Rare case of combined vascular malformation of the face: a successful surgical management.

Combined vascular malformation affecting the facial region is an extremely rare clinical entity that is debilitating both functionally and emotionally. Treatment warrants a multidisciplinary approach with the aim of removing the vascular anomalies and ameliorating any functional facial disfigurement. Here, we present a case of a 40-year-old female with combined vascular malformation of the face who was treated successfully with surgical intervention accompanying significant resolution of facial disfigurement.

Effects of Momordica Charantia (Karela/bitterguord) in Type 2 Diabetic Patients Taking Allopathic Drugs: A pilot study.

Background Momordica charantia is evoloving as supplementary therapy in type 2 diabetes mellitus. Animal studies reveal its anti-diabetic and lipid lowering property. However, clinical studies with human subjects are very few. Objective To find out the effects of Momordica charantia supplements on glycemic and lipid profile among type 2 diabetes mellitus patients taking allopathic drugs. Method A comparative study was conducted in internal medicine department of B P Koirala Institute of Health Sciences, Dharan from July 2015 to May 2016 after ethical clearance. Twenty two uncomplicated type-2 diabetes mellitus patients were enrolled. Group A patients were supplemented with allopathic drug (oral anti-diabetic agents) only and Group B with add on treatment of 200 ml juice of Momordica charantia along with allopathic drug daily for ninety days. Fasting, post prandial blood sugar and lipid profile levels were compared between baseline and ninety days post supplementation. Data was collected and entry was done in Statistical Packages for Social Services version 20.0, using independent t test with p < 0.05. Result Add on treatment with 200 ml of Momordica charantia along with anti-diabetic drug daily significantly reduced fasting (p= < 0.0001) and post prandial blood sugar (p < 0.0001). Treatment with anti-diabetic drugs only reduced fasting (p = 0.0008) and post-prandial blood sugar but the reduction was not significant ((p =0.0001). There was improvement in lipid profile by both anti-diabetic drugs alone and Momordica charantia along with anti-diabetic drug, but it was not significant. Conclusion Add on treatment with 200 ml/day juice of Momordica charantia is effective in glycaemic control in type-2 diabetes mellitus patients as compared to the allopathic treatment alone.

Prescribing Skills of First and Second Year MBBS Students of A Teaching Hospital.

INTRODUCTION: To ensure safe, effective and rational prescribing by tomorrow's doctors it is important to assess the prescribing skills of today's medical students. The aim of this study was to assess the prescribing skills of MBBS preclinical students of a Teaching Hospital. METHODS: First and second year medical students were given different sets of common clinical scenarios and asked to write a prescription for these. The physician and drug related components were analyzed following the WHO guidelines. The data were statistically analyzed using Chi-square test for 99% and 99.99% Confidence Intervals. P values < 0.01 and < 0.0001 were considered significant respectively. RESULTS: MBBS first year student scored 123 (82%) and 94 (62.66%) in physician and drug related component respectively. MBBS second year students scored 139 (92.66%) and 111 (73.33%) in physician and drug related components respectively. Results obtained from the element prescriber's address and telephone number, date of prescription and patient's address on the prescription of first year and second year medical students were highly significant (p<0.0001). CONCLUSIONS: Prescribing skill of first and second year MBBS students is not satisfactory. Prescribing deficiencies were found on both the physician and drug related components which emphasizes the need of adequate prescribing knowledge in order to minimize the prescription errors and irrational prescribing. Based on this study, we suggest all the undergraduate medical students should be regularly trained and evaluated to further help minimize the prescribing errors.

Cumplimiento de las normas de la calidad de atención establecidas por el compromiso de gestión en los pacientes diabéticos del Área de Salud de Alajuelita, en el periodo enero a julio de 2007 / Achivement of patients care standards established by the agreement on management for diabetic patients in the Alajuelita Health Center from january to july, 2007

Justificación y objetivo: este trabajo evalúa el nivel del cumplimiento de las normas de la calidad de atención a los usuarios diabéticos del Área de Salud de Alajuelita, y los factores determinantes en el incumplimiento, para proponer sugerencias con el fin de mejorarlas. Materiales y métodos: se realizó un estudio observacional analítico de corte transversal tipo descriptivo, basado en los datos de los expedientes de los pacientes diabéticos. Mediante un muestreo consecutivo se analizaron 500 expedientes clínicos de los pacientes diabéticos del Área de Salud de Alajuelita, para determinar el nivel del cumplimiento de las normas de calidad de atención en el paciente diabético entre enero y julio de 2007. La recolección de los datos se efectuó mediante una hoja precodificada, diseñada con base en la utilizada para el control de los pacientes diabéticos, en el marco del compromiso de gestión a nivel nacional. Se entrevistó a los 40 trabajadores del Área, directamente relacionados con el cumplimiento de las normas del compromiso de gestión...

Regulación internacional del uso de pesticidas: la experiencia de Costa Rica / International regulations of the use of pesticides: The Costarican experience

Pesticides are poisons designed to kill living organisms considered pests. Costa Rica have used these substances for pest control in agriculture for more than half a century since the first records of importation into the 1970s the use of these has been increasing. Today, Costa Rica remains one of the countries of Central America with the highest rates of pesticide use Objective: The present study is to analyze the policies, rules and practices related to Costa Rican agricultural chemicals, in the light of international practice and case study of banana workers affected by the use of pesticides. Development: The study establishes the agreement of the national policy, standards, regulatory instruments, control and monitoring of pesticide applications in relation to the existing internationally. Conclusion: In Costa Rica about 25 000 workers were exposed to the product Nemagon in the banana. In addition, women and children of banana workers affected by the toxicity of these products...

Los plaguicidas son sustancias tóxicas diseñadas para eliminar organismos vivos considerados plagas. En Costa Rica se han utilizado para el control de plagas en la agricultura por más de medio siglo y desde los primeros registros de importación en los años setenta el uso de estos ha ido en aumento. Hoy en día, Costa Rica continúa como uno de los países de la región centroamericana con los mayores índices de uso de plaguicidas. Objetivo: El presente estudio tiene como finalidad analizar las políticas, las normas y las prácticas costarricenses relacionadas con los agroquímicos, a la luz de la práctica internacional y del estudio de caso de los trabajadores bananeros afectados por el uso de plaguicidas. Cuerpo: El estudio establece la concordancia del sistema nacional en materia de políticas, normas, instrumentos reguladores, control y monitoreo de la aplicación de pesticidas, en relación con el existente en el ámbito internacional. Conclusión: En Costa Rica unos 25 000 trabajadores fueron expuestos al producto Nemagón en la zona bananera. Además, las mujeres y los niños de los trabajadores bananeros fueron afectados por la toxicidad de estos productos...