Dr. Ram Prasad Subedi Health blog

Mad Hatter Syndrome : The felt hat industry has been traced to the  mid 17th century  in France, and it was probably introduced into England some time around  1830 . A story passed down in the hat industry gives this account of how mercury came to be used in the process: In Turkey camel hair was used for felt material, and it was discovered that the felting process was speeded up if the fibers were moistened with camel urine. It is said that in France workmen used their own urine, but one particular workman seemed consistently to produce a superior felt. This person was being treated with a  mercury compound for Syphilis  , and an association was made between mercury treatment of the fibers and an improved felt. Eventually the use of solutions of mercuric nitratewas widespread in the felt industry, and mercury poisoning became endemic.  Dementia and erethism were indeed a common ailment among  19th Century  hatmakers. The crazy Mad Hatter of...

• Hippocratic Oath : The Hippocratic Oath is traditionally taken by physicians, in which certain ethical guidelines are laid out. Several parts of the Oath have been removed or re-worded over the years in various countries, schools and societies. • Declaration of Geneva : The declaration of Geneva was intended as a revision of the Hippocrates Oath to a formulation of that oaths’ moral truth that could be comprehended and acknowledged modernly. It was adopted by the General Assembly of the World Medical Association (WMA) at Geneva in 1948 and amended in 1968, 1984, 1994, 2005 and 2006. • Declaration of Tokyo: This was adopted in 1975 (amended in 2005 and 2006) during the assembly of the WMA. It refers to the guidelines for doctors concerning torture, degradation or cruel treatment of prisoners. • Declaration of Helsinki: The WMA originally developed this declaration in 1964 and underwent major revision in 1975. It refers to the ethical principles for medical research involving human sub...

 Asepsis : Prevention of contact with microorganisms  Cleaning : Removal of adherent visible blood/soil/proteinaceous substances/ microorganisms/debris from surfaces, crevices, serrations, joints, lumens of instruments/devices/equipment by manual/mechanical process for handling or further decontamination  Detergent : Surface cleaning agent (hydrophilic and lipophilic component) that acts by lowering surface tension  Disinfection : Thermal or chemical destruction of most of the pathogens  Germicide : Agent that destroys microorganisms, especially pathogens  Hospital disinfectant : Disinfectant registered for use in any medical facility; efficacy is demonstrated against Salmonella choleraesuis, Staphylococcus aureus, Pseudomonas aeruginosa  Sanitizer : Agent that reduces number of bacterial contaminants to safe levels as per public health requirements (mainly used for inanimate objects)  Sterile : State of being free from all living microorganisms

  Ventilation in ARDS:   Acute Respiratory Distress Syndrome, (ARDS) is a condition of diffuse alveolar damage and inflammation, secondary to any number of possible processes. While ARDS always causes hypoxemia, not all hypoxemia is ARDS. ARDS is the most common severe complication of COVID-19, contributing to the severe morbidity and mortality of the infection. ARDS is defined by 4 criteria: 1.       1.  The condition must be acute (< 7 days) 2.     2.  The findings are not solely explained by cardiogenic pulmonary edema 3.     3.    The chest X-ray must have bilateral opacities 4.     4.      While on at least 5 cmH 2 O of positive pressure ventilation, the ratio of PaO 2  to FiO 2  (expressed as a decimal, such as 0.7) must be < 300 1.       Mild ARDS is a PaO 2 /FiO 2  ratio of 200-300 2.       Moderate ARDS ...

Timeline of Pandemics Pandemic means disease prevalent over whole country or world. Human being is being suffered from several infectious pandemics from (160 s – 2020 s). As human spread across the world diseases also spread in the same manner. Pandemics brought the concept of Quarantine and advanced the modern public health measures. Many lives past away due to such pandemics. Following is the timeline of pandemics. picture source: slideshare.net Antonine Plague: Year: 165-180 Death: 5 million Cause: Measles or small pox Occurred at the Roman Empire Imported by troops. Plague of Justinian: Year: 541-542 Death: 30-50 million Cause: Yersinia pestis bacteria Fleas were infected with the plague. Japanese Smallpox Epidemic: Year: 735-737 Death: 1 million Cause: Variola major virus Killed 1/3 rd of Japan’s population. Imported to Japan by a fisherman. Black Death: (Bubonic plague) Year: 1347-1351 Death: 200 million Cause: Yersin...

As a Emergecy house officer i had seen many cut wound, severed part of body. They always come within 6 hour into the hospital but simply they put ice on  that amputed part in a plastic wrap which made impossible  to restore the finger joining. Because cells of the amputated part is dying and irreversible cell injury is already occuring due to unfavorable condition . Which lead to loss of digit or body parts.  Modes of cut injury:  woking without personal hand protection.  injuries cause by blender machine, meat cutter knife , wooder cutter , wall cutter machine slippage, Tin cutter machines, different advanced factory machine injuries.             fig: tip of digit lost of little finger                  fig:  lost tip of thumb Fig: Amputed thumb was on ice in a plastic bag So people should understand the exact way to preserve amputed finger or...

I still remember when we i was suffering form  rice watery diarrhoea (cholera) during childhood days, my parent used to kept us inside home with separate utensils and bedding and clothing for roughly 5-6 days. That was also a quarantine. In this year most of the people of the people in this world  experienced  quarantine.  First of all quarantine was introduced for plague during 14th century. Lets see what other diseases has role of  quarantine with duration. Quarantine surveillance periods for some infectious diseases are as follows Cholera = 5 days  Plague = 40 days Rabies = 14 days Severe Acute Respiratory Syndrome ( SARS ) = 10 days Small pox = 21 days Yellow fever = 6 days Ref: Quarantine Regulations 2000 based on Quarantine Act 1908; Essential Public Health (Radcliffe Publishing, 2003) / page 398

Human Development Index (HDI)  • Human development index (HDI) is defined as "a composite index combining indicators representing three dimensions - longevity (life expectancy at birth); knowledge (mean years of schooling and expected years of schooling.  Before the year 2009, the indicators used were adult literacy rate and gross enrolment ratio) and income (GNI per capita in purchasing power parity in US dollars)".  • Thus the concept of HDI reflects achievements in the most basic human capabilities, viz, leading a long life, being knowledgeable and enjoying a decent standard of living. Hence, these three variables have been chosen to represent those dimensions.  • The HDI is a more comprehensive measure than per capita income. Income is only a means to human development, not an end. Nor is it a sum total of human lives. Thus by focusing on areas beyond income and treating income as a proxy for a decent standard of living, the HD! provides a more comprehensive...

CUSTOMS The mere existence of a society, the mere plurality of individuals gives rise to customs from which no single member of the community can escape. The 'highly developed' societies of the modern world are just as replete with social customs as the ' primitive societies' of the past. CULTURE The word "culture" is widely used in sociology. It is the central concept around which cultural anthropology has grown. Culture is defined as "learned behaviour which has been socially acquired". Culture is the product of human societies, and man is largely a product of his cultural environment. Culture is transmitted from one generation to another through learning processes, formal and informal. ACCULTURATION Acculturation means "culture contact." When there is contact between two people with different types of culture, there is diffusion of culture both ways. EMPORIATRICS   Term coined to describe the science of the health of travellers, Travelle...

SOME IMPORTANT ARTICLES OF Constitution of Nepal.  Article 16: Right to life of dignity  Article 17: Right to freedom Article 18: Right to Equality Article 21: Right of the victim of crime Article 22: Right against Torture Article 23: Right against preventive           Detention  Article 27: Right to information Article 28: Right to privacy Article 29: Right against Exploitation Article 30: Right to  Fresh environment Article 31: Right regarding education   Article 34: Right to labour   Article 35: Right regarding Health Article 36: Right regarding food Article 38: Women´s right Article 39: Child right Article 43: Right to Social security Article 44: Consumer´s right Ref: Constitution of Nepal 2072 ( 2015 AD.)

Covid-19 Overview: Corona Virus Disease (Covid-19) is an infectious disease highly contagious in nature caused by newly emerged member of coronal virus family. Previously corona virus known to cause common cold, SARS and MERS disease. It was believed to originated from wholesale Sea food market of Wuhan , capital city Hubei province in the People's Republic of China. First case was reported in 31st December 2019. Timeline of disease: Dec 31, 2019: WHO is informed of cases of pneumonia of unknown etiology detected in Wuhan city China. Jan 11, 2020: Report of first known death due to an illness caused by novel coronavirus. Jan 30, 2020: the WHO declares "Public health emergency of international concern". Feb 7, 2020: Chinese medic who tried to warn about the virus, dies from Novel corona virus disease. Feb11, 2020: WHO announced a name for new coronavirus disease COVID-19. Feb 29, 2020: US reports its first Covid-19 death. Mar 3, 2020: WHO warns of severe and mou...

Do you still wet your bed??? Look guys! he /she is still urinating in their bed. "Urinator" is a silly name given to them by their friends and family members. A Child is good in studies ,active in  sports. Still he/she have to face humiliation due to their bedwetting problem. We have heard people having sleepwalking, night terror,  and bedwetting . What is the reality  or truth behind it? Now, let's discuss why some children experience  bedwetting . Medically bedwetting is called nocturnal enuresis defined as "Urinary incontenance more than equal to 2 times per week for more than equal to 3 months in a person more than 5 years old". Sleep cycle has 2 stages : Non-REM Sleep and REM Sleep (Rapid Eye Movement Sleep ie. sleep with dreams )   Non-REM or Dreamless Sleep has 3 parts. 1. N1= superficial sleep.  2. N2= Deeper sleep where bruxism or tooth grinding occurs. 3. N3= Deepest sleep, where bedwetting , Night terror, sleepwalking occurs.  So bed wett...

As monsoon starts in Nepal, movements of peoples in the community increases so leads to increase the cases of common prevalent diseases.  Many diseases occurs during rainy season like Acute Gastroenteritis, Typhoid fever, Dengue fever , Malaria, Viral hepatitis and seasonal flu. Following are the some common monsoon diseases with features. 1. Typhoid Fever  Typhoid fever also known as Enteric fever caused by a bacteria called Salmonella typhi which found in infected person's stool. Spread by faeco-oral route (unfiltered water,  unhygienic street foods, flies, uncleaned hands, uncleaned plate and glass).Infected patients may develop: high Fever , weakness of body, loss of appetite, vomiting, constipation initially , Fatigue, diarrhea, Headache, Rash in chest and back called rose spot , confusion in 2nd and third week of disease onset.               Rash in typhoid(rose spot)              ...