NepMed is a Nepal MEDLINE(Medical Literature Analysis and Retrieval System Online) by Nepal Health Research Council(NHRC). It includes bibliographic information for articles from academic biomedical journals covering medicine, dentistry, nursing, pharmacy, dentistry veterinary medicine, and allied health sciences.
Recent Publications
Comprehensive diabetes and non-communicable disease educator in the low-resource settings
(Nepal Medical Association, 2016) Bhattarai, Madhur Dev
Abstract
The role of self-management education in diabetes and other major non-communicable diseases is clearly evident. To take care of and educate people with diabetes and other major NCD under the supervision of medical professionals and for education of other health care professionals, Comprehensive Diabetes and NCD Educators are needed in the routine service in peripheral health clinics and hospitals. The areas of training of CDNCD educator should match with the cost-effective interventions for diabetes and other major NCD that are feasible and planned for implementation in primary care in the low resource settings. Most of such interventions are part of diabetes education as required for Diabetes Self-Management Education programmes and traditional Diabetes Educator. The addition of use of inhaled steroids and bronchodilator in chronic respiratory disease and identification of presenting features of cancer, also required for many people with diabetes with various such common co-morbidities, will complete the areas of training of traditional Diabetes Educator as that of CDNCD Educator. Staff nurse and health assistants, who are as such already providing routine clinical service to all patients including with diabetes and major NCD in peripheral health clinics and hospitals, are most appropriate for CDNCD Educator training. The training of CDNCD Educator, like that of traditional Diabetes Educator, requires fulfillment of sufficient hours of practical work experience under supervision and achievement of the essential competencies entailing at least 6 month or more of intensive training schedules to be eligible to appear in its final certifying examination.
Keywords: CDNCD Educator; Diabetes; Diabetes educator; DSME; Global NCD alliance; NCD; Non-Communicable diseases; WHO PEN.
Early recognition of fibrodysplasia ossificans progressiva-Important for the clinician
(Nepal Medical Association, 2016) Singh, Ankur; Pradhan, Gaurav; Chandravati Kumari; Kapoor, Seema
Abstract
Fibrodysplasia ossificans progressiva is a rare disorder of heterotopic ossification. Procedures like biopsy and surgery are known to be aggravating factors in promoting heterotopic ossification Clues to clinical diagnosis may therefore be a great advantage to treating orthopedician. Valgus deformity of great toe is an important diagnostic clue for treating physicians and thus aids in preventing the clinicians from subjecting the patients to unnecessary invasive and traumatic procedures. Hence clinical clues to early diagnosis are important in establishing the correct diagnosis and directing future management.
Keywords: Fibrodysplasia ossificans progressiva; Valgus deformity of greater toe.
Caesarian scar pregnancy - a diagnostic dilemma
(Nepal Medical Association, 2016) Gupta, Pratiksha; Huria, Anju; Kaur, Dilpreet; Mehra, Reeti
Abstract
Caesarean scar pregnancy is one of the rarest forms of ectopic pregnancy. Transvaginal ultrasound and color flow Doppler provides a high diagnostic accuracy. A delay in diagnosis and treatment can lead to uterine rupture, major hemorrhage, hysterectomy and serious maternal morbidity and mortality. Early diagnosis can offer treatment options of avoiding uterine rupture and hemorrhage, thus preserving the uterus and future fertility. Primary health care provider should know about this rare entity, because if diagnosed timely, and referral to specialized centre is done without delay will definitely save maternal morbidity and mortality. Management plan should be individualized. Termination of pregnancy is the treatment of choice in the first trimester. Expectant treatment has a poor prognosis because of risk of rupture. In this case report we aim to discuss the associated diagnostic dilemma, most appropriate methods of diagnosis and management, with their implications in clinical practice.
Keywords: Scar pregnancy; Caesarian section; Methotrexate.
Acute ischemic stroke and acute on chronic kidney disease
(Nepal Medical Association, 2016) Raja Ahsan Aftab; Amer Hayat Khan; Hadeer Akram AbdulRazzaq; Azreen Syazril Adnan
Abstract
Ischemic stroke is due to either local thrombus formation or emboli that occlude a cerebral artery, together with chronic kidney disease represent major mortality and morbidity. Here wer present a case of 53 years old Malay man, admitted to a hospital in Malaysia complaining of sudden onset of weakness on right sided upper and lower limb associated with slurred speech. Patient was also suffering from uncontrolled hypertension, hyperlipidemia, chronic kidney disease stage 4, and diabetes mellitus(un controlled). He was diagnosed with acute ischemic stroke with cranial nerve 7 palsy (with right hemiparesis), acute on chronic kidney disease precipitated by dehydration and ACE inhibitor, and hyperkalemia. Patients with ischemic disease and chronic kidney disaese require constant monitering and carefull selected pharmacotherapy. Patient was placed under observation and was prescribed multiple pharamacotherpay to stabalise detoriating condition.
Keywords: Ischemic disease; Chronic kidney disease; Uncontrolled hypertension.
Muscular hamartoma of intestine causing intestinal obstruction
(Nepal Medical Association, 2016) Upadhyaya, Paricha; Shrestha, Girishma; Karki, Smriti; Agarwal, Meenu
Abstract
Hamartomatous causes of small bowel obstructionare uncommon and of them, most are attributed to inflammatory bowel diseases and also certain medications such as NSAIDs. We describe a case of muscular hamartoma in a patient without prior chronic medical condition with brief review of literature.
Keywords: Bowel; Hamartoma; Muscle; Obstruction.