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Corona Update Nepal

B.P. Koirala Institute of Health Sciences

Abhishek Subedi June 8, 2020

B.P. Koirala Institute of Health Sciences is the hospital with the best care services in the eastern part of Nepal. The hospital was established on January 18, 1993 and subsequently upgraded as an autonomous Health Sciences University in October, 1998 with a mandate to work towards developing a socially responsible and competent health workforce, providing health care and involvement in innovative health research.  The hospital is located in the Ghopa, Dharan of the Sunsari District. It has extended its continued health services through teaching district concepts to Primary Health Care Centres, District Hospitals and Zonal Hospitals in different districts of the region.

B.P. Koirala Institute of Health Sciences

The Institute is named after the visionary leader of the Nepal Bisheshwar Prasad Koirala. It is one of the successful examples of Nepal- India co- operation.  BPKIHS has also been envisioned by the Nepali Parliament as a centre of national importance to produce a skilled health workforce to meet the country’s need and also to function as a centre in the field of tropical and infectious diseases. It aims to be the centre of excellence in patient care, teaching and health sector research.

Mission and Goal of BPKIHS

  • The main mission of BPKIHS is to improve the health status of the people of Nepal by providing holistic health care through training of compassionate, caring, communicative and socially accountable health workforce acting as agents of change and through advancement in research and innovation in service as well as education to ensure healthy individuals and families by collaborating with all stakeholders.
  • In the field of research, high priority is accorded to the areas requiring greater attention to solve the existing and emerging health problems threatening the well being of large population groups using multi-disciplinary, integrated and problem solving approach, greater emphasis is placed on research which will lead to application of available knowledge for the benefit of large number of people.

Services of BPKIHS

This hospital has continued to make big efforts into the path of healthcare in the nation. It has provided a wide range of services to the community starting from emergency care to general, medical and surgical care in numbers of medical and surgical subspecialties. The hospital is rapidly developing its standard into the true multi speciality and super speciality hospital with the experts in Diagnostic imaging and Therapeutic areas. 

1.OPD services

OPD services of this hospital run daily from Sundays to Thursday (full time) and Friday (half day). They also run OPD services on public holidays too for the half day only. Patients get comprehensive care at the general OPD and special cases are referred to Special OPD. Special OPD comprises all major and minor departmental services including services from the Dental college. Super speciality services are also run by the departments. They provide general check up, comprehensive care, paediatric and adult chest, heart, gastro- hepatic, neurological and endocrinology, general and specialized surgery, female health problems and obstetrics care, skin and sexually transmitted disease, mental health issues and de- addiction. The hospital also has extensive OPD services like pre anaesthesia check up, Orthopaedic check up, head, neck, ear, eye and nose clinic and whole range of oral and maxillofacial services.

Super specialized OPD services are provided by each department in the form of super speciality clinics. For example, Medicine OPD runs tropical and infectious disease clinic, adult chest clinic, cardio clinic, gastro- enterology and Hepatology clinic, diabetes and endocrinology clinic. Whereas urology and gastro- biliary surgery are run as different super speciality clinics under General surgery. There are also other special clinics such as infertility clinics, vertigo clinics, Separate leprosy, allergy clinics and Rehabilitation services.

Physiotherapy and rehabilitation, Speech therapy , Yoga and clinic and De- addiction clinics are also fully functioning at BPKIHS. There are about 1000 patients per day at OPD, the service remains the busiest throughout the year. But the care provided by them remains effective and qualitative.

2. OT and minor procedure services

OT services (major, intermediate, minor and Day care OT services) are provided by the department of General surgery under Gastrointestinal surgery, open urology, Paediatric surgery, Neurosurgery, Endourology surgery and Laparoscopy surgery. Major operations are performed in ten sessions in major OT and 4 sessions per week is a day care OT.

Minor procedures like cardiology services such as ECG, TMT (Treadmill Stress Test), ABMP, Holter, Echo, Coronary Angiography, Coronary Angiography & Angioplasty, Renal Angiography , PTMC, PPI, TPI, Pericardiocentesis . Endoscopy and Colonoscopy are performed under gastro- hepatology service. Peritoneocentesis, pleural fluid tappings, Bronchoscopy and PFTs are performed routinely. Dialysis Services (Peritoneal and Hemodialysis) are also done routinely. 

OT and minor procedure Services : Departments of Eye and ENT routinely perform various minor procedures along with major surgeries. Some of them being SICS + POOL, ECCE +IOL, Phacoemulsification, Cataract surgery, DCR, Penetrating Keratoplasty, Amniotic Membrane transplantation, Orbitomy, eyelid reconstruction, contracted socket, enucleation, evisceration, Contact Lens application, YAG laser,Oculoplastics, Chalazion and stye removal etc under Ophthalmology surgeries whereas syringing, cautery for epistaxis, foreign body removal from ENT, tissue and structures repair, tonsillectomy,FESS,myringotomy and myringoplasty, etc. under ENT Department. Electroconvulsive Therapy (ECT) is routinely performed by the Psychiatry department.

3. Radiology and Laboratory services

The hospital provides radio- diagnostic services through advanced digital radiological equipment.  The services that are included are digital X-rays, Mammogram, IVU, MCU/RGU, Venogram, Barium Studies, T-tube cholangiogram, Sinogram, Fistulogram, HSG, USG, CT Scan, MRI, Sialogram and Doppler services. The laboratory service is provided through a fully automated clinical chemistry analyzer ( Roche Hitachi Cobass C 3- 11) and the services are routine chemistry test, therapeutic drug monitoring and immunoassay. Biochemical tests like TFT, TSH, fT3, fT4, PSA, PRL, LH, FSH, CA-125, B-HCG, ANA, DNA, ADA, Hb-F, Hb electrophoresis, serum electrophoresis, etc.  These services are provided by the biochemistry department .

The department of microbiology various bacteriological, parasitological, mycological, mycobacterial and serological tests are done along with the CD4 count service. Culture sensitivity, staining procedures, Microscopy, Stool occult blood, Blood for Malaria parasites (PS and QBC) and microfilaria, Bone marrow/splenic aspirate for LD bodies, Optimal, rk39, DAT, and a wide range of immunological services for different diseases are performed. 

The tests like Histopathology, Cytopathology (FNAC/USG Guided FNAC/CT guided FNAC/PAP Smears/Fluids/Sputum/BAL), Hematology (CBC, Urine for RE and Ketone Bodies, Bence Jones Protein, Pregnancy ELISA, Semen Analysis, Body fluid analysis, AEC, ESR, Retics, PS, BT, CT, PT, aPTT, HbF, Osmotic fragility, Coombs test, Blood grouping, G6PD, BM Cytology, PS for Cytology, etc.), Special staining and chemistry, Cyto Special Staining (AFB/PAS/Mucicarmine), Histo special staining (AFB, PAS, Giemsa, Oil Red O, Masson Trichrome, Congo Red, Reticulin, Melanin bleach, Iron stain, Gram’s staining, etc.) and Cytochemistry (MPO/PAS/Sudan Black). Immunohistochemistry (B-cell, T-cell, CD stains, desmin, ER, PR, EMA, NSE, Thyroglobulin, CEA, AFP, etc) are also done.

The laboratory also provides clinical services like EEG, NCV, EMG and VEP run by the clinical physiology department. Cytogenetics lab is run by the department of Anatomy. Refraction, Perimetry, Biometry, USG and Optometry services are provided by Ophthalmology (Laboratory). Audiological tests like PTA, Impedance, ABR, HAT and other special tests are done by the ENT department.

4.DOTS TB Clinic

The hospital started DOTS ( DIrectly Observed Treatment Short Course) in 1st Bhadra of year 2057 BS. This is the main DOTS centre of the Dharan Municipality. It is being run in association with the National tuberculosis program and involving Municipality of Dharan and District Health Office, Sunsari. This clinic provides a facility for diagnosis, treatment and management of complications. It also facilitates other DOTS sub-centres of Dharan Municipality for training and supervision. There are regular review meetings of the main centre with the sub centres, DHO and Dharan Municipality.

5. Emergency Hospital Service

The hospital has the best emergency services in the eastern part of Nepal. They provide 24 hour emergency service and more than 40,000 patients have been treated in the emergency department a year.It is currently the largest (in manpower) in Nepal and provides state-of-the-art comprehensive, individualized emergency medical care and urgent care to the citizens of the eastern region of Nepal and the surrounding areas of India. The manpower of over 100 personnel from HOD to Helpers makes it rational for its daily patient inflow of around 130 patients per day. The Australasian TRIAGE scoring system at BPKIHS is the first instance as such in Nepal and now the similar practice is being replicated by other institutions of Nepal and India following the huge success at BPKIHS.

The emergency department has services like emergency operation theatre, emergency x- ray, emergency CT scan and USG service. It also has laboratory service in which the reports are out within 2 hours. ECG is done bedside and ABG analysis within minutes. On-call residents from various departments stay at emergency stay at ER to provide expert care and make possible admissions at Wards promptly. There is a separate Emergency in Observation room for patients who are stable but need observation for some time before discharge. Every case in the Emergency Room is assessed by experienced and qualified doctors in direct supervision of the Emergency Residents and Faculty.

6. In patient services

The patient services provided by the hospital are prompt and efficient through the huge infrastructure, ample bed facility and quality and experienced doctors and staff. Each clinic has its own inpatient ward and a core team of dedicated staff. More than 40, 000 patients are admitted in different wards of the hospital. Separate Ward blocks for Internal Medicine, Surgery, Paediatrics, Obstetrics and Gynaecology, Psychiatry and Maternal and Child Health Care (MCH) are present in BPKIHS along with a multicomplex for Orthopaedics, ENT, Dermatology, Ophthalmology and Oral Surgery. There is Intensive Care Units (ICU) for paediatrics (PICU), Neonates (NICU), Maternal (MICU), Deluxe (DICU) and general. A Separate Coronary Care Unit (CCU) and Medical ICU also runs as Inpatient Service. Tropical Ward (part of the Medical ward) provides care and treatment for tropical and infectious diseases patients separately.

7. Institutional Practice

The hospital allows faculty to practice privately in the institute without hampering the routine teaching, learning and patient services activities.

The BPKIHS has been the best hospital not only in the country but also to the neighboring country India. It has provided best and comprehensive quality care to the patients and also the core centre of the nation which produces best and competent health care providers. The hospital uses modern technology and infrastructure to cure and diagnose the disease of the people.


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