Bhutan Health Journal最新文献_第5页

Uterine didelphys: diagnosis in late pregnancy 子宫白喉:妊娠晚期的诊断

Bhutan Health Journal Pub Date : 2019-11-13 DOI: 10.47811/bhj.88

N. Dorji, Nidup Gyeltshen

引用次数: 2

Improving healthcare performance by focusing on individual productivity of healthcare provider and system thinking: a strategy proposal 通过关注医疗保健提供者的个人生产力和系统思维来改善医疗保健绩效:一项战略建议

Bhutan Health Journal Pub Date : 2019-11-13 DOI: 10.47811/bhj.89

C. Wangmo

{"title":"Improving healthcare performance by focusing on individual productivity of healthcare provider and system thinking: a strategy proposal","authors":"C. Wangmo","doi":"10.47811/bhj.89","DOIUrl":"https://doi.org/10.47811/bhj.89","url":null,"abstract":"Bhutan’s health system, despite its commendable achievements in past few decades, continues to face shortage of skilled healthcare professionals and quality issues in service delivery. While recruiting more professionals, advocating for population health, better patient experience and safety, healthcare provider wellness has been overlooked. As the recent pay revision receives warm welcome from the health fraternity, a sense of greater professionalism and responsibility will be expected. Yet, aforementioned challenges still remain. Life and aspirations of professionals, brought up and trained in society that provides free healthcare and education, will become more convoluted. Mentorship program for healthcare providers at the beginning of their career and institutionalizing enabling environment for their personal and professional development need to be looked into. Decisions to pursue specialization should be a result of genuine interest and not a presumed exit hallway from professional frustrations, nor a shortcut to hefty pay. A promising and congruous career pathway can improve job satisfaction among health care providers. Endeavors to improve healthcare service delivery are present at every level but lack of coordination hampers favorable outcome. Variation in healthcare is major cause of adverse healthcare outcome and it is also known that every system is perfectly designed to achieve the results it gets. After conceptualizing few desired outcomes, a strategy framework that leads to health system improvement through improved individual productivity and systemic reforms enhancing intra- and inter sectoral coordination, while using evidence-based practice and existing resources, is proposed.","PeriodicalId":410038,"journal":{"name":"Bhutan Health Journal","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127798812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Blood Lead Levels in children 2 through 59 months old in Bhutan 不丹2至59个月大儿童血铅水平

Bhutan Health Journal Pub Date : 2019-11-13 DOI: 10.47811/bhj.83

Phillip Erbele, Deki Pem, Phensum Tobgay, S. Pelden, M. Gurung, Sonam Ugen, Krista Erbele

{"title":"Blood Lead Levels in children 2 through 59 months old in Bhutan","authors":"Phillip Erbele, Deki Pem, Phensum Tobgay, S. Pelden, M. Gurung, Sonam Ugen, Krista Erbele","doi":"10.47811/bhj.83","DOIUrl":"https://doi.org/10.47811/bhj.83","url":null,"abstract":"Introduction: Pediatric lead exposure has long-term health, public health, and economic consequences; however, it is an underrecognized problem in low and middle-income countries. Our objective was to determine the prevalence of elevated blood lead levels (EBLLs) (greater than or equal to 5mg/dL) and evaluate risk factors for EBLLs in infants and children in two cities in Bhutan.\u0000Methods: A cross-sectional study of children 2 through 59 months old was conducted in Thimphu and Phuentsholing, Bhutan during 2018. Blood was obtained by finger-stick and tested using a LeadCare II analyzer (Meridian Bioscience). Data were double entered in EpiData 3.1 and validated. Excel, Prism8, and STATA/IC 15.1 were used for analysis.\u0000Results: Among 531 participants, the prevalence of EBLLs was 43.88%. The prevalence of EBLLs in girls and boys was 37.40% (n=262) and 50.19% (n=269), respectively (p= 0.004). The prevalence in Thimphu was 52.35% (n=361), compared to 25.88% (n=170) in Phuentsholing (p less than 0.001). In Thimphu, 70.47% (n=149) of 1 - 4 year old children tested in spring had EBLLs, compared to 51.45% (n=138) in autumn (p=0.001). Of the risk factors assessed, only regularly eating with fingers or hands was significantly associated with EBLLs (p < 0.001).\u0000Conclusions: Nearly half of participants in two cities in Bhutan had elevated blood lead levels. Seasonal exposure to lead appears to be present. The high prevalence in this study is alarming. Further studies are urgently needed to both characterize the sources of lead and validate these findings on a larger scale.","PeriodicalId":410038,"journal":{"name":"Bhutan Health Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130502513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

The eradication of polio in Bhutan in the context of global polio eradication 在全球消灭小儿麻痹症的背景下在不丹消灭小儿麻痹症

Bhutan Health Journal Pub Date : 2019-05-15 DOI: 10.47811/bhj.79

T. Dorji, T. Dorji, B. Melgaard

引用次数: 2

Knowledge, attitude and practice on advanced cardiac life support (ACLS) among the general duty medical officers in Bhutan 不丹普通值班医务人员对高级心脏生命支持(ACLS)的知识、态度和做法

Bhutan Health Journal Pub Date : 2019-05-15 DOI: 10.47811/bhj.77

Sona Pradhan, K. Tenzin, Dorji Pelzom, J. Dorji, Passang Dorji, M. Gurung

引用次数: 2

Incidence and factors associated with surgical site infections at the Surgical Ward, National Referral Hospital, Bhutan 不丹国家转诊医院外科病房手术部位感染的发生率和相关因素

Bhutan Health Journal Pub Date : 2019-05-15 DOI: 10.47811/bhj.74

S. Jamtsho, T. Wangdi, P. Wangdi, Phurba Wangdi

{"title":"Incidence and factors associated with surgical site infections at the Surgical Ward, National Referral Hospital, Bhutan","authors":"S. Jamtsho, T. Wangdi, P. Wangdi, Phurba Wangdi","doi":"10.47811/bhj.74","DOIUrl":"https://doi.org/10.47811/bhj.74","url":null,"abstract":"Introduction: 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.\u0000Methods: 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.\u0000Results: 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.\u0000Conclusions: 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.","PeriodicalId":410038,"journal":{"name":"Bhutan Health Journal","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126890879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

A rare case of urinary bladder stone secondary to migrating Intra Uterine Device. 子宫内节育器迁移继发膀胱结石一例。

Bhutan Health Journal Pub Date : 2019-05-15 DOI: 10.47811/bhj.76

S. Jamtsho

引用次数: 0

Association of maternal serum beta human chorionic gonadotropin (B-hCG) level with intrayterine growth restriction: a case control study 母体血清β -人绒毛膜促性腺激素(B-hCG)水平与宫内生长限制的关系:一项病例对照研究

Bhutan Health Journal Pub Date : 2019-05-15 DOI: 10.47811/bhj.110

Yeshey Dorjey

{"title":"Association of maternal serum beta human chorionic gonadotropin (B-hCG) level with intrayterine growth restriction: a case control study","authors":"Yeshey Dorjey","doi":"10.47811/bhj.110","DOIUrl":"https://doi.org/10.47811/bhj.110","url":null,"abstract":"Introduction: 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. \u0000Methods: 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.\u0000Results: 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.\u0000Conclusions: The study concluded a significant association between the raised levels of B-hCG with IUGR.\u0000 ","PeriodicalId":410038,"journal":{"name":"Bhutan Health Journal","volume":"174 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132246337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Mental Health Matters: Everyone's Responsibility 心理健康问题:每个人的责任

Bhutan Health Journal Pub Date : 2019-05-15 DOI: 10.47811/bhj.72

D. Nirola

引用次数: 0

Methodology and criteria for setting national health research priorities in Bhutan: a workshop report 确定不丹国家卫生研究优先事项的方法和标准:一份讲习班报告

Bhutan Health Journal Pub Date : 2019-05-15 DOI: 10.47811/bhj.78

Debbie L. Humphries, Hannah Ingber, M. Gurung, K. Khoshnood

引用次数: 1