Patient Satisfaction with Outpatient Physiotherapy Services in Dhulikhel Hospital, Kathmandu University Hospital, Nepal.

Background The quality of care provided to recipients of health services is measured by the satisfaction of patient. Patient satisfaction is the extent to which patient feels that their needs and expectations have been met on behalf of their expenses made to get quality health services. Satisfied patients adhere to the treatment plan, seek for further services and provide feedback. Therefore, such study in Nepal would be important and first of its kind to assess the quality of physiotherapy services. Objective To evaluate the level of satisfaction of patient receiving outpatient Physiotherapy services and the relationship between the items within the questionnaire. Method The MedRisk Instrument for Measuring Patient Satisfaction (MRPS) with Physical Therapy Care was administered to 256 patients to identify the level of patient satisfaction. Result There was a high level of satisfaction of patient receiving Outpatient physiotherapy services using MRPS (Mean = 4.18; SD = 0.39). The relationships between individual item scores and Global satisfaction (Item 11) were explored with bivariate correlation analysis. The Internal factors correlated most strongly with the global satisfaction whereas the external factors had the lowest correlation with the global satisfaction. Conclusion Patient satisfaction is an important aspect of the measurement of quality of care. Thus, it must be evaluated timely to provide quality services to the patients. There was high level of satisfaction reported by patient receiving outpatient physiotherapy services in the Dhulikhel Hospital.

Impairment and Functional Status of People with Disabilities Following Nepal Earthquake 2015.

Background An earthquake of 7.8 magnitude with an epicenter at Gorkha on 25th April 2015 and a second earthquake of 6.5 magnitude with an epicenter at Sindhupalchwok on 12th May 2015 struck Nepal, killing more than 8,500 people and injuring over 18,500 individuals, and leading to various forms of disabilities. Objective To investigate the impairments and functional status of the earthquake victims through a survey. Method A survey was carried out in the catchment area of Bahunepati and Manekharka outreach centers of Sindhupalchowk district and Gaurishankar outreach center of Dolakha district of Dhulikhel Hospital. These were some of the most earthquake affected areas. Physical disability was identified using a disability survey form given by the Ministry of Women, Children and Social Welfare, Government of Nepal. World health organization disability assessment schedule (WHODAS 2.0) was used to identify the level of disability. Result Twenty-nine persons with disability (PWD) at Bahunepati, four PWD at Manekharkha and two PWD at Gaurishankar and their catchment areas were identified. Level of disability was an average of 56%, with the majority of survivors having upper extremities fractures (27.6%), followed by lower extremities fractures (17.2%) and miscellaneous injury (17.2%). A few spinal cord injuries and head injuries were also identified. Conclusion The level of disability among the injured people was high. Therefore, an urgent need of physiotherapy rehabilitation is warranted to improve the quality of life of the earthquake victims.

Discrimination of squamous cell carcinoma in situ from seborrheic keratosis by color analysis techniques requires information from scale, scale-crust and surrounding areas in dermoscopy images.

Scale-crust, also termed "keratin crust", appears as yellowish-to-tan scale on the skin's surface. It is caused by hyperkeratosis and parakeratosis in inflamed areas of squamous cell carcinoma in situ (SCCIS, Bowen's disease) and is a critical dermoscopy feature for detecting this skin cancer. In contrast, scale appears as a white-to-ivory detaching layer of the skin, without crust, and is most commonly seen in benign lesions such as seborrheic keratoses (SK). Distinguishing scale-crust from ordinary scale in digital dermoscopy images holds promise for early SCCIS detection and differentiation from SK. Reported here are image analysis techniques that best characterize scale-crust in SCCIS and scale in SK, thereby allowing accurate separation of these two dermoscopic features. Classification using a logistic regression operating on color features extracted from these digital dermoscopy structures can reliably separate SCCIS from SK.

A survey on community perceptions of jaundice in east Delhi: implications for the prevention and control of viral hepatitis.

Using senior health professionals as interviewers, a 30-cluster sampling survey was carried out to investigate community perceptions of pilia (the local word for jaundice) in east Delhi (India). Of 416 persons (mostly mothers of children aged < 2 years) interviewed, 339 (81%) were aware of pilia as an illness. Only 322 (77%), 164 (39%), 73 (18%) and 71 (17%) people knew about correct symptoms, dangers, causes and prevention of pilia. Most of the correct responses were related to the faeco-orally transmitted viral hepatitis. Literate respondents were significantly more aware of pilia (chi 2 52.81, P < 0.0001), its symptoms (chi 2 48.88, P < 0.0001), causes (chi 2 39.34, P < 0.0001), dangers (chi 2 19.3, P = 0.0007), and prevention (chi 2 60.8, P < 0.0001). However, age of the respondents had no significant bearing (P > or = 0.05) on the correctness of responses. About 293 (70%) subjects considered pilia as a treatable illness; of them, 193 (66%) and 77 (26%) respectively expressed their preference for the 'modern' and indigenous systems of medicine for its treatment. In contrast, 110 (38%) respondents said that they would prefer faith healers for the treatment of pilia. Although only 31 (7%) persons were aware of a vaccine against pilia (hepatitis B vaccine), virtually all agreed to have their children immunized if such a vaccine were made available. The study underscores the usefulness of pilia in lay-reporting of viral hepatitis and epidemiological studies on jaundice-associated illnesses and the need for educating the community about its causes and prevention to increase people's participation in controlling viral hepatitis and other diseases that mainly manifest as jaundice.