Year: 2024

Historically zoonotic diseases have taken millions of lives like plague and worms.

Here are some facts about zoonotic diseases, along with citations from reputable sources:

1. Prevalence:

   Approximately 60% of all infectious diseases in humans are zoonotic. This highlights the significant role that animals play in human health. (Source: World Health Organization [WHO], 2020)

2. Types of Zoonotic Diseases:

   Common zoonotic diseases include rabies, Lyme disease, West Nile virus, and COVID-19. Each has unique transmission routes and impacts. (Source: Centers for Disease Control and Prevention [CDC], 2021)

3. Transmission:

   Zoonotic diseases can be transmitted through various pathways, including direct contact with animals, bites, consumption of contaminated food, and exposure to contaminated environments. (Source: National Institutes of Health [NIH], 2018)

4. Emerging Threats:

   Many new and emerging infectious diseases are zoonotic in nature. The increase in wildlife trafficking, habitat destruction, and climate change is contributing to the rise of these diseases. (Source: EcoHealth Alliance, 2021)

5. Prevention:

   Strategies to prevent zoonotic diseases include improving animal health, promoting safe food practices, and enhancing surveillance of wildlife and livestock health. (Source: WHO, 2020)

These facts illustrate the importance of understanding zoonotic diseases and implementing preventive measures to protect public health.

Examples of zoonoses and zoonotic diseases:

There are several zoonoses and zoonotic disease are spreading throughout the world now but the most important are listed below.

1. Rabies: 

2. Lyme Disease: 

3. West Nile Virus: 

4. Salmonella: 

5. Brucellosis: 

6. Hantavirus: 

7. Zika Virus: 

8. Ebola Virus Disease: 

9. Avian Influenza (Bird Flu): 

10. COVID-19: 

11. Others

• Blastomycosis (Blastomyces dermatitidis)
• Psittacosis (Chlamydophila psittaci, Chlamydia psittaci)
• Trichinosis (Trichinella spiralis)
• Cat Scratch Disease (Bartonella henselae)
• Histoplasmosis (Histoplasma capsulatum)
• Coccidiomycosis (Valley Fever)
• Intestinal Illness Acquired From Animals
• Reptiles and Amphibians: Salmonella
• Chicks and Ducklings: Salmonella
• Bioterrorism Diseases

• Wash hands thoroughly with soap and water, especially after handling animals, their waste, or visiting animal facilities.
• Avoid direct contact with stray or wild animals.
• Use protective gloves when handling animals or cleaning up after them.

2. Vaccination and Treatment

• Vaccinate pets and livestock against zoonotic diseases, such as rabies.
• Ensure animals are regularly dewormed and treated for parasites.
• Seek prompt treatment for animal bites or scratches, especially from unknown animals.

3. Environmental and Sanitation Control

• Maintain cleanliness in homes, farms, and animal facilities.
• Properly dispose of animal waste and garbage to prevent rodent and insect infestations.
• Avoid consuming or handling food and water contaminated by animals.

4. Food Safety Practices

• Cook meat thoroughly to kill harmful pathogens.
• Avoid consuming raw or undercooked animal products, such as milk, eggs, or meat.
• Wash fruits and vegetables properly, especially if grown near animals.

5. Wildlife and Pest Control

• Limit exposure to wildlife, especially in residential or farming areas.
• Implement pest control measures to keep rodents and insects (which can spread diseases) under control.
• Avoid keeping wild animals as pets, which can increase the risk of zoonotic infections.

6. Biosecurity Measures on Farms

• Separate new animals from the existing herd until they’re deemed disease-free.
• Regularly clean and disinfect animal enclosures, feeding areas, and equipment.
• Implement strict biosecurity measures for farm workers and visitors to prevent disease spread.

7. Education and Awareness

• Educate communities about the risks of zoonotic diseases and methods for prevention.
• Train workers who handle animals on safe practices and protective measures.
• Inform the public on responsible pet ownership and wildlife interactions.

8. Travel Precautions

• Avoid close contact with animals when traveling to areas with known zoonotic outbreaks.
• Ensure that food and water consumed in endemic areas are safe and properly prepared.
• Follow all travel advisories related to zoonotic diseases.

Taking a suitable approach that combines hygiene, vaccination, environmental control, and awareness can significantly reduce the risk of zoonotic disease and its transmission.

1. Rabies
2. Anthrax
3. Brucellosis
4. Plague
5. Ebola virus disease
6. Marburg virus disease
7. Leptospirosis
8. Salmonellosis
9. Campylobacteriosis
10. Lyme disease
11. Rocky Mountain spotted fever
12. Q fever
13. Lassa fever
14. Nipah virus infection
15. Hantavirus pulmonary syndrome
16. Japanese encephalitis
17. West Nile virus
18. Zika virus
19. Yellow fever
20. Rift Valley fever
21. Avian influenza (Bird flu)
22. Swine influenza (Swine flu)
23. Bovine tuberculosis
24. Toxoplasmosis
25. Cat scratch disease
26. Chagas disease
27. Echinococcosis (Hydatid disease)
28. Leishmaniasis
29. Tularemia
30. Chikungunya
31. SARS (Severe Acute Respiratory Syndrome)
32. MERS (Middle East Respiratory Syndrome)
33. COVID-19
34. Malaria
35. Schistosomiasis
36. Cryptosporidiosis
37. Giardiasis
38. Filariasis
39. Dracunculiasis (Guinea worm disease)
40. Trichinellosis
41. Fascioliasis
42. Lymphocytic choriomeningitis virus (LCMV)
43. Venezuelan equine encephalitis
44. Eastern equine encephalitis
45. Monkeypox
46. Cysticercosis (from Taenia solium)
47. Psittacosis (Ornithosis)
48. Parrot fever
49. Dengue fever
50. Hepatitis E

Disclaimer: This article may contain texts or images that are not suitable for people below 18 years. If your’re below 18 years leave this article and go to ▶homepage.

There are basically two types of erectile dysfunction:

• Primary erectile Dysfunction: a man has never been able to attain or sustain erection
• Secondary erectile dysfunction: a man has previously been able to attain or sustain erection but now he is unable to do so.

Based upon the above types, the causes of ED can be listed as below:

1. Vascular causes/disorders
2. Neurologic causees/disorders
3. Hormonal causes
4. Psychological/Psychiatric causes
5. Systemic illness related causes

Vascular cause of erectile dysfunction:

Atherosclerosis, is the major vascular cause to be noted. Other include smoking, endothelial dysfunction, diabetes and autoimmune vasculitis.

Age is the important factor that plays great role side by side on this.

Generally low testosteone level from other hormonal dysorder also causes penile vascular abnormality and hence ED.

1. Stroke
2. Seizures
3. Multiple sclerosis
4. neuropathies
5. spinal cord injuries
1. Diabetic neuropathy
2. Surgical damage of nerves
6. Complication of pelvic surgeries
7. cancer surgeries
8. Cystectomy(removal urinary bladder)
9. TURP (surgery of prostate)

Hormonal disorders of erectile dysfunction include :

1. primary hypogonadism
2. secondary hypogonadism
3. medicaltion like anti andogens

Other causes of erectile dysfunction:

1. Pelvic radiation
2. Structural disorders of penis like pyronie disease
3. prolonged perineal pressure
4. Perineal trauma
5. sickle cell disease

Medication like cocaine use, alcohol, trazodone and inta cavernous injection of multiple injection may also c a use penile tissue destruction and the erectile dysfuncton.

No, vasectomy cannot cause erectile dysfunction. The explanation is: it blocks the way from which sperms come out by mixing with semen but it doen not reduce serum testosterone level. 

The testosterone that is produced in testicles is released into the blood but not into the semen. Hence this will have no effect on serum testosterone level hence in sexual function as well.

Diagnosis of erectle dysfunction is done clinically. For further confirmation and to rule out other causes further tests cn be done on the basis of clinical judgement.

1. Clinical evaluation
2. Screening for depression and mental illnesse
3. Serum testosterone level

Sometimes partner sexual dusfunction can also be takie ninto account to rule out the cause related to partner compliance.

Examination is also focused to pelvic, genital and systemic evluation based on history given by the patient.

Patient should be throughly evaluated for hypogonadism and pyronie disease.

Laboratory testing can be done from testosterone level to LH and prolactin as well.

Screening should be done for occult diabetes, dyslipidemia, hyperprolactinemia, thyroid disorders, cushing syndrome as well.

Penile vascular study can be done using vaoactive agents and ultrasound.

Nocturnal penile erection episode can also be measured/monitored to rule out the disgnosis.

If the patient has any of the following underlying systemic illnesses like diabetes, prolactinsecreting pituitary tumor, hypogonalism, pyronie disease appropriate treatment should be started immediately. Thyroid disease,  dislipidemia, cushing syndrome should also be treated appropriately.

Several vitamins and herbal medicine are claimed to be effective for erectile dysfunction but are not proven yet to be effective.

indian implant for erectile dysfunction

The most common drugs used to treat are 5-phosphodiasterase inhibitors like sildenafil, tadalafil etc. These drugs are available over the counter in several countries. These medications are taken orally.

If these treatment are not working, intracavernous or intraurethral prostaglandin E1, vaccum device, surgical implantation or penile prosthesis can be tried and are the final line of the treatment in case of erectile dysfunction.

CBC stands for Complete blood count. Occasionally it is also called Full blood count or Total count/Differential ccount. In the CBC total number of blood cells i.e., WBC ( and its subtypes), RBC and platelets per unit volume are measured. Full blood count may occasionally include Hemoglobein, Hematocrit and other RBC parameters as well. 

Following are the measurements done in the total blood count. 

• WBC count
• Differential WBC count
• Neutrophil
• Lymphocyte
• Monocyte
• Basophil
• Eosonophil
• Hemoglobein
• RBC
• Hematocreit or Pack cell volume (PCV)
• Mean cell volume
• Mean cell hemoglobein
• Mean cell hemoglobein concentration

The number of parameters provided by the CBC report may also depend upto the machine used for measurement.

CBC test price

Platelets floating in blood vessel

CBC blood test price in nepal: Judgement

Types of WBC in CBC

What to expect while getting your CBC done?

RBC

Normal CBC values for healthy adult

• WBC
• RBC
• HB
• MCV
• MCH
• MCHC
• HCT
•  Erythrocyte count 
• Male: 4.3–5.9 million/mm3
•  Female: 3.5–5.5 million/mm3
•  Erythrocyte sedimentation rate (Westergen) 
• Male: 0–15 mm/hr
•  Female: 0–20 mm/hr
•  Hematocrit 
• Male: 41–53%
•  Female: 36–46%
•  Hemoglobin, blood 
• Male: 13.5–17.5 g/dL
•  Female: 12.0–16.0 g/dL
•  Hemoglobin, plasma < 4 mg/dL < 0.62 µmol/L
•  Leukocyte count and differential
•  Leukocyte count 4,500–11,000/mm3
•     Segmented neutrophils 54–62%
•     Band forms  3–5%
•     Eosinophils 1–3%
•     Basophils 0–0.75%
•     Lymphocytes 25–33%
•     Monocytes 3–7%
• Mean corpuscular hemoglobin 25–35 pg/cell
• Mean corpuscular hemoglobin concentration 31%–36% Hb/cell 
• Mean corpuscular volume 80–100 µm3 80–100 fL
• Partial thromboplastin time (activated) 25–40 sec 
• Platelet count 150,000–400,000/mm3 
• Prothrombin time 11–15 sec
• Reticulocyte count 0.5–1.5% of RBCs 

Molecular structure of a Drug Named Paracetamol or Acetaminophen also called Tylenol

Drug banning is common worldwide. The specific drug or drug combination if found not useful, harmful, low quality or misused the regulation agency of the country may ban particular drug or drug formulation or combination as necessary.

It is illegal to buy, sell, recomment or use such drug in any situation in the country before ban is released or the regulatory body has provided specific written permission for special use situation of the drug.

There are plentyof drugs banned in Nepal for various reasons. 

These drus are not allowed to sale, prescribe and distribute in Nepal and doing such is a criminal activity and is punishable.

DDA is responsible for banning drugs in Nepal as a governing authority of Nepal.

1. Interaction
2. Possibility of poisoning 
3. Possibility of overdose
4. Ineffectiveness
5. Potential banned status of one drug or component

Here is list of banned drugs and combinations in Nepal

Drug banned in nepal with reason

Thank you for reading.

Feel free to comment your opinion down nbelow.

Here is the latest NHPC Notice 2080 Shrawan 12 

राष्ट्रिय चिकित्सा शिक्षा ऐन २०७५ले व्यवस्था गरे बमोजिम, चिकित्सा शिक्षाको क्षेत्रमा राज्यको लगानी अभिवृद्धि गर्दै, चिकित्सा शिक्षालाई नेपालको राष्ट्रिय आवश्यकता अनुरुप विकास गरी, चिकित्सा शिक्षाको नियमनलाई एकीकृत तथा चुस्त बनाउन, चिकित्सा शिक्षा सम्बन्धी शिक्षण संस्थाको स्थापना र सन्चालन सम्बन्धी कार्यलाई व्यवस्थित गर्न तथा चिकित्सा शिक्षामा गुणस्तर, पेशाधर्मिता, संस्थागत जवाफदेही, भौगोलिक सन्तुलन र सामाजिक न्याय कायम गरी, विपन्न लगायत सबै विध्यार्थीहरुको समान पहुँच सुनिश्चित गर्नकालागि, चिकित्सा शिक्षा सुधार गर्ने सम्बन्धमा विभिन्न समयमा गठित आयोग, समिति तथा कार्यदलको प्रतिवेदनको मर्म र भावना समेतलाई दृस्टीगत गरी, चिकित्सा शिक्षा आयोगको स्थापना र संचालन भएको हो। ऐनले चिकित्सा शिक्षालाई यसरी परिभाषित गरेको छ – “चिकित्सा शिक्षा” भन्नाले स्वास्थ्य पेशा सम्बन्धी सबै विधा र तहका शिक्षा (हेल्थ प्रोफेसनल एजुकेसन) सम्झनु पर्छ।

What is CEE for bachelor level?

It is designed to evaluate the understanding of fundamental concepts, problem-solving skills, and critical thinking abilities necessary for success in medical education. The results of the CEE are used by medical and nursing colleges to select students for their programs, ensuring that admitted candidates are well-prepared for the rigorous study and training required in these professions.

Here is pdf of  PG CEE nepal 2024.

MEC calendar will be updaed here

Here  I have prepared 30 MCQs for your practice and we can discuss the
questions in the class or sparately.

Introduction