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Introduction: The birth of a child with an intellectual disability is the most traumatic event experienced by the parents and their families. The main objective of this study is to identify parental stress and coping in rearing children with intellectual disabilities in Kathmandu valley. Methodology: A descriptive cross-sectional study was conducted among 222 parents (either mothers or fathers) of children with an intellectual disability visiting nine organizations selected through probability proportionate to size sampling. Data were collected through interview techniques using the Nepali-translated Parental Stress Scale and cope tool developed. Results: Maximum respondents (76.1%) were mothers with an overall mean age of 46.28±12.73 years. The major stress expressed was anxiety-related to a child's future after parents' death (19.8%) and most used coping measure was sharing feelings (44.6%) were expressed as major stress and coping measures used respectively. The overall mean score of parental stress was 64.58±9.22 and parental coping was 106.45±9.72. Maximum respondents have a moderate level of stress (54.5%) followed by severe stress (43.2%) and a moderate level of coping (86.9%) followed by a maximum level of coping (13.1%). There was a significant association of level of stress with relationship to the child, parent’s education, and presence of co-disability in the intellectually disabled child. There was a significant association of level of coping with parents’ education. Conclusion: Maximum respondents had a moderate level of stress and a moderate level of coping mechanisms. Parental stress was high in mothers, illiterate parents, and parents having an intellectually disabled child of 17 years or younger. Parental coping was high among Hindu and literate parents.

Introduction: Stress persists when a person is unable to cope with the situations of the past, present or future. Stress may be associated with physical and psychological abnormalities. Acne vulgaris is a chronic inflammatory disease of the pilo-sebaceous units with prevalence of more than 85% in adolescent age group. Materials and Methods: Three hundred one patients were recruited in the study. Inclusion criteria included new acne patients of age 16 years and above as well as those who were using but not improving with topical or oral acne therapies. Exclusion criteria included patients receiving sedatives, antidepressants, or glucocorticoids, patient suffering from chronic illnesses like diabetes, hypothyroidism, chronic kidney disease, migraine and other diseases. This questionnaire included biodata of the patients, clinical history and their perceived stress scale. Global Acne Grading System (GAGS) was used to assess acne severity in relation to stress using the Perceived Stress Scale (PSS). Results: The results indicated an increase in stress severity positively correlated with an increase in acne severity, which was statistically significant (p

INTRODUCTION: Does Achilles Tendon taping affect gait parameters in overweight and obese adults? Step length, stride length, and cadence are all shorter in these individuals, with increased fall ratios. OBJECTIVE: To know the effect of Achilles Tendon taping on gait parameters in overweight and obese individuals. METHODS: A clinical trial will be conducted in a physical therapy outpatient clinic. A total of forty participants with a Body Mass Index (BMI) greater than 25 will be recruited by convenience sampling method. Each group will have 20 participants, aged between 18 and 35 years old, overweight with BMI>25 to 29.9, and obese with BMI>30. Both groups will walk for 10 meters and one minute using a gait analyzer and both groups will have taping on the Achilles Tendons. The predictor variable will be the taping of the Achilles Tendon, and the outcome variables will be step length, stride length, and cadence, which will be measured before and immediately after taping. SPSS 20.0 software will be used for statistical analysis with a significance level of p

Introduction: Moyer’s probability table is most commonly used to predict the mesiodistal width of permanent canines and premolars in mixed dentition. However, the table was formulated using data from Caucasian population. This study was performed to compare the Moyer’s prediction table with actual value in Nepalese Newar population as ethnicity is one of the important factor to determine teeth width. Materials & Method: Combined mesiodistal width of permanent canine and premolars were measured in 150 study models of Nepalese Newar orthodontic patients (75males and 75 females). The value was compared with the Moyer’s prediction table at all probability level. Result: There was no statistically significant difference between the actual combined width and that predicted from Moyer’s table at 85% probability level for maxilla and at 75% level for mandible in male, at 95% probability level for maxilla and at 85% probability level for mandible in female. Conclusion: Moyer’s probability level can be used to predict the combined mesiodistal width of permanent canines and premolars in Nepalese Newar population but at specific probability level.

We report a case of 28-year-old HIV-positive male with giant condyloma acuminata in anogenital region. This homosexual patient presented with a large foul smelling growth along with maggots in a perianal region refractory to treatment at presentation. The patient was successfully managed with excision and there was no recurrence of lesion at last follow-up at 2-months. The case highlights the rare presentation and management of difficult-to-treat case of giant condyloma acuminata with maggots of anogenital region in HIV-positive patients.

Introduction: Direct and indirect bonding has revolutionized clinical orthodontics by reducing chair-side time and enhancing patient comfort. Clinicians often hesitate to bond molars due to ambiguity on shear bond strength. This study was conducted to compare shear bond strengths of two commercially available bondable molar tubes. And asses mesh if the mesh design had a role to play in differences in shear bond strength. Materials & Method: 30 extracted maxillary molars were divided into Group I and II (n=15).Group I bonded with Victory series MBT (3M Unitek). And Group II bonded with Ortho classic proprietary Pad- Lok (Navy orthodontics). Teeth were mounted on a jig and Shear Bond Strength was evaluated on an Instron universal testing machine at a cross head speed of 1mm/minute. They were also subjected to scanning microscopic examination to check the base pattern. Result: Shear bond strength of navy orthodontic tubes were (18.0675+/- 4.0187 MPa) was significantly higher than 3M victory series (8.93 +/2.493MPa). Unpaired T-test shows a higher significant difference in SBS between two groups at 1% of significance. SME showed that navy orthodontic tube base was pad-lock mesh design, while 3M was a single mesh base design. Conclusion: 3M victory series molar tube exhibited a near ideal while other sample showed far higher shear bond strength than recommended. Higher values may result in enamel fracture.

Background: Mandibular retrusion is the main cause of Skeletal Class II malocclusion characterized by skeletal retrusion of mandible with skeletal or dentoalveolar protrusion of maxillary. Objectives: This study was conducted to evaluate effect of treatment with twin-block appliances on pharyngeal dimensions. Methodology: This study was conducted in in the Department of Orthodontics & Dentofacial Orthopedics in Kathmandu Medical College. Twenty patients of age group 7 to 14 years with skeletal class II malocclusion with mandibular retrusion were selected. Variables evaluated were depth of nasopharynx; height of nasopharynx; depth of oropharynx; depth of hypopharynx; soft palate length; soft palate thickness and soft palate inclination. The lateral cephalograms were obtained for all subjects before the start of treatment and after a follow-up period of approximately three months in treatment. Results: Results showed that depth of nasopharynx increased by 1 mm, height of nasopharynx increased by 0.78 mm, depth of nasopharynx increased by 1.97 mm, depth of hypopharynx increased by 0.79 mm, soft palate length decreased by 4 mm, soft palate thickness increased by 2 mm and soft palate inclination decreased by 7.01 mm. The results for depth of pharynx and soft palate thickness were statistically significant. Conclusion: This study concluded that the use of twin block appliance for class II patients corrects sagittal dimension of oropharynx and hypopharynx. Early intervention for mandibular retrognathism in class II malocclusion helps enlarge the airway dimensions and decrease potential risk of obstructive sleep apnea syndrome for growing patients in the future.

Background: Injury to a young child’s teeth and face is a traumatic experience for the child and parents. Prompt and effective action on traumatized teeth significantly increases the likelihood of a positive treatment outcome. Adequate knowledge of school teachers in emergency situation arising during school hours can prove to be a boon for the child’soral health.Objectives: To assess the knowledge of school teachers of Bhaktapur about emergency management of dental trauma and also to measure the relationship between socio demographic characteristic of teachers and knowledge about dental emergencies.Methods: The cross sectional study was conducted among 424 schools teachers of Bhaktapur district from September 2014 to March 2015. Simple random sampling was done to select the schools. Questionnaire was distributed among the teachers after taking their informed written consent. Data was collected and sent for statistical evaluation. Frequenciesand percentage were calculated. Chi-square and Fisher’s Exact test were applied.Results: Nearly one third (32.2%) teachers who had information on dental trauma knew the proper management of displaced teeth (p=0.01). Statistically significant difference was found among those who had fi rst aid training and proper management of displaced teeth (p=0.04). Teachers who had experienced dental trauma in their students were only confident of managing displacement of traumatized teeth (p=0.02).Conclusion: Knowledge of the school teachers in Bhaktapur was seen to be inadequate for emergency management of fracture and avulsed tooth.

Background. T follicular helper (TFH) cells are involved in the humoral immune responses. This study is aimed at examining the frequencies of different subsets of CD4+CXCR5+TFH cells in adult patients with minimal change disease (MCD).Methods. A total of 27 patients and 14 healthy controls (HC) were characterized for the levels of sera cytokines, inducible T-cell costimulator (ICOS), and programmed death 1 (PD-1) of positive TFH cells by flow cytometry. The level of sera IL-21 was examined; 24 h urinary protein and eGFR were calculated. The potential correlation between the frequency of different subsets of TFH cells and the values of clinical measures in MCD patients were analyzed.Results. The frequency of circulating CD4+CXCR5+, CD4+CXCR5+ICOS+, and CD4+CXCR5+PD-1+TFH cells and the levels of sera IL-17A, IFN-γ, IL-2, IL-10, IL-4, and IL-21 were significantly higher in MCD patients (P<0.05) than that in the HC group. Furthermore, the percentages of circulating CD4+CXCR5+TFH cells were negatively correlated with the values of eGFR (r=-0.4849,P<0.05) and the percentages of CD4+CXCR5+PD-1+TFH cells were correlated positively with the levels of serum IL-21 (r=0.6137,P<0.05) and 24 h urinary protein (r=0.1410,P<0.05) in those patients. Also, the percentages of CD4+CXCR5+ICOS+TFH cells were correlated positively with the levels of serum IL-21 (r=0.6201,P<0.05) and 24 h urinary protein (r=0.7519,P<0.05). Following standard therapies, the percentages of circulating CD4+CXCR5+, CD4+CXCR5+PD-1+, and CD4+CXCR5+ICOS+TFH cells and the levels of serum IL-21 were significantly reduced, but the levels of serum IL-4 and IL-10 were increased (P<0.05).Conclusions. A higher frequency of CD4+CXCR5+TFH cells that existed in adult patients with MCD could be new target for intervention of MCD.