Bhutan Health Journal
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Radio-pathological correlation of a retroperitoneal teratoma in a 2-year-old girl: a case report
Get PDFRetroperitoneal teratoma is a extragonadal germ cell tumor comprising 5% of all teratomas in children, and the third most common retroperitoneal neoplasm in children. This is a case report of a 2 years old girl who presented with abdominal distension and palpable mass. The imaging findings of the mass was characteristic of retroperitoneal teratoma which was confirmed by histopathology report following complete excision. Retroperitoneal tumor is an uncommon tumor in children with characteristic imaging findings. Computed tomography is mainly used to evaluate the extent of the disease. Most of the retroperitoneal tumors are benign and curable with complete surgical excision
Perception of students on the teaching methodologies utilized at Khesar Gyalpo University of Medical Sciences of Bhutan
Get PDFIntroduction: Recently, there have been numerous innovations in the field of medical education. Teaching methodology is one of the areas that have received the most attention. The aim of this study was to assess the students’ perceptions of the effectiveness of different teaching methods, teaching aids and forms of evaluation at two faculties under Khesar Gyalpo University of Medical Sciences of Bhutan.
Methods: This analytical cross-sectional study was conducted between 1st June and 31st July 2015 using a self-administered questionnaire in 150 first year and 148 final year students from the Faculty of Nursing and Public Health and Faculty of Traditional Medicine. Each participant completed a questionnaire containing items soliciting their opinions on teaching methods, teaching tools, and assessment methods.
Results: Modern teaching methods are being practiced at the two faculties studied under KGUMSB. PowerPoint presentation and overhead projector were most preferred by both the groups. Also there was lack of exposure to computer-assisted learning in both the groups.
Conclusions: We conclude that the teaching methodologies at KGUMSB are in line with current trends. However, this study also reveals that there is a need to institute robust strategies to encourage more computer-assisted learning
Methodology and criteria for setting national health research priorities in Bhutan: a workshop report
Get PDFThe Bhutanese health system is committed to providing health services for all citizens and is interested in strengthening the country’s health research capacity. The objectives of this workshop were to understand the range of health research activities in Bhutan; to formulate a prioritized research agenda for the Ministry of Health (MoH); to share challenges, gaps and opportunities in health research; and to provide insights for future prioritization exercises. The MoH partnered with Khesar Gyalpo University of Medical University of Bhutan and USA-based facilitators to develop and pilot a methodology for health research priority setting. The Bhutan priority setting process was adapted from the Combined Approach Matrix and the Essential National Health Research methods. The methodology proved successful in the systematic creation of a list of health research priorities. Future priority setting processes will build on this workshop, continuing to refine and strengthen the priority setting process in Bhutan.
The eradication of polio in Bhutan in the context of global polio eradication
Get PDFBhutan has made tremendous health gains in public health, particularly in vaccine-preventable diseases. Polio was eradicated two years ahead of the launch of the Global Polio Eradication Initiative and only 12 years after the introduction of oral polio vaccination nationwide. The last case of clinical poliomyelitis in Bhutan was reported in 1986. Bhutan maintains a very high coverage of polio immunisation coupled with a strong health system and surveillance network. The success story in the elimination of polio provides examples for other successful public health programmes now and in the future
Association of maternal serum beta human chorionic gonadotropin (B-hCG) level with intrayterine growth restriction: a case control study
Get PDFIntroduction: Intrauterine growth restriction (IUGR) is a major cause of perinatal morbidity and mortality. The human chorionic gonadotropin (B-hCG) is suggested to be released in large amounts into the maternal circulation due to placental dysfunction. Studies have shown that raised levels of B-hCG was associated with IUGR in the first and second trimesters. However, no study was done during the third trimester. Therefore, the objective of the study was to determine the association of B-hCG level with IUGR during 3rd trimester.
Methods: A case-control one year-period study completed in the Department of Obstetrics and Gynaecology, BSMMU, Bangladesh. Pregnant mothers diagnosed with IUGR were taken as case (n=55) and mothers without IUGR as control (n=55). Serum B-hCG levels of these two groups were measured. The data was analysed with SPSS-16 software. Chi-square test was used for analysis.
Results: The mean estimated fetal weight (EFW) of case was significantly less as compared to control (p<0.001). Out of 55 pregnancies with IUGR, 14 (25.5%) had raised level of B-hCG as compared to only 4(7.3%) of control had raised B-hCG level. The odds ratio (OR) of developing IUGR in pregnant women with raised B-hCG level was found to be 4.4 fold (95% CI: 1.331- 14.237) higher than the pregnant women with normal level of B-hCG.
Conclusions: The study concluded a significant association between the raised levels of B-hCG with IUGR.
Incidence and factors associated with surgical site infections at the Surgical Ward, National Referral Hospital, Bhutan
Get PDFIntroduction: The burden related to surgical site infection (SSI) and antibiotic sensitivity of the organisms causing SSI is acause of concern. This is the first study to assess SSI at Bhutan’s largest surgical centre.
Methods: This was an observational descriptive study conducted involving patients undergoing incisional surgeries at the Department of Surgery, JDWNRH from July – December 2017 using convenient sampling. Data was collected using a pro forma. The health care workers conducted the first two wound examinations and the information on the third examination was done though phone call. Southampton Wound Score (SWS) was used to assess the postoperative wound. The Research Ethics Board of Health, Bhutan, gave ethical approval.
Results: The incidence of surgical site infection was 30.7% and the most common organism was Escherichia coli. SSI occurred in Southampton Wound Grade I and IV. Contaminated (46.2%) and dirty (33.3%) wounds had higher incidence of SSI. Patients age >60 years (p= 0.049) and those with contaminated wound (p= 0.005) were significant risk factors for SSI. Hypertension, diabetes, smoking, alcohol intake and obesity, elective or emergency case, and the seniority of surgeon were not risk factors for SSI.
Conclusions: The incidence of SSI is high and antibiotic sensitivity patterns a cause of concern. Strict infection control and patient safety measures need to be implemented
Knowledge attitude and practice of exclusive breastfeeding among breastfeeding mothers in Trongsa district, Bhutan
Get PDFIntroduction: The World Health Organization (WHO) has estimated around 1.4 million deaths and 10% of the disease burden in children under 5 years of age is due to non-exclusive breastfeeding in the first 6 months of life. As per the WHO, exclusive breastfeeding is considered the best nourishment for children in first six months. However, majority of the mothers fail to practice exclusive breastfeeding due to inadequate or lack of knowledge which poses a challenge. Thus, this study intends to assess knowledge, attitude and practices among breastfeeding mothers in Trongsa.
Methods: A cross-sectional study was used. Data was collected from 205 breast feeding mothers in Trongsa District using the pre-tested structured questionnaire.
Results: Majority (98%) of the mothers had an adequate knowledge on exclusive breastfeeding starting from early initiation, the feeding of colostrum and providing complementary feeding. Health staff and the national television were the main source of information for the mothers on exclusive breastfeeding. However, in terms of practice, 20% of them did not exclusively breastfeed and had given additional feeds along with breast milk with the assumption of insufficient mother’s milk. Similarly, 13.2% of them had squeezed and thrown away the colostrum.
Conclusions: Despite mothers having good knowledge on exclusive breastfeeding, it was not practiced and followed. This study’s findings indicate a gap between the knowledge and the actual practice of exclusive breastfeeding among breastfeeding mothers in Trongsa
A rare case of urinary bladder stone secondary to migrating Intra Uterine Device.
Get PDF Intrauterine contraceptive devices (IUCDs) is one of the most commonly used in Bhutan. IUCDs are effective, safe, cheap, and has minimal systemic side effects. One of the major but rare complications is perforation of uterus and migration into pelvic and abdominal cavity and organs. Migrating into urinary balder is a rare complication. We report the first case of bladder stone secondary to migrating Copper T in a 50-year-old female who presented to the surgical department of Jigme Dorji Dorji Wangchuck National Referral Hospital
