Morphometric Analysis of Mandibular Ramus for Sex Determination on Orthopantomogram.

BACKGROUND: Mandible is the strongest and most dimorphic bone of skull which resists postmortem changes and plays an important role in sex determination. Skeletal characteristic differ in different population therefore need of population specific studies. The aim of present study was to determine sex by morphometric analysis of mandibular ramus. METHODS: A cross sectionalstudy was performed in orthopantomogram of patients collected from Dental Department of Patan Hospital, Lalitpur, Nepal. One hundred and fifty digital orthopantomogram of patient fulfilling inclusion criteria were included in the study. Five different mandibular parameters (maximum ramus breadth, minimum ramus breadth, condylar height/maximum ramus height, projective height of ramus, and coronoid height) were measured bilaterally resulting in total 300 rami being assessed. Orthopantomogram were made with Planmeca ProMax classic 2D machine and all the measurements on digital radiograph were performed with Planmeca Romexis viewer software version 5.1.0.R. Discriminant function analysis was performed to find the most significant predictors for determining sex. RESULTS: All the measured mandibular parameters were statistically significantly higher in male than females (P<0.001). Condylar height was the most significant predictors for determining sex. The discriminate function equation was derived to determine sex with an overall accuracy of 84.0%. CONCLUSIONS: Morphometric analysis of mandibular ramus using digital orthopantomogram showed a high sexual dimorphism.

Frost Delay of a Water-Absorbing Surface with Engineered Wettability via Nonfreezing Water.

Frost is common when a solid surface is subjected to a humid and cold environment. It can cause various inconveniences, complications, or fatal accidents. Water-repellent surfaces have demonstrated an antifreezing capability by enabling the water droplets to roll or bounce off before they freeze. However, these surfaces are often limited by their inability to shed the small water condensates, which can eventually grow and freeze. Recently, surfaces that can rapidly absorb and hydrogen bond with these water condensates have demonstrated significant delay in frost formation and growth. This is attributed to a lower freezing temperature of the absorbed water which makes it stay in a nonfreezing state. Herein, we report a surface with preferential wettability of water over oil (i.e., superhydrophilic and oleophobic wettability) that can significantly delay frost formation. The surface is fabricated by copolymerizing poly(ethylene glycol) diacrylate (PEGDA) and perfluorinated acrylate (1H,1H,2H,2H-heptadecafluorodecyl acrylate, HDF-acrylate) applied to a silane-grafted glass substrate (HDF-PEGDA). An HDF-PEGDA surface can quickly absorb condensed water which enables it to delay frost formation and growth for up to 20 min at a surface temperature of -35 °C. Also, the surface demonstrates that its frost-resistant capability remains almost unaffected even after being submerged in an oil bath due to its in-air oil repellency. Differential scanning calorimetry (DSC) measurements reveal that the significant quantity of absorbed water in an HDF-PEGDA surface remains in a nonfreezing state with a Tm value as low as -33 °C. A mathematical model that can predict the time at which the surface begins to be covered with frost is developed. Finally, an HDF-PEGDA is layered with a PEGDA copolymerized with sodium acrylate (Na-acrylate) that enables the continuous release of the absorbed water by posing forward osmotic pressure and regeneration of an HDF-PEGDA surface.

Water-Responsive Self-Repairing Superomniphobic Surfaces via Regeneration of Hierarchical Topography.

Superomniphobic surfaces that can self-repair physical damage are desirable for sustainable performance over time in many practical applications that include self-cleaning, corrosion resistance, and protective gears. However, fabricating such self-repairing superomniphobic surfaces has thus far been a challenge because it necessitates the regeneration of both low-surface-energy materials and hierarchical topography. Herein, a water-responsive self-repairing superomniphobic film is reported by utilizing cross-linked hydroxypropyl cellulose (HPC) composited with silica (SiO2) nanoparticles (HPC-SiO2) that is treated with a low-surface-energy perfluorosilane. The film can repair physical damage (e.g., a scratch) in approximately 10 s by regenerating its hierarchical topography and low-surface-energy material upon the application of water vapor. The repaired region shows an almost complete recovery of its inherent superomniphobic wettability and mechanical hardness. The repairing process is driven by the reversible hydrogen bond between the hydroxyl (-OH) groups which can be dissociated upon exposure to water vapor. This results in a viscous flow of the HPC-SiO2 film into the damaged region. A mathematical model composed of viscosity and surface tension of the HPC-SiO2 film can describe the experimentally measured viscous flow with reasonable accuracy. Finally, we demonstrate that the superomniphobic HPC-SiO2 film can repair physical damage by a water droplet pinned on a damaged area or by sequential rolling water droplets.

Adherence to Anti- Hypertensive Medications among Patients in Selected Health Facilities of Nepal.

BACKGROUND: Hypertension is a non-communicable disease and one of the most prominent modifiable risk factors for cardiovascular diseases. 7.6 million premature deaths are attributed to high blood pressure around the world. Better adherence with antihypertensive medications improves quality and length of life. This research focuses on the extent of adherence towards prescribed antihypertensive treatment, and identify factors influencing non-adherence. METHODS: Descriptive cross-sectional study design was undertaken in various health care centers (2 primary health care center and 3 hospitals) of Nepal. A total of 348 individuals (age above 30) who suffered from hypertension visiting health institutes were included in the study. Adherence was calculated using Morisky Medication Adherence scale. RESULTS: Adherence level to the antihypertensive medication as per the morisky adherence scale, 38.8% had medium level of adherence, 37.4% had a low adherence level, and 23.9% had a high adherence level among 348 participants. From the total participants, 89 admitted to be irregular in medication use. 56% of them claimed to do so because of forgetfulness, 12.4 % because of consistent exercise and low-salt diet, 10.1% due to the lack of affordability. CONCLUSIONS: Our study had concluded that the majority of participants had medium to low levels of adherence to anti-hypertensive drugs. Forgetfulness was major cause for irregular medication. Patient education and counseling, family support also seem to be important for proper adherence to drugs. Thus, health care providers should allocate ample time in educating, counseling clients and family.

Prevalence of Dental Anomalies in the Patient with Cleft Lip and Palate Visiting a Tertiary Care Hospital.

INTRODUCTION: Dental anomaly is one of the major problems in a child born with cleft lip and palate. These anomalies have deleterious effects on the dentition leading to aesthetic problems, impairment of mastication andimproper phonation. The aim of our study was to find out the prevalence of dental anomalies in patient with cleft lip and/or palate radiographically. METHODS: A descriptive cross-sectional study was conducted from the 208 radiographs, collected by the convenience samplingtechnique with cleft lip and/or palate in Department of Burns, Plastic and Reconstructive Surgery, Nepal Cleft and Burn Centre, Kirtipur Hospital from January 2017 to July 2019.Ethical clearance for the study was obtained from Institutional Review Committee. Demographic data were collected and radiographs were evaluated for possible dental anomalies. Data obtained were entered and analysed in Statistical Package for Social Sciences version 23. RESULTS: Dental anomalies were highly prevalent among cleft lip and palate patients with at least one anomaly present in 188 (90.4%) of patients with male 120 (57.4%) presenting more anomalies than female 88 (42.6%) population. The most common anomaly was dental agenesis 161 (77.9%). The prevalence of positional anomaly, morphological anomaly and supernumerary teeth were found to be 54 (26%), 33 (15.9%) and 20 (10%) respectively. Lateral incisor showed the highest incidence of agenesis among all other missing teeth 223 (65.2%). CONCLUSIONS: The prevalence of dental anomalies among patients with cleft lip and/or palate was found to be high. Tooth agenesis was the most common anomaly observed in the study with lateral incisor having the highest incidence of agenesis.

Prevalence of Temporomandibular Joint Disorders and its Association with Para Functional Habits in the Patients Attending Tertiary Care Hospital.

BACKGROUND: Temporo-mandibular disorders is a collective term used to describe problems involving muscles of mastication and temporomandibular joint. The study aimed to evaluate the prevalence of temporo-mandibular disorders and its association with parafunctional habits in patients visiting department of dentistry, Patan Academy of Health Sciences. METHODS: A cross-sectional study was carried out among 213 patients coming to Patan Academy of Health Sciences. A screening questionnaire recommended by American Association of Orofacial Pain was used to determine the signs and symptoms of temporo-mandibular disorders. RESULTS: The prevalence of temporomandibular disorders was 31.9 %. The three most common parafunctional habits were chewing gums (32.4 %), mouth breathing (19.7 %) and biting of objects (14.6 %) respectively. Statistically significant association was found between nail biting, grinding of teeth, biting of lips and objects and mouth breathing with signs and symptoms of temporomandibular disorders (p<0.05). Among the signs and symptoms of temporomandibular disorders, getting headaches, neck pain or toothaches often was the most frequent signs of temporomandibular disorders (n=105, 49.3 %). Feeling of recent change in bite was the second most frequent sign reported by 82 participants (38.5 %). CONCLUSIONS: The parafunctional habits between nail biting, grinding of teeth, biting of lips and objects and mouth breathing have statistically significant association with signs and symptoms of temporomandibular disorders.

Rehabilitation of Severely Attrited Teeth with Hobo Twin Stage Technique: A Case Report.

Restoration of excessively worn dentition is a challenging treatment procedures. It requires efficient diagnosis and treatment plan. Hobo's techniques and Pankey Mann Schuyler's philosophy are widely used and documented for full mouth rehabilitation. We have reported the case of a 56-year- old male patient who presented with the severely worn dentition and had difficulty in chewing. To rehabilitate this case Hobo's twin stage technique had been adopted as it is based on scientific data and mathematical analysis for both disocclusion and anterior guidance thus reducing chair side time. Keywords: attrited; hobo; occlusion; rehabilitation.

Knowledge and Awareness Regarding Dental Implants among Patients Attending a Tertiary Care Center.

INTRODUCTION: Loss of natural teeth is a debilitating and irreversible process, which leads to functional, cosmetic and psychological morbidities. Dental implant serves as one of the options of tooth replacement, which are stronger, functionally effective and more durable. However, public awareness regarding it has been found to be low in Asian countries. This study was designed to know the status of knowledge and awareness of dental implant. METHODS: Seventy nine patients visiting dental department of Patan Academy of Health Sciences were included in this study through non-probability sampling. Data on knowledge and awareness regarding dental implants were collected through a survey after ethical approval from Institutional Review committee of Patan Academy of Health Sciences. Data entry was done in Epidata and analyzed with the help of Statistical Package of Social Sciences version 20. RESULTS: Total 33 (41.8%) of study populations choose dental implant as alternative for replacing teeth, 22 (30.4%) choose fixed dental prosthesis. 36 (45.6%) and 32 (40.5%) of population stated that long treatment time and high cost respectively as the disadvantages of dental implants. Only 12 (15.2%) were aware that dental implants are anchored in jaw bone. The source of information about dental implants was dentists for 48 (60.8%) of the patients followed by friends, media and medical doctors. CONCLUSIONS: Within the limitations of this study, we conclude that awareness of patients attending tertiary care center of Kathmandu valley is low. Hence, there is a need of organizing dental education programs to create awareness about dental implants.

Clinical Evaluation of Maxillary Anterior Teeth in Relation to Golden Proportion, Red Proportion and Golden Percentage.

BACKGROUND: Golden proportion, recurrent esthetic dental proportion and golden percentage are the widely accepted tools to measure perceived mesiodistal width of maxillary anterior teeth. Our study was aimed to identify appropriate tool among the above mentioned proportion to measure perceived mesiodistal width. METHODS: A cross-sectional observational study was conducted in National Academy of Medical Sciences, Bir Hospital, Nepalese Army Institute of Medical Sciences and Patan Academy of Health Sciences between March 2014 to March 2015.Sixty-three respondents were recruited in the study by the convenient sampling technique. Photographs of the maxillary anterior teeth were taken using digital single reflex camera with macrolens. Data analysis was done using SPSS version 17.0 and paired sample t- test was performed. RESULTS: In our study the golden proportion was 14.28% between central and lateral incisor and 12.69% between canine and lateral incisor. Therefore, golden proportion in our scenario doesn't exist. Recurrent esthetic dental proportion in female Aryans was 71 and 71 on left side and 71and 75 on right side. Golden percentage of respondents was near to values 11, 15, 22, 22, 15, and 12 %. CONCLUSIONS: Golden percentage is an appropriate anterior tooth proportion which may serve as a guideline for the restoration of anterior tooth. RED proportion is applicable only in Mongoloid female population.

Status of Tobacco Smoking and Diabetes with Periodontal Disease.

INTRODUCTION: Periodontitis is multifactorial disease that along with dental caries remains one of the commonest cause of tooth loss worldwide. Effective management requires clear understanding of risk factors. Smoking has a dose-dependent effect on periodontium. Similarly, individuals with diabetes have severe forms of periodontal diseases. We aim to assess the prevalence of periodontal disease in dental patients in relation to smoking and diabetes. METHODS: The study was conducted among 522 patients visiting the Periodontics Department, Kantipur Dental College. Individuals willing to participate had to sign an informed consent and undergo interview and clinical examination. Data collection, done on a structured proforma, was analysed using SPSS 20.0. RESULTS: Prevalence of periodontitis was 372 (71.3%), diabetes 33 (6.3%) and smoking as 138 (26.4%). Hypertension was observed in 64 (12.3%) patients and family history of diabetes among 94 (18%). Among the 372 periodontitis patients, smoking behaviour was present in 120 (32.3%), diabetes in 32 (8.6%), family history of diabetes in 72 (19.4%) and hypertension in 62 (16.7%). Conversely, 120 (87%) smokers, 33 (97%) diabetics, 72 (76.6%) with family history of diabetes, 62 (96.9%) hypertensive, 216 (41.4%) male and 156 (29.9%) female participants had periodontitis. Smoking behaviour was more in males: 115 (39.4%) compared to 23 (10%) females. CONCLUSIONS: Periodontitis was significantly associated with smoking, diabetes, hypertension and age. It is recommended that tobacco cessation and diabetes control be promoted as an integral component of periodontal therapy and oral health be included as an essential element of general health when conducting national health surveys.