Background The traumatic or degenerative internal derangement of the knee requires certain investigations for the establishment of diagnosis, in addition to clinical history and a thorough physical examination. The use of arthrography and arthroscopy improves the accuracy of the diagnosis. MRI scanning of the knee joint has often been regarded as the noninvasive alternative to diagnostic arthroscopy. Objective The purpose of the study was to correlate clinical and low field MRI findings with arthroscopy in internal derangement of the knee. Methods Forty one patients with suspected internal derangement of the knee were subjected to MR examination followed by arthroscopy. Clinical criteria used were history, mode of injury, Mc Murray’s, Apley’s grinding, Thessaly’s test for meniscal injury. Drawer test was considered to be essential for clinical diagnosis of cruciate ligament injury. MRI of the knee was performed in low field open magnet (0.35T, Magnetom C, Seimens). Arthroscopy was done within two months of MR examination and was considered gold standard for the internal derangement of the knee. Results The sensitivity, specificity, diagnostic accuracy of clinical examination were 96.1%, 33.3% and 73.1% respectively for medial meniscal tear; 38.4%, 96.4% and 78.1% respectively for lateral meniscal tear. The sensitivity, specificity, diagnostic accuracy of MRI were 92.3%,100% and 95.1% for medial meniscal tear; 84.6%96.4% and 92.6% respectively for lateral meniscal tear. ConclusionClinical examination showed higher sensitivity for medial meniscal tear compared to MRI, however with low specificity and diagnostic accuracy. Low field MRI showed high sensitivity, specificity, diagnostic accuracy for meniscal and cruciate ligament injury, in addition to associated derangement like articular cartilage damage, synovial thickening.DOI: http://dx.doi.org/10.3126/kumj.v9i3.6300 Kathmandu Univ Med J 2011;9(3):174-8

Introduction: The lack of knowledge among health care professionals leads to diagnostic delays,further spread of disease, and poor infection control practices. Health care professionals must beupdated knowledge regarding COVID-19. This study aims to assess the knowledge of health careprofessionals regarding COVID -19 in a medical college in Chitwan. Methods: A Knowledge, Attitude and Practice Study was carried out in a tertiary care hospitalin Chitwan, Nepal from April 22, 2020, to April 28, 2020. The institutional review committee ofChitwan Medical College provided ethical approval for the research. Data were collected with anonline questionnaire using Google forms. The questionnaire was sent out to 724 potential responderswho included health care professionals from medical, dental, nursing, and allied health sciences inChitwan Medical College. A convenient sampling method was used for data collection. Data wereanalyzed using Statistical Package of Social Sciences. Results: A total of 181 respondents completed the web survey. Overall, a total of 35 (19.3%)respondents were found to have “Good” knowledge; 105 (58%) respondents had “Fair” knowledgeand 41 (22.7%) respondents had “Poor” knowledge regarding various aspects of COVID-19. Therewas no significant difference among the various health professional groups in their knowledgescores under the four knowledge domains. Conclusions: The study of knowledge of health care professionals could act as a reference for theprevention and better management of COVID-19. This study shows that there is a need to implementperiodic educational interventions and training programs on infection control practices for COVID-19across all healthcare professions.

PurposeTo determine and compare the shear bond strength (SBS) of bracket-bonding system cured with light-emitting diode (LED) and halogen-based light-curing unit at various polymerization times.Materials and methodsNinety six human maxillary premolar teeth extracted for orthodontic purpose were divided into four groups, according to the light-curing unit and exposure times used. In the halogen group, the specimens were light cured for 20 and 40 seconds. In the LED group, the specimens were light cured for 5 and 10 seconds. Stainless steel brackets were bonded with Enlight bonding system, stored in distilled water at 37°C for 24 hours and then submitted to SBS testing in a universal testing machine at a crosshead speed of 0.5 mm/minute. Adhesive remnant index (ARI) was used to evaluate the amount of adhesive remaining on the teeth determined by stereomicroscope at 10× magnification.ResultsThe highest mean SBS was obtained with the halogen 40 seconds (18.27 MPa) followed by halogen 20 seconds (15.36 MPa), LED 10 seconds (14.60 MPa) and least with LED 5 seconds (12.49 MPa) group. According to analysis of variance (ANOVA) and Tukey’s multiple-comparison test, SBS of halogen 20 seconds group was not significantly different from halogen 40 seconds group, LED 5 seconds group and LED 10 seconds group, whereas halogen 40 seconds group was significantly different from LED 5 seconds and LED 10 seconds group. The method of light curing did not influence the ARI, with score 2 being predominant.ConclusionPolymerization with both halogen and LED resulted in SBS values that were clinically acceptable for orthodontic treatment in all groups. Hence, for bonding orthodontic brackets, photoactivation with halogen for 20 seconds and LED for 5 seconds is suggested.

BackgroundMixed dentition space analysis forms an important part of orthodontic diagnosis and treatment planning. Regression equations are widely used for mixed dentition analysis which can vary among races. This study aimed to find out the new regression equation in estimating the size of unerupted canines and premolars for Nepalese Brahmins/Chhetris.MethodsHundred Nepalese Brahmins/Chhetris (50 males and 50 females) who met our criteria were selected among the patients attending to the Orthodontic Out-Patient Department, Institute of Medicine, Kathmandu. The mesiodistal widths of all mandibular permanent incisors; maxillary and mandibular canines and premolars were measured and analyzed. The results were also compared with predicted values from the Moyers and the Tanaka and Johnston methods. Correlation and linear regression analyses were performed between the predicted and actual tooth sizes for Nepalese Brahmins/Chhetris and standard regression equations were developed.ResultsNo significant differences were observed when the sum of canine and premolars of one quadrant is compared between sides and sex. Significant and high positive correlations were found between the mandibular incisors and the combined mesiodistal widths of the canines and premolars for the maxillary (r = 0.72) and mandibular (r = 0.73) segments. Significant differences were observed between the measured values from this study and from Moyers (50 % and 75 % probability) and Tanaka-Johnston methods.ConclusionsThe equations and charts commonly used for North American children (50th or 75th percentile) did not accurately predict for our sample, so new regression equations and tables were developed for Nepalese Brahmins/Chhetris children.

BackgroundAssessment of growth status of a patient is a key component in orthodontic diagnosis and treatment planning for growing patients with skeletal discrepancy. Skeletal maturation based on hand-wrist radiograph and cervical vertebral maturation (CVM) are commonly used methods of growth assessment. Studies have shown that stages of dental calcification can also be used to assess skeletal maturation status of an individual, whereas other studies have suggested that the relationship between dental calcification and skeletal maturation should be interpreted with caution owing to racial variation.ObjectiveTo evaluate the relationship between permanent mandibular second molar calcification stages and skeletal maturity assessed by CVM among a group of Nepalese orthodontic patients.Materials and methodsOne hundred and sixty-eight digital radiographs (84 orthopantomograms and 84 lateral cephalograms) were obtained from the records of 84 patients who sought orthodontic treatment in Orthodontic and Dentofacial Orthopaedic Unit, Department of Dentistry, Institute of Medicine, Kathmandu. Two parameters were used in this study, namely, CVM stages from lateral cephalogram and Demirjian index (DI) stages from orthopantomogram. The evaluation of digital radiographs was carried out on a computer screen with a resolution of 1,280×800 pixels. The association between DI stages of permanent mandibular second molar and CVM stages was assessed.ResultsA statistically significant association was found between DI and CVM stages for both male and female subjects with Pearson’s contingency coefficient value of 0.751 and 0.766 for male and female subjects, respectively.ConclusionSkeletal maturation can be reliably assessed with dental calcification stages of permanent mandibular second molar for Nepalese orthodontic patients.