Background: Peripheral intravenous catheter-related phlebitis is a common and signi¿ cant problem in clinical practice. This study was carried out to determine the occurrence of peripheral intravenous catheter related phlebitis and to de¿ ne the possible factors associated to its development. Materials and methods: Prospective observational study was carried out on 230 clients who were under ¿ rst time peripheral infusion therapy during two months period: September -October, 2007. Peripheral infusion site was examined for signs of phlebitis once a day. Jackson Standard visual phlebitis scale was used to measure the severity of the phlebitis. SPSS software was used to enter, edit and analyze the data and t-test, chi-square test, binary logistic regression and ROC curve were used to draw the statistical inferences. Results: Phlebitis developed in 136/230 clients (59.1%). It was very mild in most cases. Increased incidence rates of infusion related phlebitis were associated with male sex, small catheter size (20 gauge), insertion at the sites of forearm, IV drug administration and blood product transfusions. The incidence rate of phlebitis rose sharply after 36 hours of catheter insertion. Conclusion: Peripheral Intravenous therapy related phlebitis at KUTH, Dhulikhel Hospital is a signi¿ cant problem. Related risk factors as found in the present study were insertion site (forearm), size of catheter (20G) and dwell time (>= 36 hours). There were higher incident of phlebitis among the client with Intra venous drug administration and especially between ages 21 -40 years. Therefore more attention and care are needed in these areas by the care provider.Key words: Phlebitis, Intravenous Therapy, Catheter, Risk Factors, KUTH, Nepal. I ntravascular devices are common and play very important role in modern day medical practice. One of the devices most used is the peripheral intravenous catheter (PIC) for IV À uids, IV medications, blood product administration, or blood sampling 1 . About 50% of hospital patients require intravenous (IV) access 2 . Although such catheter provides necessary intravascular access, their use puts client at risk for associated complications which may be local and systemic.One of the most common complications of PIC is phlebitis that may occur in up to75% of hospitalized patients 3 . It remains a signi¿ cant problem in clinical practice and causes patient discomfort, catheter replacement, prolong hospital stay and health care cost. Many factors have been implicated in the genesis of phlebitis namely (1) chemical factors such as irritant drugs and À uids, (2) mechanical factors: such as catheter material, size of cannula, site of insertion, duration of cannulation (dwell time) 4 etc. Many cases of PICs related phlebitis has been noted at KUTH, Dhulikhel Hospital, Kathmandu University Teaching Hospital. A prospective observational study was conducted to assess the magnitude of the problem as well as to shed some light on possible contributing factors. Awareness of such factors may help to ...

BackgroundPharmacovigilance activities are in a developing stage in Nepal. ADR reporting is mainly confined to healthcare professionals working in institutions recognized as regional pharmacovigilance centers. Community pharmacists could play an important role in pharmacovigilance. This study was conducted among community pharmacists in Lalitpur district to examine their knowledge and attitude about pharmacovigilance before and after an educational intervention.MethodsKnowledge and attitude was studied before, immediately after and 6 weeks following the intervention among 75 community pharmacists. Responses were analysed using descriptive and inferential statistics. A pretested questionnaire having twelve and nine statements for assessing knowledge and attitude were used. The overall scores were obtained by adding the ‘knowledge’ and ‘attitude’ scores and ‘overall’ scores were summarized using median and interquartile range. Wilcoxon signed-rank test for repeated samples was used to compare the differences between knowledge and attitude of the pharmacists before and after the educational program.ResultsKnowledge scores [median (interquartile range)] improved significantly between pre-test [39 (44–46)], post-test [44 (44–44)] and retention period of 6 weeks after the intervention [46 (43–46)]. Knowledge score improved immediately post-intervention among both males [44 (41–47)] and females [44 (43–45)] but the retention scores (after 6 weeks) were higher [46 (42–48)] among males. Attitude scores improved significantly among females [46 (44–48)]. The overall scores were higher among pharmacists from rural areas.ConclusionKnowledge and attitude scores improved after the educational intervention. Further studies in other regions of the country are required. The national pharmacovigilance center should promote awareness about ADR reporting among community pharmacists.Electronic supplementary materialThe online version of this article (doi:10.1186/s13104-016-2343-5) contains supplementary material, which is available to authorized users.

Nepal is a low-income, landlocked country located on the Indian subcontinent between China and India. The challenge of finding human resources for rural community health care settings is not unique to Nepal. In spite of the challenges, the health sector has made significant improvement in national health indices over the past half century. However, in terms of access to and quality of health services and impact, there remains a gross urban-rural disparity. The Patan Academy of Health Sciences (PAHS) has adopted a community-based education model, termed “community based learning and education" (CBLE), as one of the principal strategies and pedagogic methods. This method is linked to the PAHS mission of improving rural health in Nepal by training medical students through real-life experience in rural areas and developing a positive attitude among its graduates towards working in rural areas.This article outlines the PAHS approach of ruralizing the academy, which aligns with the concept of community engagement in health professional education. We describe how PAHS has embedded medical education in rural community settings, encouraging the learning context to be rural, fostering opportunities for community and peripheral health workers to participate in teaching-learning as well as evaluation of medical students, and involving community people in curriculum design and implementation.

An interesting case is presented of a wooden foreign body in the neck entering through the right lower vestibule of the mouth. The foreign body traveled subcutaneously in the neck and got stuck in the clavicle, without damaging any vital structures. In this case, the authors highlight the mode of entry of the foreign body, the peculiarity of the wooden foreign body, the management protocol and the outcomes of the penetrating neck injury by the wooden stick.