Search

Byline: Rajesh. Gongal, Shambhu. Upadhyay, Kedar. Baral, Max. Watson, George. Kernohan Introduction: Nepal is beginning to develop palliative care services across the country. Most people live in rural areas, where [...]

Nepal has witnessed demographic and epidemiological transition resulting in the shift from infectious diseases to non-communicable diseases as the major disease burden. Around 60% of mortalities and morbidities are attributable to non-communicable diseases of which the majority end with the need for palliative care services. The current palliative care services in Nepal are in the infancy stage compared with other services. Undignified dying is a challenging public health problem and as such requires a public health approach to address it with the involvement of all stakeholders. Recognizing the need for the end spectrum of non-communicable diseases patients, the Ministry of Health, Nepal recently introduced the policy to address the unmet need through the community-based palliative care program, a laudable initiation., Keywords: community health care; Nepal; palliative care; public health.

Academic ability test has been used predominantly in student selection of medical and allied health profession education programs in Nepal. But the use of academic performance as the single selection criterion puts the students from low socioeconomic background at greater disadvantage despite equal suitability due to the lack of adequate guidance and support during their schooling. To address this limitation, use of aptitude test i.e. both the general cognitive and non-cognitive ability tests that measures fluid intelligence and personality traits respectively has been practiced. The measurement of non-cognitive traits has been found to predict the clinical examination score. In Nepal, for the first time, Patan Academy of Health Sciences implemented the assessment of aptitude test (both cognitive and non-cognitive ability test) for the student selection in the undergraduate medical program. Since the inception, Medical Education Commission in Nepal embraced Mental Agility Test, a component of an aptitude test, along with the academic ability test for the nationwide common entrance test in all the undergraduate Health Professions Education Programs. This indeed is an innovative approach in student selection, but in the context of Nepal whether the use of these tools is appropriate in the entrance exam requires psychometric evaluation and further validation through graduates' performance after their enrolment. Keywords: Health professions education; mental agility test; student selection.

Aim: To determine the evidence-based values of prophylactic drainage in gastric cancer surgery., Methods: One hundred and eight patients, who underwent subtotal gastrectomy with D1 or D2 lymph node dissection for gastric cancer between January 2001 and December 2005, were divided into drain group or no-drain group. Surgical outcome and post-operative complications within four weeks were compared between the two groups., Results: No significant differences were observed between the drain group and no-drain group in terms of operating time (171 +/- 42 min vs 156 +/- 39 min), number of post-operative days until passage of flatus (3.7 +/- 0.5 d vs 3.5 +/- 1.0 d), number of post-operative days until initiation of soft diet (4.9 +/- 0.7 d vs 4.8 +/- 0.8 d), length of post-operative hospital stay (9.3 +/- 2.2 d vs 8.4 +/- 2.4 d), mortality rate (5.4% vs 3.8%), and overall post-operative complication rate (21.4% vs 19.2%)., Conclusion: Prophylactic drainage placement is not necessary after subtotal gastrectomy for gastric cancer since it does not offer additional benefits for the patients.