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NID pre enrollment – 5 steps registration 2081 update: NID pre enrollment Rastriya Parichaya Patra Online Registration 2081

NID pre enrollment is a process of online registration of your personal data in a government portal to get National identity card (NID) in Nepal.

राष्ट्रिय परिचयपत्र अनलाइन फारम भर्ने तरिका

The postal allows to submit you the identification information to the posrtal and lets you provide biometric from the nearby office to the portal and letss you get national identification card.

What is National identification card?

NID or national identity card of Nepal is a new form of card with electronic data embeded in it which has all of the personal data as well as biometric information of a person in it.

The card is electronically readable and has biometric informations also available for verification purpose.

NID pre enrollment system

NID pre enrollment system is a givernment protal which can be accessed by visiting the Department of National identification and civil registration.

The website for DONIDCR can be accesses by clicking this link. 

How to fill NID pre enrollment form online?

In this article we will guide you through step by step process of NID pre enrollment form fill u pso please read till the end.

There will be a link called pre enrollment form fillup as shown in the image. 

Step 2: Click on login fr individuals in the DONIDCR site

Step 3: Enter your phone number and enter the OTP from DONIDCR

Click on new entry as shown in photo below

Step 4: Fill the required personal information correctly

Click next after filing up each section.

After finishing the form fill up step by step as shown in above photo scroll down to the last page and click the submit button.

अनलाईन आवेदन भर्न पूर्व ध्यान दिनु पर्ने कुराहरु
  • नेपालीमा भर्नु पर्ने फिल्डमा नेपालीमा र English मा भर्नु पर्ने फिल्डमा English मा Type हुने गरी Configure गरिएको छ।
  • नेपालीमा भर्नु पर्ने फिल्डमा Nepali Unicode Romanized को Layout अनुसार टाईप गर्नु पर्नेछ। Nepali Unicode Romanized मा कसरी टाईप गर्ने हेर्नको लागि यँहा Click गर्नुहोस्।
  • बिक्रम संबत (BS) बाट ईस्वी संवतमा (AD) Date Conversion स्वतः हुन्छ।
  • “*” चिन्ह अंकित Field हरु अनिवार्य भर्नु पर्ने (Mandatory) Fields हुन।
  • Mandatory Fields भरिसके पश्चात Save Draft गरेपछि १३ digit को आवेदन नम्बर प्राप्त हुन्छ।
  • Appointment लिदाँ आफुलाई पायक पर्ने स्थान Dropdown मा देखिए सो स्थान छनौट गर्नुहोस र आफुलाई उपयुक्त मिति र समयको Appointment लिनुहोस् अन्यथा “Others/अन्य” छनौट गरी मिति र समयको लागि नजिकको जिल्ला प्रशासन कार्यालय वा ईलाका प्रशासन कार्यालयमा सम्पर्क गर्नुहोला।

Step 5: Click on submit and choose the place you want to provide your biometrics

  1. Photo
  2. Signature
  3. Fingerprint

Original citizenship card should be brought by the person and himsself should be present to provide the Biometric information.

Important notice regarding NID pre enrollment form fillup

You do not have to know hoow to type Nepali in NID preenrollment form. The system helps automatically. Read following notice for details.

NID pre enrollment contact number

To contact NID pre enrollment office contact following office

Important notice regarding Contact number nid pre enrollment 

Here is given the special number dedicated for NID pre enrollment .

Please contact if you have any issues.

NID Card Download method

NID Card print method

Thank you if you have any query please contact us.

How to check SEE result here.

What is HbA1c and what is its normal value?

What is HbA1c what are its normal values? 

Table of Contents(toc)

HbA1c, or glycated hemoglobin, is a blood test that shows the average blood sugar level over the past  3 months. It’s a way to measure how much glucose (sugar) has attached to hemoglobin, a protein in red blood cells that carries oxygen.

Introducton and definition of HbA1c

Because red blood cells live for about three months, this test gives an idea of long-term blood sugar control, especially important for monitoring diabetes. For people with diabetes, it helps check if treatment is working.

Normal range for HbA1c:

  • Non-diabetic: Less than 5.7%
  • Prediabetes: 5.7% to 6.4%
  • Diabetes: 6.5% or higher

Target HBA1C in Diabetes

T
In general, people with diabetes often aim for an HbA1c below 7%, but this can vary depending on individual goals.
Normal range of hba1c image

How is HBA1c formed(Biochemistry)?

HbA1c, or glycated hemoglobin, forms when glucose (sugar) in the blood attaches to hemoglobin molecules in red blood cells. Hemoglobin is the protein that carries oxygen throughout the body, and it is found in red blood cells, which have an average lifespan of about 120 days. 
When blood sugar levels are high, more glucose binds to hemoglobin, forming HbA1c. This process, called glycation, happens gradually and is irreversible, meaning the HbA1c stays in the blood cells until they are replaced. 
Because this test reflects glucose attachment over the lifespan of the red blood cells, HbA1c levels are a useful indicator of average blood sugar over the past two to three months. 
This makes it a valuable measure in monitoring and managing conditions like diabetes, where blood sugar control is essential.

Here’s the formation of HbA1c step by step:

  • Glucose in Blood: Glucose (sugar) circulates in the bloodstream and is available to all cells in the body.
  • Interaction with Hemoglobin: In red blood cells, hemoglobin—a protein responsible for carrying oxygen—interacts with glucose.
  • Formation of Glycated Hemoglobin: When glucose attaches to hemoglobin, it forms a compound called glycated hemoglobin, or HbA1c.
  • Irreversible Bond: Once glucose binds to hemoglobin, the bond is irreversible, meaning the HbA1c stays attached until the red blood cell is replaced.
  • Lifespan of Red Blood Cells: Red blood cells live for about 120 days, so HbA1c reflects average blood sugar levels over the past 2 to 3 months.
  • Indicator of Blood Sugar Control: Because HbA1c shows long-term glucose levels, it is a key indicator in monitoring conditions like diabetes.

What increases the HbA1c?

High Blood Sugar Levels: Consistently elevated glucose levels, often due to uncontrolled diabetes or poor dietary choices, directly increase HbA1c.

What are the risk factors for high blood sugar levels?

  • Inadequate Diabetes Management: Insufficient insulin or other diabetes medications can lead to higher blood sugar, thus increasing HbA1c.
  • Lack of Physical Activity: Physical inactivity reduces the body’s ability to use glucose effectively, leading to higher blood sugar and HbA1c.
  • Poor Diet: Diets high in carbohydrates and sugary foods raise blood sugar, increasing HbA1c.
  • Stress: Physical or emotional stress can cause the body to release hormones like cortisol, which can increase blood sugar levels.
  • Illness or Infection: Acute illness or infection can temporarily raise blood sugar, contributing to higher HbA1c.
  • Hormonal Changes: Conditions like polycystic ovary syndrome (PCOS) or hormonal imbalances can impact insulin sensitivity, raising blood sugar and HbA1c.
  • Certain Medications: Drugs like steroids and some psychiatric medications can increase blood glucose levels and HbA1c.
  • Liver or Kidney Disease: These conditions can affect how the body processes glucose, potentially raising HbA1c.
  • Sleep Deprivation: Poor sleep quality or insufficient sleep can increase insulin resistance and blood sugar, leading to higher HbA1c.
normal range of hba1c image

Nepal Nursing Council License Exam Questions 2024

Model Question : Nepal Nursing Council License Exam Questions 2024

model image exam passed

Table of Content(toc)

What is the primary purpose of conducting a physical assessment during the admission process?

A) To establish a baseline for future assessments
B) To determine the financial capability of the patient
C) To prescribe medication
D) To identify social needs

Which of the following is an essential step when administering medications via intravenous (IV) route?

A) Ensure the patient drinks plenty of water
B) Check for drug allergies before administration
C) Place the patient in a semi-Fowler’s position
D) Ensure that the patient has had a meal before administration

Which vitamin is primarily synthesized by the skin when exposed to sunlight?

A) Vitamin C
C) Vitamin E
D) Vitamin K

A patient complains of chest pain and shortness of breath. What is the most appropriate initial nursing action?

A) Encourage the patient to take deep breaths
B) Notify the physician immediately
C) Administer oxygen and monitor vital signs
D) Give the patient water to drink

Which of the following vital signs is most indicative of hypovolemic shock?

A) Increased blood pressure and heart rate
B) Decreased blood pressure and increased heart rate
C) Decreased heart rate and blood pressure
D) Increased blood pressure and decreased heart rate

In Maslow’s hierarchy of needs, which of the following is considered a basic physiological need?

A) Self-esteem
B) Love and belonging
C) Safety and security
D) Food and water

What is the normal range for fasting blood glucose levels in adults?

A) 40-70 mg/dL
B) 70-100 mg/dL
C) 120-140 mg/dL
D) 140-160 mg/dL

Which of the following is a sign of hypokalemia?

A) Confusion
B) Muscle weakness
C) Hypertension
D) Diarrhea

When caring for a patient with a nasogastric (NG) tube, what is the best method to confirm tube placement before administering a feeding?

A) Check the pH of the aspirated content
B) Listen for bowel sounds
C) Check the patient’s breath sounds
D) Measure the patient’s blood pressure

A patient with tuberculosis is receiving rifampicin. Which of the following instructions should the nurse provide to the patient?

A) Expect urine and other body fluids to turn red-orange
B) Avoid all dairy products
C) Take the medication with meals
D) Limit fluid intake throughout the day

Answers: 

1. A  
2. B  
3. B  
4. C  
5. B  
6. D  
7. B  
8. B  
9. A  
10. A

Ayurvedic Medicine for Weight Loss: Lose weight in a Healthy Way Today

Ayurvedic Medicine for Weight Loss: Lets make healthy weight today (herbal)

Table of Contents(toc)
Ayurvedic Medicine for Weight Loss

What is healthy weight?

A healthy weight is the weight range where your body can function at its best, minimizing risks for chronic diseases and enhancing overall well-being. It’s determined by a mix of factors, including Body Mass Index (BMI), Waist-to-Height Ratio (WHtR), Waist-to-Hip Ratio (WHR), and body fat percentage, giving a fuller picture beyond just numbers on a scale.

BMI (Body Mass Index): 

BMI is a widely used tool to categorize weight by dividing weight in kilograms by height in meters squared. A BMI of 18.5–24.9 is generally considered “healthy” for most adults. However, it doesn’t account for muscle mass or body composition, so other measures are often used alongside it.

WHtR (Waist-to-Height Ratio): 

This ratio compares waist circumference to height. A healthy WHtR is typically less than 0.5, indicating that waist circumference is less than half of your height. This can help assess abdominal fat, which has a strong link to health risks, especially heart disease and diabetes.

WHR (Waist-to-Hip Ratio): 

WHR is the ratio of waist circumference to hip circumference. A healthy WHR is generally below 0.9 for men and below 0.85 for women. Higher WHRs suggest more abdominal fat, a risk factor for various metabolic and cardiovascular conditions.

Body Fat Percentage: 

This measures the proportion of fat in the body. Healthy body fat ranges vary by age and gender but typically fall between 10–20% for men and 20–30% for women. Body fat measurement can provide more insight into body composition, as people with the same weight may have different fat and muscle distribution.
These measurements, used together, help determine if you’re at a healthy weight for your specific body type and lifestyle, offering a more accurate snapshot of your health than any single measure alone.

What ayurvedic medicines can reduce weight in healthy way?

Ayurveda offers several herbs and formulations that may support weight management in a holistic and gentle manner. These are usually meant to improve digestion, enhance metabolism, and balance the body’s internal energies without causing harsh side effects. Here are some widely recommended Ayurvedic options:

1. Triphala

  • About: A blend of three fruits—Amalaki (Amla), Bibhitaki, and Haritaki—triphala helps improve digestion, detoxifies the body, and supports regular bowel movements.
  • How It Helps: It enhances digestion and metabolism, allowing better nutrient absorption and waste elimination.
  • Use: Often taken as a powder mixed with warm water at night or as capsules.

2. Guggul (Commiphora Mukul)

  • About: Guggul is a resin from the Mukul myrrh tree known for its anti-inflammatory and metabolism-boosting properties.
  • How It Helps: It’s believed to support healthy cholesterol levels, improve thyroid function, and increase fat metabolism.
  • Use: Commonly available in tablet form or in combination with other herbs in Ayurvedic formulations like “Medohar Guggulu.”

3. Garcinia Cambogia (Vrikshamla)

  • About: This tropical fruit contains hydroxycitric acid (HCA), which may help suppress appetite.
  • How It Helps: It can reduce the body’s capacity to store fat and may help curb overeating.
  • Use: Often taken as a capsule or powdered supplement.

4. Ashwagandha (Withania Somnifera)

  • About: Known for its stress-relieving properties, ashwagandha helps regulate cortisol, the stress hormone.
  • How It Helps: By reducing stress, ashwagandha may prevent stress-induced eating and help balance weight.
  • Use: Typically taken as a powder or in capsule form.

5. Lemon and Honey in Warm Water

  • About: This classic Ayurvedic remedy helps cleanse the digestive tract and kickstart metabolism.
  • How It Helps: It stimulates digestion and acts as a natural detox, which may support weight loss.
  • Use: One teaspoon of honey and half a lemon in warm water each morning on an empty stomach.
herbal medicines

6. Vijaysar (Pterocarpus Marsupium)

  • About: Often used in diabetes management, vijaysar helps regulate blood sugar levels, which can indirectly support weight management.
  • How It Helps: Stabilizing blood sugar reduces cravings and prevents spikes in insulin.
  • Use: Available as a powder or tablet. Some people use a wooden tumbler made from vijaysar to drink water, which can further support metabolism.

7. Cinnamon (Dalchini) and Ginger (Adrak)

  • About: Both spices are known for boosting digestion and improving metabolism.
  • How They Help: Cinnamon helps stabilize blood sugar, while ginger aids digestion and can improve satiety.
  • Use: Add cinnamon powder or ginger to warm water or tea, or incorporate them into meals.

8. Mustak (Cyperus Rotundus)

  • About: Known as a digestive tonic, mustak is often used in Ayurvedic treatments for its ability to reduce fat accumulation.
  • How It Helps: It aids in breaking down excess fat tissue, improves digestion, and has mild laxative properties.
  • Use: Usually available in powder form; often taken with warm water.

Important Guidelines for Ayurvedic Weight Management

  • Follow a balanced diet and exercise:

   Ayurveda emphasizes that these herbs are most effective when used alongside a balanced diet rich in whole foods and regular physical activity.

Eating meals slowly and stopping when full is crucial for proper digestion.

  • Stay consistent: 

Herbal remedies typically work gradually, so consistency is key.

  • Exercise

  • Sleep

Always consult an Ayurvedic practitioner or healthcare provider before starting any new herbal regimen, as these can interact with other medications or conditions. Please consult with your ayurvedic or generalphysician before trying these regimen on your own.

Is Ayurvedic Medicine Safe?

Ayurvedic medicine has a long history of use, emphasizing a diet rich in whole foods, vegetables, whole grains, and lean proteins. This approach encourages moderation, mindful eating, and prioritizes prevention, physical activity, stress management, and balanced living, which are generally safe and beneficial for health.

However, it’s essential to approach Ayurvedic herbal preparations with caution, as they’re not regulated by the FDA. More studies are needed to confirm their safety and effectiveness.

When considering an Ayurvedic practitioner, research carefully, as most states in the U.S. don’t require a license for Ayurvedic practice, nor is there federal certification or licensure. Discuss any Ayurvedic recommendations with your doctor to ensure they’re suitable for your individual health needs.

Wounds and gangrene, general principle of management of wounds, wounds classification

Wounds and gangrene, general principle of management of wounds, wounds classification in nepali

Table of Contents(toc)
steps of wound healing

Introduction

A wound is an injury to the body’s tissue, often involving a break in the skin or damage to underlying structures.
A wound is an injury to the body’s tissue, often involving a break in the skin or damage to underlying structures. 
Wounds can result from various causes, including cuts, burns, or accidents. 
Proper care and hygiene are essential for promoting healing and preventing infection, which can complicate recovery. 
types of wounds
Depending on the severity, wounds may require medical treatment, such as stitches or antibiotics, to aid the healing process.

Types of wound

Various types of wound can be listed as below
  1. Abrasion
  2. Laceration
  3. Incision
  4. Puncture
  5. Avulsion
  6. Contusion (bruise)
  7. Penetrating wound
  8. Gunshot wound
types of wounds

Types of surgical wound 

types of surgical wounds
  1. Clean wound
  2. Clean-contaminated wound
  3. Contaminated wound
  4. Dirty or infected wound

Steps of wound healing 

  1. Hemostasis
  2. Inflammation
  3. Proliferation
  4. Maturation (or Remodeling)

Signs of wound infection

  1. Redness
  2. Swelling
  3. Warmth
  4. Pain or tenderness
  5. Pus or discharge
  6. Foul odor
  7. Fever
  8. Delayed healing

Role of antibiotics in wound healing

Antibiotics help prevent or treat infections in wounds. They kill or stop the growth of bacteria, which can slow down healing.
By keeping the wound free from infection, antibiotics allow the body to repair the tissue more effectively and reduce the risk of complications.

Factors affecting wound healing

  1. Age
  2. Nutrition
  3. Oxygen supply
  4. Infection
  5. Chronic diseases (e.g., diabetes)
  6. Medications (e.g., steroids)
  7. Moisture balance
  8. Blood flow
  9. Wound size and depth
  10. Presence of foreign bodies
  11. Stress
  12. Smoking

Powerpoint on Wounds and gangrene, general principle of management of wounds

Zoonotic disease control program Nepal 2024: Disease Transmitted from Animals to Humans

Introduction : Zoonotic disease control program Nepal animal human disease transmission

zoonoses and zoonotic diseases

(toc)Table of Contents

Introduction

Zoonotic diseases are illnesses that can be passed between animals and humans. They can be caused by viruses, bacteria, parasites, or fungi that normally live in animals but can jump to people.
This can happen through direct contact with an infected animal, bites, or even through the environment, like contaminated water or food.
Understanding zoonotic diseases is important because they can affect our health, especially as humans and animals increasingly interact in various settings. 
By recognizing the risks and knowing how these diseases spread, we can take steps to protect ourselves and prevent outbreaks which keep on happening in modern world of today equally.
Historically zoonotic diseases have taken millions of lives like plague and worms.

Epidemiology and disease burden of Zoonotic disease in modern era

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: 

A viral disease typically transmitted through the bite of an infected animal, primarily affecting mammals.

2. Lyme Disease: 

Caused by bacteria transmitted through tick bites, it can lead to serious long-term health issues if untreated.

3. West Nile Virus: 

Transmitted by mosquitoes that have fed on infected birds, this virus can cause severe neurological disease in humans.

4. Salmonella: 

Often contracted from contaminated food, particularly raw or undercooked animal products, this bacterial infection can lead to gastrointestinal illness.

5. Brucellosis: 

Caused by bacteria from infected animals (often livestock), it can spread through unpasteurized dairy products or direct contact.

6. Hantavirus: 

Spread primarily through contact with rodent droppings, urine, or saliva, this virus can cause severe respiratory disease.

7. Zika Virus: 

Transmitted primarily by mosquitoes, this virus can also spread through sexual contact and can cause birth defects.

8. Ebola Virus Disease: 

Believed to originate from fruit bats, it can be transmitted to humans through contact with infected animals and human bodily fluids.

9. Avian Influenza (Bird Flu): 

Caused by influenza viruses that infect birds, it can occasionally infect humans, particularly those in close contact with infected poultry.

10. COVID-19: 

Caused by the SARS-CoV-2 virus, it is believed to have originated from bats and may have been transmitted to humans through an intermediate host.
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

Prevention of zoonoses and zoonotic diseases

Here are some effective methods for preventing zoonoses (diseases transmitted between animals and humans) and zoonotic diseases:

1. Personal Hygiene

  • 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.

List of 50 zoonotic diseases (and zoonoses)

  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

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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”
}
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Erectile dysfunction icd 10: How to treat erectile dysfunction

Erectile dysfunction icd 10 : Treatment and solution

erectile dysfunction

(toc) Table of Contents

Introduction of Erectile Dysfunction

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.
Erectile dysfunction is one of the most common male sexual dysfunction in modern world are facing now.
It is the inability to attain or sustain an erection satisfactory for sexual intercourse including sufficient hardship or time.
Most erectile dysfunction is most commonly related to vascular (blood vessels), neurologic(brain or nerves), psychological(thought or mental status), and hormonal disorders(mostly make hormones like testosterone); use of a medication can also be a significant cause.
Evaluation typically includes screening for underlying disorders and measuring testosterone levels in blood.
Treatment options include oral phosphodiesterase inhibitors, intraurethral suppositories, intracavernosal injections, vacuum erection devices, and surgical implants.
These topics will be discussed separately below.

Causes of erectile dysfunction

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:

Out of these, Vascular cause is the most common cause of erectile dysfuntion.
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.

Neurological causes of erectile dysfunction include:

  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)
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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 

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.
Vasectomy (copyright: mayoclinic)

Can Vasectomy and permanent male sterilization cause erectile dysfunction ?

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 Erectile Dysfunction

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
Patient can also be evaluated for the vascular, neurological and systemic illnesses as well.
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.

Treatment options for Erectile Dysfunctions

Various treatment approaches can be taken to treat erectile dysfunction. the approach can be summarised as below.

  1. Treatment of underlying cause
  2. Drugs
  3. Psychotherapy
  4. vaccum devices
  5. Self injectable drugs
  6. penile prosthesis 
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.
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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.

What are respiratory fluoroquinolones and what are their uses?

Table of Contents(toc)

Respiratory Fluoroquinolones: Introduction, Uses and Side Effects

Respiratory fluoroquinolone are a class of antibiotics that are used to treat various kind of the bacterial infections, including those affecting the respiratory system.

These medications work by mechanism of  inhibiting the growth of bacteria, ultimately leading to their death.

Structure of ciprofloxacin

What are the  Fluoroquinolones?

Fluoroquinolones are a group of synthetic antibiotics that were first developed in the 1960s. These antibiotics are widely used now a days to treat various kind of infections. 

They have a broad spectrum of activity, which means they can target a wide range of bacteria of different groups. This makes them highly valuable in treating infections caused by both gram-positive and gram-negative bacteria.

With widespread use, antimicrobial resistance to fluoroquinolones has grown.

What Respiratory Infections are Treated with Fluoroquinolone?

Respiratory fluoroquinolone are commonly prescribed to treat a variety of respiratory infections, including:

  • Pneumonia: A lung infection that can be caused by bacteria, viruses, or fungi. If it is bacterial fluoroquinolone can be used.
  • Chronic bronchitis: A condition characterized by persistent cough with mucus production.
  • Sinusitis: Inflammation of the sinuses, often caused by bacterial infection.
  • Community-acquired pneumonia (CAP): Pneumonia acquired outside of a healthcare setting.
  • Hospital-acquired pneumonia (HAP): Pneumonia that develops during a hospital stay.
  • Ventilator-associated pneumonia (VAP): Pneumonia that develops in patients who are on a ventilator.

How do Fluoroquinolones Work?

Fluoroquinolones interfere with the DNA replication of bacteria. They target enzymes called DNA gyrases and topoisomerases, which are essential for bacterial growth and survival. By inhibiting these enzymes, fluoroquinolones prevent bacteria from replicating their DNA and ultimately cause them to die.

Common Respiratory Fluoroquinolones

Several fluoroquinolones are commonly used to treat respiratory infections while others are less useful for bacteria that acauses upper and lower respiratory tract infection. Some of the most well-known examples include:

  • Ciprofloxacin

    • DOSE is 500 mg orally twice daily or 400 mg iv twice daily for adults

  • Levofloxacin

    • Dose is 500-750 mg orally or iv daily

  • Moxifloxacin

    • Dose is 400 mg daily for 5-10 days 

  • Gemifloxacin

    • 320 mg once daily for 5 days

  • Ofloxacin

    • 200 mg once dailt for uti and 400 mg once dailly for pneumonia / respiratory infections

Benefits of Fluoroquinolones over other antibiotics

Fluoroquinolones offer several benefits, including:

  • Broad-spectrum activity: They can target a wide range of bacteria.
  • High bioavailability: They are well-absorbed by the body.
  • Long half-life: They remain in the body for a long time, allowing for once-daily dosing.
  • Effective against resistant bacteria: They can be effective against some antibiotic-resistant bacteria.
    For example levofloxacin has great antipseudomonal activity where pseudomonas is highly resistant gram negative anaerobe which is resistant to most of the penicillins and cephalosporing.

Note: Other antipsuedomonal antibiotics include: Piperacillin + tazobactum, third /forth generation cephalosporin like cefepime or ceftazidime, fluoroquinolones like levofloxacin, carbapenems, and monobactams.

Fluoroquinolones are also particularly inportant to use in case of  cartilage infections like chondritis or malignant otitis externa especially ciprofloxacin as this antibiotic has good cartilage penetration the cartilage to reach the target site.

Potential Side Effects of fluoroquinolone group of drugs

While fluoroquinolones are generally well-tolerated, they can cause some side effects. These may include:

  • Gastrointestinal disturbances: Diarrhea, nausea, and vomiting.
  • Nervous system effects: Headache, dizziness, and insomnia.
  • Joint pain: Tendinitis and tendon rupture. Achilles tendon rupture is most common
  • Allergic reactions: Rash, itching, and difficulty breathing.

Important Considerations for giving Fluoroquinolone

It’s important to note that fluoroquinolones should only be used under the guidance of a healthcare professional.

They should not be self-medicated. Additionally, overuse of fluoroquinolones can contribute to antibiotic resistance, making it more difficult to treat infections in the future.

As resoiratory fluoroquinolones are also the second line antitubercular drugs they should be cautiously used in part of the world where tuberculosis is common. 

Also the possibility of tuberculosis should be ruled out beforehand either by sputum Acid fast staining (AFB staining) or Gen-eXpert whichever modality is available in high risk patients. 

Conclusion

Respiratory fluoroquinolones are valuable medications for treating various bacterial infections of the respiratory system.

Fluoroquinolones act by inhibiting DNA dependent RNA synthesis in the bacterial cells.

They offer several benefits, including broad-spectrum activity and effectiveness against resistant bacteria. However, it’s essential to use them appropriately and under medical supervision to minimize side effects and prevent the development of antibiotic resistance.

CBC- Complete clood count : Normal range in Nepali

What does CBC mean in medical?

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. 

What is measured in cbc blood test

What is measured in cbc panel?

  • 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
Some labs may also include other less commonly done tests. 
The number of parameters provided by the CBC report may also depend upto the machine used for measurement.

CBC test price

Price of CBC test varies from 150 rupees to 600 rupees in Nepal. That is $1 to $5. But this test may be even cheaper or expensive in various health facilities and hospitals. You will get cheap in Government hospitals while expensive in private hospitals. I have noticed hospitals charging upto 800 rupeed for the test here in Nepal.   
Platelets floating in blood vessel

CBC blood test price in nepal: Judgement

The range of CBC price tho varies, very expensive rate is not logical. Though they claim that they carge for the facility, the reliability and the quality of equiment they use for test. You always have option to choose the facility of your affordibility. 
Top government hospitals in kathmandu TU teaching hopital, Patan hospital, Bir hospital and Civil hospital charge less than 350 rupees for CBC test. 
Types of WBC in CBC

CBC test price in nepal: How to choose?

If you’re searching for very high reliability and cheap price choose the above mentioned Government hospitals otherwise you can do it anywhere. Some low quality facility may not perform it well so be careful. 

What to expect while getting your CBC done?

  • You need to get your vein pricked
  • blood should be collected in purple vial or EDTA vial
  • It may take upto 3 hours for CBC report to get 
  • Some time if technical problem occur you may need to repeat test
  • If any findings are abnormal your doctor may order other tests as well
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 



Do you want to get your CBC or full body checkup done?

Drug Banned in Nepal with Reason 2024!

What are the drugs banned in Nepal and who banned them for what?

Table of Contents(toc)
Molecular structure of a Drug Named Paracetamol or Acetaminophen also called Tylenol

Introduction

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.

Which Drugs are banned in Nepal?

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.

Government of Nepal has banned the folowing medicines for production,
sale-distribution and import.

Who is responsible for drug regulation in Nepal?

DDA is responsible for banning drugs in Nepal as a governing authority of Nepal.
drug banned in nepal with reason

The reason for drug ban include

  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

The ban should not be applicable to the veterinary products
and topical preparations.
The reason for drug banned in nepal with reason is  Interaction Possibility of poisoning, Possibility of overdose, Ineffectiveness, Potential banned status of one drug or component.



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