Short and Long Term Impact on Oral Health Related Quality of Life After Maxillofacial Trauma.

BACKGROUND: Maxillofacial fracture cases require detailed diagnosis, planning and timely restoration of the proper function and aesthetics of the traumatized tissues, as well as appropriate physical, psychological and social rehabilitation to achieve the best possible treatment outcome. Oral health related quality of life allows oral healthcare professionals to evaluate the efficacy of treatment protocols from patients' perspectives and allows clinician to address and measure the clinically meaningful changes. METHODS: The study was carried out in 86 patients with fracture of any one facial bone from September 2020 to March 2022 in Department of Dental Surgery, Nepalgunj Medical College Teaching Hospital, Kohalpur, Nepal. The quality of life was assessed by using Nepali version of Oral Health Impact Profile (OHIP-14) questionnaire, modified to address maxillofacial injury/treatment. RESULTS: A total of 86 patients (male: Female ratio=40:3) were included in the study with mean age of 30.69±11.88 years. Patient with fracture of mandible and midface showed complete recovery on OHIP-14 Scale after 6 months whereas, in patient with panfacial fracture some residual effect in quality of life (0.13±0.50) was seen in two domains psychological discomfort (0.06±0.25) and social disability (0.06±0.25) even after 6 months. CONCLUSIONS: Impact of maxillofacial fracture on quality of life is long lasting and huge on patients. Referral to a psychiatrist or psychologist might be beneficial in addition to open reduction and internal fixation of maxillofacial fractures as early as possible to achieve better quality of life in maxillofacial fracture cases.

Academic Stress among Adolescents of Rural Nepal: A Community-based Cross-Sectional Study.

BACKGROUND: Adolescents are in the transition phase between childhood and adulthood. Their mental health influences many aspects in their life as they go through many physical and emotional changes. Adolescent mental health is harmed by changes in emotional and physical state, as well as increased academic pressure. This study aimed to assess academic stress and its associated factors among adolescents in rural Nepal. METHODS: A community-based cross-sectional survey was conducted among 424 adolescents residing in Karnali Province, Nepal. Academic stress was measured using Student Assessing Academic Stress. Multivariate logistic regression analysis was used to examine associated factors at the significance level of 0.05. RESULTS: Of the total students, 19.8% had moderate academic stress and 2.4% of them had high academic stress. Female students had thrice higher odds of having academic stress as compared to male students (Adjusted Odds Ratio:3.47; 95% Confidence Interval:1.91to 6.31, p-value:<0.001). Grade 10 students had higher odds of having academic stress as compared to grade 9 (Adjusted Odds Ratio:2.02; 95% Confidence Interval:1.13 to 3.61, p-value:0.017). Students of literate mothers were more likely to experience academic stress than those with illiterate mothers (Adjusted Odds Ratio:0.53; 95% Confidence Interval:0.29 to 0.96, p-value:0.036). Students with unsatisfactory academic performance had thrice higher odds of having academic stress as compared to students with satisfactory academic performance (Adjusted Odds Ratio:3.12; 95% Confidence Interval:1.46 to 6.67, p-value:<0.003). CONCLUSIONS: The findings of the study showed that high school students have academic stress, which is related to many factors at home and school. Understanding academic stress and parents and teachers providing the best support to the students could help lessen the burden.

Liver injury in COVID-19: prevalence and its associated factors in Nepal - A retrospective cross-sectional study.

Liver impairment has been reported as a common clinical manifestation in patients with Severe Acute Respiratory Syndrome Coronavirus 2 infection, with varying degrees of severity ranging from a mild elevation of liver enzymes to acute liver failure. However, the prevalence and clinical significance of liver injury in Coronavirus Disease 2019 (COVID-19) patients, particularly in low- and middle-income countries such as Nepal, remains poorly understood. To investigate the hepatic injury related to this disease and its clinical significance, the authors conducted a retrospective study that included adult patients with COVID-19 infection in security hospitals of Nepal. Methodology: The authors performed a retrospective chart review on 1007 COVID-19-positive patients who underwent a liver function test during their admission in two COVID-19 dedicated hospitals in Nepal from April 2021 to January 2022. The data were collected and entered into Microsoft Excel before being exported to SPSS version 24 for analysis. Univariate and multivariate logistic regression were used to determine factors associated with liver injury. We reported adjusted odds ratios (aOR) with 95% CI. Results: Of the total, 549 (54.5%) patients had an acute liver injury. Among 549 patients, 68.1% were mild, 27.9% were moderate, and 5.0% were severe. Out of 1007 patients, 1.4% had cholestatic liver injury. Most patients with mild, moderate, and severe liver injury had greater than or equal to 10 C-reactive proteins (CRP). In multivariate logistic regression, sex, and CRP were significantly associated with the presence of liver injury. Males had 1.78 times higher odds of having a liver injury compared to females (aOR:1.78; 95% CI: 1.37-2.30, P-value:<0.001). Similarly, patients who had CRP greater than 10 had higher odds of having liver injury compared to those who had CRP less than 10 (aOR: 1.84; 95% CI: 1.41-2.39; P-value: <0.001). Conclusions: The present study reveals that COVID-19 infection is commonly associated with mild increased liver enzymes. However, the likelihood of developing acute liver injury was found to be higher in patients with an inflammatory state indicated by CRP levels greater than 10. Furthermore, the study highlights the sex-based difference in the prevalence of liver injury, with males demonstrating a higher predisposition.