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Pātan, Nepal

Butterworth K.,Patan Hospital
Education for health (Abingdon, England) | Year: 2011

Experts suggest that distance learning continuing medical education (CME) is only effective when there is the opportunity for two-way discussion and reflection. The value of on-line mentoring has been mainly studied in the West. We examined the benefits and practical implications of providing mentors for distance learning CME in a low technology setting. We conducted a randomized controlled trial with qualitative and quantitative analysis of the impact of mentoring on completion of CME and quality of reflective learning. Twenty-six of 64 doctors completed all four CME modules. Non-completers were interviewed by telephone. Odds ratio analysis suggested that mentored doctors were three times more likely to complete their CME; however, this did not reach statistical significance (p = 0.07, 95% CI 0.89-10.57). Being in rural practice (p = 0.05) and younger in age (p = 0.005) were significantly associated with completion of CME. Mentored doctors seemed to show a higher quality of reflection on learning. Contact between mentors and mentees was difficult. Both mentors and mentees felt that optimal use of the system was not made. Despite mentors' perceptions that they had little impact, mentored doctors did appear to be more likely to complete CME. Work is needed to increase the quality of interpersonal and educational interaction between mentors and mentees. Source


Butterworth K.,Patan Hospital | Hayes B.,National Academy of Medical science | Zimmerman M.,Nick Simons Institute
Education for Health: Change in Learning and Practice | Year: 2011

Context: Experts suggest that distance learning continuing medical education (CME) is only effective when there is the opportunity for two-way discussion and reflection. The value of on-line mentoring has been mainly studied in the West. Objectives: We examined the benefits and practical implications of providing mentors for distance learning CME in a low technology setting. Methods: We conducted a randomized controlled trial with qualitative and quantitative analysis of the impact of mentoring on completion of CME and quality of reflective learning. Results: Twenty-six of 64 doctors completed all four CME modules. Non-completers were interviewed by telephone. Odds ratio analysis suggested that mentored doctors were three times more likely to complete their CME; however, this did not reach statistical significance (p=0.07, 95% CI 0.89-10.57). Being in rural practice (p=0.05) and younger in age (p=0.005) were significantly associated with completion of CME. Mentored doctors seemed to show a higher quality of reflection on learning. Contact between mentors and mentees was difficult. Both mentors and mentees felt that optimal use of the system was not made. Discussion: Despite mentors' perceptions that they had little impact, mentored doctors did appear to be more likely to complete CME. Work is needed to increase the quality of interpersonal and educational interaction between mentors and mentees. © K Butterworth, B Hayes, M Zimmerman, 2011. Source


Paudyal B.,Patan Hospital
Journal of Nepal Health Research Council | Year: 2010

Antiphospholipid syndrome is an autoimmune disease that presents with recurrent arteriovenous thrombosis, repeated pregnancy loss and elevated titres of antiphospholipid antibodies in the blood. It is a common cause of acquired thrombosis and can manifest within any part of the vascular tree. Inferior Venacava thrombosis at outset, however, is not a common manifestation of systemic lupus erythematosus associated-antiphospholipid syndrome particularly in children. Here, we present a 14-year old girl who developed antiphospholipid syndrome as a presenting manifestation of systemic lupus erythematosus. Source


Gangol R.,Patan Hospital | Maharjan D.,Kathmandu Medical College Teaching Hospital
Journal of the Nepal Medical Association | Year: 2010

Introduction: This study evaluates if addition of information leaflet after the usual verbal counseling improves the level of understanding of patients undergoing surgery about their disease, the need for surgery and its complications. Methods: It is a prospective observational case control study in which the control group receives verbal counseling only and the study group is given an information leaflet in addition to the verbal counseling after random allocation. An interviewer (surgical resident) interviews both the group using a set questionnaire. The answers are scored and added to give total marks. Results: There were total 114 patients undergoing gall bladder surgery with 59 in the study group and 55 in the control group. The level of understanding was good or satisfactory in 18.2 % in the control group compared to 76.3 % in the study group (P<0.000). This statistically significant improvement was seen even among illiterate group when analyzed separately. Conclusions: Addition of information leaflet significantly improves the patients understanding of their disease irrespective of their education status. Source


Shrestha S.R.,Patan Hospital | Yadav B.K.,Patan Hospital
Journal of the Nepal Medical Association | Year: 2010

Introduction: Still birth is a common adverse outcome of pregnancy, associated with many risk factors like prematurity, infection, birth injury, eclamptic disorders. Methods: A hospital based, retrospective study was conducted at Patan Hospital in the year 2064. The number of still births and their associated risk factors were assessed. Results: There were three thousand and five hundred and eighty eight deliveries. Among all deliveries, still birth cases were counted forty seven with a rate of 14 per thousand deliveries. The major risk factors were prematurity, low birth weight, fetal distress and maternal jaundice. Conclusions: Prematurity was the commonest risk factor for still birth. Source

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