Introduction: Medical students need leadership and other 'human' skills to address many of the health challenges facing society.Objective: The present study was conducted to obtain student opinion about the effectiveness of different modules in developing these skills, note students perceived levels of knowledge and skills in these areas and obtain suggestions for further improvement at KIST Medical College, Lalitpur, Nepal.Method: The present study was conducted using a questionnaire developed by the authors among the first batch of undergraduate medical students.Basic demographics were noted and participants rated the effectiveness of different learning modalities in developing these skills and also noted their present level of knowledge about the topics.Free text comments were also obtained.Result: Fifty-eight of the 75 students (77.3%) participated.Majority were male, self-financing and from urban areas.The mean overall effectiveness scores of different modalities in developing human skills were 190.09 (maximum 300).Correlation seminars and pharmacology small group sessions were regarded as less effective in developing these skills.The mean perceived knowledge score was greater than 3 (maximum 5) in most areas.Mean perceived skills scores in most areas were also greater than 3 except for breaking bad news and tolerance for differing views.Medical humanities sessions and community health exercises were especially appreciated.Conclusion: The different sessions were moderately effective in developing these skills.Students' perceived knowledge and skills levels were moderate.Further studies among other batches of students are required.
Student self-evaluation of confidence in key skills using a retro-pre questionnaire before and after the introduction of the structures physical examination skills module at KIST Medical College, Nepal. The before scores are between 1-5: 1-being not aware, 2-not confident, 3-Somewhat confident, 4-very confident, 5-can do independently The after scores are between 1-4: 1-not confident, 2-somewhat confident, 3-very confident, and 4-can do independently
Background: Peer-assisted learning has been informally used in medical schools in Nepal. The manuscript describes feedback from first year students about learning sessions conducted by third year students. Methods: Two third year medical students (BS, AKS) conducted interactive learning sessions for first year students during the last week of March and first two weeks of April 2011. The session for each subject was of 2 hours duration and the number of students was 25 for some sessions and 50 for others. The sessions concentrated on revising concepts of the module and preparing students to answer theory question papers. Student opinion was studied using a questionnaire. Results: Seventy-five of the 100 students (75%) completed the questionnaire. The common feedback obtained were the sessions concentrated on must know areas (36 respondents), the learning environment was friendly (21 respondents), and students learned how to answer exam questions (12 respondents). Conclusions: The feedback suggests that student perception of peer teaching was positive and more sessions can be considered in future. Further studies are required.
Introduction: During a week-long orientation program at KIST Medical College newly joined first year undergraduate medical (MBBS) students are introduced to the institution, to teaching-learning activities, to the MBBS curriculum and to faculty members.The program has been conducted previously for three batches of students but feedback has not been obtained.Hence the study was conducted to study knowledge and attitude scores of students before and after the orientation program among the newly joined fourth batch of students, and note student perception about the effectiveness of different sessions.Method: A questionnaire administered at the end of the program measured knowledge and attitudes of students about selected subject areas before and after the program.Students were asked to indicate their present level of knowledge and attitude and also indicate their levels at the beginning of the program.The median knowledge and attitudes scores were calculated and compared among male and female respondents.The median scores before and after the module was compared using appropriate nonparametric tests (p <0.05).The effectiveness of different lecture sessions was also studied.Result: Sixty-three of the 72 students (87.5%) participated in the study.Forty students (63.5%) were male, 21 (33.3%) were female and two did not mention their gender.The median knowledge and attitudes scores significantly increased after the program.The effectiveness score was 3 for most sessions expect a few where the score was 4. Conclusion: The knowledge and attitude scores in different subject areas improved after the module.The program was perceived by students to be effective.
The national treatment guidelines of Nepal have adopted Artemisinin Combination Therapies (ACTs) for the treatment of uncomplicated falciparum malaria since 2004. Emergence of Artemisinin resistance in the Greater Mekong Sub-region (GMS) and beyond may become a threat for Nepal as well. The main objective of this study was to assess the therapeutic efficacy of antimalarial drug artemether-lumefantrine in uncomplicated P. falciparum infected patients at health centers/hospitals treated over the period of 2 years (2013–2014). Giemsa stained thick and thin smears, prepared from uncomplicated falciparum malaria patients who visited the selected sentinel sites in Nepal during 2013 to 2014 and met the inclusion criteria that included parasitemia (1000–10,000 /μL of blood), were evaluated until 28 days after ACTs treatment, following a World Health Organization (WHO) therapeutic efficacy protocol. Based on the re-occurrence of fever and resurge in parasitemia, the study patients were classified as resistant or susceptible. Blood specimens on filter papers were further analyzed by Polymerase Chain Reaction (PCR), specifically for the K13 propeller gene mutation (a recently identified molecular marker for ACT resistance). A total of 56,013 suspected malaria cases were screened for this study. Of which, 120 (0.21%) were infected with falciparum malaria. Out of 120, 28 cases of P. falciparum (28/120; 23.33%) were enrolled in the study, of which 24 cases completed the post-treatment follow up for 28 days. Only one case out of 24 (4%) was identified as a late treatment failure (LTF). K13 mutation, a proxy indicator for ACT resistance in parasites, was not detected on the day 1, which indicates resistance had not yet reached the molecular level. Only one case of late treatment failure was identified in this study. ACT combination using artemether-lumefantrine was still effective for the treatment of uncomplicated falciparum malaria in Nepal. A close monitoring and supervision for ACT resistance is essential for future malaria treatment in Nepal.
Student feedback for the introduction of structured physical examination skills at KIST Medical College, Nepal derived from an SPEST questionnaire for both students and faculty. Only student data is shown as the faculty SPEST results are mainly qualitative. 1st data file: Scores were provided out of 5 for questions i-vii (1=strongly disagree; 5=strongly agree), whilst the overall score for each section was given out of 10 (1 being poor and 10 being excellent). 2nd data file: Proportion of students for each score provided in response to the questions "I would rate the session........on a scale of 1 to 10 (1 being the least and 10 being the most important)”. 3rd data file: Proportions of students preferring either the tutorial, demonstration, practice or all three sub-sessions for each session.
Introductions: Guidelines on antibiotics use in surgical patients recommends a single dose prophylaxis for clean-contaminated cases and therapeutic course for contaminated and dirty cases. Compliance to this guideline is poor among diabetic patients. The aim of this study was to test the efficacy of single dose antibiotic prophylaxis on the occurrence of postoperative surgical site infection (SSI) in clean-contaminated surgery in diabetic patients.Methods: Retrospective cross-sectional study was carried out at KIST Medical College and Teaching Hospital from September 2008 to August 2012 involving 144 diabetic patients who underwent major clean-contaminated surgery. Forty eight patients received one gram of ceftriaxone intravenously as prophylactic antibiotic within 30 minutes prior to incision (group 1) and 96 patients received three doses of ceftriaxone (group 2). One dose was given within 30 minutes prior to incision and other two doses were given postoperatively. All patients were followed up for 30 postoperative days on outpatient basis. The SSI rates were compared in two groups. Pus from the infected wound was tested for culture and sensitivity.Results: The SSI rates in group 1 and group 2 were of 5/48 (10.42%) and of 9/96 (9.37%) respectively. There was no significant difference in SSI rates between group 1 and group 2 (p=0.322).Conclusions: Single dose of Ceftriaxone shows the similar effect as three doses in clean-contaminated surgery in diabetic patients.
Cervical cancer is the most common form of cancer among women in developing countries. Hospital based data in Nepal also showed cervical cancer is most commonly occurring cancer among women in Nepal. Pap smear is the very significant screening test for reduction of incidence and mortality from cervical cancer but many developing countries failed to obtain high coverage of target population. Hence failed to achieve major impact of cervical cancer screening. National guidelines for cervical cancer and prevention in Nepal is formulated in 2010 and set target population age range of 30-60 with 50% coverage of target population with in a five years span. This study was aimed to elicit baseline survey of cervical cancer screening in a locale where resource for cervical cancer screening is easily available. Population based cross sectional study was done from October 2006 to March 2007. 1547 ever married women aged 16–59 were selected with cluster randomization procedure from Bharatpur municipalities, where BPKMCH (BP Koirala Memorial Cancer Hospital) is located. Free cervical cancer screening was conducted in collaboration with International Agency for Research on Cancer (IARC) France and BPKMCH. Ethical clearance was obtained from Nepal Health Research council. Interviews were performed using a standard questionnaire to elicit required information. Out of 1033 participants 394 were 16-29 years old. Among them 117 (30%) had at least one Pap test prior coming to the clinic. 16(4%) were age 16-19, 42(11%) were age 20-24 and 59 (15%) were age 25-29. This concludes Present opportunistic cervical cancer screening in Bharatpur is directed towards screening significant proportion of women with less risk.DOI: http://dx.doi.org/10.3126/jmmihs.v1i4.11994Journal of Manmohan Memorial Institute of Health SciencesVol. 1, Issue 4, 2015page : 3-8
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