14 Entamoeba histolytica were isolated. Conclusion: During the outbreak of diarrhea in Monsoon 2022, adults were affected most. The culture of acute watery diarrhea showed two cases of Vibrio cholera

Agro-morphological Diversity of High Altitude Bean Landraces in the Kailash Sacred Landscape of Nepal

Many varieties of bean are widely grown across diverse agro-ecological zones in Nepal. And opportunities exist for improving the crops and enhancing their resilience to various biotic and abiotic stressors. In this context, an experiment was conducted from June to October 2016 in Khar VDC of Darchula district to study the phenotypic traits of nine landraces of bean (Phaseolus vulgaris L.). The bean landraces were planted using randomized complete block design in three sites (Dhamidera, Dallekh and Sundamunda villages), with three replications in each site for their comparative analysis. The study considered the following phenotypic traits: days to emergence, days to 50% flowering, days to 90% pod maturity, number of nodes, pod length, pod width, number of pods, number of seeds per pod and weight and grain yield for 100 seeds. Kruskal-Wallis test showed significant differences in the landraces both within and among locations. KA-17-08-FB and KA-17-04-FB were late  flowering (63 and 65 days respectively) compared to other landraces whereas KA-17-07-FB flowered earliest (within 42 days). In all three sites, three landraces namely KA-17-07-FB, KA-17-04-FB and KA-17-06-FB were found to be relatively more resistant to pest and diseases than other landraces. Eight out of nine landraces in Dhamidera and Dallekh villages and seven out of nine in Sundamunda village produced seeds greater than 1.0 t/ha. Among the nine varieties KA-17-02-FB was the highest yielding variety, with an average yield of 3.8 t/ha. This study is useful for identifying suitable landraces for future promotion based on their maturity, grain yield, diseases resistance and other qualitative and quantitative characteristics

Institutional delivery in public and private sectors in South Asia: a comparative analysis of prospective data from four demographic surveillance sites

BACKGROUND: Maternity care in South Asia is available in both public and private sectors. Using data from demographic surveillance sites in Bangladesh, Nepal and rural and urban India, we aimed to compare institutional delivery rates and public-private share. METHODS: We used records of maternity care collected in socio-economically disadvantaged communities between 2005 and 2011. Institutional delivery was summarized by four potential determinants: household asset index, maternal schooling, maternal age, and parity. We developed logistic regression models for private sector institutional delivery with these as independent covariates. RESULTS: The data described 52 750 deliveries. Institutional delivery proportion varied and there were differences in public-private split. In Bangladesh and urban India, the proportion of deliveries in the private sector increased with wealth, maternal education, and age. The opposite was observed in rural India and Nepal. CONCLUSIONS: The proportion of institutional delivery increased with economic status and education. The choice of sector is more complex and provision and perceived quality of public sector services is likely to play a role. Choices for safe maternity are influenced by accessibility, quantity and perceived quality of care. Along with data linkage between private and public sectors, increased regulation should be part of the development of the pluralistic healthcare systems that characterize south Asia

Institutional delivery in public and private sectors in South Asia: A comparative analysis of prospective data from four demographic surveillance sites

__Background:__ Maternity care in South Asia is available in both public and private sectors. Using data from demographic surveillance sites in Bangladesh, Nepal and rural and urban India, we aimed to compare institutional delivery rates and public-private share. __Methods:__ We used records of maternity care collected in socio-economically disadvantaged communities between 2005 and 2011. Institutional delivery was summarized by four potential determinants: household asset index, maternal schooling, maternal age, and parity. We developed logistic regression models for private sector institutional delivery with these as independent covariates. __Results:__ The data described 52 750 deliveries. Institutional delivery proportion varied and there were differences in public-private split. In Bangladesh and urban India, the proportion of deliveries in the private sector increased with wealth, maternal education, and age. The opposite was observed in rural India and Nepal. __Conclusions:__ The proportion of institutional delivery increased with economic status and education. The choice of sector is more complex and provision and perceived quality of public sector services is likely to play a role. Choices for safe maternity are influenced by accessibility, quantity and perceived quality of care. Along with data linkage between privat

Cause-specific neonatal mortality: analysis of 3772 neonatal deaths in Nepal, Bangladesh, Malawi and India.

OBJECTIVE: Understanding the causes of death is key to tackling the burden of three million annual neonatal deaths. Resource-poor settings lack effective vital registration systems for births, deaths and causes of death. We set out to describe cause-specific neonatal mortality in rural areas of Malawi, Bangladesh, Nepal and rural and urban India using verbal autopsy (VA) data. DESIGN: We prospectively recorded births, neonatal deaths and stillbirths in seven population surveillance sites. VAs were carried out to ascertain cause of death. We applied descriptive epidemiological techniques and the InterVA method to characterise the burden, timing and causes of neonatal mortality at each site. RESULTS: Analysis included 3772 neonatal deaths and 3256 stillbirths. Between 63% and 82% of neonatal deaths occurred in the first week of life, and males were more likely to die than females. Prematurity, birth asphyxia and infections accounted for most neonatal deaths, but important subnational and regional differences were observed. More than one-third of deaths in urban India were attributed to asphyxia, making it the leading cause of death in this setting. CONCLUSIONS: Population-based VA methods can fill information gaps on the burden and causes of neonatal mortality in resource-poor and data-poor settings. Local data should be used to inform and monitor the implementation of interventions to improve newborn health. High rates of home births demand a particular focus on community interventions to improve hygienic delivery and essential newborn care