Intrusion of tooth is resisted by:

 # Intrusion of tooth is resisted by:
A. Apical and interradicular fibers
B. Oblique and horizontal fibers
C. Alveolar crest and oblique fibers
D. All Periodontal fibers

The correct answer is C. Alveolar crest and oblique fibers.

The principal fibers of periodontal ligament are arranged in six groups and are named according to their
location and direction of attachment. 

1. Transseptal group
Location: These fibers run into the interproximal space over the crest of alveolar bone and get inserted in the cementum of neighboring tooth.
Function: They have the innate capacity to reconstruct themselves in periodontal disease even there is destruction of the alveolar bone. This unique property of fibers is responsible for returning teeth to their original state after orthodontic therapy.

2. Alveolar crest group (apico-oblique)
Location: Cervical root to alveolar crest of alveolar bone proper
Function: Prevent extrusion and lateral tooth movements

3. Horizontal group
Location: Mid root to adjacent bone proper
Function: Resists horizontal forces

4. Oblique group (coronal-oblique)
Location: Apical one-third of root to adjacent bone proper
Function: Resists vertical masticatory stresses and convert them into tension on alveolar bone

5. Apical group
Location: Apex of root to fundic proper
Function: Prevent tooth tipping, resist luxation and protect neurovascular supply to the tooth

6. Interradicular group
Location: Between roots to alveolar bone proper
Function: Prevent luxation, torquing and tooth tipping

The Unsung Hero of Dentistry: Why Dental Practice Management Software is Essential

 The world of dentistry is a constant hustle. Between patient appointments, procedures, and administrative tasks, it's easy for crucial aspects of running a smooth practice to fall by the wayside. This is where dental practice management software (PMS) steps in as the unsung hero, streamlining operations and boosting efficiency.

Why is Dental Practice Management Important?

Imagine juggling appointment scheduling, billing, insurance verification, patient records, and inventory management – all manually. It would be a logistical nightmare. Dental practice management software automates these tasks, freeing up valuable time for dentists and staff to focus on what matters most: patient care.

Here's how a PMS empowers your practice:

  • Enhanced Patient Experience: Streamlined scheduling allows patients to book appointments online, reducing wait times and improving convenience. Electronic health records (EHR) ensure accurate and readily available patient information. Secure communication tools within the PMS facilitate appointment reminders and follow-up communication.
  • Improved Efficiency: Tasks like scheduling, billing, and insurance verification are automated, saving valuable time and reducing errors. Staff can focus on providing excellent patient care without getting bogged down in paperwork.
  • Boosted Revenue: Timely and accurate billing with integrated insurance processing ensures you get paid faster. Automated appointment reminders minimize missed appointments and lost revenue. Efficient inventory management helps avoid stockouts and unnecessary purchases.
  • Data-driven Decision Making: PMS software provides valuable reports and insights on practice performance. Analyze appointment trends, track patient demographics, and identify areas for improvement.
  • Compliance with Regulations: Secure storage of patient data and streamlined documentation processes help your practice stay compliant with HIPAA and other regulations.

Popular Dental Practice Management Software Options

With a plethora of PMS options available, choosing the right one for your practice depends on several factors, including practice size, budget, and specific needs. Here's a glimpse into some of the most commonly used dental practice management software solutions:

  • Dentrix: A comprehensive solution catering to practices of all sizes, Dentrix offers a robust set of features including scheduling, billing, charting, reporting, and patient engagement tools. It also integrates with various third-party applications.
  • Eaglesoft: Renowned for its user-friendliness and focus on clinical workflows, Eaglesoft streamlines patient charting, treatment planning, and practice management. It caters well to smaller and mid-sized practices.
  • CareStack: Cloud-based and scalable, CareStack offers a modern platform with a focus on patient engagement and practice analytics. It is particularly well-suited for practices looking for a flexible and customizable solution.
  • Open Dental: An open-source option gaining traction, Open Dental is a cost-effective solution that offers a decent feature set. However, it requires some technical expertise for setup and customization.
  • Dentiflow: Another cloud-based platform, Dentiflow caters specifically to dental practices. It offers modules for scheduling, charting, billing, and patient communication, along with features like online appointment booking and mobile app access.

Choosing the Right Dental PMS

Before diving in, consider these factors:

  • Practice Size and Needs: A solo practitioner might not require the same level of functionality as a large group practice. Identify your specific needs and budget accordingly.
  • Ease of Use: User-friendliness for both dentists and staff is crucial. Consider user interfaces, training options, and technical support offered by the software provider.
  • Scalability: Will your practice grow in the future? Choose software that scales with your needs.
  • Integration with Existing Systems: Ensure the PMS integrates seamlessly with your existing dental imaging software, EHR systems, and lab management tools.
  • Security: Data security is paramount. Look for HIPAA-compliant software with robust security features.

Investing in a Dental Practice Management Software is an investment in your practice's future. By automating tasks, improving efficiency, and boosting patient satisfaction, a PMS can be the key to unlocking the full potential of your dental practice.

The term which indicate teeth or other maxillary structures too low down in the face is called:

 # The term which indicate teeth or other maxillary structures too low down in the face is called:
A. Attraction
B. Abstraction
C. Distraction
D. Protraction

The correct answer is B. Abstraction.

When the dental arch is closer to the Frankfort plane than normal, it is called attraction. When the dental arch is farther from the Frankfort horizontal plane (i.e. lower than normal) it is called abstraction.

Torque prescription for maxillary central incisor according to MBT in degrees is:

 # Torque prescription for maxillary central incisor according to MBT in degrees is:
A. 17
B. 10
C. -7
D. 0

The correct answer is A. 17.

Torque in orthodontics refers to the buccopalatal crown-root inclination of a tooth. To implement torque, larger dimensional archwires are inserted and engaged into brackets. This generates an activating force as the wire is manipulated into the bracket slot. Torque is not directly “in the wire.” Instead, it results from torsion in an archwire when it interacts with a bracket slot. When the wire twists compared to the bracket slot, it creates a couple (a rotational force) that affects the tooth’s inclination. Torque is not related to the angle of the bracket slot or the axial inclination of the tooth. In orthodontic treatment, torque control is often required, especially for maxillary incisors. Proper torque helps achieve an ideal inter-incisal angle, adequate incisor contact, and sagittal adjustment of the dentition for an ideal occlusion. The goal is to achieve the desired buccopalatal inclination of the crowns and roots. The MBT system is a popular pre-adjusted edgewise appliance system.

In the MBT system, torque prescription is based on the specific bracket design and the desired tooth movement. Orthodontists select brackets with predetermined torque values to achieve the desired crown-root inclination. The torque values are typically printed on the bracket prescription chart provided by the manufacturer. According to MBT, torque prescription for maxillary central incisor in degrees is 17 degrees. 

Which cusp on a maxillary first molar has two ridges: one that forms part of a transverse ridge and the other that forms part of an oblique ridge?

 # Which cusp on a maxillary first molar has two ridges: one that forms part of a transverse ridge and the other that forms part of an oblique ridge?
a. Mesiobuccal
b. Mesiolingual
c. Distobuccal
d. Distolingual

The correct answer is B. Mesiolingual. 

The mesiolingual cusp has triangular ridge as well as buccal ridge as shown in the figure of right maxillary first molar. 

From which view are only two roots visible on a maxillary first molar?

 # From which view are only two roots visible on a maxillary first molar?
a. Mesial
b. Distal
c. Buccal
d. Lingual

The correct answer is A. Mesial.

On both the maxillary first and second molars from the mesial view, two roots can be seen: the lingual
root and the mesiobuccal root, which is considerably wider buccolingually than the hidden distobuccal root.  On the first maxillary molar, the convex buccal outline of the mesiobuccal root often extends a little buccal to the crown outline, but the apex of this root is in line with the tip of the mesiobuccal cusp.

The furcations are likely to be farthest away from the cervical portion of the tooth in which of the following teeth?

 # The furcations are likely to be farthest away from the cervical portion of the tooth in which of the following teeth?
A. Mandibular first molar
B. Mandibular second molar
C. Mandibular third molar
D. Maxillary first molar

The correct answer is C. Mandibular third molar. 

Both maxillary and mandibular third molar roots are noticeably shorter than on firsts or seconds. They are very crooked, often curving distally, and more commonly fused most of their length resulting in a long root trunk with the furcation located only a short distance from the apices of the roots. 

What is the main purpose of miniplates in orthodontic practice?

 # What is the main purpose of miniplates in orthodontic practice?
A. To manage skeletal discrepancy without dental adverse effects 
B. To serve as an alternative anchorage system for mini-implants 
C. To withstand torsional force 
D. To anchor soft tissue to root apices

The correct answer is: A. To manage skeletal discrepancy without dental adverse effects. 

Miniplates are an alternative form of orthodontic TADs. They are anchored on skeletal bone using monocortical titanium screws and are indicated for orthopaedic traction to manage skeletal discrepancy without dental adverse effects. They can also be used as an alternative anchorage system when mini-implant insertion is unsatisfactory. While miniplates can be used as an alternative anchorage system, their primary purpose is not specifically to serve as an alternative to mini-implants.

Unlike mini-implants, miniplates can resist various types of force applications and have a lower failure rate. They are able to withstand force with a magnitude of 400–500 g. Additionally, the portion of a miniplate covered by soft tissue can be anchored apically to root apices, helping to avoid potential root damage and reduce soft tissue irritation.

Skeletal class II growth pattern 18 years old Female

 # Mr. Baburam Bhattarai brought his two children one female and one male for dental checkup. The female was 18-years-old & the male was 12 years old. Both had a skeletal class II growth pattern. The growth modification can be done only for the following: 
A. Only in male 
B. Only in female 
C. In both the male & female 
D. Cannot be done 

The correct answer is A. Only in Male.

Though the chronological age may be misleading and the status of growth has to be evaluated through CVM stages, growth modulation is possible in 12 year males and it's not possible in 18 year females. 

Test done when midline diastema and high frenal attachment is present

 # Prachanda, a 20-year-old boy went to his dentist with a complaint of spacing between his upper central incisors. On examination there was presence of mid line diastema. There was a high frenal attachment. Which test will the dentist do to confirm it?
 A. Montoux test 
B. Cotton test 
C. Ganong’s test 
D. Blanch test

The correct answer is D. Blanch Test.

To confirm the high frenal attachment in the presence of a midline diastema, the dentist would perform the Blanch test. This test involves lifting the lip and pulling it outward. If blanching (whitening) occurs in the soft tissue palatal to or between the central incisors, it indicates a high labial frenum attachment. Therefore, the correct answer is D. Blanch test.

Lesions within the basal ganglia produce the following signs except:

 # Lesions within the basal ganglia produce the following signs except: 
A. Hypotonia 
B. Tremor 
C. Hemiballisumus 
D. Athetosis

Lesions within the basal ganglia can lead to various motor disturbances. Let's analyze the given signs:

1. Hypotonia: This refers to reduced muscle tone or decreased resistance to passive movement. It is associated with basal ganglia dysfunction.

2. Tremor: Tremors are rhythmic, involuntary movements. Basal ganglia lesions can indeed cause tremors.

3. Hemiballismus: Hemiballismus is characterized by sudden, wild, and flinging movements of one side of the body. It specifically results from damage to the subthalamic nucleus within the basal ganglia.

4. Athetosis: Athetosis involves slow, writhing, and twisting movements, often affecting the hands and fingers. It is also associated with basal ganglia dysfunction.

Given the options, the sign that is not directly associated with basal ganglia lesions is Hypotonia. Hypotonia is more commonly related to other brain regions or spinal cord abnormalities.

Remember, basal ganglia play a crucial role in motor control, coordination, and movement regulation. Any disruption in this area can lead to various motor symptoms. 

Perfusion of oxygen supply in a free flap can be correctly estimated by:

 # Perfusion of oxygen supply in a free flap can be correctly estimated by:
a) Pulse oximetry 
b) Laser Doppler flowmetry 
c) Prick test 
d) Fluroscopy

The correct answer is B. Laser doppler flowmetry.

Let's go through each option:

a) Pulse oximetry: Pulse oximetry measures the oxygen saturation of hemoglobin in arterial blood non-invasively. However, it may not provide an accurate estimation of oxygen supply in a free flap because it only measures the oxygen saturation of blood and does not directly assess tissue perfusion. While it can indicate overall oxygenation status, it may not reflect the oxygen supply to a specific tissue like a free flap.

b) Laser Doppler flowmetry: Laser Doppler flowmetry is a non-invasive technique used to measure tissue perfusion by detecting the movement of red blood cells. It can provide real-time information about blood flow in the microcirculation of tissues, including free flaps. Therefore, it is often used to monitor the perfusion of oxygen supply in free flaps during surgery and postoperative care. This option is correct because it directly assesses tissue perfusion, which is crucial for evaluating the viability of free flaps.

c) Prick test: A prick test, also known as a pinprick test, is typically used to assess sensory nerve function by evaluating the patient's ability to perceive pain or touch in a specific area. It is not a suitable method for estimating oxygen supply in a free flap. While changes in sensation may indicate compromised blood flow to the flap, the prick test itself does not directly measure tissue perfusion or oxygen supply.

d) Fluoroscopy: Fluoroscopy is a medical imaging technique that uses a continuous X-ray beam to create real-time moving images of the internal structures of a patient. While fluoroscopy can provide valuable information about blood flow and vascular anatomy, it is not commonly used to estimate oxygen supply in free flaps. Fluoroscopy is more often utilized for guiding interventional procedures or diagnosing vascular issues but is not specifically tailored for assessing tissue perfusion in free flaps.

Hence, Laser Doppler flowmetry is the correct choice for estimating the perfusion of oxygen supply in a free flap as it directly measures tissue perfusion and is commonly used in clinical practice for this purpose.

The teeth most likely to be transposed are:

 # The teeth most likely to be transposed are:
A. Mandibular Premolars and maxillary incisors
B. Maxillary premolars and mandibular incisors
C.  Maxillary molars and canines
D. Mandibular molars and canines

The correct answer is B. Maxillary premolars and mandibular incisors.

Transposition is a rare positional interchange of two adjacent teeth. It occurs with a prevalence of approximately 0.3% and equally affects males and females. The teeth most likely to be transposed
are mandibular incisors and maxillary premolars, and this usually occurs as a consequence of ectopic eruption. There appears to be a genetic component to this problem. In the early mixed dentition years, transposition can develop when distally directed eruption of the permanent mandibular lateral incisor leads to loss of the primary mandibular canine and primary first molar. If left untreated, this can result in a true transposition of the permanent lateral incisor and canine.

The first material used for orthodontic TADs was:

 # The first material used for orthodontic TADs was:
A. Titanium
B. Stainless Steel 
C. Vitallium
D. Nickel - Chromium

The correct answer is C. Vitallium.

To date, three types of materials have been used for orthodontic TADs: titanium alloy, stainless steel
and vitallium. Vitallium was the first material used for orthodontic TADs. However, due to undesirable biocompatibility and a higher failure rate, vitallium was gradually replaced by titanium alloy. Stainless steel is also used for orthodontic mini-implants and recent evidence indicates that the success rate is similar between titanium alloy and stainless steel mini-implants. Nowadays, due to high biocompatibility of titanium, orthodontic TADs made of titanium alloy are most frequently used in clinical practice.

Reference: Clinical Insertion Techniques of Orthodontic Temporary Anchorage Devices, Wiley Blackwell

Who first advocated the opening of mid palatal suture to expand the dental arch?

 # Who first advocated the opening of mid palatal suture to expand the dental arch?
Emerson C. Angell 
B. Pierre Fauchard
C. Edward H. Angle 
D. Raymond Begg

The correct answer is A. Emerson C. Angell.

In 1860 Emerson C. Angell was probably the first person to advocate opening of the midline suture to provide space in the maxillary arch, because he took a very strong stand against extraction.

Ref: Graber, 7th Edition

Double lip is a feature of:

 # Double lip is a feature of:
 A. Aschers syndrome
B. Parry Romberg syndrome
C. Pierre Robin Syndrome
D. Mieschers syndrome

The correct answer is A. Aschers syndrome.

Ascher syndrome was first described in 1920 by an ophthalmologist. This syndrome presents as blepharochalasis(swelling of the eyelids), double lip and nontoxic thyroid enlargement. The thyroid enlargement is not present in all cases of this syndrome. The syndrome is often undiagnosed because of its rarity.

Otocephaly is a developmental disorder of:

 # Otocephaly is a developmental disorder of:
 A. Zygoma
B. Jaw bone
C. Occipital bone
D. Parietal bone

The correct answer is B. Jaw bone.

Otocephaly, also known as agnathia–otocephaly complex, is a very rare and lethal cephalic disorder characterized by the absence of the mandible (agnathia), with the ears fused together just below the chin (synotia). It is caused by a disruption to the development of the first branchial arch. It occurs in every 1 in 70,000 embryos.  

Reference: WIKIPEDIA

MCQs on Pharmacology - Drugs acting on Autonomic Nervous System

# The highest seat of regulating autonomic functions is located in:
A. Hypothalamus
B. Medulla
C. Spinal cord
D. Midbrain

# Catecholamines are synthesized from which amino acid?
A. Histamine
B. Phenylalanine
C. Tryptophan
D. Glycine

MCQs in Pharmacology - Drugs acting on Central Nervous System

# CNS depressant drug which reduces excitement without much effect on sleep is (also called anti anxiety drug):
A. Anticholinergic
B. Antipsychotic
C. Sedative
D. Hypnotic

# CNS depressant drug which produces sleep but patient may be awakened by inducing pain. This type of drug is called:
A. Antileptic
B. Antisympathetic
C. Sedative
D. Hypnotic

MCQs in General Pathology - Cardiovascular Pathology

# All of the following are examples in which active hyperemia is seen EXCEPT:
A. Inflammation and high grade fever
B. Blushing of face following emotion
C. Muscular exercise
D. Cardiac congestive failure

# Which of the following is true of heart failure cells?
A. Hemosiderin pigment laden alveolar macrophages present in venous congestion of lungs
B. Also called as Aschoff nodules present in endocardium seen in rheumatic fever
C. Also called as Mallory bodies seen in alcoholic cirrhosis of liver
D. Cells responsible for cardiac failure in congestive cardiac failure

MCQs in General Pathology - Acute and Chronic Infections

# Adenopathy is clinically manifested by:
A. Hyposalivation
B. Swelling
C. High grade fever
D. All of the above

# Lepra cells are seen in abundance in:
A. Tuberculoid leprosy
B. Lepromatous leprosy
C. Histoid leprosy
D. Intermediate leprosy

Psammoma bodies are associated with:

 # Psammoma bodies are associated with:
 A. Metastatic calcification
B. Dystrophic calcification
C. Apoptosis
D. Necrosis

The correct answer is B. Dystrophic calcification.

Psammoma bodies are round microscopic calcific collections. It is a form of dystrophic calcification. They are the characteristic feature of papillary carcinomas. 

A young adult shows non fluctuant, tender and red swelling in the marginal gingival lesion. This is most likely to be a:

 # A young adult shows non fluctuant, tender and red swelling in the marginal gingival lesion. This is most likely to be a:
 A. Periodontal abscess
B. Periapical abscess
C. Gingival abscess
D. Periapical sinus

The correct answer is C. Gingival abscess.

Gingival abscess
■ Localized, painful rapidly expanding lesion of sudden onset. 
■ It is limited to marginal gingival or interdental papilla. 
■ It is due to foreign substances carried deep into the tissues such as a toothbrush bristle, a piece of apple core, or a lobster shell. 
■ Gingival abscess involves marginal and interdental gingiva, whereas periodontal abscess involves attached gingiva. 

Palmar and plantar hyperkeratosis is a feature of:

 # Palmar and plantar hyperkeratosis is a feature of:
 A. Down syndrome
B. Papillon Lefevre Syndrome
C. Chediak-Higashi Syndrome
D. Klinefelter syndrome

The correct answer is B. Papillon Lefevre Syndrome.

Papillon-Lefevre Syndrome 
1. This is characterized by hyperkeratotic skin lesions and severe destruction of the periodontium. 
2. These changes may appear before the age of 4 years. 
3. Skin lesions are—hyperkeratosis of localized areas on palms, soles, knees, and elbows. 
4. Periodontal involvement is early inflammatory changes that lead to bone loss and exfoliation of teeth. Primary teeth are lost by 5 or 6 years of age. The permanent dentition erupts normally but the permanent teeth are lost within a few years. 

Ions participating in clotting mechanism are:

 # Ions participating in clotting mechanism are:
 A. Iron
B. Copper
C. Calcium
D. Aluminium

The correct answer is C. Calcium.

In the presence of calcium ions and other clotting factors, factor X activates an enzyme called prothrombin activator. This enzyme then converts the plasma protein prothrombin into thrombin. Thrombin is an enzyme that, in turn, converts fibrinogen to fibrin which causes the blood to clot.

Side effects of Phenytoin do not include:

 # Side effects of Phenytoin do not include:
 A. Osteomalacia
B. Gum hypertrophy
C. Folate deficiency
D. Blindness

The correct answer is D. Blindness. 

Adverse effects:  After prolonged use numerous side effects are produced at therapeutic plasma concentration; others occur as a manifestation of toxicity due to overdose.

At therapeutic levels
• Gum hypertrophy is common (20% incidence), especially in younger patients. It is due to the overgrowth of gingival collagen fibers. This can be minimized by maintaining oral hygiene.
• Hirsutism, coarsening of facial features (troublesome in young girls), acne.
• Hypersensitivity reactions are—rashes, DLE, and lymphadenopathy; neutropenia is rare but requires discontinuation of therapy.
• Megaloblastic anemia: Phenytoin decreases folate absorption and increases its excretion.
• Osteomalacia: Phenytoin interferes with metabolic activation of vit D and with calcium
• It can inhibit insulin release and cause hyperglycemia.
• Used during pregnancy, phenytoin can produce ‘fetal hydantoin syndrome’ (hypoplastic phalanges, cleft palate, hare lip, microcephaly), which is probably caused by its areneoxide metabolite.

Reference: Essentials of medical pharmacology, KD Tripathi.

At what temperature is blood stored in blood banks?

 # At what temperature is blood stored?
 A. -4 degrees
B. 4 degrees
C. 6 degrees
D. 8 degrees

The correct answer is B. 4 degrees celsius.

With the modern surgical and medical procedures, the demand for blood has greatly increased. It is for this reason that blood banks were started where blood from voluntary donors could be stored, so that it was always available on demand. Most blood banks have lists of would-be donors so that they may be contacted when required.

Storage of blood: After a donor has been screened for donation, one unit of blood (450 ml) is collected, under aseptic conditions, from the antecubital vein directly into a special plastic bag containing 63 ml of CPD-A (citrate-phosphate-dextrose-adenine) mixture. The blood bag is suitably sealed, labeled, and stored at 4 degree C, where it can be kept for about 20 days. (Faulty storage, i.e. overheating or freezing can lead to gross infection and hemolysis). The citrate prevents clotting of blood, sodium diphosphate acts as a buffer to control decrease in pH, dextrose supports ATP generation via glycolytic pathway and also provides energy for Na+- K+ pump that maintains the size and shape of red cells and increases their survival time, and adenine provides substrate for the synthesis of ATP, thus improving post-donation viability of red cells.

Blood is stored at low temperatures for 2 reasons: one, it decreases bacterial growth, and two, it decreases the rate of glycolysis and thus prevents a quick fall in pH.


Which mandibular plane is considered while calculating FMA (Frankfort mandibular plane angle) in cephalometry?

The mandibular plane used for FMA measurement is : A plane tangent to the lower border of mandible which connects with the menton anteriorly and posteriorly it bisects the distance between the right and left lower borders of the mandible in the region of the gonial angle. See Figure. 

The FMA angle is defined as the angle formed by the following two reference planes:
i. FH plane (Frankfort horizontal plane—A line between the most superior point of the external auditory meatus and inferior border of the orbit).
ii. Mandibular plane (A plane tangent to the lower border of mandible which connects with the menton anteriorly and posteriorly it bisects the distance between the right and left lower borders of the mandible in the region of the gonial angle). 

In most cephalometric analyses, the occlusal and mandibular planes are measured relative to the sella-nasion (SN) line, the basion-nasion (BaN) line, or the Frankfort horizontal plane. Ideally, according to Tweed, the incisor mandibular plane angle (IMPA) should be 90 degrees, the Frankfort mandibular angle (FMA) 25 degrees, and thus the Frankfort mandibular incisor angle (FMIA) 65 degrees. (The sum of three angles of a triangle equals 180 degrees.) Moreover, the IMPA angle also relates to creating additional space in the mandibular arch in that for each 3 degrees advancement of the lower incisor, 2.5 mm of space is gained in the mandibular dental arch. Conversely, reduction of the IMPA from 90 degrees, for example, to 87 degrees would decrease the available space for tooth alignment in the mandibular dental arch by 2.5 mm. 

Gangrene due to known infectious agent is:

 # Gangrene due to known infectious agent is:
 A. Wet gangrene
B. Dry gangrene
C. Pyoderma granulosum
D. Fournier gangrene

The correct answer is D. Fournier gangrene. 

Fournier gangrene, a relatively rare form of necrotizing fasciitis, is a rapidly progressive disease that affects the deep and superficial tissues of the perineal, anal, scrotal, and genital regions. Named after Dr. Alfred Fournier, the French dermatology and venereal specialist, it was initially described in 1883 as necrotizing fasciitis of the external genitalia, perineal, and perianal region in five of Dr. Fournier’s patients. Also known as necrotizing fasciitis, the disease involves the rapid spread of severe inflammatory and infectious processes along fascial planes affecting adjacent soft tissue; therefore, the disease may initially go unnoticed or unrecognized as there may be minimal or no skin manifestations in its early stages.

This disease process results from polymicrobial aerobic and anaerobic synergistic infection of the fascia and subcutaneous soft tissue. Gram-positive bacteria such as Group A Streptococci and Staphylococcus aureus and gram-negative bacteria such as E. Coli and Pseudomonas aeruginosa are organisms most commonly grown in wound cultures of Fournier gangrene patients as it is usually polymicrobial. These bacteria can be introduced through several sources, including urinary, bowel, or dermal. Urinary tract infections and other infectious processes of the perineum, such as perianal abscesses or even a simple pimple, may also provide a starting point for the infection. 

Surgical manipulation of the genital and perineal area similarly can provide the initial insult required to develop Fournier gangrene. Any traumatic insult or localized area of skin breakdown to the perineum or scrotum can lead to bacterial access to the subcutaneous tissues and begin the process, ultimately resulting in Fournier gangrene. About 25% of cases had no known or identifiable etiology.

Biosafety level 4 (BSL-4) pathogen is:

 # Biosafety level 4 (BSL-4) pathogen is:
 A. XDR strain of Mycobacterium tuberculosis
C. Ebola
D. Measles

The correct answer is C. Ebola.

Biological Safety Levels (BSL) are a series of protections relegated to the activities that take place in particular biological labs. They are individual safeguards designed to protect laboratory personnel, as well as the surrounding environment and community.

These levels, which are ranked from one to four, are selected based on the agents or organisms that are being researched or worked on in any given laboratory setting. For example, a basic lab setting specializing in the research of nonlethal agents that pose a minimal potential threat to lab workers and the environment are generally considered BSL-1—the lowest biosafety lab level. A specialized research laboratory that deals with potentially deadly infectious agents like Ebola would be designated as BSL-4—the highest and most stringent level.

The Centers for Disease Control and Prevention (CDC) sets BSL lab levels as a way of exhibiting specific controls for the containment of microbes and biological agents. Each BSL lab level builds upon on the previous level—thereby creating layer upon layer of constraints and barriers. These lab levels are determined by the following:
  • Risks related to containment
  • Severity of infection
  • Transmissibility
  • Nature of the work conducted
  • Origin of the microbe
  • Agent in question
  • Route of exposure
 Summary of Biological Agents and BSL levels

Once bone is formed, it grows by:

 # Once bone is formed, it grows by:
 A. Interstitial growth only
B. Appositional growth only
C. Both appositional and interstitial growth
D. Degenerative changes into bony structures

The correct answer is B. Appositional growth only.

Which is growth by the addition of new layers on those previously formed. Bone formation begins in the embryo where mesenchymal cells differentiate into either fibrous membrane or cartilage. 

This leads to two paths of bone development:
1. Intramembranous ossification is so called because it takes place in membranes of connective tissue. Osteoprogenitor cells in the membrane differentiate into osteoblasts: a collagen matrix is formed which undergoes ossification. Note: The maxilla and mandible as well as the cranial vault are forrmed this way.

2. Endochondral ossification is how the remainder of the skeleton forms and takes place within a hyaline cartilage model. Cartilage cells are replaced by bone cells (osteocytes replace chondrocytes), organic matrix is laid down and calcium and phosphate are deposited. This type of ossification is principally responsible for the formation of short and long bones. Note: The ethmoid, sphenoid, and occipital bones (bones of the cranial base) form this way.

The incisor overjet is increased for a class II case that is undergoing treatment. The reason is:

 # The incisor overjet is increased for a  class II case that is undergoing treatment. The reason is:
 A. Loss of anchorage
B. Arch collapse
C. Crowding in the lower arch
D. None of the above

The correct answer is A. Loss of anchorage.

Following are the features of anchorage loss in class II cases:
- Increase in overjet
- Molar relation  becoming more class II
- Normal canine relation without any change

Which of the following are typical and acceptable preventive and therapeutic measures for dealing with the periodontal problems during fixed appliance therapy?

 # Which of the following are typical and acceptable preventive and therapeutic measures for dealing with the periodontal problems during fixed appliance therapy?
 A. Elimination of gingivitis prior to placing orthodontic appliances
B. Home care instructions regarding the use of toothbrush and water pik during orthodontic treatment
C. Megavitamin therapy
D. Scaling and curettage immediately after appliance removal

The correct answer is A. Elimination of gingivitis prior to placing orthodontic appliances.

The mean value of visible plaque and visible inflammation showed significant increases during orthodontic treatment. Therefore, prior to orthodontic treatment, patients should have a high level of periodontal health and it should be maintained during the treatment period. Considering the relationship between orthodontic treatment and gingival health, patients, orthodontists and periodontists should cooperate during orthodontic treatment.

Reference: Boke F, Gazioglu C, Akkaya S, Akkaya M. Relationship between orthodontic treatment and gingival health: A retrospective study. Eur J Dent. 2014;8(3):373-380. doi:10.4103/1305-7456.137651

FDA approved locally delivered minocycline for subgingival placement is marketed under trade name:

 # FDA approved locally delivered minocycline for subgingival placement is marketed under trade name:
 A. Periochip
B. Atridox
C. Arestin
D. Elyzol

The correct answer is C. Arestin.

FDA has approved Arestin 2% Minocycline for subgingival placement as an adjunct to scaling and root planning.

Periochip: Chlorhexidine chip placed in the pocket for local drug delivery.

The recommended concentration of acidulated phosphate (APF) fluoride gel is:

 # The recommended concentration of acidulated phosphate (APF) fluoride gel is:
 A. 2%
B. 8%
C. 1.23%
D. 10%

The correct answer is C. 1.23%.

Brudevold's solution or APF solution is prepared by dissolving 20 gms of NaF in 1 Litre (2% NaF) of 0.1M phosphoric acid and to this 50% hydro fluoric acid is added to adjust the pH at 3.0 and fluoride ion concentration at 1.23% APF gel is prepared by adding gelling agents like methylcellulose and hydroxyl ethyl cellulose and the pH is adjusted between 4-5.

Duraphat is:

 # Duraphat is:
 A. Lacquer
B. Sodium Fluoride in varnish form
C. Stannous Fluoride
D. Sodium Fluoride 2%

The correct answer is B. Sodium fluoride in varnish form.

Duraphat 50 mg/mL Dental Suspension is to be applied by the dental professional and not for self medication by the patient. 1 mL suspension contains 50 mg sodium fluoride (5% w/v), equivalent to 22,600 ppm fluoride ion (22.6 mg of fluoride) in an alcoholic solution of natural resins.

Recommended dosage for single application:
For primary teeth: up to 0.25 mL (= 5.65 mg fluoride)
For mixed dentition: up to 0.40 mL (= 9.04 mg fluoride)
For permanent dentition: up to 0.75 mL (= 16.95 mg fluoride)
For caries prevention: the application is usually repeated every 6 months but more frequent
applications (every 3 months) may be made.
For hypersensitivity: 2 or 3 applications should be made within a few days.
The patient should not brush the teeth or chew food for 4 hours after treatment.
Method of administration: For dental use.

  • Hypersensitivity to any ingredients of Duraphat.
  • Ulcerative gingivitis.
  • Stomatitis.
  • Bronchial asthma.

Special warnings and precautions for use
Application of Duraphat 50 mg/mL Dental Suspension to the whole dentition should not be carried out on an empty stomach. On the day when Duraphat has been applied, no high dose fluoride preparations, such as fluoride gels, should be used. The administration of fluoride supplements should be suspended for several days after applying Duraphat. Prolonged daily ingestion of excessive fluoride may result in varying degrees of fluorosis.

Interaction with other medicines and other forms of interaction
The presence of alcohol (33.8% v/v) in the Duraphat formula should be considered.

Fertility, pregnancy and lactation
As this product contains 33.8% v/v of ethanol (each dose contains up to 0.2 g of alcohol), it is recommended to avoid its use in pregnant women and during lactation.

Undesirable effects
Gastrointestinal disorders: Very rare (<1/10,000): Stomatitis, gingivitis ulcerative, retching, oedema mouth and nausea may occur in sensitive (allergic) individuals
- if necessary, the dental suspension layer can easily be removed from the mouth by brushing and rinsing.
Skin and subcutaneous tissue disorders: Very rare (<1/10,000): Irritation in sensitive individuals, angioedema
Immune System Disorders: Not known (cannot be estimated from the available data)

Hypersensitivity. Respiratory, thoracic and mediastinal disorders: Very rare/Isolated report (<1/10,000): Asthma

Overdose: Accidental ingestion of large amounts of fluoride may result in acute burning in the mouth and sore tongue. Nausea, vomiting and diarrhoea may soon occur after ingestion (within 30 minutes) and are accompanied by salivation, haematemesis, and epigastric cramping abdominal pain. These symptoms may persist for 24 hours. If less than 5 mg fluoride/kg body weight has been ingested, give calcium (eg milk) orally to relieve gastrointestinal symptoms and observe for medical assistance. For accidental ingestion of more than 15 mg fluoride/kg body weight, admit immediately to a hospital facility. 

A malocclusion is characterized by protrusion of maxilla, labioversion of maxillary incisors deep overbite and overjet. These are typical characteristic of which malocclusion?

 # A malocclusion is characterized by protrusion of maxilla, labioversion of maxillary incisors deep overbite and overjet. These are typical characteristic of which malocclusion?
 A. Class I
B. Class II Div 1
C. Class II Div 2
D. Class III

The correct answer is B. Class II Div 1.

Class I Incisor Relationship
Lower incisal edges occlude with or lie immediately below the cingulum plateau of the upper incisors.

Class II Incisor Relationship
The lower incisal edge lies posterior to the cingulum plateau of the upper incisors.

Class II Division 1 Incisor Relationship : The upper central incisors are proclined or of average inclination. There is an increase in overjet.

Class II Division 2 Incisor Relationship : The upper central incisors are retroclined. The overjet is usually minimal but may be increased.

Class III Incisor Relationship: The lower incisal edges lies anterior to the cingulum plateau of the upper incisor.

MECEE MDS 2024 RESULT Medical Education Commission

 MECEE MDS 2024 RESULT Medical Education Commission

Government of Nepal
Directorate of Examination
ENTRANCE RESULT Wednesday, February 7, 2024

Program: Masters of Dental Surgery (MDS)  50th Percentile (Cut-off) Score: 71.25

1 31434 HIMAL DAHAL 132.5 1
2 31268 BISHAL CHAPAGAIN 128 2
3 31328 ROSHANI SUBEDI 125.75 3
4 31447 PRIYANKA DHAKAL 123 4
5 31438 MEGHA SHRIVASTVA 121.25 5
6 31485 SAMBRIDHI MATHEMA 120.5 6
7 31220 NIRAJAN BHANDARI 120.5 7
8 31056 KRISHNA DEV MAHATO 120.25 8
9 31413 RAMAN LAMA 119 9
10 31444 PRAVIN BHATTARAI 118.75 10
11 31402 ABHINAW SUBEDI 117.5 11
12 31528 PRATIMA KHADKA 117 12
13 31380 PRABESH BANSTOLA 116.25 13
14 31529 AASHISH KOIRALA 115.5 14
16 31354 ASMITA GYAWALI 113.25 16
17 31274 ROMIN SHRESTHA 112.5 17
18 31120 SUNAYAN SUBEDI 112.5 18
19 31192 MILAN KOIRALA 111.75 19
20 31490 SABHYATA PAUDEL 111.75 20
21 31470 ASMINA CHHETRI 111.25 21
22 31147 MINU MISHRA 111.25 22
23 31249 BHESH RAJ PARAJULI 110 23
24 31480 SAMIKSHA SHARMA 109.75 24
25 31180 RAJU PANDEY 109.25 25
26 31346 SUSMITA SHRESTHA 108.75 26
27 31323 RITESH THAPA 108.75 27

28 31062 PRIYANKA ROY 108.75 28
29 31125 TRIPURARI SHUKLA 108.5 29
30 31216 RIYA GUPTA 108 30
31 31365 PRAKRITI BASUKALA 108 31
32 31241 AYUSH GURAGAIN 107.75 32
33 31395 ELIJMA RANJIT 107.5 33
34 31494 ASMITA PARAJULI 107.5 34
35 31435 KISHOR SUBEDI 107 35
36 31079 SARANGA GHIMIRE 107 36
38 31133 SHOVA SAPKOTA 105.75 38
39 31526 DHARMA PRATAP BHARKHER 105.5 39
40 31390 DIPTI SHRESTHA 104.75 40
41 31181 BISHOW DEEP POUDEL 104.5 41
42 31057 NIROJ CHAUDHARY 104.5 42
43 31414 KRIPA LAMICHHANE 104.25 43
44 31031 KIRAN THAKUR 103.75 44
45 31355 LAXMI PARAJULI 103.75 45
46 31183 USHA SAPKOTA 103.75 46
47 31410 KAJAL MEHTA 103.75 47
48 31185 BIPLAV KUMAR CHAUDHARY 103.5 48
49 31460 SRISTI ADHIKARI 103.25 49
50 31399 RAKSHYA KC 103 50
51 31237 SANJITA PANDEY 103 51
52 31455 SNEHA SAPKOTA 102.5 52
53 31451 ROSHAN KUMAR YADAV 102.25 53
54 31030 JITENDRA RAY YADAV 101.75 54

55 31273 UJWAL MEHTA 101.75 55
56 31474 ICHHYA PRADHAN 101.5 56
57 31456 SUBANI PAUDEL 101.25 57
58 31143 NITESH ADHIKARI 101.25 58
59 31430 RICHA YADAV 100.75 59
60 31172 MELINA MULMI 100 60
61 31263 REETU SHARMA 99.75 61
62 31376 PRAKRITEE LIMBU 99.75 62
63 31433 DOLLY AGRAWAL 99.25 63
64 31525 BINAY KUMAR YADAV 99.25 64
65 31285 ASHRU SHRESTHA 99 65
66 31035 GYANENDRA SHARMA 98.75 66
67 31214 PARIKSIT TIMILSINA 98.5 67
68 31160 PRAKASH POUDYAL 97.75 68
69 31527 PUSHPA LAL SHAH 97.5 69
70 31338 UJJWAL SHRESTHA 97 70
71 31271 KUSUM K.C. 97 71
72 31397 ANIL KUMAR 96.75 72
73 31491 RENU MEHTA 96.5 73
74 31467 KERISHNA KANSAKAR 96.25 74
75 31221 SAROJ MAHARJAN 96.25 75
76 31092 BIBEK SUNAR 95.25 76
77 31209 PRIKSHA KHANAL 95 77
78 31176 JYOTI KHAREL 95 78
79 31389 PRAKASH SUWAL 95 79
80 31109 SRIJANA JAIRU 94.75 80
81 31530 SLESHA GURUNG 94.75 81
82 31211 SMRITI CHAUDHARY 94.75 82
83 31496 ANAMOL DUMARU 94.5 83
84 31315 SUMAN PUDASAINI 94 84
85 31327 RAKSHAK MANANDHAR 93.75 85
86 31052 RAJ KUMAR SHRESTHA 93.75 86
87 31006 AJIT KUMAR YADAV 93.75 87
88 31275 PRIYANKA SHAH 93.75 88
89 31326 SUBASH MEHTA 93.5 89
90 31303 REBIKA SHRESTHA 93.25 90
91 31359 RITI GUPTA 93 91
92 31409 SAGAR PARIYAR 92.5 92
93 31477 PRAKRITI KAFLE 92.5 93
94 31110 MANISH KUMAR DEV 92 94
95 31311 SAUJANYA PANT 92 95
96 31093 BIMAL POUDEL 91.75 96
97 31314 SABYA MANANDHAR 91.75 97
98 31381 SABIN GWACHHA 91.75 98
99 31046 SUNITA PUN 91.75 99
100 31305 DIVYA JHA 91.5 100
101 31505 KRITISHA ACHARYA 91.25 101
102 31324 SUSHANT KUMAR THAKUR 91.25 102
103 31367 SURESH DAHAL 91.25 103
104 31281 ASMITA KUMARI SAH 91 104
105 31158 AKASH NHEMAPHUKI 91 105
106 31145 PINKY AGRAWAL 90.75 106
107 31335 MANISHA KHARBUJA 90.75 107
108 31522 RAJMEE SHRESTHA 90.75 108
109 31516 INCHUNA BARAL 90.5 109
110 31146 PABITRA REGMI 90.5 110
111 31306 REGINA DAHAIT 89.75 111
112 31067 ELINA SHRESTHA 89.75 112
113 31207 AISHWARYA JOSHI 89.25 113
114 31471 SRISHTI POUDEL 89.25 114
115 31195 SRIJA JOSHI 89.25 115
116 31426 RIJU SHRESTHA 89 116
117 31144 BENUJA BHANDARI 89 117
118 31104 NITU CHAUDHARY 89 118
119 31074 SAMJHANA GAUTAM 88.75 119
120 31234 ANUJA RUWALI 88.75 120
121 31009 PRANAV KUMAR JHA 88.75 121
122 31497 BISHEK DAHAL 88.5 122
123 31362 KRITI SHRESTHA 88.5 123
124 31071 ROSHAN KUMAR SHAH 88.5 124
125 31349 ANUKA DANGOL 88.25 125
126 31422 SIDDHARTHA SHAKYA 88.25 126
127 31012 PALLAVA KUMAR UPADHAYAYA 88.25 127
128 31464 SHIKHA ADHIKARI 88.25 128
129 31429 ASMITA BHATTARAI 87.5 129
130 31204 RABINA CHAUDHARY THARU 87.25 130
131 31396 ANU PARAJULI 87.25 131
132 31400 SUSHMITA CHHETRI 87 132
133 31345 SRISTI NAPIT 86.75 133
134 31233 RADHA SHAH 86.5 134
135 31022 RIJA MANANDHAR 86.5 135
136 31073 AAKRITI JHA 86.5 136
137 31507 SUJANA THAPA 86.25 137
138 31416 BAMINA MAHARJAN 86.25 138
139 31217 SUBHEKSHYA GYAWALI 85.5 139
140 31436 RAMITA LAMA 85.5 140
141 31357 SHRISTI GAUTAM 85.25 141
142 31091 APPU YADAV 85 142
143 31026 SANJAYA PANDEY 85 143
144 31111 ASMITA KUMARI BHANDARI 84.75 144
145 31025 AMRITA KUMARI YADAV 84.75 145
146 31283 RADHA JAISWAL 83.75 146
147 31521 SANJU PANDIT 83.25 147
148 31128 BINAYA BHANDARI 82.75 148
149 31475 ANISHA KHADKA 82.5 149
150 31517 PRAKRITI SHARMA 82.5 150
151 31301 PAYAL JHA 82.5 151
152 31224 RASHILA MANANDHAR 82.5 152
153 31510 ASMITA KATUWAL CHHETRI 82.5 153
154 31325 BIMALA KHATRI 82.5 154
155 31280 SADIKSHA GAUTAM 82 155
156 31378 SUJAN TIMSINA 82 156
157 31299 PRAMILA KHANAL 81.5 157
158 31193 ARABINDA SHRESTHA 81.5 158
159 31236 DURGA PANTHA 81 159
160 31107 ASHWIN KUMAR GUPTA 81 160
161 31123 SARITA KUMARI YADAV 80.75 161
162 31288 SAMPADA POKHREL 80.75 162
163 31219 MONICA JHA 80.5 163
164 31350 ANUP OJHA 80.5 164
165 31502 KRISHA SUWAL 80.5 165
166 31452 ASTHA RAJBHANDARI 80.25 166
167 31450 DIPAK RAUT 80.25 167
168 31164 SAHIRA RAJBHANDARI 80.25 168
169 31203 ROMARIYA MAHARJAN 80.25 169
170 31113 PRATIMA PATHAK 80.25 170
171 31514 PRAKRITI RUPAKHETY 80 171
172 31302 PUJA BHAGAT 80 172
173 31166 SHEKHAR KUMAR MANDAL 79.75 173
174 31230 SONU THAPA MAGAR 79.5 174
175 31334 SONAM MISHRA 79.5 175
176 31262 PRANISHA BHANDARI 79.25 176
177 31394 MANIKA SHRESTHA 79 177
178 31238 KRISTINA SAPKOTA 79 178
179 31053 DEEPENDRA POKHAREL 79 179
180 31351 AGYA TIMSINA 78.75 180
181 31267 TANUJA G.C. 78.5 181
182 31235 MANOJ SHRESTHA 78.25 182
183 31072 RAVI RANJIT SHAH 78.25 183
184 31342 POONAM SHRESTHA 78.25 184
185 31033 AVINESH SHRESTHA 78.25 185
186 31332 RACHITA BHATTARAI 78.25 186
187 31518 ASMITA PAUDYAL 78 187
188 31190 RANJANA SHAH 78 188
189 31353 ROJINA POUDEL 78 189
190 31244 AATISH PANGENI 77.75 190
191 31403 REKHA YADAV 77.75 191
192 31382 PRERANA ARYAL 77.5 192
193 31284 SABINA KARKI 77.5 193
194 31425 ANISHA SHRESTHA 77.5 194
195 31375 PRIYA BAJRACHARYA 77.5 195
196 31431 AYUSHI ADHIKARI 77.25 196
197 31377 SMRITI PANDIT 77 197
198 31508 RANJANA KHANAL 76.75 198
199 31503 KAJAL THAKUR 76.75 199
200 31228 PUNAM RAI 76.75 200
201 31242 ASTHA UPADHYAYA 76.5 201
202 31050 RANJANA SHAH 76.25 202
203 31229 ANUPA TIWARI 76.25 203
204 31511 SAYANA ACHARYA 76.25 204
205 31369 DILASHMA THAPA 76.25 205
206 31366 BIRAT THAPA 76 206
207 31515 SUNIRA KARKI 76 207
208 31487 SUSMITA ADHIKARI 76 208
209 31095 VIJAY RAI 76 209
210 31463 PRATIMA PANTA 75.75 210
211 31252 SAGAR PANTHI 75.75 211
212 31440 SIMPHONI SHRESTHA 75.75 212
213 31005 SARITA SHAH 75.75 213
214 31188 SUSMITA THAPA 75.5 214
215 31404 KIRTI KUMARI WASTI 75.25 215
216 31358 SIMA KUMARI VERMA 75.25 216
217 31100 BHUWAN CHAUHAN 75 217
218 31446 SWORUPA WAGLE 75 218
219 31013 SITA KUMARI DAS 75 219
220 31476 RADHA MANDAL 75 220
221 31361 PRAMISHA KARKI 75 221
222 31388 SANDEEP DHOJU 75 222
223 31202 PREETI SHAH 75 223
224 31401 SALINA MAHARJAN 75 224
225 31078 DINESH KUMAR SHRESTHA 74.5 225
226 31298 MANISHA MEHTA 74.5 226
227 31173 PAMI KARNA 74.5 227
228 31162 SUSHIL POKHAREL 74.25 228
229 31265 PRAGYA TULSI 74.25 229
230 31290 SRISHTI POKHREL 74.25 230
231 31500 MANITA SITAULA 74.25 231
232 31254 ARZOO KHATRI 74 232
233 31523 UDIKSHYA MAHARJAN 74 233
234 31008 AJAY KUMAR ROY AMATYA 74 234
235 31223 NEHA SHAH 73.75 235
236 31150 SHIVANI BHANDARI 73.75 236
237 31154 MILAN RAI 73.75 237
238 31509 LAXMI KARKI 73.75 238
239 31347 ASMINA SHRESTHA 73.5 239
240 31119 BIMAL CHAND 73 240
241 31519 SANGITA PANTHI 73 241
242 31124 ROJEENA ADHIKARI 73 242
243 31139 NIROJ CHHETRI 73 243
244 31106 MONA BASNET 72.75 244
245 31077 MADHU SUDAN SHARMA 72.75 245
246 31393 MELINA SURYABANSHI 72.5 246
247 31090 PAWAN KUMAR GUPTA 72.5 247
248 31034 SANJIV PRASAI 72.5 248
249 31392 SUSMITA TIMILSINA 72.25 249
250 31304 JAY PRAKASH YADAV 72.25 250
251 31089 SAGAR REGMI 72 251
252 31058 RAZIYA MIYA 71.75 252
253 31473 NISCHALA CHAULAGAIN 71.5 253
254 31075 ANANDA JYOTI OLI 71.5 254
255 31226 JYOTI MAHATO 71.25 255
256 31448 PINKY JHANG 71.25 256
257 31182 AAYUSHA THAPA 71.25 257
258 31086 BIMAL DEO 71.25 258
259 31445 SHRESTA GHIMIRE 71.25 259
260 31189 SANDHYA ADHIKARI NEUPANE 71.25 260