Journal Issue: Volume: 20, No. 3 & 4 (1998)
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Volume
Number
Issue Date
1998
Journal Title
Journal ISSN
ISSN (Print) : 1993-2979 | ISSN (Online) : 1993-2987
Journal Volume
Articles
Suicide in Kaski District
(Institute of Medicine, 1998) Upadhyaya, Kapil Dev; Pol, Klaasjan
Abstract
The Western Region Community Mental Health Programme conducted a study about suicide in two phases. In phase I, 287 cases brought to the Western Region Hospital for post mortem were analyzed to discover the causes of death. The 49 cases of hanging and the 20 cases of poisoning were taken as suicide cases. A suicide rate ratio of 12.4 was found. In phase II, interviews were done with relatives of complete suicide cases when the dead body was brought to hospital for post mortem, and with the relatives of attempted suicide cases when they were in the hospital for treatment. In cases of suicide, hanging was found as the most common means, followed by poisoning. Use of poison was the main method of attempted suicide. Mental illness, particularly depression and psychosis, alcoholism and clear psychosocial stress were important causes of suicide in this study. Some of the relatives of the deceased responded as if everything was normal before committing suicide.
Keywords: Suicide, hanging, poisoning
Evaluation of suicidal symptoms in adult depressive in-patients at Tribhuvan University Teaching Hospital
(Institute of Medicine, 1998) Koirala, NR; Nepal, MK; Sharma, VD
Abstract
The data on the frequency of the suicidal symptoms in depressed patients varies widely. The reported rates generally show that about 40% - 70% of patients with affective disorders show suicidal symptoms, about 15% of depressed patients end up their lives by suicide and more than 50% of patients who attempt suicide are also more likely to have a severe and major type of depression. The information was collected about the severity of depressive illness and the reporting of suicidal symptoms in the 80 ICD-10 diagnosed depressive in-patients. Rating was done as per Hamilton Rating Scale for Depression and details of suicidal symptoms were collected for suicidal wishes, ideation, gesture and attempts. Correlation of suicidal symptoms with other variable was calculated with Spearman correlation coefficient. Thirty-two point five percent of the male patients and 67.5% of the female patients reported suicidal symptoms. Female patients showed more suicidal ideation, wishes and attempts as compared to the male group. Positive and significant correlation was observed between suicidal symptoms, total HDRS Score and duration of the illness. Age showed negative correlation with suicidal symptoms.
Keywords: Suicide, Hamilton Depression Rating Scale, TUTH
User fees and the cost of irrational prescribing
(Institute of Medicine, 1998) Holloway, KA; Gautam, BR
Abstract
Lack of funds, insufficient drug availability and irrational prescribing undermine primary health care in Nepal. This study measured the cost of irrational prescribing and the impact of different kinds of user fee on the cost of irrational prescribing. The study took place within cost-sharing drug re-supply schemes (CSDS) in rural hilly E. Nepal, where the drug supply is supplemented and a nominal user fee charged. A before-after non-randomized controlled trial was conducted. The cost per prescription, the cost of irrational prescribing (wastage) per prescription and % drug cost recovery were measured. It was found that more than one-third the value of all drugs dispensed to patients had been irrationally prescribed and that item fees were associated with 20% financial savings due to reduced irrational prescribing as compared to flat fees. If all irrational prescribing were eliminated it maybe that an amount of drugs equivalent to value of the annual HMG drug indent would last the year round in many health facilities.
Identification of malaria endemicity in rural areas of Nepal: A malariometric and seroepidemiological study in children
(Institute of Medicine, 1998) Sherchand, Jeevan B; Shrestha, Mathura P; Ohara, Hiroshi
Abstract
A cross-sectional study was performed to determine malaria morbidity and malaria endemicity in children between 2-9 years of age in three villages of Southern Nepal. Malariometric survey and seroepidemiology were compared. A total of 604 children from the three villages were tested. Tulashi and Chisapani villages were found to have equal endemicity with high parasitaemia (>12%), high level of malaria antibody (>40%) and high rate of spleen (>60%) indicating a hyperendemic area. In comparison Lumbini village had low parasitaemia (<5%), low antibody level (<25%) and low spleen rate (<25%) indicating a mesoendemic area. This study would be useful for the surveillance system in identifying endemicity and effective planning of malaria control programme in these areas. The variation in endemicity for these villages are multifactorial such as human behaviour in relation to vector behaviour and gradual deterioration of health care system for malaria, which has been discussed in this study.
Keywords: Malariometric survey, Sero-epidemiology, Children, Nepal
Cataract surgery in Mechi Eye Care Centre, Nepal
(Institute of Medicine, 1998) Singh, Sanjay Kumar; Dahal, Tulasi; Sharma, Divya
Abstract
Since the establishment of Mechi Eye Care Centre, 783 patients have had cataract surgeries with the implantation of intraocular lens in their eyes in the period between 1 December 1996 and 15 May 1998. Ninety-one percent of the patients regained vision better than 6/18 with minor refractive correction. There was no sight threatening and eye threatening complications noted in the intraoperative and postoperative period.