Journal Issue: Volume: 39, No. 2 (2017) August
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2017
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ISSN (Print) : 1993-2979 | ISSN (Online) : 1993-2987
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Articles
Nobel discoveries from isolates of multidrug resistant Acinobacter baumannii and multidrug resistant Escherichia coli in Nepal
(Institute of Medicine, 2017) Sherchand, JB
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Mobile teledermatology for Dermatological Care in Rural Nepal: Dermatology training of medical officers at primary health care centers
(Institute of Medicine, 2017) Shrestha, DP; Baral, S; Shahi, PV; Rosdahl, L
Abstract
Introduction: Skin diseases are common in Nepal but dermatologists are very few, and there is no adequate training for Medical officers to diagnose and treat common skin diseases. We developed a training program based on Mobile teledermatology and evaluated its effectiveness.
Methods: Five medical officers from 3 primary health care centers of Kavre District were trained in their respective working centers. They did 12 days of mobile teledermatology sessions in which they saw minimum of 60 common skin diseases in direct supervision of a dermatologist. Medical officers were involved in all aspect of patient care from history taking, examination of skin lesions, writing down the prescription to counseling and follow up. The effectiveness of training was evaluated by, difference in skin disease knowledge before and after the training, ability to diagnose and treat common skin diseases independently at the end of the training and feedback from the trainees.
Results: Altogether 337 skin diseases were seen by 5 medical officers. There was significant difference between the skin disease knowledge before and after the training (p-value 0.009). At the end of the session they were able to diagnose independently 87% (80%-95%) of common skin diseases. All of them strongly agreed that this is the effective way of training
Conclusions: Mobile teledermatology is the feasible and effective method of dermatology training to the medical officers at primary health care centres in remote areas, while providing skin care to the villagers at the same time.
Keywords: Mobile teledermatology, dermatology training, medical officers, rural Nepal
Evaluation of image quality of pelvis antero-posterior view radiographs
(Institute of Medicine, 2017) Joshi, BR; Bhusal, D
Abstract
Introduction: Pelvic radiography is a common radiographic examination. Thus it is important to depict entire anatomical structure with an acceptable image quality. This study was done for quantitative evaluation of pelvis radiographs by depiction of the anatomical and physical details.
Methods: In this cross-sectional study, about 11.5 pelvis radiographs were selected over two months period. Eight image quality criteria i.e. anatomical coverage, sharp bony detail, rotation, collimation, artifact, beam centering, SI joint visibility and gonad protection were included.
Results: Out of the 115 radiographs, only about 13 fulfilled all the image quality criteria, the rest 87 lacked either one or more of the criteria.
Conclusions: To a great extent the quality of the pelvic radiographs depends on the skill of radiographer, equipment condition Ex-ray machine CR reader) and also co-operation of patients.
Keywords: Conventional radiography, image quality, pelvic radiographs
Restriction Fragment Length Polymorphism (RFLP) typing of Mycobacterium tuberculosis isolates from Nepal
(Institute of Medicine, 2017) Rijal, B; Ghimire, P
Abstract
Introduction: Many studies to characterize Mycobacterium tuberculosis by RFLP have shown that predominance of Beijing genotype in China and many neighboring countries. Nepal is just bordering in southern part of China. We have tried to differentiate Mycobacterium tuberculosis isolates of Nepal by RFLP in first time in Nepal.
Methods: A standard protocol was followed for isolation, Identification and RFLP typing of 60 strains of Mycobacterium tuberculosis of Nepal.
Results: Of the 60 isolates interpretable result was found in 31 isolates. The study detected that the Beijing family 12 (38.7%), was predominant type followed by single band 12 (25.5%). Indigenous type, not reported from other part of the world was also detected in 7 strains (22.6%).
Conclusion: Beijing type is the predominant RFLP type of Mycobacterium tuberculosis in Nepal and some other endogenous type also prevails which needs further study.
Keywords: Mycobacterium tuberculosis, RFLP, Nepal
Psychiatric morbidity pattern in patient after earthquake at Tribhuvan University Teaching Hospital Nepal
(Institute of Medicine, 2017) Chapagai, M; Tulachan, P; Shakya, S; Dhungana, S; Pant, SB
Abstract
Introduction: A trauma is an event that is not within the normal range of the common experience. It is perceived as overwhelming physically and/or emotionally and may involve a perceived threat to the individual or a loved one. The basic aim of this study is to evaluate sociodemographic characteristic and pattern of psychiatric morbidity in patient attending at Tribhuvan University Teaching Hospital after earthquake.
Methods: A cross sectional study was carried out on patients attending psychiatric OPD services of Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, a tertiary care hospital, from April 2015 to mid Sep. 2015.
Results: Among 1057 cases who visited the outpatient services at Department of Psychiatry during first four and half months after major earthquake on 25 April 2015, 108 were directly related to earthquake The most commonly diagnosed conditions were F 41.9 Anxiety Disorder Unspecified (15.7%), F43.2 Adjustment disorder (13.9%). F 43.1 Post-traumatic stress disorder (8.3%) and Moderate depressive episode (7.4%). Two cases were referred with incidence of deliberate self harm.
Conclusion: This study has contributed in new knowledge regarding the psychological conditions aftermath of natural disasters in Nepal and also the need of research to determine the prevalence of post-disaster mental health conditions tike posttraumatic stress disorder (PTSD), anxiety and depressive disorders, resilience and factors associated with the impact of event among the survivors
Keyword: Earthquake. PTSD, Psychiatric morbidity.