Health Sciences Institute Research Articles

Participant Experience with Protocol Research Kidney Biopsies in the Kidney Precision Medicine Project.

Kidney biopsies are procedures commonly performed in clinical nephrology and are increasingly used in research. In this study, we aimed to evaluate the experiences of participants who underwent research kidney biopsies in the Kidney Precision Medicine Project (KPMP). KPMP research participants with AKI or CKD were enrolled at nine recruitment sites in the United States between September 2019 and January 2023. At 28 days postbiopsy, participants were invited to complete a survey to share their experiences, including motivation to participate in research, comprehension of informed consent, pain and anxiety during and after the biopsy procedure, overall satisfaction with KPMP participation, and effect of the study on their lives. The survey was developed in collaboration with the KPMP Community Engagement Committee and the Institute of Translational Health Sciences at the University of Washington. One hundred and eleven participants completed the survey, 23 enrolled for AKI and 88 for CKD. The median age was 61 (interquartile range [IQR], 48-67) years, 43% were women, 28% were Black, and 18% were of Hispanic ethnicity. Survey respondents most commonly joined KPMP to help future patients (59%). The consent form was understood by 99%, and 97% recognized their important role in this study. Pain during the biopsy was reported by 50%, at a median level of 1 (IQR, 0-3) on a 0-10 scale. Anxiety during the biopsy was described by 64% at a median level of 3 (IQR, 1-5) on a 0-10 scale. More than half conveyed that KPMP participation had an effect on their diet, physical activity, and how they think about kidney disease. KPMP survey respondents were most commonly motivated to participate in research protocol kidney biopsies by altruism, with excellent understanding of the informed consent process. This article contains a podcast at https://dts.podtrac.com/redirect.mp3/www.asn-online.org/media/podcast/CJASN/2023_11_20_CJN0000000000000334.mp3This article contains a podcast at https://dts.podtrac.com/redirect.mp3/www.asn-online.org/media/podcast/CJASN/2023_11_20_Spanish_CJN00000000.mp3.

Immunological Responses of Arsenicum album 30CH to Combat COVID-19: Protocol for a Double-Blind, Randomized, Placebo-Controlled Clinical Trial in the Pathanamthitta District of Kerala.

COVID-19 is a recent major public health concern caused by the SARS-CoV-2 virus, with approximately 44.6 million COVID-19-positive cases and 530,000 deaths in India (as of February 1, 2023). The COVID-19 vaccination drive in India was initiated in January 2021; however, an effective preventive strategy with high efficacy and immunological safety remains elusive. The aim of this study is to assess the immunogenic responses of Arsenicum album 30CH (AA30CH) as COVID-19 prophylaxis, including assessment of immunological markers, innate and acquired immune responses, COVID-19 symptoms, and its associated antibody responses. This randomized controlled clinical trial (RCT) will include two parallel comparator groups of AA30CH and placebo with an allocation ratio of 1:1 conducted in the Pathanamthitta district of Kerala, India. The placebo or AA30CH will be administered in three intervention schedules and blood samples will be collected before and after each of the intervention schedules. Based on the inclusion and exclusion criteria, 112 participants per arm (with an expected dropout of 20%) will be screened. Immunogenic responses will be evaluated by determining the antigen density and modulation in immunological markers and lymphocyte subsets CD3, CD4, CD8, CD24, CD27, CD38, CD4 interferon-γ, CD4 CD17, CD4 CD25 (activated T lymphocytes), T cells, B cells, dendritic cells (mature and immature), and natural killer cells on days 1, 5, 23,27, 45, 49, and 66. The innate and acquired immune responses will also be evaluated by a real-time reverse-transcriptase polymerase chain reaction (RT-PCR) array profiler (84-gene set) before and after the study interventions. The toxicity status of AA30CH in study participants will be evaluated through hepatic, renal, and hematological parameters and peripheral smears on days 1, 5, 23, 27, 45, 49, and 66. The number of participants developing COVID-19-like symptoms per National Centre for Disease Control guidelines and the number of participants testing positive for COVID-19 in RT-PCR during follow-ups in any of the three intervention schedules will be identified. Moreover, a subgroup analysis will be used to assess the COVID-19 antibody responses between vaccinated and unvaccinated participants. This RCT protocol has been approved by various committees and funded by the Central Council for Research in Homoeopathy, Ministry of Ayush, Government of India. The project has been implemented in collaboration with the Department of Homoeopathy, Government of Kerala. The RCT was rolled out on January 25, 2023, and enrollment was completed April 3, 2023. The immunological assays will be conducted at the Department of Biotechnology-Translational Health Science and Technology Institute, Faridabad, India. This study will represent the first evaluation of the immunological efficacy and safety of AA30CH in an RCT, which may significantly impact the use of homeopathy as an evidence-based medicine approach. Clinical Trials Registry-India CTRI/2022/08/045089; https://tinyurl.com/mryrpkvk. DERR1-10.2196/48479.

Dilemmas of outsourcing: a case study of a health science and technology institute

The present study analyzes the impact of outsourcing in a federal drug industry in particular in the scope of human resource (HR) management. Quantitative and qualitative techniques were applied to describe the phenomenon, its effects and its peculiarities in the productive ambience of their daily lives. The quantitative research was carried out focusing on historical data and percentages related to the performance of the outsourced workforce in the public sphere, considering a time frame from 2002 to 2022. of the laboratory's HR areas. The results showed that the public laboratory has a high number of outsourced workers, with their management guaranteed in different standards for their employment relationships, generating normative and people management incompatibilities. Despite this, the doctrinal processes of people management are corroborated in their actions, demonstrating the practical difficulty in many of their concepts in the public context.

Management of Paediatric Airway in Post-intubation Subglottic Stenosis Associated with Japanese Encephalitis.

Subglottic stenosis is narrowing of the area in between the vocal cords and the cricoid cartilage. It can cause respiratory problems which can be mild to severe. Study the management of paediatric airway in post-intubation subglottic stenosis associated with Japanese encephalitis. Case Setting and Design: Retrospective study of 18 patients presenting with encephalitis out of which 6 cases were of post-intubation subglottic stenosis associated with Japanese encephalitis between the study period of one year (September 2017-September 2018) in the, Department of Otolaryngology and Head and Neck Surgery, North Eastern Indira Gandhi Regional Institute Of Health And Medical Sciences, Shillong, Meghalaya, India. Fifteen patients were treated in the study period. Different approaches were used. Post-intubation subglottic stenosis depends on the duration of intubation and the quality of life post-tracheostomy depends on the type of tube used. Bronchoscopic assisted procedures during the tracheostomy or after an interval helps to decrease the morbidity. Management of paediatric airway in post-intubation subglottic stenosis associated with Japanese encephalitis needs proper strategy and dedicated and intensive post-operative care. Bivona® silicone tracheostomy tube is a better option.

A critical review of the perioperative fluid therapy and hemodynamic monitoring recommendations of the Enhanced Recovery of the Adult Pathway (RICA): A position statement of the fluid therapy and hemodynamic monitoring Subcommittee of the Hemostasis, Transfusion Medicine and Fluid Therapy Section (SHTF) of the Spanish Society of Anesthesiology and Critical Care (SEDAR).

In an effort to standardize perioperative management and improve postoperative outcomes of adult patients undergoing surgery, the Ministry of Health, through the Spanish Multimodal Rehabilitation Group (GERM), and the Aragonese Institute of Health Sciences, in collaboration with multiple Spanish scientific societies and based on the available evidence, published in 2021 the Spanish Intensified Adult Recovery (RICA) guideline. This document includes 12 perioperative measures related to fluid therapy and hemodynamic monitoring. Fluid administration and hemodynamic monitoring are not straightforward but are directly related to postoperative patient outcomes. The Fluid Therapy and Hemodynamic Monitoring Subcommittee of the Hemostasis, Transfusion Medicine and Fluid Therapy Section (SHTF) of the Spanish Society of Anesthesiology and Critical Care (SEDAR) has reviewed these recommendations and concluded that they should be revised as they do not follow an adequate methodology.

PRODUCTIVITY VIEWED FROM ORGANIZATIONAL DEVELOPMENT, COMMITMENT, AND WORK CULTURE IN HEALTH HIGHER EDUCATION

The purpose of this study was to analyze the effect of organizational development, commitment and work culture toward the work productivity of the employees of the STRADA Indonesia - Institute of Health Sciences. The research method used in this research is descriptive method with a quantitative approach. The location of the research was carried out at the STRADA Indonesia - Institute of Health Sciences (IIK) with 61 lecturers and education staff as the respondents. The instrument used is a questionnaire regarding organizational development, commitment, culture and employee’s work productivity. The results of this study indicated that both partially and simultaneously organizational development, commitment and work culture affected the work productivity of STRADA Indonesia - Institute of Health Sciences employees. And the most dominant effect on productivity was work culture, which meant that a positive work habits that grew in the organization had to be maintained in order to continue to increase employee’s work productivity at the STRADA Indonesia - Institute of Health Sciences (IIK).

Knowledge, attitude, practice, and generation of electronic waste (e-waste) among students of health sciences in a private college in Pune

Background: In "the era of information," e-waste is a major threat to solid waste management and public health. E-waste contains dangerous and destructive compounds that may affect the environment and human health if not properly handled. The objective of the study was to assess the knowledge, attitude, practice on e-waste and to determine e-waste generation rates for two electronic products: computers and cell (mobile) phones among health science students of the Symbiosis Institute of Health Sciences, Pune. Methodology: A web-based and institution-based cross-sectional study of students pursuing different health science courses was conducted. Out of 680 students, 405 were randomly selected, dispersed in six strata, and the Google questionnaire was disseminated using a proportionate probability to size ratio, with 188 participants responding at a 46.41% response rate. Results: Out of 188 respondents, 95 (50.6%) and 77 (41.2%) study subjects knew about the health and environmental risks associated with e-waste. Physical damage caused 126 (67%) of the research participants to replace their electronics. 67% would learn about e-waste management if it were on the course. 66% purchase 1-3 electronics devices every year, while 23% purchase 4-6. Overall e-waste generation rates among the participants were 0.223 units/capita/year for computers and 0.42 units/capita/year for mobile phones. Conclusion: This research reveals a lack of understanding and behaviours related to e-waste among students of health sciences, highlighting the need for health education on e-waste for public health and awareness on safe e-waste disposal, both of which are critical for a risk-free future.

Education on Prevention of HIV Virus Transmission in Adolescents at SMAN 7 Kediri

HIV (Human Immunodeficiency Virus) is a virus that attacks human white blood cells and can cause decreased body immunity, this virus is very dangerous. As a result, if not treated immediately will develop into AIDS and can be life threatening. Therefore, we, students of the Bachelor of Nursing Study Program, Strada Indonesia Institute of Health Sciences, Kediri, carry out community service activities to provide education on preventing the transmission of the HIV virus to PMR teenagers at SMA 7 Kediri. We use the offline Activity Unit (SAP) method. Based on the results of the respondents' knowledge about preventing the transmission of the HIV virus in young PMR when practicing their knowledge, it showed that 33.3% or 2 respondents still did not understand what HIV was and as many as 15 respondents or 66.7% indicated that they already understood what HIV was and how to prevention. Before the activity was carried out on participants, data was obtained from 17 respondents, there were 100% who did not understand HIV as a whole, in independent activities and character building in adolescents to be aware of the importance of prevention methods and the characteristics of the HIV virus. This figure shows us that all the respondents who attended this activity did not really know HIV thoroughly.

Improving Community Knowledge about Asthma Prevention and Treatment in Ngronggo Village

Asthma is one of the most common types of disease suffered by Indonesian people. Behaviors that can cause shortness of breath (asthma), especially in Kediri City, are increasing, for example exposure to cigarette smoke, dust, animal dander and so on, this is due to a lack of knowledge about the dangers of exposure to trigger substances and the influence of an unfavorable environment. As a result, a person is careless about the presence of substances that can trigger shortness of breath. Therefore, we, students of the Bachelor of Nursing Study Program at the Strada Indonesia Institute of Health Sciences, carry out community service activities to provide education about preventing and treating asthma. The aim of this research is to increase knowledge of asthma prevention and treatment in Ngronggo Village. Bronchial asthma is an inflammatory disease that occurs in the respiratory tract involving various types of cells. Bronchial asthma is a chronic inflammatory disorder of the airways that involves many inflammatory cells such as eosinophils, mast cells, leukotrienes. This chronic inflammation is associated with airway hyperresponsiveness. Using the offline Extension Event Unit (SAP) method. After counseling, almost 82% of respondents were able to understand how to prevent and treat asthma.

Apolipoprotein E Polymorphism And Dyslipidemia In Elderly Patients Of Calcific Aortic Stenosis

Objective: This study aimed to investigate the impact of the Apo E polymorphisms on plasma lipid profile and to identify the polymorphism of the apo-E gene as genetic predictor of calcific AS in Pakistani population. Methodology: This was a case control study conducted in Dow University of Health Sciences and National Institute of Cardiovascular Disease, Karachi. It included total of 100 individuals, 50 echocardiographically identified calcific AS cases and 50 age and gender matched controls. Apo E allele frequencies were computed, lipid profiles were estimated and Apo E gene polymorphism was identified by the techniques of polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP). Result: Apo E 2, 3, and 4 allele frequencies were 16%, 52%, and 32% in calcific AS cases, and 10%, 52%, 28% in controls respectively (p=0.622). Out of 50 cases, 18% presented with mild AS, 22% moderate AS and 60% lied in severe calcific AS. It was observed that levels of total cholesterol (TC), triglyceride (TG) and low-density lipoprotein (LDL) were higher in Apo E4 allele as compared to other genes in both cases and control. Conclusion: The findings of this study suggested that Apo E4 allele of Apo E gene is an impotent risk factors for dyslipidemia while Apo E4 allele is not associated with calcific AS contemplates distinctive genetic backgrounds of CAD and AS.

To prove or improve? Examining how paradoxical tensions shape evaluation practices in accreditation contexts.

Although programme evaluation is increasingly routinised across the academic health sciences, there is scant research on the factors that shape the scope and quality of evaluation work in health professions education. Our research addresses this gap, by studying how the context in which evaluation is practised influences the type of evaluation that can be conducted. Focusing on the context of accreditation, we critically examine the types of paradoxical tensions that surface as evaluation-leads consider evaluation ideals or best practices in relation to contextual demands associated with accreditation seeking. Our methods were qualitative and situated within a critical realist paradigm. Study participants were 29 individuals with roles requiring responsibility and oversight on evaluation work. They worked across 4 regions, within 26 academic health science institutions. Data were collected using semi-structured interviews and analysed using framework and matrix analyses. We identified three overarching themes: (i) absence of collective coherence about evaluation practice, (ii) disempowerment of expertise and (iii) tensions as routine practice. Examples of these latter tensions in evaluation work included (i) resourcing accreditation versus resourcing robust evaluation strategy (performing paradox), (ii) evaluation designs to secure accreditation versus design to spur renewal and transformation (performing-learning paradox) and (iii) public dissemination of evaluation findings versus restricted or selective access (publicising paradox). Sub-themes and illustrative data are presented. Our study demonstrates how the high-stakes context of accreditation seeking surfaces tensions that can risk the quality and credibility of evaluation practices. To mitigate these risks, those who commission or execute evaluation work must be able to identify and reconcile these tensions. We propose strategies that may help optimise the quality of evaluation work alongside accreditation-seeking efforts. Critically, our research highlights the limitations of continually positioning evaluation purely as a method versus as a socio-technical practice that is highly vulnerable to contextual influences.

Clinical Epidemiological Profile of De Novo Postpartum Hypertensive Disorder in BP Koirala Institute of Health Sciences, a Tertiary Care Center in Eastern Nepal

Clinical Epidemiological Profile of De Novo Postpartum Hypertensive Disorder in BP Koirala Institute of Health Sciences, a Tertiary Care Center in Eastern Nepal

Detailed Morphometric Analysis on Left Coronary Artery in the Population of North-East India.

Introduction The left ventricle, the cardiac chamber responsible for blood supply to the whole of systemic vasculature, receives most of its blood supply from the left coronary arteries (LCAs). Atherosclerosis of these vessels leading to myocardial infarction is a leading cause of death. Several invasive diagnostic or therapeuticcoronary interventionsare available for such patients. Just like any vascular procedure, a prior comprehensive knowledge of the dimensions of these vessels and their branching pattern is essential to perform these procedures uneventfully. No previous studyin the population of North-Eastern India documents the population-specific reference for morphometric values of left coronary arteriesand their anatomic variations. So, this study aims to fill up this lacuna. Methods This study was conductedin the Department of Anatomyin collaboration with the Catheterization Lab, Department of Cardiology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Shillong. Coronary angiograms (CAG) of 100 subjects - 38 females and 62 males - were obtained from the Cardiac Catheterization Lab. Coronary angiograms were studied for the normal variant anatomy and morphometryof the LCAs - the left main coronary artery (LMCA), left anterior descending (LAD), and left circumflex (LCX). Results The mean length and luminal diameter of LMCA werefound to be 9.13±3.23 mm and 4.38±0.58 mm, respectively. The mean length of LAD and LCX were109.46±14.49 mm and 66.27±11.56 mm, respectively. Ramus intermedius was present in 32% of the subjects, whereas the remaining subjects had bifurcations of LMCA. We also found that 86% of patients had "wrap-around LAD", while in 11% of our subjects, LAD failed to reach the apex. Diagonal branches originating from LAD were single, duplicated, and multiple in 14%, 62%, and 24% respectively. The marginal branches were found to be single, double, and multiple in 20%, 51%, and 29% respectively. Conclusion This study establishes abaseline reference on morphometry of the left coronary artery specific to thepopulation of North-East India.This study may be of assistance to radiologists and cardiologists when performing procedures on the left coronary arteries in the population of North-Eastern India, with respect to the prevalence of anatomic variations.

The Assembly of a New Human Osteological Collection: The XXI CEIC as a Forensic Pedagogical Tool

This technical note aims to characterize and contextualize the creation of a new collection of identified skeletons stored in the University Institute of Health Sciences—CESPU. This project presents unique and innovative pedagogical opportunities, with students actively involved in the cleaning and processing of the bones and antemortem/postmortem information gathering, as well as in anthropology research projects. This XXI Century Identified Skeletal Collection is composed of 98 complete adult skeletons of both sexes and is still expanding, being the 10th contemporary collection available in Portugal. The skeletons consist exclusively of Portuguese nationals who died between 1946 and 2007, and the 42% that have been processed so far are in good preservation. Comparative learning outcomes after implementing this active learning strategy are not yet available. Improvements are expected since more participation and enthusiasm in classes and research were perceived.

Effectiveness of Scalp Nerves Block in Reducing the Immediate Postoperative Pain in Patients Undergoing Craniotomy in Elective Neurosurgical Procedures

Objective: To determine the usefulness of regional scalp block in controlling pain after craniotomy. Methodology: This prospective, randomized, double-blind, placebo-controlled study was conducted at the Pakistan Institute of Health Sciences, Islamabad from November 2021 to April 2022. Adult patients aged 18 to 65 years, scheduled for elective craniotomy for neurosurgical procedures with an American Society of Anesthesiologists (ASA) physical status of I or II, of either gender, were included. Patients underwent craniotomy for their respective lesions. Patients were randomized into two groups: one receiving a regional scalp nerve block of 0.5% bupivacaine with 1:100,000 epinephrine after general anesthesia, and the other undergoing general anesthesia as a placebo. Pain intensity was assessed using the Visual Analog Scale (VAS) pain score at baseline (preoperatively), at 1 hour postoperatively, and at 6 hours postoperatively. Results: The mean age of patients in the treatment group was 43.14 years, while in the control group, it was 42.55 years. The treatment group had 26 males (54.2%) and 22 females (45.8%), while the control group had 25 males (52.1%) and 23 females (47.9%). There was no significant difference in the VAS score preoperatively (p > 0.05). Patients undergoing surgeries lasting less than 3 hours showed that the treatment group had a significantly lower mean VAS score of 3.08 at 1 hour compared to the control group's score of 5.11 (p = 0.027), while at the 6-hour post-surgery it was insignificant (p = 0.844). For surgeries lasting more than 3 hours, the treatment group had a significantly lower mean VAS score at 1 hour and at 6 hours post-surgery compared to the control group (p < 0.05). There were no overall complications associated with the subcutaneous injection of epinephrine and bupivacaine in blocking the scalp nerves. Conclusion: The administration of scalp nerve blocks using bupivacaine and epinephrine prior to surgical incisions has demonstrated notable advantages in terms of postoperative pain management. Such nerve blocks can offer superior postoperative analgesia compared to the control group.

Association of Smoking with Dental Caries and Periodontal Health Status Among Incarcerated Women in Karachi

Objective: To assess the association of smoking with dental caries and periodontal health status among incarcerated women in Karachi facility, Sindh, Pakistan.
 Study Design: Cross-sectional study.
 Place and Duration of study: Department of Community, Sindh Institute of Oral Health Sciences, Karachi Pakistan, from Dec 2021 to Feb 2022.
 Methodology: All female inmates between the ages of 18-65 years, serving various jail terms, including those sentenced to life, prisoners condemned to death and awaiting trial, were included in the study. For each participant, dental caries and periodontal status examinations were performed. Dental caries was scored using the DMFT index, while periodontal status was scored using the CPI index. Smoking status (yes or no) and duration of smoking were observed.
 Results: Out of 131 women, 76(58%), 42(32.1%), and 13(9.9%) had a DMFT score between 0-5, 6-10, and 11 or higher, respectively. 14(63.6%) and 2(9.1%) women smokers had moderate to severe periodontitis. The association between smoking and severe periodontitis was statistically significant (p=0.023). Employment status prior to incarceration was significantly associated with smoking (p=0.02).
 Conclusion: We concluded that the rate of severe periodontitis was higher among incarcerated women who were smokers. Women in prison require regular oral health assessment and increased awareness about oral health management. Smoking was not a significant factor associated with dental caries or periodontal disease.Keywords: CPI index, Dental caries, DMFT, Oral health, Periodontitis, Smoking, tobacco.

Complete Blood Count (CBC) in COVID-19 Patients Attending at Bangladesh Institute of Health Sciences (BIHS) General Hospital, Dhaka, Bangladesh

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is the infectious agent that causes Coronavirus Disease 2019 (COVID-19), a contagious illness. The epidemic has continued since it was first discovered in Wuhan, Hubei, China, in December 2019. The WHO estimated that 800 million people worldwide (or one in ten) may have COVID-19 infection on October 5. More than 1.07 million fatalities and 37 million cases have been documented as of October 11, 2020, spanning 188 nations and territories; more than 25.7 million patients have recovered. Fever, coughing, exhaustion, shortness of breath or other breathing issues, and a loss of taste and smell are typical symptoms. Acute respiratory distress syndrome (ARDS), which can be brought on by cytokine storm, multi-organ failure, septic shock, and blood clots, can affect some people while the majority only have moderate symptoms. One to fourteen days may pass during the incubation period. The aim of this study was to observe the Complete blood count in COVID-19 & Non COVID-19 Patients in Bangladesh. A descriptive cross-sectional study was conducted for the study. Data were collected from Bangladesh Institute of Health Sciences (BIHS) General Hospital and Hematology Department of Bangladesh University of Health Sciences (BUHS). A pretested semi-structured questionnaire was used for the data collection. The standard method of diagnosis is by real-time reverse transcription polymerase chain reaction (RT-PCR) from a nasopharyngeal swab. The results showed that, among 100 patients, 50% patient was Covid-19 positive &50% patient was negative. In comparison between Covid-19 positive & negative CBC result showing that Hb% remain almost same, total count is slightly increased in covid-19 positive patient than non-covid-19. RBC are found in Normal range for both positive and negative patients. Platelet count & PCV are lower in Covid-19 positive patient than negative patient. Neutrophil are significantly raised in Covid-19 positive patient. Lymphocytes are significantly decreased in Covid-19 positive patient than negative. In this study males are affected 64% & females are 36% so the ratio between male& female is 3:2. More positive patients were found in the age between 50-70 years & has risk among 40-80 years. According to this study, it can be concluded that there is an association among neutrophil, lymphocyte and other cell status in clinically in COVID-19 & non COVID-19 Patients.

Knowledge of Oral Biopsy Procedure among Dental Interns at a Tertiary Hospital in Eastern Nepal

Introduction: Various diagnostic procedures are available to reach a diagnosis in case of oral lesions. Biopsy is one of the important tools for confirmatory diagnosis. It becomes imperative not only for dentists but future dentists to have adequate knowledge regarding oral biopsy procedures.
 Objective: To assess the knowledge of oral biopsy procedure among dental interns.
 Methodology: A web-based cross-sectional study was conducted among interns at College of Dental Surgery, B.P. Koirala Institute of Health Sciences. A questionnaire was prepared and Google Form link was shared with the signed-up participants via messaging apps; Viber and WhatsApp. The descriptive statistics were calculated using Microsoft Excel 2016.
 Results: Out of 54 participants, 53 (98.15%) and 50 (92.5%) of the interns knew about incisional and excisional biopsy respectively. Only 27 (50%) of them responded that every lesion should be sent for histopathological examination. Only 25 (46.3%) of the interns were aware that the removal of tissue by laser or electrosurgery can introduce artefacts or tissue distortion and 27 (50%) responded that punch biopsy generally produces few artefacts within the biopsied sample. Seventy seven percent of the interns responded that volume of the fixative should be two times the volume of the biopsy specimen, while 15 (27.78%) responded that normal saline could be used as a fixative.
 Conclusion: The present study revealed, dental interns had a good understanding regarding oral biopsy and also highlighted the need for further training and modifications in curriculum.

Bladder Lesions in Cystoscopic Bladder Biopsies-A Clinicopathological Study

Introduction: In urinary bladder lesions, the clinical presentation is quite variable, the nonneoplastic lesions can mimic neoplastic and vice-versa bothering both clinicians and patients. The present study aims to study the clinic-pathological and histological features of various lesions of the urinary bladder in the specimens received through cystoscopic biopsy or transurethral resection.
 Objectives: The objectives of this study were to study the clinicopathological features of various bladder lesions and their frequencies and to correlate the clinical diagnosis with histological diagnosis.
 Methodology: The study was a descriptive cross-sectional involving patients with urinary bladder lesions requiring cystoscopic biopsy or transurethral resection conducted in the Department of Pathology of BP Koirala Institute of Health Sciences, Dharan over a period of one year (November 2016 to October 2017) .
 Results: Among 40 patients, mean age was 56.40 years and male and female ratio was 1.5:1. The mean duration of symptoms was 3.49 months. The most common presenting feature for both neoplastic and non-neoplastic was 75%, but hematuria was (86.36%) presenting feature in neoplastic cases and dysuria (88.88%) in non-neoplastic with each group accounting 55% and 45% respectively. Urothelial carcinoma (86.36%) was the commonest neoplastic lesion while cystitis (72.22%) was the commonest non-neoplastic lesion. NMIBC was the predominant lesion (78.95%) in urothelial tumor. Grading showed low grade (63.15%) and high grade (36.85%) respectively. The correlation analysis between clinical diagnosis and histological diagnosis revealed perfect correlation for non-neoplastic lesions and strong correlation for neoplastic lesions having highly significant result (p<0.001)
 Conclusion: Urinary bladder is a common site of diverse lesions; with neoplastic being more common. Urothelial carcinoma was the most common type of neoplastic lesion and cystitis was the most common type of non-neoplastic lesion. Non-neoplastic lesions can mimic neoplastic lesions clinically. Histological diagnosis differs significantly from the clinical diagnosis indicating the importance of histological diagnosis in planning treatment.

Patient and Public Engagement in Health Research: Learning from UK Ideas

One of the new ideas in health and social care research in the UK is around involving patients and the general public in all aspects of research. This paper led by seven MSc students from Manmohan Memorial Institute of Health Sciences in Nepal. They attended Bournemouth University modules as part of the Erasmus+ exchange programme in 2022 and worked with two UK-based academics. The authors outline the thinking behind this process, and offer an example. They address its importance in improving the quality of the research as well as adding value to its societal relevance.