ABSTRACT
Background: Mapping of resources helps us in identifying those resources which can be used more pragmatically, for interventions and programs related to human health especially during emergency conditions. Resource mapping identifies the resources that can realistically be used for health related interventions, programs and during an emergency. Aim and Objectives: The primary objective was to locate the basic healthcare related resources available in that area. Secondary objectives were to Understand and compare these resources along certain important dimensions using qualitative research methods and to identify possible existing gaps, share the results with the local stakeholders and suggest effective interventions. Material & Methods: Manual mapping method was used to locate the available healthcare related services in urban slum area. FGDs were held to compare utilization of resources along eight dimensions. In depth interviews were held with existing healthcare service providers, stakeholders and local residents to assess their utilization and needs. Results Existing health services used by community were local herbal clinic, district hospital, Anganwadi Centre, mobile clinic, wellness clinic and All India Institute of Medical Sciences (AIIMS) Jodhpur. Conclusions The manual mapping and qualitative techniques used showed that existing resources lacked in (a) providing in situ primary care (b) clinical services by a female gynecologist (c) health education services to address existing drug addiction and substance abuse.This exercise helped in rapid need assessment and prioritizing of interventions.
ABSTRACT
Background: Spectrum of female breast diseases is manifold and includes various non-neoplastic and neoplastic conditions. This study focused on the clinico-pathological profile of several breast diseases, including fibrocystic change, fibroadenoma and breast carcinoma. Methods: This cross sectional analytic observational study included Fine Needle Aspiration Cytology cases of female breast diseases diagnosed over three years from 2011 to 2014 in Chitwan Medical College Teaching hospital in Central Nepal. Univariate analysis was carried out to find out age group-wise proportion of the diseases in relation to five cytologic categories and various cytomorphologic diagnoses. Independent samples t-test was used to find out the significance of difference between mean age of benign and malignant breast diseases. Results: The proportion of benign, suspicious for malignancy and malignant breast diseases was 90.4 %, 0.8% and 8.8 % respectively. The mean age of patients at diagnosis for benign diseases and malignant disease was 31.7± 10.4 years and 49.2 ± 12.0 years respectively. t-test showed difference in mean age between benign and malignant diseases to be statistically significant (t=8.79, p= <0.001). Fibrocystic change and fibroadenoma were the most common breast disease overall and the most common neoplasm respectively. 58.1 %, 25.9 % and 6.5 % of all carcinoma cases in this study were found below 50, below 40 and below 30 years of age respectively. Conclusions: Fibrocystic change and fibroadenoma are most common disease of breast and most common neoplasm of breast respectively. Breast cancer occurs in younger women in Nepal in comparison to women in developed countries. Therefore, breast cancer prevention programs in Nepal should target young women also.
ABSTRACT
Alveolar ridge atrophy poses a clinical challenge towards the fabrication of a successful prosthesis. Resorption of denture bearing areas results in an unstable non-retentive dentures associated with pain and discomfort. Prosthetic Rehabilitation of a patient with severely resorbed ridge is the most challenging therapy a prosthodontist can undertake. For a favourable prognosis of the denture therapy, impression technique selected should be based on the present state of the basal tissue support. This article presents rehabilitation of a patient with severely resorbed mandibular ridge with the application of neutral zone concept being incorporated into impression making in an effort to achieve successful complete denture therapy. Finally, patient had more stable, retentive and functionally efficient complete denture. In conclusion, neutral zone impression technique proved to be a quite effective method for prosthetic rehabilitation of patient with severe mandibular ridge resorption.
ABSTRACT
Radiofrequency (RF) catheter ablation has ushered in a new era in the management of patients with symptomatic tachyarrhythmias. By providing the ability to cure the underlying arrhythmic substrate, RF catheter ablation obviates the need for life-long antiarrhythmic drugs. In the reported series, the success has been high and the complications have been infrequent and relatively minor. Not unexpectedly, RF catheter ablation has become the treatment of choice for patients with symptomatic paroxysmal tachyarrhythmias. The role of radiofrequency catheter ablation in infants and small children remains controversial, and awaits a larger experience and longer follow-up data.