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Monday, August 23, 2010

Fixed dose combination in treatment of Tuberculosis in Nepal

Nepal as a nation is battling with tuberculosis since long time .DOTS(directly observed treatment short course )have been successful in containing tuberculosis in Nepal.But with the emergence of HIV and emergence multi-drug resistance tuberculosis ,tuberculosis is now again spreading it's fangs .The government of Nepal along with the Ministry of Health knowing this problem has launched Fixed dose combination in treatment in treatment of tuberculosis from fiscal year 2065/66 B.S.(2008/09).Fixed dose combination is not a new approach in countries like Brazil and South Africa but in countries like Nepal it is relatively newer approach.
The difference between fixed dose combination and mono-therapy is that the different essential drugs that were used in treatment of different categories of tuberculosis that is CAT-I (category one ),CAT-II and CAT-III tuberculosis were given separately , so patients had to take many tablets as much as 16 tablets daily ,so this was one of the main cause that people used to avoid taking drugs in the middle of treatment course , as the result of which the drug compliance among the patient use to fall in the course of treatment. But now with the Fixed dose combination patient have to take as maximum upto 5 tablets per day .The reason behind this is the drug that are used in intensive as well as continuous phase are combined into one ,as for treatment in intensive phase of category I tuberculosis four drugs are required all are combined into one .So the compliance for patient is increased besides this storage for the drug distribution is also improved .As for Nepal FDCS have been started now what will be it's result has to be seen .

Thursday, February 18, 2010


Recently i was a part of study that was carried out to know the attitude of the medical students. As i was a part of a only one of the league of the study i don't what was the result of the study but i have certain inferences from the study.The study was carried among the 1st year , third year ,interns to know that what they think about the medical carrier.At the beginning most of the students who join the medical studies have this idea of serving the humanity , working for the poor and lifting the health standards of the country.But as the students progress to the higher level it seemed as if the attitude to be changing people being more carrier oriented and thinking more about their carrier goal their motto while joining the medicial studies seems to be overpowered by their carrier goals and as their reach the internship only their carrier seem to be in the mind of the students.This is the result what i have felt from one study and it might not be conclusive and more study and time should be devoted into this to know the actual fact .

Saturday, January 30, 2010


Recently there was a massive campaign in network sites regarding a health issue ie,breast cancer.It was asked to the females to write the colour of their inner garment in their wall in network site as facebook,twitter.It left many people suprised what is happening and after sometime most of the people found out the reason behind it.As the result of which a kinda debate started people came to know the disease that is breast cancer.But what was it's benifit is still to be known but definately it started the debate about the disease,it's effect and many people were made aware due to this campaigh.
So where are we Nepali people can use networking sites for making people about different health issues.Can we use these type of sites to raise awareness.Are Networking sites that much popular among Nepali people.These thing are to be seen and definately in future Nepali people will use networking sites to raise there voices in different and diverse issues ,and media will also take note of it.Definately we can use networking to raise awareness in different public health issues.

Saturday, January 23, 2010


Recently i was in Devghat for organizing camp for pilgrims during Maghe Sankantri.As a doctor ,I came to know the health problem in gathering of momentous scale.
This is a gathering of millions of people at a place.As, people gather a day before to take bath in the river, during night there are thousands of people.As it is mass gathering it is difficult to organize it perfectly.Food and water start getting scarce with passage of time and there is little place to accomadate people during night.
As a team leader of the camp I felt that there were four main public health problems during the health camp.
1.Firstly due to drinking of unpurified water people suffered from diahorreal diseases.
2.Secondly due to staying all night in the cold and bathing early people sufferd from cold.
3.Another problem was people jumping into boat to cross the river and over-crowding in boat poised the danger of people being drowned .
4.The most hazordous problem was human waste all around the riverbank which can lead to spread of infectious diseases.
These were the public health problem which can be improved in the days to come.

Saturday, January 9, 2010


One things that concerns most of us now a days is our weight.Due to change in our habit and due to influence of new modern life styles our habits are changing ie , our eating habits,working habits and different stresses of our life.So how can we acess that our weight is correct according to our height or not.
This can be acessed by a simple formula.It is called BMI(Body mass index).
That is you should know your weight in kgs and height in mertesand worked according to the formula.
BMI=18-25(normal weight)
BMI=>40(obesity that affects our health)
By this we can acess our weight and find out wether it is correct or not.

Thursday, December 31, 2009


One of the images we see frequently now a days is people wearing masks to avoid swine fle ,but how much it is effective.
On the public level it might be true but experts are skeptical.A viorologist from leading London Hospital says that''Really ,there is very little evidence that masks actually offer much protection against flu''.
Dr Ronald Cutler says ''The problem is that when someone sneezes they tend to take mask off .I think mask give people false sense of security''.However ,because people are wearing mask they will think they are safe and go to crowded areas .The best advice will be to wash your handsand cover your mouth when sneezing .Masks alone will not save , measures like handwashing ,safe use and disposal of tissue and cleaning environmental surfaces are key.Face masks should be well-fitted and can be continuously used for 8-10 hours ,but must be replaced if taken out at any stage.
So preventive measures can be
1.Stay home if sick and receive health advices.
2.wash your hand thoroughly and frequently.
3.stay away from crowd if possible.
4.N95 respirators are useful in preventing transmission of virus so it can be used by health personnel.But it is difficult to breath through and not useful for common people. it can be said that surgical masks doesn't block the virus entering lungs so cover your face while sneezing and wash your hand frequently after contact with object as door knob.