STUDY DESIGN: 50 patients aged 2-18 years who perform CIC were included in this cohort study. Patient compliance with CIC was evaluated using the validated Intermittent Catheterization Adherence Scale (ICAS). CIC difficulties were assessed using the validated Intermittent Catheterization Difficulty Questionnaire (ICDQ). Data was obtained on patients' co-morbidity, caregiver factors, socio-economic factors, CIC technique, access to catheters and facilities, urinary tract infections, incontinence, urology tests and treatment. Statistical analysis was performed.

RESULTS: Mean age was 6.68 ± 4.34 years. 32 (64%) patients commenced CIC within the first month of life. Mean daily CIC frequency was 4.70 ± 1.33.30 (60%) participants showed strong adherence to CIC. 39 (78%) participants were able to catheterize with no or minor difficulties. Pain (6, 12%), transient blocking sensation (6.12%), and urinary incontinence (3, 6%) were the predominant difficulties encountered. CIC performed by caregiver was associated with improved adherence compared to patient self-catheterization (p = 0.039). The mean age of participants who self-catheterized was 10.7 ± 3.7 years. Strong adherence was also observed among patients who purchased their own CIC catheters (p = 0.007). Participants with lower ICDQ score were more likely to be compliant with CIC (p = 0.007). CIC adherence was not affected by patient's age, gender, co-morbidity, mobility, caregiver factors, socio-economic factors, and age at initiation of CIC. There was no significant association between CIC adherence and febrile urinary tract infections, upper tract deterioration, and bladder stones at 6 months follow-up.

DISCUSSION: There is lower CIC adherence when a child begins to self-catheterize and healthcare providers should be alert during this period of transition. Though most patients with spina bifida have decreased urethral sensation, some patients do experience significant pain during CIC which may impact their compliance. These patients would need a review of their catheterization techniques to improve adherence. The limitations of our study are its modest sample size from a single center and short study period. Our study provides insights into the feasibility of instituting CIC in developing countries.

Materials and Methods: This questionnaire study was conducted among 460 dental professionals of different age groups. Parameters such as posture of dentists, working alone or with an assistant, and number of breaks were recorded. Type of MSDs and the type and effectiveness were recorded.

Results: BDS students were seventy, interns were 112, general dentists were 186, and specialists were 92. Year of practice was <5 years in 215, 5-10 years in 70, 10-20 years in 35, and >20 years in 140 students. Fourteen percent of students, 18% interns, 45% general practitioners, and 32% of specialists had a prevalence of MSD. Most common MSDs in students were upper back pain seen in 6%, in interns were upper back pain seen in 8%, in general practitioners were shoulder pain seen in 21%, and in specialists were hand/wrist pain seen in 10%. Forty-five percent of students, 67% interns, 72% general dentists, and 80% of specialists had idea about ergonomics. Seventy-four percent of students, 80% of interns, 83% of general dentists, and 87% of specialists think that ergonomics may improve performance. Sitting position was preferred seen in 53% of students, 58% of interns, 65% general dentists, and 60% of specialists. Forty-five percent of students, 47% of interns, 56% of general dentists, and 52% of specialists perform physical activity during work. The difference was found to be statistically significant (P < 0.05). Seventy-nine percent of students, 83% of interns, 86% of general dentists, and 88% of specialists show prolong sitting or standing.