Prevalence and Risk Factors for Occupational Voice Disorders in Nepalese Teachers: A Cross-Sectional Study.

Introduction Teachers are a high-risk group for the development of vocal dysfunction, as they use voice extensively in their profession. Objective To know the prevalence and risk factors associated with voice strain in teachers. Methods A cross-sectional study was conducted among schoolteachers in Chitwan, Nepal. The Voice Handicap Index questionnaire was used as a survey tool. Result A total of 315 teachers were enrolled in the study. The mean age of the participants was of 36.7 years. Teachers from public schools, primary grade classes, > 50 pupils in the classroom, > 24 hours of classes per week, dust in class, and recurrent tonsil problems were associated with various degrees of vocal handicap. Conclusion There is a high prevalence of voice disorder among teachers. A holistic approach, which includes teacher education regarding voice care during their work and management of their voice handicap by taking into consideration different risk factors, must be adopted.

Metabolic syndrome in patients with lichen planus: A case-control study.

Background: Lichen Planus (LP) is a chronic dermatosis affecting the skin and mucous membranes. Chronic inflammation and oxidative stress in patients with LP is a trigger predisposing to Metabolic Syndrome. Objectives: To study the association of Metabolic Syndrome in patients with LP. Materials and Methods: A hospital-based prospective case-control study was conducted from April 2021 to January 2023 including 75 histopathologically confirmed patients with LP and 82 age and sex-matched controls according to the inclusion and exclusion criteria. Metabolic Syndrome was diagnosed using Modified National Cholesterol Education Programme Adult Treatment Panel III criteria. Statistical analysis of the data was performed using Statistical Package for the Social Sciences software, version 26. The chi-square test was used for data analysis. Results: The majority (30.6%) of the patients belonged to the age group 31-40 years. The mean age of patients with LP was 46.13 ± 14.9 years. Female predominance (69.3%) was observed in our study. Patients with classic LP (54.6%) were predominantly observed. Metabolic Syndrome was significantly prevalent in LP patients than in controls (32% vs. 13.4%, p = 0.005, OR 3.037) and was significantly associated with morphology (only oral mucosal involvement, 61.5%, p 0.027, OR 3.9), severity (severe LP, 58.6%, p < 0.001, OR 7.79), and duration of the disease (≥6 months, 55.5%, p 0.001, OR 5.42). 71% of Metabolic Syndrome was observed in females (p 0.847). Among patients with metabolic syndrome, the majority belonged to the age group between 31 and 40 years (37.5%, p 0.378). Systolic and Diastolic Blood Pressure values (≥130/85 mm of Hg), Serum Triglycerides (≥150 mg/dl), and Low-Density Lipoprotein (>130 mg/dl) were significantly elevated, and High-Density Lipoprotein (<40 mg/dl) was significantly low in LP than in controls (p < 0.05). Conclusion: The study showed a significant association of Metabolic Syndrome in patients with LP. Thus, patients with LP need to be screened to avoid complications associated with Metabolic Syndrome that is, Diabetes Mellitus, Cardiovascular Disease, colorectal cancer, and stroke.

Road Traffic Accident among Patients Presenting to the Emergency Department of a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Introduction: Road traffic accidents are a public health problem and have emerged as the leading cause of mortality and morbidity. Head is the most commonly affected site of road traffic accidents. The aim of this study was to find out the prevalence of road traffic accidents among patients presenting to the emergency department of a tertiary care centre. Methods: A descriptive cross-sectional study was conducted at the Emergency Department from 12 January 2022 to 14 June 2022. Ethical approval was taken from the Institutional Review Committee (Reference number: COMSTH-IRC/2021-171). Data was collected using a self-structure questionnaire and from emergency tickets. A convenience sampling method was used. Point prevalence and 95% Confidence Interval were calculated. Results: Among 7654 patients, the prevalence of road traffic accidents was found to be 734 (9.58%) (8.49-10.66, 95% Confidence Interval). Most of the accidents took place on Friday 139 (18.94%). The majority of them were soft tissue injuries 279 (38.01%). Conclusions: The prevalence of road traffic accidents was found to be higher compared to similar studies done in similar settings. Accident preventive strategies should be focused on and implemented by all the stakeholders. Keywords: emergencies; mortality; soft tissue injury; traffic accidents.

Assessing Impact of Health Education in Improving Knowledge of Children on Child Sexual Abuse.

BACKGROUND: Every year, millions of children around the world face sexual abuse and exploitation. Sexual and reproductive health education is an important form of health promotion action against it. This study aims to assess the impact of health education program in improving knowledge of the children on child sexual abuse. METHODS: A school based pre-experimental study was done among 120 lower secondary level students of a private school in Bharatpur municipality of Chitwan District, Nepal during March 2021. An interventional health education program imparting knowledge on child sexual abuse and its preventive measures was given to the children. Their knowledge was assessed and compared before and after intervention using paired t-test. Data analysis was done using SPSS version 17 software. RESULTS: The mean age of children was 13.77±0.65 years with 1:1.18 girls to boys ratio. The level of knowledge of the children on child sexual abuse and its preventive measures increased significantly post-intervention as compared to pre-intervention. The mean scores of post-test (29.80±4.53) was higher than pre-test (17.04±6.96). The intervention was proved effective with statistically significant t-test values (t=20.996, p=<0.001). About 6.7% children disclosed an experience of child abuse post-intervention. CONCLUSIONS: The school based health education program effectively increased the knowledge of the children on child sexual abuse, thus helping in preventing and protecting them from child sexual abuse and its harmful effects.

Mean Subpubic Angle of Patients Visiting Department of Radiodiagnosis of a Tertiary Care Hospital: A Descriptive Cross-sectional Study.

INTRODUCTION: The subpubic angle in the pelvis is most often used to estimate the sex with a higher degree of accuracy. Despite the anthropological and obstetric importance of the subpubic angle, only a few studies exist in the Nepalese population. The objective of this study was to determine the mean subpubic angle of the patient visiting the department of radiodiagnosis of tertiary care hospital. METHODS: This was a descriptive cross-sectional study comprising 332 pelvic digital radiographs of the patients visiting the department of radiodiagnosis of a tertiary care center from March to August, 2021. Ethical approval was taken from the Institutional Review Committee at College of Medical Sciences (Reference number: COMSTH-IRC/2021-62). Convenience sampling method was done. Demographic data like age and sex were noted. In the radiograph, the subpubic angle was measured using the program Digimizer Image Analysis Software. The collected data were analysed using the Statistical Package for the Social Sciences version 20. Point estimate at 95% Confidence Interval was calculated along with mean and standard deviation for continuous data. RESULTS: Among 332 pelvic radiographs studied, the mean subpubic angle was found to be 120.42±22.27° (118.02-122.81 at 95% Confidence Interval). The subpubic angle in females was 137.96±12.47° and that in males was 101.10±12.56°. CONCLUSIONS: Our findings are similar to those of other studies, with a minor variation. The subpubic angle was comparatively higher in females than males in the present study. The findings of this study may be of interest to forensic scientists and obstetricians.

Prevalence of Newly Diagnosed End-Stage Renal Disease Patients in a Tertiary Hospital of Central Nepal, Chitwan: A Descriptive Cross-sectional Study.

INTRODUCTION: End-stage renal disease patients are in rising trend globally, and they have been found to occur predominantly in developing countries. Many studies have been published before, within and across the countries, to know the clinicodemographic profile of end-stage renal disease patients. However, no such studies were done in Chitwan, Nepal. This study's main objective was to find the prevalence of newly diagnosed end-stage renal disease patients. METHODS: A hospital-based descriptive cross-sectional study was carried out in the Department of Nephrology from May 2016 to April 2019. Convenient sampling was done, and all the consecutive new end-stage renal disease patients were included in the study. The ethical approval was taken from the Institutional Review Committee (reference number. 2016/COMSTH/IRC/042). The prevalence and demographic profile of new end-stage renal disease patients were studied. The data were analyzed with appropriate statistical tools. RESULTS: A total of 250 new end-stage renal disease patients were found among 2200 admitted patients. The prevalence of new end-stage renal disease was found to be 250 (11.36%). Out of 250 patients, males were 156 (62.4%), and females were 94 (37.6%). The mean age was 49.6±15.5 years. The commonest cause of the incident end-stage renal disease was Type 2 Diabetes mellitus 89 (35.6%). CONCLUSIONS: The prevalence of new end-stage renal disease was found to be quite high. The commonest cause of the incident end-stage renal disease was Type 2 Diabetes Mellitus.

Effectiveness of Fentanyl in Facilitating Cannulation of Ampulla of Vater during Endoscopic Retrograde Cholangiopancreatography.

BACKGROUND: Endoscopic retrograde cholangiopancreatography is carried out under moderate sedation mostly by use of propofol, opioids and benzodizepines. The aim of study is to assess difficulty in cannulation of ampulla of vater with the use of fentanyl. METHODS: A prospective randomized double blind comparative study was conducted at Bharatpur Hospital from August 2019 to August 2020 among patients undergoing Endoscopic retrograde cholangiopancreatography. Total 100 patients were enrolled in study and were divided in two groups - Group P (propofol and midazolam) and Group FP (propofol, midazolam and fentanyl). Ease of cannulation was determined using Freeman scale. Independent sample t-test was used to compare mean between two groups and Chi Square test was used to compare categorical variables. RESULTS: Mean age (51.36±17.750 years versus 56.74±16.995 years), weight (58.88±8.151 kg versus 57.32±8.431 kg) and gender distribution (14 versus 12 male patients and 36 versus 38 female patients) were comparable in both groups-Group P and Group FP. There were 34 patients in Group P and 37 patients in Group FP with easy cannulation and 16 patients in Group P and 13 patients in Group FP with difficult cannulation, which was comparable (p value=0.509) Conclusions: Cannulation of ampulla of vater is not affected by the use of fentanyl in combination with propofol when compared to propofol alone and can be routinely used during endoscopic retrograde cholangiopancreatography.

Comparison of Proton Pump Inhibitor and Triple Therapy Regimen for Laryngospharyngeal Reflux Disease.

BACKGROUND: Laryngopharyngeal reflux is retrograde flow of contents of the stomach to the larynx and the pharynx. The study aims to compare two regimens (proton pump inhibitor monotherapy versus triple therapy) on the outcome of Helicobactor pylori positive laryngopharyngeal reflux disease. METHODS: The presence of laryngopharyngeal reflux was determined by reflux symptom index and reflux finding score. The presence of Helicobactor pylori in the tissue was confirmed by rapid urease test. All urease test negative laryngopharyngeal reflux patients were given a course of proton pump inhibitors and results were evaluated. All urease test positive patients were divided into two groups. One group was given a course of proton pump inhibitors and another group was given a course of triple therapy and the results were compared. RESULTS: A total number of 704 laryngopharyngeal reflux patients were screened for urease test. Among them 138 patients (19.6 %) were urease test negative and were given proton pump inhibitor therapy. Improvement in both reflux finding score (average score 11.75) and reflux symptom index (average score 5.25) score was observed after 3 months with p-value<0.05. In urease test positive patients, improvement in scores was observed in both proton pump inhibitors and triple therapy group, however marked improvement in the clinical features was observed in triple therapy group with p-value<0.05. CONCLUSIONS: The study reveals association between laryngopharyngeal reflux and Helicobactor pylori. Proton pump inhibitor therapy is sufficient if no Helicobactor pylori is detected, however incase of presence of Helicobactor pylori, triple therapy gives better results.

Clinicodemographic Profile of Kidney Diseases in a Tertiary Hospital of Central Nepal, Chitwan: A Descriptive Cross-sectional Study.

INTRODUCTION: Spectrum of kidney diseases differs significantly in developing and developed countries. However, there is no central registry regarding the nature of such diseases in Nepal and our center either. The study aims to know the clinicodemographic spectrum of kidney disease patients admitted to our hospital. METHODS: This study was a descriptive cross sectional study done in the department of Nephrology, College of Medical Sciences Teaching Hospital from May 2018 to April 219. Convenient sampling was done and all the consecutive kidney disease patients irrespective of their age, sex, and renal diagnosis were included in the study. Ethical approval was taken from the Institutional Review Committee of the college (reference number. 2016/COMSTH/IRC/049). Clinicodemographic profile of kidney diseases were studied using statistical package for the social sciences version 20 and were represented as mean, standard deviation, number, percentage and ratio. RESULTS: Out of a total of 829 patients, the commonest clinical syndrome and the histological patterns were end-stage renal disease 248 (29.9%) and IgA nephropathy 18 (20.7%) respectively. The mean age was 51.4±18.6 years. The commonest reason for hospitalization was sepsis 372 (44.8%). Males were 486 (58.6%) and females were 343 (41.4%). CONCLUSIONS: The commonest clinical presentation and the reason for admissions were end-stage renal disease and sepsis syndrome respectively.

Mean Nasal Index of Dental Students of A Dental College in Nepal.

INTRODUCTION: Human nose is one of the important anthropometric parameters for identification of sex and ethnicity of an individual of an unknown identity. The nasal index holds a great value in anthropological studies, because it is one of the anthropometric indices acknowledged in nasal surgery as well as management. The study aims to find the mean nasal index and the nose type of dental students of Kantipur Dental College of Nepal. METHODS: This descriptive cross-sectional study was conducted among 140 dental students in the Department of Anatomy, Kantipur Dental College Teaching Hospital and Research Center, Basundhara, Kathmandu. The studied population belongs to dental students of Kantipur Dental College and Research Centre. The nasal parameters include nasal height, nasal width which was measured using Digital Vernier Caliper and the nose was classified in three different types based on the value of nasal index. RESULTS: The mean nasal index of total population was 81.34±14.88 mm with confidence interval range of 78.85 and 83.83 mm. Mesorrhine type of nose was found to be most common among the total population. Mean nasal index in male is 84.49±12.46 mm and in female is 80.66±15.32 mm. CONCLUSIONS: This study concludes that the mean values of nasal index of the students fall under mesorrhine type of nose.

Prevalence of Leptoprosopic type of Face among Dental Students.

INTRODUCTION: Facial index is useful for anatomists, forensic scientists and plastic surgeons during treatment of congenital and traumatic deformities, identification of individuals in medico-legal cases and identifying craniofacial deformities and they help us in distinguishing one person from another. Very few researchers from Nepal have worked on these facial features with respect to population and environment. The study aims to find the prevalence of leptoprosopic type of face among dental students of Kantipur Dental College, Kathmandu, Nepal. METHODS: The descriptive cross-sectional study was conducted among 173 dental students of age group 17-25 years in the Department of Anatomy, Kantipur Dental College Teaching Hospital and Research Center, Basundhara, Kathmandu from September to December 2018. Ethical clearance was obtained from Institutional Review Committee of the institution and convenience sampling was done. The facial parameters include facial height, facial width which was measured using Digital Vernier Caliper and Sliding Caliper respectively. The face was classified into three different types based on the value of facial index, according to Bannister Classification. Data was analyzed using SPSS 20. RESULTS: Prevalence of leptoprosopic type of face was 70 (40.46%) [40.39-40.53 at 95%CI]. Among these, 37 (21.39%) were males and 33 (19.07%) were females. Leptoprosopic was most common which was followed by hyperleptoprosopic in 64 (36.99%), mesoprosopic in 26 (15.03%), euryprosopic in 12 (6.94%) and hypereuryprosopic facial types in 1 (0.58%). All three facial parameters including facial height, facial width and facial index were greater in male than in female. CONCLUSIONS: This study concludes that the leptoprosopic face was most common followed by hyperleptoprosopic, mesoprosopic, europrosopic and hypereuroprosopic type of face.