Background: Canines are known for their higher resistance to trauma and pathological alterations when compared to other teeth. Among all the teeth, canines show highest sexual dimorphism.Methods: This descriptive cross-sectional study was commenced from January 2019 to April 2019 after the ethical approval from Institutional Review Committee. The maximum mesio-distal widths of right and left mandibular canines and mandibular inter-canine arch width were measured on the cast with the help of a divider and digital vernier callipers. Mandibular canine index was calculated by dividing the mesio-distal width of each mandibular canine with inter-canine arch width. Data was entered and analyzed using Statistical Package for the Social Sciences version 21. Results: Sex predictability by using mandibular canine index in the present study showed poor sex predictability (57.5% - 62.5%).Conclusions: Sex determination should be done by other methods and mandibular canine index should be used cautiously in Nepalese population.Keywords: Canine dimorphism; forensic anthropology; forensic dentistry; forensic identification, sex determination.

Introduction: Anti-hypertensive medications are prescribed for the management of high blood pressure which is the leading cause of mortality in chronic hemodialysis patients. The objective of our study was to find out the prevalence of anti-hypertensive medication use among chronic hemodialysis patients visiting the outpatient Department of Nephrology of a tertiary care centre. Methods: This was a descriptive cross-sectional study conducted among chronic hemodialysis patients visiting the Department of Nephrology of a tertiary care centre from 2 April 2022 to 30 September 2022. Ethical approval was taken from the Institutional Review Committee (Reference number: 062-078/079). A convenience sampling method was used. Point estimate and 95% Confidence Interval were calculated. Results: The prevalence of anti-hypertensive medications use was present in 102 (97.14%) (93.95-100, 95% Confidence Interval) patient undergoing hemodialysis. The three common drugs prescribed for hypertensive patients were amlodipine 79 (77.45%), torsemide 59 (57.84%), and prazosin 48 (47.05%). Conclusions: The prevalence of antihypertensive medication use among patients undergoing hemodialysis was higher than other similar studies done in similar settings.

Fever is defined as rise in normal body temperature above 98.6°F. Clinical thermometer is a medical instrument for measuring human body temperature. The traditionally used mercury in glass thermometer was replaced by digital thermometer due to mercury toxicity. Non-contact infra-red thermometer is a non-invasive thermometer used for un-cooperative pediatric patients. The objective of this study is to determine the clinical efficiency of non-contact infrared thermometer over axillary digital thermometer and mercury in glass thermometer over a range of body temperature by using paracetamol in febrile patients. This descriptive hospital based cross sectional study was conducted from 5th December 2019 till 23rd August 2020 after ethical approval from Institutional Review Committee of Nepal Medical College and Teaching Hospital. Mercury in glass thermometer, axillary digital thermometer and non-contact infrared thermometer were used to measure body temperature in febrile patient. Body temperature was re-measured one hour after administration of paracetamol. Data was entered and analyzed with statistical package for social sciences version 16. Axillary digital thermometer has high predictability in the upper body temperature range (in febrile state) but its predictability is low in lower body temperature range (our normal body temperature). Non-contact infrared thermometer in comparison with axillary digital thermometer has lower predictability in both upper and lower body temperature range. Clinical efficiency of non-contact infrared thermometer is less than that of axillary digital thermometer and mercury in glass thermometer in febrile patients.

Adverse drug reaction (ADR) is an injury caused by taking medication. ADR may occur following single dose or prolong administration of drug or combination of two or more drugs. While major advancements of discipline of pharmacovigilance have taken place in the West, not much has been achieved in Asian countries. Labour is characterised by forceful and painful uterine contraction that result in cervical dilation and foetus decent from the birth canal. Anti-spasmodic drugs like hyoscine butylbromide and valethamate bromide have been used to accelerate cervical dilation and thus reduce the labor duration. The objective was to observe ADR with hyoscine and valethamate for cervical dilation during labor. It was a hospital based cross sectional study. Investigation was carried out in the form of questionnaire. All the consecutive patients who were in active stage of labor were included in the study. They were given Intravenous (IV) valethamate bromide 8mg and hyoscine butylbromide 20mg, 3 doses half an hour apart. After administration of the drug, the progress of labor was monitored and management was done as per protocol in obstetrics and gynaecology department. ADR reported were blurred vision in 47.7% of the patients, followed by dry mouth (36.9%) and tachycardia (19.2%). Other ADRs were nausea (6.2%), dizziness (3.8%), flushing (2.3%), vomiting (1.5%), fever (1.5%) and constipation (1.5%). No statistical significance was found when ADR was compared between the age group of 18-25 years and 26-35 years. Therefore, ADR reported were irrespective of the age of the patients and no life threatening or severe forms of ADR were seen with hyoscine and valethamate during cervical dilation.

Appendectomy is one of the most common emergency surgical procedures performed in the world. The inflammation of the appendix triggers severe pain in the right lower quadrant of the abdomen. Additionally, the post-operative incision site pain may be distressing to the patients. Analgesic drugs like tramadol (opioid analgesics) and ketorolac (nonsteroidal anti-inflammatory drug - NSAID) are used to manage post-operative pain. The objective was to compare tramadol and ketorolac for pain management by observing the pain-free interval in post-operative patients with appendectomy. A descriptive cross-sectional study was conducted in the department of surgery from November 2019 to May 2020 to observe the duration of pain-free intervals between tramadol and ketorolac. The total number of appendectomy patients selected was 100. Fifty patients received tramadol and the next 50 patients received ketorolac. The data was entered in SPSS and an independent sample t-test was applied to determine the difference in duration of the pain-free interval between ketorolac and tramadol. The average duration of pain-free for the tramadol group was 4.95±1.19 hours (4 hours 57 minutes) while for the ketorolac group was 5.24±1.36 hours (5 hours 14 minutes). The difference was statistically insignificant. We also observed that the tramadol group (88%) received more anti-emetic drugs than the ketorolac group (24%). Therefore, post-operative pain management with ketorolac was found to be as effective as tramadol with comparable duration of the pain free interval.