| The
department has three basic
responsibilities: teaching,
service and research. Besides
these, the department actively
participates in various
community and extramural
activities of the institute. It
endeavors to groom and develop
its faculty and students to
acquire skills in teaching and
learning activities,
professional expertise and
research acumen. Each faculty
pursues Internal Medicine and a
subspecialty interest. Thus we
have been able to form a nucleus
of Tropical Medicine /
Infectious Disease (Dr. Suman
Rijal, Dr. Rabin Shrestha),
Cardiology (Dr. Prahlad Karki,
Dr. Pramod Acharya),
Gastroenterology & Hepatology
(Dr. Matrika Regmi, Dr R Laxmi
Chauhan, Dr Bikram Pradhan),
Pulmonary Medicine and Critical
care (Dr. Narendra Bhatta),
Nephrology (Dr. Sanjib Kumar
Sharma) and Neurology (Dr.
Bhupender Kumar Bajaj). We
propose to develop a nucleus of
Endocrinology. |
| Plan of
Action: |
It is
proposed to develop a nucleus of
endocrinology. It has also been
envisaged to expand the
cardiology services by making
available permanent pace maker /
Stress Echo, Trans esophageal
ECHO, Angiography (Cath Lab) and
training of faculty member in
non-interventional and
interventional cardiology.
Similarly, the renal services
are to be further strengthened.
Steps are being taken to extend
renal replacement service
(continuous ambulatory
peritoneal dialysis),
development of Preventive
Nephrology Clinic and community
survey and prevention of renal
diseases. BPKIHS being a major
referral Institute for
Nephrology, it is proposed to
develop all modalities of
Nephrology services, Renal
Diseases Prevention Program and
Research program in Nephrology.
Plans for further expansion of
services by starting endoscope
sclerotherapy, colonoscopy and
ERCP are also on anvil.
Establishment of the office
spirometry, training of a
faculty member in interventional
pulmonology, upgrading of the
existing bronchoscopy services,
acquisition of the computer to
record the case and management
details of patient and
inter-institutional
collaborations in the field of
Respiratory medicine / trans
bronchial biopsy.
A two-year in-service programme
to improve technical know-how of
laboratory staff posted in TMT,
Echo, ERCP, Colonoscopy,
endoscope and dialysis unit is
also being planned for. Increase
the activities of the tropical
and infectious diseases at
BPKIHS by (i) direct admissions
to the tropical and infectious
diseases ward to include
patients with HIV/AIDS, tetanus,
malaria and kala-azar. (ii)
Start drug trials and
interventional research projects
on prevention of vector-borne
diseases (iii) increase
collaborations with established
tropical disease institutes for
exchange of faculty and students
and (iv) expand HIV services to
include distribution of
medications per the national
guidelines for HIV and STDs.
|
|
Services |
Besides
routine professional services in
ward and OPD, special
investigative procedures like
Echocardiography, Holter
monitoring, Upper
gastrointestinal endoscopy,
Pulmonary function tests,
Bronchoscopy, Nerve conduction
studies, Electromyography, Blink
Reflex, Repetitive Nerve
Stimulation, Evoked Potentials (
VEP, BAEP, SSEP) and
Electroencephalography are also
offered. The department also
runs a dialysis unit providing
both hemodialysis as well as
peritoneal dialysis. In the CCU
temporary pacemakers can be
inserted.
|
| Public
Health/Community Service |
- Inaruwa OPD = 522
- Community Health Check
up Program = 5397
- Dr Sanjib Sharma. "Renal
Disease Detection and
Prevention Program" in
Community of Dharan
Combined project of BPKIHS
(Department of Medicine,
Biochemistry and College of
Nursing); Rotary Club,
Dharan, Ghopa and Nepal
Diabetes and Kidney Care
Foundation
- Diabetes and Kidney
disease check up = 3218
- Camp run by
HMG,(Ministry of Health)
- Taplejung Camp
- Okaldhunga = 3800
- Terathum = 3783
- Khotang = 1245
|
|
Hospital Service |
In-patient services are
provided to patients admitted in
the medicine ward, isolation
beds, coronary care unit,
medical intensive care unit and
the tropical and infectious
diseases ward. Initial clinical
evaluation of the patient,
diagnostic work-up, clinical
decision-making and therapeutic
interventions are carried out
under the supervision of the
faculty members. Analysis of the
signs and symptoms, clinical
decision-making and minor
intervention procedures are
taught to the interns and house
physicians when posted. In
addition, an opinion on internal
medicine problems for patients
admitted under other specialties
is provided via routine and
urgent consultations.
- Specialty O.P.D. 6 days
a week [9.00 AM 1.00 PM]
- Specialty paying clinic
3 days a week [Afternoons
2.00 PM 5.00 PM]
- Emergency service on
call 7 days a week [24
hours]
- Upper G. I. endoscopy 5
days a week [6 Sessions]
- Echocardiography 3 days
a week [2.00 PM 5.00 PM]
- Peritoneal dialysis & 7
days a week [24 hours]
- Haemodialysis
- Bronchoscopy 2 days a
week [Morning and
Afternoons]
-----------------------------
Specialty Clinic
----------------------------
- Gastroenterology 1 day
[Sunday 2.00 PM 5.00 PM]
- Cardiology 1 day
[Tuesdays 9.00 AM 1.00 PM]
- Adult Chest Clinic 1 day
[Wednesdays 9.00 AM 1.00
PM]
- Nephrology 1 day
[Thursdays 9.00 AM 1.00
PM]
- Diabetes Clinic and
Renal Disease
- Prevention clinic 1 day
[Mondays 2.00 PM 5.00 PM]
- Neurology Clinic 2 days
[Sundays/Wednesday 2.00 PM
5.00 PM]
- Infectious Diseases
Clinic 1 Day [Tuesday 3.00
PM 5.00 PM]
|
|
Dialysis and Nephrology service: |
|
BPKIHS is the
only center providing
hemodialysis and peritoneal
dialysis services in Eastern
Nepal. The unit is providing
24-hour services for renal
patients and facilities for
peritoneal dialysis and
hemodialysis exist round the
clock. With the acquisition of
11 hemodialysis machines donated
by The Royal London Hospital,
London, the services will be
further expanded. Continuous
ambulatory peritoneal dialysis
is also offered if indicated.
The Nephrology clinic started
functioning from Aswin 2057. It
is currently being held once a
week at 9 am on Thursday under
the supervision of Dr. Sanjib
Kumar Sharma. The Diabetes
Clinic and Renal Disease
Prevention clinic is held on
Monday afternoons. |
|
Diabetes clinic (Renal disease
prevention clinic): |
| Prevalence of
diabetes mellitus is high even
in the eastern Nepal as
elsewhere in the world, which
amounts to approximately 8% of
the general population. Diabetic
Nephropathy being the leading
cause of end stage renal disease
which can be prevented if proper
glycemic control is initiated
early in the course of diabetes
mellitus. So, this clinic has
been started along with
Ophthalmologist and Dietician to
educate and treat the patients
of diabetes. |
|
Cardiology services: |
| The Cardiology
clinic started functioning from
Aswin 2057. It is currently
being held once a week at 9 am
on Tuesdays under the
supervision of Dr. Prahlad Karki
and Dr Promod Acharya. Currently
offered services include
Electrocardiography,
Echocardiography, Holter
monitoring and Ambulatory Blood
Pressure monitoring. Plans are
on to re-instate the treadmill
test. An active Coronary Care
Unit also is run by the
department. |
|
Respiratory and critical care
medicine services |
|
The department of internal
medicine has expanded its
service for the patients with
respiratory diseases by
providing care through the
nucleus of respiratory and
critical care medicine.
Currently it provides the
service through three different
Modalities Dr Narendra Bhatta is
Incharge of Respiratory and
Critical care ,includig the
Bronchoscopy services in the
department of Internal Medicine
|
---------------------
Adult Chest Clinic
--------------------------
The department of internal
medicine has expanded its
service for the patients with
respiratory diseases by
providing care through the
nucleus of respiratory and
critical care medicine.
Currently it provides the
service through three different
Modalities Dr Narendra Bhatta is
Incharge of Respiratory and
Critical care ,includig the
Bronchoscopy services in the
department of Internal Medicine
---------------------
Bronchoscopy services
---------------------
The department pf internal
medicine has received a state of
the art Olympus video
bronchoscope system from
Government of Japan. This has
helped us to expand the existing
bronchoscopy services .
Currently transbronchial biopsy
and Trans bronchial needle
aspirations are also done along
with routine bronchoscopy
services.
---------------------
Respiratory lab
--------------------
Currently office spirometry
services are provided through
the respiratory lab. there are
plans to upgrade this service to
a completely functional
pulmonary function test
laboratory in near future.
--------------------
Medical intensive care Unit
(MICU)
-------------------
The department of internal
medicine has started the Medical
ICU which at present consists of
four beds. there are two
ventilators at present . it is
proposed to upgrade this medical
ICU by addition of two more beds
and two more ventilators . soon
we would be acquiring the non
invasive ventilators also. The
medical ICU has been
instrumental in providing care
to the critically ill patients
as well s training the Junior
residents in pulmonary and
critical care medicine. |
|
Gastroenterology Clinic |
|
Enormous numbers of the patients
with gastrointestinal and
hepato-biliary disease have been
presenting in MOPD as evidenced
by previous years records. So
the Gastroenterology Clinic has
been started for clinical
practice and teaching,
investigational facilities and
to develop treatment protocol
for prevalent gastrointestinal
and hepato-biliary diseases. |
|
Neurology Services: |
|
Special Neurology Services
including outpatient and
inpatient care, and
neuroelectrophysiology tests
have been started since May 2004
under supervision of Dr.
B.K.Bajaj. Neurology clinic is
run twice a week benefiting more
than 200 patients every month.
Postgraduate students of
medicine, psychiatry and family
medicine are being trained in
management of neurological
disorders.
Neuroelectrophysiology services
including NCV, EMG, Blink
reflex, Repetitive Nerve
Stimulation Evoked potentials
(BAEP, VEP, SSEP) and EEG are
now being regularly conducted by
the department of Medicine.
Attempt is being made to
identify the residents in
faculty development for further
training, so that there is
continuity in the availability
of these services |
|
Infectious Diseases Clinic |
|
This clinic was started in April
2005 to provide better services
for patients infected with human
immunodeficiency virus. The
epidemic of HIV infection in
Nepal is slowly unfolding with
increasing number of patients
being aware that they are HIV
positive. The aim of the clinic
is to provide comprehensive care
to patients infected with HIV,
educate healthcare professionals
as well as patients regarding
HIV, develop a database on HIV
patients seeking services from
the clinic and promote research
in the field of HIV. In this
coming year plans are underway
for BPKIHS to be one of the four
centers in Nepal that will be
providing anti-retroviral
therapy for HMG. |
