Saturday, July 31, 2010

New batch of Nurses to Join soon


New batch of nurses who passed out this July will soon join the Ministry of Health. All the candidates seem to have cleared the joint interview and are now waiting for the appointment letters.


The news is not so good for Mongar as I understand that only about four of them are being posted to Mongar. This will hardly make a difference to the huge gap of nursing shortage existing in Mongar Hospital at the moment. Moreover, couple of them are going for trainings soon.

Off to Bangkok

I will not be able to update the blog for sometime( may be about 2 weeks) as I am going away to Bangkok to attend a training on HIV/AIDS. Please bear with no posts or few posts please.

Other people in the team include Dr Damber, Dr Subba, Dr Lotay,Dr Kinley( Ped), Dr Thukten, Mr Thupten(Pharmacist).

Thursday, July 22, 2010

CME: Poisoining


Today, we had a CME session on Poisoning , in which the medical specialist, Dr Kesang, discussed in detail the approach to cases of Poisoning in the Emergency Department. Common poisonings were discussed including Mushroom Poisoining. A brief account on snake poisoning, use of charcoal and other emergency procedures were discussed.


Wednesday, July 21, 2010

Second round HPV vaccination


The second round HPV vaccination will be conducted nation wide tomorrow. Most of the recipients will be school girsl after the age of 12 years.The first round was conducted in May.


Some of us(doctors) from MRRH will be going for supervision of the activity.....
Updated: here is a picture from one of the vaccination sites!

ACC in action!

Officials from the Anti-Corruption Commission are stationed at MRRH for last couple of days and verifying all the equipment that have been procured and supplied to the hospital during 2007-2008, with the establishment of the new Hospital.

Tuesday, July 20, 2010

Clinical Case Conference on Tuesdays


Here onwards, the clinical case conference where in doctors of MRRH meet to discuss a puzzling case or an interesting case, will be done on Tuesdays instead of Thursdays. The regular CMEs will be done on Thursdays, provided participation is encouraging.
Meanwhile , the surgical specialist discussed a case of Gynecomastia in a young male (due to adrenal cortical tumor) toaday.

Monday, July 12, 2010

Improving Casualty Services

The doctors, casualty staff and the administration sat together for more than an hour to discuss some of the management issues in the Casualty particularly pertaining to patient monitoring, timely information to the specialists and more vigilance on the part of nurses and clinical staff caring for patients admitted to casualty.

Saturday, July 10, 2010

Change of CME schedules

Henceforth, the weekly CME sessions conducted on Fridays till date, will now be conducted on Thursdays. This change was made as the OT staff felt that they are not able to attend on Fridays due to OT of two departments.
The Clinical conference amongst doctors will be done on Wednesdays.

CME: Evidence Based Medicine

An interesting discussion ensued following the presentation on this important and evolving area of Evidence Based Medicine by Dr Min, anaesthesiologist of our hospital. He covered all the vital aspects of this fascinationg area (which has always been one of my favourite topics).

About 35 participants attened the session.

Thursday, July 8, 2010

Case of Anasarca


A case of anasarca in a 48 year old lady which has been a diagnostic puzzle in the medical ward was discussed at the clinical case conference at the doctors Lounge today. Most of the doctors attended the session including the medical superintendent.Diagnostic possibilities were discussed and further course of investigating this patient was outlined.


It was obviously not a straightforward case of kidney , liver or a cardiac disease. Appeared more like a disorder with multisystem involvement.


Wednesday, July 7, 2010

High Patient load

The last three days at Mongar Hospital has been extremebly busy, with all time high patient loads in all the out patient departments. The Pediatric OPD alone saw more than fifty outpatients today, stretching our work beyond capacity.
We believe that it is because of the many students and parents being free to come to the hospital as it is a summer break for most of the schools.

Road blocks affect ambulance movement

Two ambulances deputed on patient referral directly from Mongar to JDW were held last night at Nobding due to heavy rains and landslides. However, the roads were cleared early this morning and the ambulances could move to Thimphu after about seven to eight hours of delay.

Saturday, July 3, 2010

Casualty Grand Round


From the 2nd of July , we have started doing a grand round daily at the casualty Unit. At 9 AM, all the specialists would gather there at the casualty and discuss all the cases that have been admitted there during the previous night. This is aimed at training the junior doctors , ACOs and the casualty staff on basic emergency management and also to reach a consensus management plan in difficult cases. This is possible through the inputs of all the doctors and specialists who are expected to participate daily.


We look forward for co-operation from all doctors and clinicians concerned.

CME: Reduced Fetal Movements

An hour long CME session was organised yesterday ( July 2nd ) at the conference hall on this important topic. Dr Sonam, the gynecologist conducted the session very interestingly. Overall, it was a very informative and educative session covering the etiology and management of reduced fetal movements in a pregnant women.
Like in the previous session of Ocular emergencies, the attendance in the session was dissapointlingly poor, with participants numbering to less than 20. If the trend continues, the CME sessions, which are mainly planned and informed in advance targetting the nursing fraternity, may soon become a thing of the past.
The clinical case conference attended by most doctors will continue as the participation has never faded.

Thursday, July 1, 2010

Clinical Case Conference



A case of Thrombocytopenia in a young lady who was in her second trimester of pregnacy and whose illness started with a spontaneous abortion, was discussed at the doctors Lounge.Most of the doctors and specialists were present for the discussion.
The most likely cause discussed was gram negative sepsis with/without DIC.