Parsonage turner syndrome: a common syndrome usually missed

Background: Parsonage-turner syndrome (PTS) is a rare syndrome that can occur in normal healthy individuals with sudden, rather abrupt, unilateral shoulder pain that may begin rather insidiously but quickly amplifies in severity and intensity. The acute period of pain is subsequently replaced over a course of a few days to weeks with progressive weakness, reflex changes, and sensory abnormalities in varying presentations that typically involve the shoulder girdle musculature and proximal upper limb muscles. There are no definite etiological factors present in causation of this syndrome.Methods: Prospective multicentric cohort study covering period from 2010 to 2020. 10 young male patients were included in the study group, all of them presented with winging of scapula and pain. Initial evaluation was done at neurology department and after failure of conservative treatment of average period of six month they were referred to plastic surgery department. All patients had ENMG findings preoperatively.Results: 10 male patients were studied with average age of 24.8 years. Partial paralysis present for an average of 1 year. Repeated micro trauma was the most common aetiology. Intraoperatively 7 patients had anomalous vascular compression of long thoracic nerve (LTN) and three had compression due to fibrous sheath. All patients had complete recovery at end of one year.Conclusion: Isolated LTN paralysis is a rare condition that is not well known. If conservative management fails, then neurolysis of the distal segment of LTN gives good result if performed within 6-12 months of paralysis.</jats:p

Circumosseous wire fixation for metacarpal fractures: an old method revisited

Background: Different methods are in use for fixation of metacarpal fractures. Krischener wire and titanium miniplates are most commonly used methods. Both these methods require special &amp; sophisticated instruments. In this study, we have used a dental wire in circumosseous fashion to fix the metacarpal fractures.Methods: In the study, we included all the fracture of metacarpals with operative indication. K-wire, minilplate system and circumosseous dental wire methods were used randomly.Results: The results were compared in term of immediate post-operative complications &amp; functional recovery in form of ability of fist formation at 06 weeks. All the three methods were found comparable, in fact in this study the results of fractures treated with circumosseous wiring were appreciable and significantly better.Conclusions: Circumossoeus use of dental wire can be an alternate method of metacarpal fracture fixation.</jats:p

Study of Upper Pharyngeal Airway Dimension in Young Adults Visiting Orthodontic Department of a Dental College: A Descriptive Cross-sectional Study

Introduction: Orthodontic treatment may affect the size and position of oropharyngeal structures altering the airway dimension. Airway dimension is considered as one of the parameter of orthodontic diagnosis and treatment planning. Narrow airway passage is associated with sleep disordered breathing. This aims to study about the measurement of upper pharyngeal airway dimension of young Nepalese adults visiting orthodontic department of a dental college.&#x0D; Methods: This descriptive cross-sectional study conducted at Department of Orthodontics, People’s Dental College and Hospital, Kathmandu. Data was collected from 8th December 2020 to 28th February 2021. Ethical clearance (Reference number. 1, CH100 06, 2077/2076) was taken from Institutional Review Committee of Peoples Dental College and Hospital, Kathmandu, Nepal. Convenient Sampling technique was done. Data was collected and analysis was done using Statistical Packageof Social Sciences 16.&#x0D; Results: Mean upper pharyngeal airway dimension was 11.40±1.84mm and 11.68±1.96mm for male and female respectively. Upper pharyngeal airway dimension was found to be almost similar for male and female.&#x0D; Conclusions: Gender diversity regarding upper pharyngeal airway dimesnion was not observed in this study while other studies also revealed similarities in upper pharyngeal airway dimension between male and female, inspite of larger craniofacial dimension in males than females.</jats:p

Assessment of role of mandibular third molar in lower anterior crowding among orthodontic patients of Kathmandu Nepal

Introduction: Crowding in mandibular arch increases with increasing age and etiology of crowding is multifactorial in nature. Role of mandibular third molar in lower anterior crowding remains a topic of controvery over a period of century. The objective of this study was to assess whether there is any correlation between presence of mandibular third molar position and lower anterior crowding.&#x0D; Materials and Method: On the basis of third molar position one hundred and six sample of pretreatment orthodontic patients aged between 17 to 38 years were divided into erupted, erupting and agenesis group. The study was conducted in Peoples Dental College and Hospital from January 2020 to March 2020 after obtaining ethical approval from the institutional review committee. This cross-sectional study was done on dental casts and orthopantomogram; brass wire was used for measuring arch length and digital vernier caliper for measuring tooth material with modified segmental arch analysis method.&#x0D; Result: Among 106 samples collected 55 (51.88%) were female and 51(48.11%) were male and the mean age was 21.53 ± 3.91 years, Chi square and ANOVA test was used for Statistical analysis. This study showed no statistically significant differences between third molar position and lower anterior crowding on right (P= 0.68) and left side (P = 0.45). The study also showed that association between the third molar position and lower anterior crowding is more on left side compared to right side.&#x0D; Conclusion: Mandibular third molars have not statistically significant difference in lower anterior crowding so, extraction of third molars for relieving the anterior crowding is not justifiable</jats:p

Average Type Smile in Posed Smile of Individuals Visiting Department of Orthodontics of a Tertiary Care Hospital: A Descriptive Cross-sectional Study

Introduction: New concepts and methods have been developed in orthodontics with patients' increased concern on esthetics. Among the various parameters of smile, smile type, smile arc, and smile symmetry are essential for a beautiful smile. The objective of this study was to find out the prevalence of average type in posed smiles of individuals visiting the department of orthodontics. Methods: This descriptive cross-sectional study was conducted from 1st April 2021 to 30th June 2021 at a tertiary care hospital. Ethical clearance was obtained from the Institutional Review Committee (Reference number: 1, CH No. 30, 2077/2078). A convenience sampling technique was used to collect a total of 413 samples of posed smile photographs. Data was collected and analysed using Microsoft Excel 2013. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage. Results: Among 413 individuals, the average type of smile was found in 193 (46.73%) (42.12-51.74 at 95% Confidence Interval). Out of 87 average smile type males, most of them 51 (58.62%) had non consonant smile arcs and 47 (54.02%) had asymmetric type smiles. On the contrary, the majority of females 76 (71.70%) had a consonant arc smile while 63 (59.43%) had an asymmetric smile. Conclusions: The prevalence of the average type of smile was higher in our study as in other published literatures.</jats:p

Gonial Angle by Lateral Cephalogram in Orthodontic Patients of a Tertiary Care Hospital: A Descriptive Cross-sectional Study

Introduction: The Gonial angle is an important parameter of the craniofacial complex for growth Patterns prediction. The gonial angle on lateral cephalometric radiograph represents the mandibular morphology concerning mandibular body and ramus. The objective of this study was to find out the mean value of gonial angle in lateral cephalometric radiographs of patients of orthodontic department in a tertiary care center. Methods: The descriptive cross-sectional study was conducted among patients from the Department of Orthodontics at People’s Dental College and Hospital between 8th December 2020 to 8th February 2021 at People’s Dental College and Hospital, Kathmandu, Nepal after obtaining Ethical approval (Reference Number. 01, CH100 09,2077/2078) by the Institutional Review Committee. A convenience sampling technique was used to collect 166 pre-treatment lateral cephalograms radiographs of patients between 17-30 years. Data were collected and entered using Statistical Package of Social Science 16. Results: The mean value of gonial angle on lateral cephalogram radiographs was 132.84±3.70 in hyperdivergent, 119.94±5.57 in hypodivergent and 124.06±3.88 in normodivergent vertical skeletal patterns and between male and female were 132.52±4.32, 133.07±3.28 in hyperdivergent, 121.46±3.78, 119.14±6.42 in hypodivergent and 123.74±5.14, 123.94±3.90 in normodivergent vertical skeletal patterns of Orthodontic Patients. Conclusions: The gonial angle value on lateral cephalometric radiographs was greater in hyperdivergent than hypodivergent and normodivergent vertical skeletal patterns. The hyperdivergent vertical skeletal pattern of female was greater than of male patient’s lateral cephalometric radiographs while hypodivergent and normodivergent vertical skeletal patterns of males were greater than female lateral cephalogram radiographs of Nepalese orthodontic patients

Gonial Angle by Lateral Cephalogram in Orthodontic Patients of a Tertiary Care Hospital: A Descriptive Cross-sectional Study

Introduction: The Gonial angle is an important parameter of the craniofacial complex for growth Patterns prediction. The gonial angle on lateral cephalometric radiograph represents the mandibular morphology concerning mandibular body and ramus. The objective of this study was to find out the mean value of gonial angle in lateral cephalometric radiographs of patients of orthodontic department in a tertiary care center. Methods: The descriptive cross-sectional study was conducted among patients from the Department of Orthodontics at People’s Dental College and Hospital between 8th December 2020 to 8th February 2021 at People’s Dental College and Hospital, Kathmandu, Nepal after obtaining Ethical approval (Reference Number. 01, CH100 09,2077/2078) by the Institutional Review Committee. A convenience sampling technique was used to collect 166 pre-treatment lateral cephalograms radiographs of patients between 17-30 years. Data were collected and entered using Statistical Package of Social Science 16. Results: The mean value of gonial angle on lateral cephalogram radiographs was 132.84±3.70 in hyperdivergent, 119.94±5.57 in hypodivergent and 124.06±3.88 in normodivergent vertical skeletal patterns and between male and female were 132.52±4.32, 133.07±3.28 in hyperdivergent, 121.46±3.78, 119.14±6.42 in hypodivergent and 123.74±5.14, 123.94±3.90 in normodivergent vertical skeletal patterns of Orthodontic Patients. Conclusions: The gonial angle value on lateral cephalometric radiographs was greater in hyperdivergent than hypodivergent and normodivergent vertical skeletal patterns. The hyperdivergent vertical skeletal pattern of female was greater than of male patient’s lateral cephalometric radiographs while hypodivergent and normodivergent vertical skeletal patterns of males were greater than female lateral cephalogram radiographs of Nepalese orthodontic patients.</jats:p

Climate Based Smart Agriculture: Need for Food Security and Sustainability

A variety of climate-smart agriculture technologies, practices, and services have been introduced in climate-smart villages as adaptation strategies to cope with climate risks and ensure stability and sustainability in agricultural production. Farmers who utilize climate-smart agriculture adaptation strategies have been shown to achieve higher output, yield, and return compared to those who do not. There are promising opportunities to scale out these strategies and immense potential to enhance crop yields and farm incomes while reducing greenhouse gas emissions. Strengthening agricultural extension services and agricultural finance by linking climate finance to traditional agricultural finance could play a significant role in scaling out climate-smart agriculture practices and technologies. This would make agriculture more sustainable and climate-resilient, thereby becoming a viable source of livelihood and food security for millions of farmers in the country. Zero budget natural farming is a climate-resilient farming system that can enhance food and nutritional security while allowing farmers to improve soil fertility and yields at lower costs, risks, and irrigation requirements. This system protects the ecosystem by improving soil organic matter, water retention, and biodiversity, while reducing air and water pollution as well as greenhouse gas emissions