scholarly journals Necessity of strengthening neurology services in Nepal

2015 ◽  
Vol 5 (2) ◽  
pp. 50
Author(s):  
R M Piryani ◽  
R S Poudel
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Head Injuries ◽  
College Teaching ◽  
Limiting Factor ◽  
Infrastructure Development ◽  
Traffic Pattern ◽  
Medical College ◽  
Age Related ◽  
Number Of Patients

Dear Editor,Stroke, head injuries and epilepsy are common neurological problems reported worldwide including Nepal. Nepal also bears the burden of nervous system infection such as meningitis, cerebral malaria, Japanese B encephalitis. The average life expectancy of Nepalese population has increased noticeably in the last twelve years; hence it may lead to increase in age related neurological conditions such as dementia, Parkinson disease. Because of poor road condition, rapidly increasing number of two- wheelers, disorganized traffic pattern, and lack of driving discipline in Nepal, motor vehicles accidents are on rise, so the head injuries too. The accompanied person along for the ride on two- wheel vehicles are not required to wear helmet and passengers in four wheelers avoid using safety belts are at risk. Moreover, the implementation of legislation to prevent driving in drunken state is limited.Presently some of the government hospitals, private medical college teaching hospitals and corporate sector hospitals located in urban areas provide neurological services. However, a large number of patients of sub-urban and rural areas having common neurological aliments have limited access. Ignorance, illiteracy, limited resources, negative attitude, discrimination, faith on traditional healers and weak economical status may be the limiting factor to access. Establishing neurological services network with public private partnership and use of latest technology may improve care and delivery of neurological services in country. At the same time government need to 1) motivate, encourage and facilitate young doctors to get training in neurosurgery and neuromedicine, 2) invest in infrastructure development, 3) create awareness among public especially of suburban and rural areas and 4) promote research.These approaches may improve quality of care and service delivery.SincerelyDr. Rano Mal Piryani- Prof of Medicine and Medical Education, Chitwan Medical CollegeMr. Ramesh Sharma Poudel- Pharmacist, Pharmacy, Chitwan Medical College Teaching Hospital

scholarly journals Regional differences in reasons for consultation and general practitioners’ spectrum of services in Northern Germany – Results of a cross-sectional observational study

2019 ◽  
Author(s):  
Ingmar Schäfer ◽  
Heike Hansen ◽  
Thomas Ruppel ◽  
Dagmar Lühmann ◽  
Hans-Otto Wagner ◽  
...  
Keyword(s):  
Observational Study ◽  
Rural Areas ◽  
Urban Areas ◽  
Medical Training ◽  
Practice Trial ◽  
Cross Sectional ◽  
Federal States ◽  
German Federal States ◽  
Number Of Patients ◽  
Individual Consultation

Abstract Background Among other factors, the patients’ consultation reasons and GPs’ spectrum of services determine the process and outcome of the medical treatment. So far, however, there has been little information on differences in reasons for consultation and GPs’ services between urban and rural areas. Our study’s goal was thus to investigate these factors in relation to the regional location of GPs’ practices. Methods We conducted a cross-sectional observational study based on standardised GP interviews in a quota sampling design. All counties and independent cities within a radius of 120 km around Hamburg were divided into three regional categories (urban area, environs, rural area) and stratified proportionally to the population size. Differences in the number of reasons for consultation and services were analysed by multivariate linear regressions in mixed models adjusted for random effects on the levels of the German federal states and administrative districts. Differences in individual consultation reasons and services were identified by logistic regression via stepwise forward and backward selection. Results Primary care practices in 34 of the 37 selected administrative districts (91.9%) were represented in the dataset. In total, 211 GPs were personally interviewed. On average, GPs saw 344 patients per month with a slightly higher number of patients in rural areas. They reported 59.1 ± 15.4 different reasons for consultation and 30.3 + 3.9 different services. There was no statistically significant regional variation in the number of different consultation reasons, but there was a broader service spectrum by rural GPs (ß=-1.42; 95% confidence interval -2.75/-0.08; p=0.038) which was statistically explained by a higher level of medical training. Additionally, there were differences in the frequency of individual consultation reasons and services between rural and urban areas. Conclusion GPs in rural areas performed more frequently services usually provided by medical specialists in urban areas. This might be caused by a low availability of specialists in rural areas. The association between medical training and service spectrum might imply that GPs compensate the specific needs of their patients by completing advanced medical training before or after setting up a medical practice. Trial registration The study was registered in ClinicalTrials.gov (NCT02558322).

scholarly journals Risk factor assessment and screening for diabetes in field practice area of a private medical college in Thiruvallur district of Tamil Nadu

2017 ◽  
Vol 4 (8) ◽  
pp. 2670 ◽  
Author(s):  
Sathish Dev ◽  
Timsi Jain ◽  
Sivaprakasam P. ◽  
Dinesh Raja
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Tamil Nadu ◽  
Univariate Analysis ◽  
The Elderly ◽  
World Health ◽  
Chi Square ◽  
Medical College ◽  
Diabetes Status ◽  
Field Practice

Background: Diabetes, which was known to be an epidemic in the urban areas, has been found to be increasing rapidly in the rural areas too as a result of the socioeconomic transitions. Diabetes is no longer only a disease of the elderly but is one of the major causes of morbidity and mortality affecting youth and middle aged people.Methods: Screening camp for diabetes was conducted by the Department of Community Medicine in three different areas in the field practice area of Saveetha Medical College and Hospital viz. Thirumazhisai, Kuthambakkam and Velavedu in Thiruvallur district of Tamil Nadu on 7th April 2016 as a part of World Health Day 2016 celebration. Data was collected using a predesigned interview schedule. Descriptive statistics was calculated using rates, ratios & proportions. Univariate analysis was done using Chi square test to find the association between various factors and diabetes status. A parsimonious regression model was developed to find the predictor variables for diabetes.Results: A total of 188 people aged above 18 years attended the screening camps. Majority of the camp attendees were females (62.2%). Proportion of people having diabetes (already diagnosed plus newly screened) was found to be 18.1% out of which 3.2% were screened positive for diabetes. On regression analysis, Intake of alcohol and perceived stress were found to be significantly associated with diabetes (p<0.05).Conclusions: This study highlights a significant burden of undiagnosed cases of diabetes in the community. This indicates the need for systematic screening and awareness programs to identify the undiagnosed cases in the community and offer early life style modifications, treatment and regular follow up to such individuals.

scholarly journals A Pattern of Age-related Macular Degeneration

2009 ◽  
Vol 48 (175) ◽  
Author(s):  
Suprada Pokhrel ◽  
O K Malla ◽  
C L Pradhananga ◽  
S N Joshi
Keyword(s):  
Macular Degeneration ◽  
College Teaching ◽  
Female Gender ◽  
Cross Sectional Study ◽  
Age Related Macular Degeneration ◽  
Cross Sectional ◽  
Medical College ◽  
Age Related ◽  
Increased Risk ◽  
Number Of Individuals

Introduction: Age related macular degeneration is a disorder of the macula most often clinicallyapparent affecting central vision and is one of the leading causes of blindness in the populationabove 50 years. The aim of this study is to determine clinical profi le of AMD in Nepalese presentingto a Teaching Hospital in Kathmandu.Methods: It was a hospital-based cross-sectional study. The subjects included in the study were thosepresenting to the Ophthalmology department of Kathmandu Medical College Teaching Hospitalfrom July 2007- Dec 2007.The total number of individuals included in the study were 402 and totalnumber of eyes were 804.Results: AMD was observed in 5.2% out of 402 subjects of 40 years and above age group withprevalence increasing with age. The prevalence of AMD was 0.7% within 40-50 years of age-groupindividuals increasing to 2.6% in 51-60 years, 6.5% in 61-70 years and to 19.3% among subjectsabove 71 years. This study revealed that the prevalence of AMD in females was higher with femalepreponderance in ratio of 2.5:1. 52.5 % AMD subjects in our study had visual impairment with 6/24-6/60 vision and 15% had vision <3/60-PL. Our study revealed statistically signifi cant increased riskfor AMD with aging (p=0.00). Increased risk was observed in female gender and diabetics though theOdds ratio (OR) was statistically insignifi cant (p=>0.01).Conclusions: Prevalence of AMD in Nepalese presenting to Kathmandu Medical College TeachingHospital was 5% with female preponderance in ratio of 2.5:1. Aging showed statistically signifi cantincreased risk for AMD development in this study.Key Words: Age-related macular degeneration, blindness, Nepalese, prevalence

scholarly journals OBSTRUCTIVE SLEEP APNEEA (OSA) AND RISK FACTORS

2016 ◽  
Vol 15 (4) ◽  
pp. 155-159
Author(s):  
E.C. Jeler ◽  
◽  
F.D. Mihaltan ◽  
Keyword(s):  
Risk Factors ◽  
Rural Areas ◽  
Urban Areas ◽  
Upper Airway ◽  
Test Group ◽  
Severe Form ◽  
Western Society ◽  
Obstructive Sleep ◽  
Number Of Patients ◽  
Comparative Results

Introduction. Obstructive Sleep Apneea (OSA) is a common condition and its predominance is directly related to the explosion of obesity in western society. Obstructive Sleep Apneea is manifested by recurring episodes of collapse of the upper airway during sleep. Obesity and the increase of neck circumference, as well as visceral fat are risk factors for OSA. OSA is more common in men than in women, although women have higher rates of obesity. Objectives. The goal of this article was to show the correlation between OSA and obesity, adipose tissue in the abdomen and neck, sex and background of the patients in the study group. Materials and methods. In this article we present the results of a test group of 101 patients diagnosed with OSA, in the records of the “Marius Nasta” Pneumoftiziology Institute, patients being evaluated at 2, 6, 12 months. Comparative results and discussion. In this study can be observed a higher frequency of male patients (82.17%) compared to female patients (17.83%). Patients go to a doctor when they are in an advanced stage of the disease (from 101 patients, 88 display the severe form OSA). Most patients were obese (100 patients out of 101) in various stages of obesity. A larger number of patients come from urban areas (89 patients) compared with the patients from the rural areas (12 patients). Conclusions. As a conclusion of this study, can be seen that obesity is closely correlated with the severity of OSA and the distribution of fat in the neck and abdomen has an important role. The disease is more common in men than women, and there is a higher number of patients from the urban areas who seek help from a doctor.

scholarly journals Pengelolaan Dana Desa di Kecamatan Balong Kabupaten Ponorogo

2019 ◽  
Vol 7 (1) ◽  
pp. 63
Author(s):  
Maretha Berlianantiya Muhammad Ridwan Eka Wardani
Keyword(s):  
Rural Communities ◽  
Rural Areas ◽  
Urban Areas ◽  
Poverty Reduction ◽  
Agricultural Sector ◽  
Rural Poverty ◽  
Infrastructure Development ◽  
The Impact ◽  
The Village

<p><em>Poverty often occurs in rural areas rather than urban areas, low education which results in low quality of human resources and lack of access is often the cause of rural poverty. In addition, most of the economies of rural communities rely solely on the traditional agricultural sector. Various poverty reduction policies have been implemented, including village fund policies. This study aims to examine the management of village funds in the Balong sub-district of Madiun Regency with a case study in the villages of Tatung and Karangmojo villages covering the management of village funds in Tatung village and Karangmojo village. Balong Subdistrict and the impact of empowerment in the villages of Tatung and Karangmojo, Balong District. This research was conducted in Balong Subdistrict, Ponorogo Regency with a Case study in Tatung Village and Karangmojo Village with qualitative methods. In the village of Tatung village funds are managed as tourist villages with a focus on Paragliding tourist rides. Whereas in Karangmojo village it is used for Bumdes in the form of Lovebird birds, providing Gapoktan assistance, and infrastructure development.</em></p>

scholarly journals Model collaborative governance dalam pembangunan desa pada masa covid-19: studi di Kabupaten Lampung Selatan

2021 ◽  
Vol 6 (1) ◽  
pp. 15-31
Author(s):  
Ardian Prabowo ◽  
Mujibur Rahman Khairul Muluk ◽  
Ainul Hayat
Keyword(s):  
Rural Communities ◽  
Rural Areas ◽  
Urban Areas ◽  
Negative Impact ◽  
Health Sector ◽  
Collaborative Governance ◽  
Infrastructure Development ◽  
Cultural Resilience ◽  
Governance Model ◽  
The Government

At present, the Covid-19 contagious disease outbreak can spread rapidly throughout the world, including Indonesia. Apart from having a negative impact on the health sector, it also impacts the economic, social, cultural, resilience, tourism and other sectors. This can threaten people in rural areas who have gaps in health accessibility and high levels of poverty compared to urban areas. So it is necessary to carry out village economic development, but still protect the health of rural communities from the Covid-19 disaster. This cannot be done by the government alone. Interdisciplinary and field cooperation is required by referring to the principles of collaborative governance. The research objective was to determine the ideal collaborative governance model in village development during the Covid-19 pandemic. This research uses qualitative methods with a descriptive approach. This method can be studied comprehensively and deeply. The results of this study indicate that in South Lampung Regency there are already several priority activities in the economic and health sectors, some of these priority activities such as Covid-19 Response Village, Village Cash Intensive Work, Village Fund Direct Cash Assistance (BLT), and other Infrastructure Development. These priority activities are collaborations carried out by the government, society and business

scholarly journals Patterns of Hepatocellular Carcinoma on Computed Tomography at Tikur Anbessa specialized hospital, Addis Ababa, Ethiopia

2020 ◽  
Vol 30 (2) ◽  
Author(s):  
Ferehiwot Getaneh ◽  
Asfaw Atnafu
Keyword(s):  
Risk Factors ◽  
Computed Tomography ◽  
Rural Areas ◽  
Urban Areas ◽  
Vascular Invasion ◽  
Addis Ababa ◽  
Cross Sectional ◽  
Specialized Hospital ◽  
Tikur Anbessa Specialized Hospital ◽  
Number Of Patients

BACKGROUND: Hepatocellular cancer is the commonest liver cancer which contributes to a high incidence of morbidity and mortality in both developed and developing countries. Despite the anticipated high burden of the disease in the country, there is paucity of data on the associated risk factors and its pattern on imaging. The aim of this study was to assess Computed Tomography patterns and the risk factors of hepatocellular carcinoma.METHODS: A cross-sectional, prospective study on patients with a diagnosis of HCC on Computed Tomography examination, at Tikur Anbessa Specialized Hospital from July, 2016 to July, 2017. All patients who had characteristic Computed Tomography features and those who were diagnosed by Fine needle aspiration cytology (FNAC)/biopsy and had Computed Tomography examination were included in the study. Risk factors identified were reviewed from patients’ medical records.RESULT: A total of 70(n=70) patients were included in the study. The mean age was 50 ± 16 years. Fifty-seven (81.4%) of the participants were males, and 13(18.6%) were females. Forty-five (64.3%) of them came from urban areas and 25(35.7%) of them were from rural areas. The lesions were focal in 52(74.3%) and infiltrative in 18(25.7%) of the cases. Vascular invasion and distant metastases were seen in 49(70%) and 17(24.3%) respectively. Twenty-nine (41%) had negative hepatitis markers, and 13(19%) were not investigated for hepatitis infection.CONCLUSION: The majority of the patients presented with advanced disease such as vascular invasion and metastases. The major risk factors such as hepatitis infection were negative in significant number of patients. The risk factors in our setting should be studied further. Moreover, high-risk group selection and screening is essential to diagnose HCC early.

scholarly journals Biochemical Findings and outcomes of the treatment of the Patients with pancreatitis admitted in Nobel Medical College Teaching Hospital, Biratnagar, Nepal

2018 ◽  
Vol 7 (2) ◽  
pp. 9-14
Author(s):  
Rupesh Kumar Shreewastav ◽  
Rishab Shrestha ◽  
Arambam Giridhari Singh
Keyword(s):  
Teaching Hospital ◽  
Statistical Significance ◽  
College Teaching ◽  
Alcoholic Pancreatitis ◽  
Biliary Pancreatitis ◽  
Female Patients ◽  
Medical College ◽  
Institutional Review ◽  
Number Of Patients ◽  
The Mean

Background: Pancreatitis is well known for its painful state of illness causing a severe impact on the quality of life which can be followed by life-threatening long-term sequelae of diabetes mellitus and pancreatic cancer as its complications.The present study was conducted to evaluate biochemical findings and outcomes following treatment of ICU admitted patients suffering from pancreatitis in Nobel Medical College Teaching Hospital (NMCTH). Materials and Methods: All the patients admitted in the ICU of NMCTH from 15th January 2017 to 14th January 2018 having been diagnosed as suffering from pancreatitis were enrolled in this study. Age, sex, differential diagnosis, blood amylase and lipase level and outcomes of the treatment of the patients were measured as major variables. Blood amylase and lipase level of these patients were estimated in the department of Biochemistry, NMCTH by the standard protocols using Randoxkits, provided by the manufacturer. The study was carried out after getting the approval from Institutional review committee (IRC). Statistical significance was compared using Student's two-tailed t-test. Results were considered significant if p ≤ 0.05. Results: The number of patients admitted in ICU and suffering from pancreatitis was 136 out of 2204 total admission in ICU within a period of 1 year. Out of 136 pancreatitis patients, 44 were of biliary pancreatitis, 40 of alcoholic and 52 were patients of pancreatitis suffered from some other unknown factors. The mean age of the patients was 41.5±14.2 year. While analyzing the pancreatitis cases gender wise, it was found that male (N=80) were more sufferers than females (N=56). The mean ±SD value of blood amylase and lipase of these patients with pancreatitis were 1040±1062 IU/L & 442±425 IU/L respectively, which was significantly higher than the normal range. The maximum numbers of pancreatitis cases were seen in age group (30-39), (44 patients). It was found in our study that male patients were more sufferers of alcoholic pancreatitis than females; where as female patients were more in number among patients with biliary pancreatitis than males. The patients after getting the proper line of treatment, 88 of them recovered completely without any complication, 38 patients developed some complication, in which 26got recovered fully and 12 were referred. Mortality was seen in 10 patients. Conclusion: The results shows a very high prevalence rate of pancreatitis, the highest number being shared by those suffering from unknown factors followed by biliary pancreatitis and alcoholic pancreatitis in the descending order. In biliary pancreatitis, female patients are more whereas, the males are taking the major share among alcoholic pancreatitis. The level of the marker enzymes (amylase & lipase) are significantly higher than the normal confirming the cases to be of pancreatitis. Out of 136 patients, except for 12 cases referred and 10 patients died, all are fully recovered and discharged.

scholarly journals Clinical Profile of Patients with Seizure in Kathmandu Medical College Teaching Hospital.

2019 ◽  
Vol 8 (2) ◽  
pp. 53-56
Author(s):  
Krishna Dhungana ◽  
Dipesh Shakya ◽  
Rabindra Shrestha ◽  
Sabnam Bhatta ◽  
Sabbu Maharjan
Keyword(s):  
Teaching Hospital ◽  
College Teaching ◽  
Cross Sectional Study ◽  
Clinical Profile ◽  
Cross Sectional ◽  
Radiographic Findings ◽  
Medical College ◽  
Number Of Patients ◽  
East Asia Region ◽  
Age And Sex

Background: Seizure is a common clinical condition. It represents a majority of patients visiting neurology OPD as well as inpatient department in Kathmandu Medical College Teaching Hospital. While the number of patients with seizure is increasing in Nepal, data on the clinical profile of patients with seizure is scarce. Thus, this study aims to find out the relative frequency of seizure in different age and sex groups. It also aims to find out the common causes of seizure in our Nepalese population. Materials and Methods: A descriptive cross sectional study was carried out in patients attending outpatient and inpatient of Neurology department of Kathmandu Medical College Teaching Hospital between periods of July 2018 to December 2018. Demographic characteristics, radiographic findings, EEG findings and drugs taken by patients were recorded according to the proforma. Results: Data from one hundred patients were collected and analyzed. Most of the patients were less than 41 years of age. Most of the patients were male. The prime cause of seizure was found to be neurocysticercosis (25%). Majority of the patients were on monotherapy. Conclusion: Our data regarding the frequency of seizure in different age and sex groups is comparable to data in South East Asia region whilst, different from the western data. In our population, neurocysticercosiswas the most common cause of seizures. Also, most seizures were controlled with monotherapy.

scholarly journals Prevalence of hearing impairment in Aligarh: a community based study

2018 ◽  
Vol 5 (7) ◽  
pp. 2926
Author(s):  
Mohammad Asif Khan ◽  
Najam Khalique ◽  
Zulfia Khan ◽  
Abrar Hasan
Keyword(s):  
Hearing Impairment ◽  
Rural Areas ◽  
Urban Areas ◽  
Uttar Pradesh ◽  
Cross Sectional Study ◽  
Age Group ◽  
Community Based ◽  
Cross Sectional ◽  
Medical College ◽  
Study Population

Background: Hearing impairment is avery complex phenomenon, which has many and serious consequencesfor people and involves many factors and issues that should becarefully examined. The objective of the study were to estimate the prevalence of hearing impairment in the study population.Methods: Study design was a community based cross sectional study. Setting was on field practice areas of the urban and rural health training centers, Department of Community Medicine, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh. No. of Participants was 422 study subjects age 18 and above 18 years; Systematic random sampling and proportionate to population size method (PPS). Statistical analysis was carried out using SPSS version 13; Chi-square.Results: Overall prevalence in present study population was found to be 23.1%. The prevalence in the rural areas (24.8%) was found to be higher than that of the urban areas (20.5%). The age specific prevalence showed that the maximum prevalence was in the age group of more than 70 years (66.6%). In the rural areas the prevalence was highest in the >70 year age group(75%) while in the urban areas it was maximum in the 61-70 year age group(61.5%). The prevalence was least in the 31-40 year age group in both urban (5.4%) as well as rural areas (14.5%). The association of hearing loss with age was found to be highly significant.Conclusions:A high prevalence of hearing impairment was found in the study. Increasing prevalence of hearing impairment was observed with advancing age.  

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