Introduction: An effective Emergency Medical Service system does not exist in Nepal. For an effective EMS system to be developed the scale of the problem and the existing facilities need to be studied. Methods: Prospective observational study was carried out on 1964 patients attending Emergency Department at Patan Hospital during one month period of September 2006. The patients were specifically enquired on mode of transport used, place of origin and whether they called for an ambulance or not. Patients triage category at the time of triaging was also noted. Information on ambulance service were collected by direct interview with the service providers and the total number of patients attending Emergency Departments daily were collected from the major hospitals of the urban Lalitpur and Kathmandu. MS Excel and SPSS software were used for data entry, editing and analysis.Results: Total 9.9% patients arrived in ambulance whereas 53.6% came in a Taxi, 11.4% came in private vehicle, 13.5 % came by bus, 5.4% came by bike and the rest 6.2% came by other modes of transportation. Only 13.5% of triage category I patients took the ambulance. There were 31 service providers with 49 ambulances and 720 patients per day attend Emergency Departments in the surveyed area. Conclusions: Very less number of patients use the ambulance service for emergency services. The available ambulances are not properly equipped and do not have trained staff and as such are only a means of transportation to the hospitals of urban Lalitpur and Kathmandu.Key Words: ambulance, emergency medical service, para-medics, triage Need of Improvement in Emergency Medical Service in Urban Cities Gongal R,1Dhungana B,1Regmi S,1Nakarmi M,2Yadav B11Patan Hospital, Lalitpur, Nepal, 2Health Care Foundation, Kathmandu, NepalCorrespondence:Dr. Rajesh GongalDepartment of SurgeryPatan Hospital, Patan, Nepal.Email: rajgongal@yahoo.comORIGINAL ARTICLE J Nepal Med Assoc 2009;48(174):139-43INTRODUCTIONThe sophisticated Emergency Medical Service (EMS) is limited to developed country only. Many developing countries are now slowly developing such system although most services are localized to the urban areas.1-5 Although inadquate ambulance services are available in the capital city of Nepa

Purpose :Findings : Conclusion : Keywords :The usage of medicinal herbs in the treatment or cure of various human ailments has been reported since past many centuries. Due to less toxicity of herbs when compared with allopathic drug, these are utilized in the development of formulations to increase efficacy. This review explores the various chemical constituents of the plant Kigelia pinnata, commonly called as Sausage tree, and their therapeutic effects in various human ailments.Kigelia pinnata has been proven to contain many secondary metabolites like alkaloids, glycosides, tannins, saponins, terpenoids, flavonoids, sterols, fatty acids, naphthaquinones, etc. The plant possesses many traditional uses such as anticancer, antileprotic, antimalarial, antibacterial, analgesic and anti-inflammatory, antiurolithiasis, antidiarrhoeal, antioxidant, antidiabetic, etc.Kigelia pinnata is an important plant bearing significant medicinal values in human. This review thus helps the researcher to evaluate and establish the use of plant in various conditions as a curative or as a prophylactic agent and it also highlights the potential of the plant as therapeutic agents in different human ailments.

Introduction: Fast-dissolving oral delivery system is a solid dosage form, which is used as a novel approach, as it dissolves rapidly in the mouth and directly reaches the systemic circulation. This facilitates rapid absorption and reduces first-pass effects. These films provide better utilization without the need to chew and do not require the need of water for administration. Fast-dissolving oral films might be useful in special patients like those with swallowing difficulties and in that in chemotherapy. This study was aimed to formulate and evaluate the fast dissolving oral films of Cetirizine Hydrochloride. Methods: Oral films of Cetirizine Hydrochloride were prepared using Hydroxy Propyl Methyl Cellulose (HPMC), Polyvinyl alcohol, glycerol, aspartame in different concentrations by the solvent casting method. Films were evaluated for different physical Films were subjected to USP dissolution studies. Results: The drug content of the nine formulations was found to be in the range as per Indian Pharmacopeia. In vitro release studies indicated 60-91% release within 30 min in the formulated oral films. The best release was found to be 91.58% of formulation F7, having a minimum concentration of HPMC alone as a polymer along with other common ingredients and minimum release was found to be 60.01% of formulation F1. Surface pH was found to be near to neutral (pH 7) which was good for buccal mucosa. Conclusion: Increasing the concentration of polymer (PVA and HPMC) while keeping the plasticizer ratio constant showed enhanced folding endurance. The dissolution rates were also increased with the increase in the concentration of the polymers. The high concentration of polymers decreased the release rate of cetirizine while a low concentration of polymers causes an increment in the release rate of cetirizine.

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Background:This is an effort just snapshot the pharmacy practice scenario in Nepal. Job satisfaction is a very important contributing factor for person’s productivity and motivation. Pharmacists are the key players of the health care system. The main objective find out the present scenario of pharmacy practice and job satisfaction of Nepalese pharmacists. We start our approach from the demographic information, choice and selection of the pharmacy education, study site, practicing site, duration of work, expected and real salary of practicing pharmacists. Methods:A practice scenario and job satisfaction related questionnaires were developed and pilot test was done with ten pharmacy practitioners who were practicing from more than ten years in Nepal for reliability. Minor modification on questionnaires was done after pilot testing. Ethical clearance was taken from the MMIHS –IRC. Results:Male pharmacists are dominating to female. The satisfaction level of Nepalese pharmacist was found to be 73.60%. Similarly, around 73.10% of pharmacists were satisfied with nature of work and 71.60% of pharmacists were satisfied with the time duration of work whereas nearly half of the pharmacists were unsatisfied with their income and pay scale. Conclusion: Till date pharmacist is not the permanent member of health care system in Nepal. 70 % pharmacists are highly productive stage of between ages 20-30 years. The inherent interest in the pharmacy profession found among Nepalese pharmacists is an optimistic and policy-makers could develop, modifying national health policy for the implementation of pharmaceutical service as an integral part of national health care system of the country for the benefit of the public health as a whole. The Government and other authorities have to consider for a universal, multifaceted measure of satisfaction not merely the salary benefits.