Journal Issue: Volume: 35, No. 1 (2013) April
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Volume
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Issue Date
2013
Journal Title
Journal ISSN
ISSN (Print) : 1993-2979 | ISSN (Online) : 1993-2987
Journal Volume
Articles
Policy Making Challenges on Dual Burden of Environment Related Diseases
(Institute of Medicine, 2014) Sherchand, Jeevan B
NA.
Availability and Use of Oxytocin in Health Facilities in Nepal
(Institute of Medicine, 2014) Poudyal, AK; Shrestha, B; Onta, SR
Abstract
Introduction: Although maternal mortality is declining over the past 15 years, it is still high in Nepal. Postpartum haemorrhage is the leading cause of maternal deaths in Nepal. Oxytocin is one of the emergency drugs, which prevent and manage postpartum haemeorrhage, listed in essential drug list, and supplied to hospitals and Primary Health Care centers in Nepal. The study aimed to assess availability, storage condition, prescriber’s knowledge and practice of Oxytocin in Nepal.
Methods: A descriptive cross-sectional explorative study was conducted in 40 health facilities of 10districts. Multiple methods–observation, interviews, store records and delivery charts analysis-were used to collect data. The respondents of the study (health facility in-charges, service providers and storekeepers) were interviewed with semi-structured questionnaire. The collected data was entered into MS-Excel and analyzed using SPSS version 17.
Results: Oxytocin was available throughout the year in 35.5% of health facilities among them only 8.3% of health facilities stored Oxytocin in refrigerator. In-charges, service providers, were not aware of recommended temperature for Oxytocin storage. Similarly, 40.7% of the service providers used Oxytocin for prevention and management of postpartum haemorrhage, 31.9% and 27.4% of service providers used Oxytocin for augmentation and induction respectively.
Conclusion: In some districts, the medicine was not available throughout the year. Majority of service providers were not aware of recommended indications to induction and augmentation. There should be a serious effort to orient the service providers about rational use of Oxytocin and store to maintain the efficacy of the drug.
Keywords: Oxytocin, post-partum hemorrhage
Human Resources for Health (HRH) and challenges in Nepal
(Institute of Medicine, 2013) Sherchand, JB
NA.
Microalbuminuria as a Marker of Preclinical Diastolic Dysfunction in Newly Diagnosed and Never-Treated Essential Hypertension
(Institute of Medicine, 2013) Gajurel, R M; Sayami, A
Abstract
Introduction: Hypertension (HTN) is a global public health problem with one fourth adults worldwide estimated to have high blood pressure (BP)1 The incidence of hypertension continues to increase in all developed and developing societies as the population grows older and more obese.2 The Framingham Study and other epidemiological surveys have clearly defined HTN as an important cause of morbidity and mortality.2-4 The aim of this study was to determine the spot urine Microalbuminuria as a marker of preclinical cardiac structural and functional changes in the form of left ventricular diastolic dysfunction in newly diagnosed and never treated essential hypertensive subjects.
Methods: A cross sectional study was used for those patients who were attended outpatient clinic of MCVTC with diagnosis of newly diagnosed and never treated hypertension over a period of October 2011 to November 2012.
Results: A total of 130 essential hypertensive patients underwent for spot urine for microalbuminuria estimation and Echocardiography for evaluation of left ventricular diastolic function. Among 56 (43.1%) urine samples showed negative test [(Microalbuminuria -); ( UACR 30 mg/Gm)] and those 74 (56.9%) samples revealed positive test [(Microalbuminuria+); (UACR 30 to 300 mg/Gm)]. Patients with microalbuminuria positive was found to have more left ventricular diastolic dysfunction than those who were negative for Microalbuminuria.
Conclusion: Microalbuminuria was found to have early preclinical marker of myocardial dysfunction in the form of left ventricular diastolic dysfunction in new and never treated essential hypertension.
Keywords: Hypertensio, Microalbuminuria, Left Ventricular diastolic dysfunction
Prognostic factors in endometrial cancer
(Institute of Medicine, 2013) Bajracharya, S R; Juan, F Y
Abstract
Introduction: Endometrial cancer (EC) is the most common malignancy of the female genital tract. It is now the fourth most common gynecological cancer among women and the sixth worldwide cancer in Western countries. It is the most curable of the 10 most common cancers in women and the most frequent and curable of the gynecologic cancers. The incidence is increasing when life expectancy rise. This study was carried out to evaluate the prognostic factors of Endometrial Cancer.
Methods: Clinico-pathological characteristics and follow-up cases of endometrial cancer were analysed retrospectively between January 2000 to December 2007 with its prognostic factors influence were statistically analysed.
Results: During the study period total 180 patients were taken. Univariate model revealed that the menopausal status, the FIGO stage, grade, histological type, myometrial invasion, ER, PR, peritoneal cytology, lymph node metastases, adjuvant therapy, and the method of operation were related with the prognosis significantly. The multivariate analysis Cox proportion hazards regression model showed that the ER (P=0.004), PR (P=0.000), myometrial invasion (P=0.006) and lymph node metastases (P=0.049) were related with the prognosis significantly.
Conclusion: The clinico- pathological character of endometrial cancer is responsible for patient’s better survival. If the patients had early detection and treated in proper modalities, this might improve the good prognosis.
Keywords: endometrial cancer, prognosis, prognostic factors