BackgroundPoor mental health among medical students is widely acknowledged. Studies on mental health among medical students of Nepal are lacking. Therefore, we conducted a study to determine the prevalence of mental disorders.MethodsA cross-sectional study was conducted among medical students at KIST Medical College and Teaching Hospital, Nepal from December 2016 to February 2017. Our survey instrument consisted of the Patient Health Questionnaire (PHQ) and questions about socio-demographic factors, smoking, marijuana use, suicidal ideation and thoughts of dropping out of medical school.ResultsThe prevalence rates were 29.2% (95% CI, 24.4% – 34.3%) depression, 22.4% (95% CI, 18.0% – 26.9%) medium to highly severe somatic symptoms, 4.1% (95% CI, 2.0% – 6.2%) panic syndrome, 5.8% (95% CI, 3.4% – 8.3%) other anxiety syndrome, 5% (95% CI, 2.7% – 7.3%) binge eating disorder and 1.2% (95% CI, 0.0% - 2.3%) bulimia nervosa. Sixteen students [4.7% (95% CI, 2.4% – 6.9%)] seriously considered committing suicide while in medical school. Thirty-four students [9.9% (95% CI, 6.8% – 13.1%)] considered dropping out of medical school within the past month. About 15% (95% CI, 11.1% – 18.6%) of the students reported use of marijuana during medical school.ConclusionsWe found high prevalence of poor mental health among medical students of Nepal. Future studies are required to identify the factors associated with poor mental health.Electronic supplementary materialThe online version of this article (10.1186/s12909-017-1083-0) contains supplementary material, which is available to authorized users.

BackgroundIn developing countries like Nepal, 90% ethanol is cheap and is available in most hospitals. The unavailability of isopropyl alcohol (IPA) in these settings led us to compare the efficacy between 90% ethanol and isopropyl alcohol pads in reducing the bacterial contamination of diaphragm of stethoscope.MethodsA randomized blinded experimental study was carried out to determine the difference between cleaning stethoscopes with 90% ethanol and IPA. Cultures of diaphragm were taken before and after cleaning with one of the cleaning agent. Colony forming units (CFU) count and organism identification was done by a blinded investigator. CFU before and after cleaning were compared using Wilcoxon signed–rank test. Mann Whitney U test was used to compare the decrease in CFU count between the cleaning agents.ResultsAbout 30% of the stethoscopes harbored potential pathogens. Significant reduction in CFU was observed with both IPA (Wilcoxon signed–rank test, P value <0.001) and 90% ethanol (Wilcoxon signed–rank test, P value <0.001). Comparing median decrease in CFU between cleaning with IPA and with 90% ethanol, no significant difference was found (Mann Whitney U test; U = 1357, P value >0.05).ConclusionsBoth 90% ethanol and IPA are equally effective in decontaminating the diaphragm of stethoscope. Selection of agent should be done on the basis of cost and availability.

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Background: Enteric fever is a major public health problem in Nepal. Trends of drug resistance help in choosing optimal empiric therapy. Objective: The objective of this study was to determine antibiotic resistance pattern of Salmonella enterica serotype typhi and Salmonella enterica serotype paratyphi isolated from blood cultures. Methodology: A descriptive study was conducted using hospital records at KIST Medical College and Teaching Hospital, Nepal. Isolates from blood cultures between January 2011 and December 2013 were included in this study. Susceptibility to various antimicrobials was determined using modifi ed Kirby-Bauer disk diffusion method. A chi-square for trend analysis was done to evaluate change in susceptibility over three years. Results: Out of 216 isolates, 68.05% were Salmonella typhi and 31.48% were Salmonella paratyphi A. In Salmonella typhi, there was signifi cant increase in cefotaxime resistance(X 2 = 4.951, p < 0.05) and ciprofl oxacin resistance (X 2 = 17.506, p < 0.001) whereas there was signifi cant decrease in ampicillin resistance (X 2 = 4.830, p < 0.05). No resistance was seen against ceftriaxone in Salmonella typhi and Salmonella paratyphi A. Resistance to chloramphenicol and cotrimoxazole was low as well, in both isolates. None of the isolates tested were multidrug resistant. Conclusion: There is emergence of resistance to cefotaxime whereas resistance to ciprofl oxacin has made its use as empiric therapy questionable. Full susceptibility of ceftriaxone makes it an excellent antibiotic for empiric therapy. Decrease in resistance to chloramphenicol, cotrimoxazole and ampicillin may again make these agents useful.

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