JNMA; journal of the Nepal Medical Association
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JNMA J Nepal Med Assoc · Mar 2018
Case ReportsMedication Error- A Case Report of Misadventure with Methotrexate.
Methotrexate is an antimetabolite drug with antineoplastic and immunomodulatory properties, useful as an antineoplastic agent in various haematological and solid tumours. MTX toxicity can occur because of accidental ingestion/overdose by the patient or because of prescription error. The toxic effects manifest as severe mucositis or as organ damage (bone marrow depression, renal/hepatic injury). ⋯ We present a case of MTX toxicity occurring as a result of prescription error resulting in repeat daily dosing of the drug, and the challenges associated with the management of the same, in a patient with multiple comorbidities. The present case emphasizes on a note of caution on the part of the prescriber and the suggestions regarding the measures which can be taken to avoid MTX toxicity. Keywords: drug overdose; Methotrexate; mucositis; pancytopenia.
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JNMA J Nepal Med Assoc · Mar 2018
Case ReportsAir due to Glue: Spontaneous Pneumothorax in a Young Adult with Glue Sniffing.
Solvent abuse, as inhalant specially, in the form of low cost adhesives like dendrite is common in low income countries among children and the teens. This habit is often a stepping stone to harder drugs. The neurological and neuropsychological effects of solvent abuse are well explored. ⋯ The pulmonary barotrauma, possibly due to increased intra-alveolar pressure, during the sniffing process can lead to alveolar rupture and in turn, pneumothorax. In the absence of other risk factors for Pneumothorax, the link between inhalant abuse and respiratory complications has to be explored in patients with history of such abuse. Keywords: inhalant abuse; pneumothorax; solvent.
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JNMA J Nepal Med Assoc · Mar 2018
Prevalence of Internet Addiction and Associated Psychological Co-morbidities among College Students in Bhutan.
Globally 3.5 billion people have access to internet and most of them are young adults and adolescents. In South Asia, Bhutan has the highest proportion of population with internet access at 37% in 2016. Many studies in Asia have reported significantly high level of internet addiction among college going students. In this light, this study was designed to estimate the prevalence of internet addiction and other co-morbidities. ⋯ The prevalence of internet addiction is high among the college going students in Bhutan. This warrants timely interventions to address the problems of internet addiction.
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JNMA J Nepal Med Assoc · Mar 2018
Nepal Health Insurance Bill: Possible Challenges and Way Forwards.
Nepal has one of the highest proportions of out of pocket expenditures on health and one quarter of the people is living below poverty line. In recent time, there is some increase of the health budget but country still relies on development partners. The endorsement of the national health insurance bill has enabled government to establish the national health insurance scheme through development of adequate policies, strategies and mechanisms for implementation at national and federal level. ⋯ Therefore, it is imperative to establish a robust mechanism like a "tree", which has strong roots of building blocks of health systems, which produces fruits that ensure improved responsiveness, efficiency and equity and financial protection. It is necessary to learn and apply from the experiences of other countries while implementing the national health insurance scheme. Keywords: bill; health; insurance; Nepal.
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JNMA J Nepal Med Assoc · Mar 2018
Knowledge of Alzheimer's Disease Among Medical Students of a Medical College.
Dementia is a public health concern as the prevalence is increasing worldwide with significant increase being in low-middle income countries. However these countries appear to be less prepared in handling this rise in terms of diagnosis and management. ⋯ Total 185 students were included in the study, 80 (43.24%) from first year and 105 (56.75%) from final year of medical study. The mean score of knowledge among the students was 17.44±2.46; 15.32±1.22 among first year and 19.06±1.87 among the final year students. Majority of the students said they have heard about dementia however, only 3 (3.75%) of first year and 43 (41.9%) from final year students have either attended a class or continuing medical education on dementia Conclusions: The knowledge about dementia was found to be average among medical students but better among final year medical students in comparison to first year. The knowledge was found to be better statistically among those who had either attended a class or continuing medical education on dementia or had exposure through different medias.