Which anti tubercular drug crosses the blood brain barrier (BBB)?

 # Which anti tubercular drug crosses the blood brain barrier (BBB)?

A. INH

B. Rifampicin

C. Ethambutol

D. Streptomycin

The correct answer is A. INH (Isoniazid).

Explanation:

INH (Isoniazid): 

- Crosses the blood-brain barrier (BBB) effectively, even in the absence of inflammation. 

- First-line drug for tuberculous meningitis due to excellent CSF penetration.

- Critical for treating CNS tuberculosis.

Other Options:

B. Rifampicin: Penetrates the BBB only when meninges are inflamed (e.g., in active meningitis). Not as reliable as INH under normal conditions.

C. Ethambutol and D. Streptomycin: Poor BBB penetration, making them unsuitable for CNS tuberculosis.

Key Takeaway:

INH is the most reliable anti-tubercular drug for crossing the BBB, especially in latent or early CNS infections. Rifampicin’s efficacy depends on meningeal inflammation.

Which of the following can be diagnosed using dark field microscopy?

 # Which of the following can be diagnosed using dark field microscopy?

A. Spirochaetes

B. Streptococci

C. Corynebacteria

D. Mycobacteria

The correct answer is A. Spirochaetes.

Explanation:

Dark field microscopy is particularly useful for observing organisms that are difficult to stain, such as Spirochaetes (e.g., Treponema pallidum, the causative agent of syphilis). These bacteria are thin and motile, making dark field microscopy ideal for visualizing their morphology and movement.

Streptococci (B), Corynebacteria (C), and Mycobacteria (D) are typically diagnosed using Gram staining, Albert staining, or acid-fast staining, respectively. They do not require dark field microscopy.

Lateral Cephalogram Samples for Analysis

 These are some samples of Lateral cephalograms you can use to study and do analyses. 

Sagittal and Lambdoid Synostosis, Low set ears

 # A two-month-old boy is referred for evaluation because he has an abnormal head shape. Physical examination shows low-set ears, and short-webbed fingers. A CT scan shows sagittal and lambdoid synostosis. Which of the following genes is most likely to cause this syndrome ?

A. TWIST1

B. FGFR1

C. FGFR2

D. RAB23

The correct answer C. FGFR2.

The most likely gene to cause the syndrome described, characterized by sagittal and lambdoid synostosis, low-set ears, and short-webbed fingers in a two-month-old boy, is C. FGFR2.

Explanation:

The clinical presentation suggests a craniosynostosis syndrome, with sagittal and lambdoid synostosis indicating premature fusion of cranial sutures, and additional features like low-set ears and short-webbed fingers (syndactyly) pointing toward a syndromic form. Among the options, mutations in FGFR2 (Fibroblast Growth Factor Receptor 2) are strongly associated with syndromic craniosynostoses, particularly Apert syndrome and Crouzon syndrome, both of which can present with multisuture synostosis (including sagittal and lambdoid) and distinctive features.

Apert syndrome (caused by FGFR2 mutations) is characterized by coronal synostosis (though sagittal and lambdoid can also be involved), syndactyly (webbed fingers/toes), midface hypoplasia, and occasionally low-set ears due to associated craniofacial anomalies. The short-webbed fingers in the question align well with Apert’s syndactyly.

Crouzon syndrome (also FGFR2-related) involves craniosynostosis (often coronal, but sagittal and lambdoid can occur) and facial anomalies like low-set ears, though syndactyly is less common.

Analysis of other options:

A. TWIST1: Associated with Saethre-Chotzen syndrome, which typically involves coronal synostosis and milder limb anomalies (e.g., partial syndactyly or brachydactyly). Multisuture involvement (sagittal and lambdoid) is less common, and severe syndactyly is not typical.

B. FGFR1: Linked to Pfeiffer syndrome in some cases, but FGFR2 is more commonly implicated. Pfeiffer includes broad thumbs/toes and partial syndactyly, but sagittal and lambdoid synostosis as the primary sutures is less frequent.

D. RAB23: Associated with Carpenter syndrome, a rare condition with craniosynostosis (often sagittal or coronal), polysyndactyly (extra digits), and other anomalies. The absence of polysyndactyly or obesity in the description makes this less likely, and short-webbed fingers align better with Apert’s syndactyly.

Conclusion: FGFR2 mutations are most likely to cause a syndrome with sagittal and lambdoid synostosis, low-set ears, and short-webbed fingers, as seen in Apert syndrome, making C. FGFR2 the best answer.

Which of the following antibiotics acts by inhibiting cell wall synthesis?

 # Which of the following antibiotics acts by inhibiting cell wall synthesis?

a) Doxycycline

b) Aminoglycosides

c) Erythromycin

d) Cefepime

The correct answer is D. Cefepime.

The correct answer is d) Cefepime.

Explanation:

Cefepime is a fourth-generation cephalosporin antibiotic that inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs), disrupting peptidoglycan cross-linking, and leading to cell lysis.

Doxycycline (a tetracycline) inhibits protein synthesis by binding to the 30s ribosomal subunit, preventing tRNA attachment.

Aminoglycosides (e.g., gentamicin) also target protein synthesis by binding to the 30s ribosomal subunit, causing misreading of mRNA.

Erythromycin (a macrolide) inhibits protein synthesis by binding to the 50s ribosomal subunit, blocking peptide chain elongation.

Thus, only Cefepime acts by inhibiting cell wall synthesis.

Traumatic injury to primary tooth leads to intrusion. After how much time, the tooth usually re-erupts?

 # Traumatic injury to primary tooth leads to intrusion. After how much time, the tooth usually re-erupts?

a) 30 days

b) 3 months

c) 6 months

d) 12 months

The correct answer is C. 6 months.

Explanation:

Intrusion of a primary tooth occurs when a traumatic force displaces the tooth apically into the alveolar bone. The potential for re-eruption depends on factors such as the degree of intrusion, the integrity of the periodontal ligament, the child's age, and the absence of complications like ankylosis or damage to the underlying permanent tooth bud. In pediatric dentistry, re-eruption is a common outcome for intruded primary teeth due to the elasticity of the periodontal ligament and ongoing alveolar growth.

While some studies suggest re-eruption can occur within 2–4 months for mild to moderate intrusions, the 6-month timeframe is more plausible in clinical practice for several reasons:

Variable Healing Dynamics: Moderate to severe intrusions may require longer for the periodontal ligament to reorganize and facilitate re-eruption, especially if there is initial swelling or minor alveolar bone remodeling.

Clinical Monitoring Period: Dentists often observe intruded teeth for up to 6 months to confirm complete re-eruption or to detect complications (e.g., failure to re-erupt, ankylosis, or pulpal necrosis). The 6-month mark is a standard endpoint in guidelines (e.g., American Academy of Pediatric Dentistry) for assessing outcomes.

Conservative Estimate: The 6-month duration accounts for cases where re-eruption is slower due to partial intrusion or minor displacement, ensuring the tooth returns to its original position without intervention.

In contrast, 30 days is too short for complete re-eruption, as initial healing and tissue reorganization take longer. 3 months may suffice for milder cases but may not cover the full spectrum of intrusion severities. 12 months is excessively long unless complications delay the process significantly. Thus, 6 months is a clinically relevant and plausible timeframe for the re-eruption of most intruded primary teeth, balancing biological healing with practical observation periods.

Bulk of lamina propria of the gingiva is made of collagen type:

 # Bulk of lamina propria of the gingiva is made of collagen type:

a) I

b) II

c) III

d) IV

The correct answer is A. Type I.

The bulk of the lamina propria of the gingiva is made of collagen type I.

Explanation:

The lamina propria of the gingiva, a connective tissue layer supporting the gingival epithelium, primarily consists of collagen type I, which provides structural strength and resilience. Collagen type I is the most abundant collagen in connective tissues like the gingiva, while other types (e.g., II in cartilage, III in reticular fibers, IV in basement membranes) are less dominant in this context.

Secretin does not cause:

 # Secretin does not cause:

a) Bicarbonate secretion

b) Augments the action of CCK

c) Contraction of pyloric sphincter

d) Gastric secretion increase

The correct answer is D. Gastric secretion increase.

Secretin does not cause d) Gastric secretion increase.

Explanation:

a) Bicarbonate secretion: Secretin stimulates the pancreas to secrete bicarbonate to neutralize acidic chyme in the duodenum.

b) Augments the action of CCK: Secretin works synergistically with cholecystokinin (CCK) to enhance pancreatic enzyme and bile secretion.

c) Contraction of pyloric sphincter: Secretin promotes relaxation of the pyloric sphincter to allow chyme to pass into the duodenum.

d) Gastric secretion increase: Secretin inhibits gastric acid secretion and gastric motility to slow digestion in the stomach, making this the correct answer.

Major and frequent influence for arterial thrombus formation is:

 # Major and frequent influence for arterial thrombus formation is:

a) Alteration in blood flow

b) Hypercoagulability

c) Endothelial damage

d) Fatty streak

The correct answer is C. Endothelial damage.

For a single-choice question on thrombus formation, the answer depends on the clinical context:

1. Arterial Thrombosis (e.g., Myocardial Infarction)

Correct Answer: [c) Endothelial Damage]

Rationale: Arterial thrombi typically form at sites of disrupted atherosclerotic plaques. Endothelial injury directly exposes prothrombotic subendothelial collagen and tissue factor, triggering platelet adhesion/aggregation and coagulation activation.

2. Venous Thrombosis (e.g., DVT)

Correct Answer: [a) Alteration in Blood Flow] or [b) Hypercoagulability]

Rationale: Venous thrombi often arise from stasis (e.g., immobility) or hypercoagulable states (e.g., Factor V Leiden). If forced to choose one, prioritize [a) Alteration in Blood Flow] as stasis is the most common trigger.

Why Not Other Options?

[d) Fatty Streak] is incorrect because it represents early atherosclerosis, not active thrombosis.

Note: In practice, all three Virchow triad components (a/b/c) contribute, but exam questions often focus on the most context-specific factor.

Exam Strategy:

If the question mentions "myocardial infarction" or "artery", choose c.

If it refers to "DVT", "surgery", or "immobility", choose a.

If genetic clotting disorders (e.g., Leiden mutation) are explicitly mentioned, choose b.

Vestibular toxicity is associated with which of the following tetracyclines?

Vestibular toxicity is associated with which of the following tetracyclines?

A. Doxycycline
B. Minocycline
C. Chlorotetracycline
D. Oxytetracycline

Top Dental Suppliers in Nepal: NDDA Members Directory

Looking for reliable dental suppliers in Nepal? The Nepal Dental Distributors Association (NDDA) represents the leading providers of dental equipment, materials, and services across the country. Whether you're a dental professional in Kathmandu valley or outside, our curated list of NDDA-associated suppliers ensures you connect with trusted vendors for high-quality dental products.

From dental chairs and imaging systems to consumables like dental cement and orthodontic supplies, NDDA members offer a wide range of solutions tailored to modern dental practices. Established to promote excellence in the dental industry, the NDDA organizes events like Nepdent 2025, fostering innovation and collaboration among dental professionals and suppliers.

Below, explore our comprehensive directory of NDDA dental suppliers, complete with proprietors' names, addresses, contact numbers, and email addresses. Find the right partner for your dental practice today and elevate your patient care with top-tier dental supplies in Nepal!

Why Choose NDDA-Associated Dental Suppliers?

• Quality Assurance: NDDA members adhere to high standards, ensuring reliable and safe dental products.
• Nationwide Reach: Access suppliers in major cities like Kathmandu, Pokhara, and Biratnagar.
• Industry Expertise: Connect with experienced vendors who understand the needs of Nepalese dental professionals.
• Innovation: Stay updated with the latest dental technology through NDDA’s events and supplier networks.

Ready to find the best dental equipment in Nepal? Browse our list of NDDA suppliers below and contact them directly for inquiries or orders.

NDDA Dental Suppliers List

Aapi Suppliers

Proprietor: Arjun Panta

Address: Bharatpur-11, Chitwan, Nepal

Contact Number: +977-056-590783, +977-9855024010

Email: aapi.dent11@gmail.com

Advance Dental Suppliers

Proprietor: Bharat Paudel

Address: Pokhara-09, Kaski

Contact Number: 9856036757

Email: rupeshpoudel69@gmail.com

Akshada Dental Pvt. Ltd

Proprietor: Manish Kumar Mandal

Address: Kathmandu -10, Baneshwar

Contact Number: 9811729531

Email:akshadadental3@gmail.com

Asap Enterprises

Proprietor: Piyush Shrestha

Address: Koteshwar, Kathmandu

Contact Number: 9840208463

Email:asap.enterprises@gmail.com

Baraha Dental Suppliers

Proprietor: Roshir Maskey

Address: Nayabasti, Gokarneshwar, Kathmandu

Contact Number: 9851007050

Email:barahadental@gmail.com

Bashyal Surgical

Proprietor: Ammar Raj Bashyal

Address: Butwal-06, Jyotipath

Contact Number: +977-071-590045, 9857031665

Email: skdbashyal@gmail.com

Bhagawati Tradelink and Suppliers

Proprietor: Sanjay Koju

Address: Dhulikhel-05, Itol

Contact Number: 9851034949

Email: photocopy388@gmail.com

Bredent Nepal Pvt. Ltd

Proprietor: Manish Raj Shrestha

Address: Lalitpur-05, Jawalakhel, Nepal

Contact Number: +977-9851056230

Email: info@bredentnepal.com

CleanX Nepal Pvt. Ltd

Proprietor: Shimpy Agrawal

Address: Baluwatar, Kathmandu

Contact Number: +977-9851123215

Email: operations@cleanxnepal.com

Dental Shop Nepal Pvt. Ltd

Proprietor: Shekhar Prasad Subedi

Address: Baneshwar, Kathmandu

Contact Number: +977-9841371771, 01-5909595

Email: dentalshopnepal1@gmail.com

Dentmark Surgical Concern

Proprietor: Shekhar Prasad Subedi

Address: Baneshwar, Kathmandu

Contact Number: +977-9841371771

Email: dentmarksurgical@gmail.com

Dentmark Surgical Pvt. Ltd

Proprietor: Hiralal Koirala

Address:Kathmandu-11, Tripureshwwar

Contact Number: 9856036046

Email:hirakoirala2018@gmail.com

Dentmart International Pvt. Ltd

Proprietor: Sandeep Kumar Agrawal

Address: Dharan-01, Sunsari, Nepal

Contact Number: +977-9851723215

Email: info@dentmartinternational.com

Dentomed Solution Pvt. Ltd

Proprietor: Keshab Prasad Lamsal

Address: Gusala, Kathmandu, Nepal

Contact Number: +977-01-5919124, +977-9451120159

Email: keshab.dentoreco@gmail.com

Dentreat Supports Pvt. Ltd

Proprietor: Pratistha Raj Kharel

Address: Bharatpur-10, Chitwan, Nepal

Contact Number: +977-9801205733

Email: kasamk96@gmail.com

East West Enterprises

Proprietor: Brijesh Lacoul

Address: Kathmandu-27, Galkapatha, Nepal

Contact Number: +977-9851276301

Email: brijesh.lacoul@ewe.com.np

Garg Dental Pvt. Ltd

Proprietor: Umesh Kumar Agrawal

Address: 127-Gairidhara, Kathmandu, Nepal

Contact Number: +977-01-4536276, +977-9851033043

Email: info@gargdental.com

Garima Dental Suppliers

Proprietor: Prashant Kumar Sanghai

Address: Gairidhara, Kathmandu, Nepal

Contact Number: +977-01-4533512, +977-9801336825

Email: garimadental@gmail.com

G-dent & Surgical Suppliers

Proprietor: Hum Nath Gautam

Address: Bharatpur-04, Pulchowk, Nepal

Contact Number: +977-9845245777

Email: gdent777@gmail.com

Integrated Health Care Pvt. Ltd

Proprietor: Sunil Baraili

Address: Nayabazar, Kathmandu, Nepal

Contact Number: +977-01-4981168, +977-9851119942

Email: sunil.baraili@gmail.com

Iskcon Impex

Proprietor: Rudra Prakash Dhakal (Rajan)

Address: Biratnagar-07, Goswara Road, Nepal

Contact Number: +977-9542045798

Email: iskconimpexbrt@gmail.com

Jiam Enterprises Pvt. Ltd

Proprietor: Jimy Shahi

Address: Dakshikali Marg, Thasikhel, Nepal

Contact Number: +977-01-5913512, +977-9801833512

Email: jiam.nepal@gmail.com

Kalinchowk Traders

Proprietor: Ramesh Timalsina

Address: Pokhara, Mahendrapool, Nepal

Contact Number: +977-061-587922, +977-9856025123

Email: rtimalsina049@gmail.com

Kantipur Dental Traders

Proprietor: Rajan Giri

Address: Basundhara-03, Kathmandu, Nepal

Contact Number: +977-9514132000

Email: kdt2081@gmail.com

Khilung Kalika Suppliers & General Trading Pvt. Ltd

Proprietor: Salik Ram Aryal

Address: Tripureshwor, Kathmandu, Nepal

Contact Number: +977-9851166689

Email: khilung.kalika@gmail.com

Kosthetik Nepal Pvt. Ltd

Proprietor: Surya Rai

Address: Kathmandu-10, Jayabageshwori, Nepal

Contact Number: +977-9851182350

Email: kosthetiknepal@gmail.com

Kushwaha Surgical & Suppliers

Proprietor: Manoj Kumar Mahato

Address: Gaur Road, Rautahat, Nepal

Contact Number: +977-055596788, +977-9844219768

Email: ranejmahato9506@gmail.com

Medident Enterprises

Proprietor: Atul Shrestha

Address: Gairidhara, Kathmandu, Nepal

Contact Number: +977-9801012445

Email: medidentservice@gmail.com

Namaste Equipment & Surgical Suppliers

Proprietor: Mangal Prasad Subedi

Address: Nepalgunj, Banke, Nepal

Contact Number: +977-081-533903, +977-9858028808

Email: mangalsubedi.eqi@gmail.com

Ojash Dental Lab & Suppliers

Proprietor: Mahesh Lal Shrestha

Address: Dailu, Kathmandu-14, Nepal

Contact Number: +977-9851311731

Email: ojashdental@gmail.com

Oleg Medical Pvt. Ltd

Proprietor: Sachin Guragain

Address: Ktm-32, Kathmandu, Nepal

Contact Number: +977-9851169537

Email: olegmedicals@gmail.com

Om Satyam Dental & Surgical

Proprietor: Dinesh Khanal

Address: Narayanghat, Chitwan, Nepal

Contact Number: +977-9855046299

Email: omsatyam299@gmail.com

Omnashi Dental & Surgical Pvt. Ltd

Proprietor: Suman Adhikari

Address: Kathmandu-16, Balaju

Contact Number: 01-4982332, 9851214192

Email: omnashi.dental@gmail.com

Smart Surgident Pvt. Ltd

Proprietor: Surya Rai

Address: Kathmandu, Nepal

Contact Number: +977-9851182350

Email: info@smartsurgident.com

Oral & Surgical Traders Pvt. Ltd

Proprietor: Niranjan Khatiwada

Address: Kathmandu, Dilibazar, Nepal

Contact Number: +977-9851217030

Email: ssvink@gmail.com

P.S. Enterprises

Proprietor: Sudip Sapkota

Address: Balkot, Bhaktapur, Nepal

Contact Number: +977-9851218657

Email: sulipsapkota008@gmail.com

Prashna Traders

Proprietor: Promod Pyakurel

Address: Kathmandu, Nepal

Contact Number: +977-01-4534017, +977-9841265939

Email: prashnatradersnepal@gmail.com

Procare Nepal Pvt. Ltd

Proprietor: Sachin Guragain, Sanjeev Baral

Address: Tripureshwor-11, Kathmandu, Nepal

Contact Number: +977-9860577865

Email: procarenepal@gmail.com

Ratna International

Proprietor: Suwaa Shrestha

Address: Ktm-13, Tahachal, Nepal

Contact Number: +977-9851111850, +977-01-5303129

Email: ssinterpt@gmail.com

Royal Dental Suppliers

Proprietor: Gynandra Prasad Shah

Address: Janakpur-01, Area Mills, Nepal

Contact Number: +977-9844104060

Email: gyanendraroyaldental@gmail.com

S Remy Trading

Proprietor: Hari Regmi

Address: Butwal-7, Nepal

Contact Number: +977-9857036110, +977-071-503251

Email: harry_rocky1990@yahoo.com

Subham Suppliers

Proprietor: Hari Raj Regmi

Address: Biratnagar-07, Gagana Road, Nepal

Contact Number: +977-9852050412

Email: subhamsuppliersbrt2@gmail.com

Summit Commercial Pvt. Ltd

Proprietor: Abinash Agrawal

Address: Kathmandu, Nepal

Contact Number: +977-9851066452

Email: arshot@live.com

Sunrise Dental & Surgical Suppliers

Proprietor: Sunil Panta

Address: Kathmandu, Koreshwor, Nepal

Contact Number: +977-9851047165

Email: sunrisedentalath38@gmail.com

Sunrise Surgident Suppliers

Proprietor: Sanjeeb Baral

Address: Ktm-11, Tripureshwor, Nepal

Contact Number: +977-9851001797, +977-9841489580

Email: sunrisesurgident@gmail.com

Sunshine Surjedent Supplies

Proprietor: Rajkumar Timalsina

Address: Lalitpur, Nepal

Contact Number: +977-9849530338

Email: timalsnaraj288@gmail.com

Ultra Care Pvt. Ltd

Proprietor: Purna Prasad Subedi

Address: Chhetrapati, Kathmandu, Nepal

Contact Number: +977-01-5345078, +977-9851037945

Email: ultracure1@gmail.com

Universal Dental & Surgical Traders

Proprietor: Sushil Baral

Address: Ktm-11, Tripureshwor, Nepal

Contact Number: +977-9851029838

Email: udstraders@gmail.com