Management and Leadership Development in Healthcare Professionals.

In the healthcare system, leadership has never been more crucial. Initiatives to improve health care in underdeveloped nations frequently fail, not for lack of clinical and public health understanding, but rather for lack of management ability. However, there are currently few possibilities for thorough leadership development at any level of career. This short communication highlights the success of the International Public Health Management Development Program by the Nepal Medical Association in conjunction with the Indian Embassy in Nepal, financed by the Ministry of External Affairs under the Indian Technical Education Corporation. Keywords: leadership; Nepal; public health; training activities.

Traumatic Spinal Cord Injury among Patients Admitted to the Spine Unit in a Tertiary Care Centre.

Introduction: Spinal cord injury usually results in disabling conditions. The incidence of spinal trauma is region-specific due to unique geography and demography. The epidemiology of spinal trauma changes with economic and social factors even in different periods. The aim of this study was to find out the prevalence of traumatic spinal cord injury among patients admitted to the Spine Unit in a tertiary care centre. Methods: A descriptive cross-sectional study was done in a tertiary care centre among patients admitted to the Spine Unit from 1 January 2022 to 31 December 2022 after receiving ethical approval from the Institutional Review Committee. Demographic details, mode of injury, level of injuries, neurological grading at the time of admission using American Spinal Injury Association grading, management methods, and complication if any were recorded. A convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Out of 465 patients, the prevalence of traumatic spinal cord injury was 316 (67.95%) (63.72-72.20, 95% Confidence Interval). A total of 243 (76.89%) cases were due to falls. The mean age of patients was 43.13±16.55 years. Conclusions: The prevalence of traumatic spinal cord injury patients was lower than the other studies done in similar settings. Keywords: falls; prevalence; spinal cord injuries.

Prevalence of Type 2 Diabetes among Patients Visiting Nepal Police Hospital in Kathmandu: A Descriptive Cross-sectional Study.

INTRODUCTION: The growing prevalence of diabetes mellitus (DM) is a critical threat for global health, including in Nepal, especially in Kathmandu District, where diabetic patients are increasing in hospitals catastrophically. This study tends to assess the prevalence rate of type 2 diabetes among admitted patients visiting a hospital in Kathmandu. METHODS: An electronic chart review was done to assess the prevalence of type 2 diabetes in Nepal Police hospital, Kathmandu, Nepal. Ethical approval was taken from the Nepal Health Research Council. Considering eligibility criteria, 8631 cases from 4 May 2018 to 31 August 2020 were observed. The calculated sample size was 500. However, all diabetic cases, i.e., 576, were processed and analyzed using Python and later visualized using MS Excel. RESULTS: The overall prevalence rate of type 2 diabetes was 6.67%. The prevalence rate was seen higher among males (7.5%). Similarly, a high prevalence rate was seen among 64-73 years, i.e., 15.10%. CONCLUSIONS: The findings showed a high prevalence rate of type 2 diabetes. Older age groups are at high risk. Urgent public health interventions including lifestyle modification measures are required to reduce the extra burden of type 2 diabetes.

Patient Satisfaction in Doctor Patient Communication in a Tertiary Care Hospital of Kathmandu: A Descriptive Cross-Sectional Study.

INTRODUCTION: Communication is an important aspect of the medical profession. Doctor-patient communication plays a significant role in health care delivery. This study aims to find outpatient department patient satisfaction in doctor-patient communication in a tertiary care hospital in Kathmandu, Nepal. METHODS: A descriptive cross-sectional study was conducted in the outpatient department of a tertiary care hospital in Kathmandu, Nepal in the month of August 2019. Validated questionnaire of Patient Satisfaction Questionnaire, consisting of 80 items, originally developed by Willis H. Ware and his colleagues were used and distributed to the patient in the outpatient department of the hospital. Their satisfaction level for doctor-patient communication was assessed on a five-point scale. The questionnaire was distributed randomly to the patient attending the hospital outpatient department during one month period. RESULTS: Out of the total participants, 420 (96%) at 95% CI (95.07±96.93) respondents reported that they were satisfied regarding communication with their doctors. Among the patients, 109 (24.0%) visited the department of medicine followed by obstetrics and gynaecology 85 (19.4%). CONCLUSIONS: The majority of participants were found to be satisfied with the doctor-patient communication. While this study has shown that the communication in the doctor-patient relationship was seen to be satisfactory, this might not show the generalized picture of the country. We should also think of ways to further improve the communication in our hospitals.

Preparedness for Coronavirus Disease in Hospitals of Nepal: A Nationwide Survey.

INTRODUCTION: Coronavirus disease pandemic has affected large number of people globally and has continued to spread. Preparedness of individual nations and the hospitals is important to effectively deal with the surge of cases. We aimed to obtain nation wide data from Nepal, about hospital preparedness for COVID-19. METHODS: Online questionnaire was prepared in accordance with the Center for Disease Control recommendations to assess preparedness of hospitals for COVID-19. The questionnaire was circulated to the over 800 doctors across the nation, who are the life members of six medical societies. RESULTS: We obtained 131 completed responses from all seven provinces. Majority of respondents had anaesthesiology as the primary specialty. Only 52 (39.7%) participants mentioned that their hospital had policy to receive suspected or proven cases with COVID-19. Presence of isolation ward was mentioned by 83 (63.4%) respondents, with only 9 (6.9%)mentioning the presence of airborne isolation. Supply of personal protective equipment (PPE) was inadequate as per 124 (94.7%) respondents. Critical care services for COVID-19 patients were possible only in hospitals of 42 (32.1%)respondents. RT-polymerase chain reaction could be performed only in the hospital of 6 (4.6%) respondents. CONCLUSIONS: It is apparent that most of the hospitals are not well prepared for management of patients with COVID-19. Resource allocation and policy making should be aimed to enhance national preparedness for the pandemic.

Functional Outcome Estimation of Bimalleolar Ankle Fractures Treated by Open Reduction and Internal Fixation at a Tertiary Care Center: A Descriptive Cross-sectional Study.

INTRODUCTION: Ankle fractures account for about 9% of all fractures in adults. Open reduction and internal fixation is the preferred treatment for such injuries. However, surgery is not free of complications, and outcomes following surgery are not always satisfactory. Therefore, this study aimed to estimate the functional outcomes of bimalleolar ankle fractures treated by open reduction and internal fixation. METHODS: This descriptive, cross-sectional study was carried out at a tertiary care center in the western region of Nepal among the patients with bimalleolar ankle fractures from March 2017 to August 2020 after approval from the Institutional review committee. Convenience sampling was done to reach the sample size. Twenty-nine cases were included in the study. Data were recorded in proforma and data analysis was done in the statistical package for social sciences (SPSS 16.0). The American Orthopedic Foot and Ankle Society (AOFAS) ankle-handfoot score was used to assess the final outcome. RESULTS: At the final evaluation mean AOFAS ankle-handfoot score score was 89.86 (±7.95). According to the AOFAS ankle-hindfoot score, there were 19 excellent (65.51%), six good (20.68%), and four fair (13.79%) results. Complications in the form of superficial infection were seen in four (13.79%) cases. CONCLUSIONS: Functional outcomes following surgical treatment of bimalleolar ankle fractures are mostly excellent to good and complications following surgery are few, therefore, surgery is a better option of treatment in bimalleolar ankle fractures.

Study on Clinico-Demographic Characteristics of Orthopaedic Cases in a Tertiary Care Centre: A Descriptive Cross-sectional Study.

INTRODUCTION: Orthopedic conditions include a range of condition varying from traumatic injuries, congenital anomalies, chronic back-pain, arthritis, rheumatologic conditions, and other. In Nepal, approximately 2.35 million people are living with musculoskeletal conditions in which 175,000 people are suffering with MSD from non-traumatic causes. The aim of the study is to observe the clinical and demographic pattern of orthopedic problems presenting in the hospital. METHODS: A descriptive cross-sectional study was done in All Nepal Hospital Private Limited in the month of November. The data from the medical record section was retrospectively collected. Sample size of 384 was included and convenience sampling technique was used. The descriptive statistical analysis was done. RESULTS: Eight hundred forty four cases were included in the study. Implant removal was the main condition for admission in the hospital 105 (12.44%) followed by Forearm Bone Fracture 84 (9.95%) and Cut Injury 64 (7.58%). Most cases presented during the time 6 PM to 12 AM 312 (36.96%). CONCLUSIONS: Most of the orthopedic cases presented in the evening and night time. Implant removal, forearm bone fracture and cut injury form the major bulk of the cases.