Journal Issue: Volume, 21, No. 1 & 2 (1999)
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Volume
Number
Issue Date
1999
Journal Title
Journal ISSN
ISSN (Print) : 1993-2979 | ISSN (Online) : 1993-2987
Journal Volume
Articles
Recording vital signs in the emergency room: Con we improve? Alistair Appleby
(Institute of Medicine, 1999) Appleby, Alistair
Abstract
Audit is the process of measurement of care, intervention designed to improve, and remeasurement. This paper describes the development of an audit in the Emergency department of a large urban hospital in Nepal using blood pressure and pulse recording
rates as measures of care. Two periods, a year apart, were compared. We investigated the impact of several interventions including the institution of a systematic training programme for resident doctors and the appointment of a registrar in Emergency
Medicine. The paper also examines whether more sensitive measures of care can be developed.
The study found an improvement in both parameters over the year studied but this did not reach statistical significance. We describe briefly how our audit could be refined and the potential for, and benefits of, audit in Nepal.
Keywords: Audit, emergency care, blood pressure, pulse
Prospective study of tubal defect in subfertile women of Nepal
(Institute of Medicine, 1999) Shrivastava, Veena; Bajaj, Satish
Abstract
This prospective study has been done to assess the prevalence of tubal defect in subfertile women. Thirty-three women who came for consultation in Sidhartha Apollo Hospital, Kathmandu from March 1997 to October 1998, for sub-fertility were included in the study. Their age, type of infertility, previous obstetrical, medical and surgical history were reviewed. Hysterosalpingogram (HSG) was done to assess their tubal status. The results of 33 cases of HSG were analysed. Incidence of tubal patency were noted. If the tubes were blocked, the site and side and associated uterine abnormalities were also noted. Co-relation of tubal block with previous history was
tried to be established. In this study the incidence of primary and secondary sub-fertility was found to be the same. Out of 33 cases, 10 were found to have tubal defect. In both the sub-fertility group, prevalence of tubal defect was the same (5 in each group). History of surgery and uterine manipulation was found in 80% of cases (8 out of 10). Normal labour and caesarean section were not found to be associated with tubal defect.
Keywords: Hysterosalpingogram (HSG), Sexually Transmitted Disease (STD), Laparoscopy
Seroprevalence of antibodies to HIV among injecting drug users in Kathmandu and HIV subtyping
(Institute of Medicine, 1999) Shrestha, Iswar Lal
Abstract
Blood samples from two hundred and twenty injecting drug users were collected for antibodies to HIV between July 1997 to June 1998.
ELISA tests were performed in duplicate on all the serum samples. One hundred and five samples 105/220 (47.7%) were tested positive for antibodies to HIV. ELISA positive samples were rechecked by western blot and confirmed to have HIV-1. Bands of gp160, gp120, gp40, p24, p31, p55 of HIV-1 were present in positive samples.Results of HIV subtyping showed subtype C, similar to the one prevalent in the Indian subcontinent.
Among one hundred and five positive cases, ninety-nine were male and six were female, M:F ratio 16.5:1. The youngest age of HIV positive case was 13 years old and the oldest was 45 years of age. The majority (70) was between the age of 20-29 years of age. The most common drug used was "Tidigesic" (bupronorphine) (90/105), followed by brown sugar (10/105), nitrazepam (4/105), and "Fortwin" (1/105). Ninety-four HIV positive persons gave the history of sharing needles among more than two persons. Frequency of drugs used varied from two times a day to maximum six. HIV positive cases were detected from 18 districts of Nepal. The majority (38/105) of the HIV positive cases were residents of Kathmandu.
Keywords: Antibodies to HIV, injecting drug users, HIV subtype, Western blot test
Medicine as a career choice: motivating factors in Nepalese medical students
(Institute of Medicine, 1999) Thakur, Amarnath; Ashokraj, Gita; Koirala, Shekhar
Abstract
This study was done to investigate the reasons which motivated Nepalese students to choose medicine. The majority of students chose medicine because of their interest in medicine and dedication for service to sick people. A desire for monetary gain and family pressure motivated a few students to choose the medical course. Other motivating factors included social prestige and better employment prospectus.
Keywords: Career choice, education, medical, undergraduate, attitude
Prevalence and recognition of depressive disorder at a primary health care centre in Pakistan
(Institute of Medicine, 1999) Koirala, NR; MH; Minhas, FA; Mirza, ZI
Abstract
The aim of the study was to determine the prevalence and recognition of depressive disorder at a primary health care centre in Pakistan. A purposive sample of four hundred consecutive adult primary health care attenders was screened using GHQ-12. In the second-stage a total of 271 subjects (256 High scorers and 15 Low scorers on GHQ-12) were assessed using ICD-10, DCR as a diagnostic instrument. The prevalence rate of depression using ICD-10 DCR was 22.25%. The corresponding rate for the Primary Health Care Physician was 11.43%, suggesting that Primary Care Physicians recognised depression in almost 58.49% of the patients who fulfill the ICD-10nDCR for depressive disorder. In primary care, depression constitutes major health problem. Despite this fact, Primary Health Care Physicians do not recognise a substantial proportion of this disorder.
Keywords: International Classification of Diseases-10th Version (ICD-10), ; Diagnostic Criteria for Research (DCR), General Health Questionnaire (GHQ-12), Primary Care Physician (PHCP); Depressive disorder.