B.P. Koirala Institute of Health Sciences

B.P. Koirala Institute of Health Sciences

Ghopa, Dharan, Nepal

Hospital Services

In patient services

Inpatient hospital services (patient care services furnished by the hospital forthe care and treatment of the inpatients) at BPKIHS has been and will remain exemplary through the huge infrastructure, ample bed facility and quality and experienced doctors and staffs.

Each clinical specialty has its own inpatient ward and a core team of dedicated staffs alongside the doctors and the nurses. With over 40,000 admissions per year and a bed occupancy rate of nearly 70%, the ward gets busy all the time, nevertheless quality ensued. Residents stay at the wards all the time for the patient care and Ward rounds are held twice a day from faculties. Recent up-to-dates are always kept in pace while undertaking the treatment and patient care and hoping for the best results always.

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. Separate Coronary Care Unit (CCU) and Medical ICU also runs as Inpatient Service. Tropical Ward (part of Medical ward) provides care and treatment for tropical and infectious diseases patients separately.

Emergency Hospital Services

The Emergency Department at BPKIHS provides care to patients with urgent medical conditions ranging from complex problems to simple but pressing ones. Care is provided 24 hours a day, serving more than 40,000 patients a year.The Emergency at BPKIHS 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 rational for its daily patient inflow of around 130 patients per day. The difference starts from the TRIAGE:

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.

After the triage nurse assessment, a patient is given an ATS Scoring. According to the score, patients are then escorted to their respective treatment areas; Resuscitation Area for ATS 1 and 2, C1/ C2 for ATS 3 and E area for ATS 4/ ATS 5. The TRIAGE process is dynamic means the scoring is reassessed and re-triaging done according to the patient condition and hence patients are re-shifted according to their requirements. The resuscitation area is well equipped with Cardiac and Oxygen monitors,SPO2 probes, Oxygen delivery system, Suction, defibrillators, etc. which are required for active resuscitation of the patient.

With the facility of Emergency Operation Theatre, Emergency X-ray, Emergency CT Scan and USG 24 × 7, the promptness one may need in the emergency can be achieved easily. Emergency Laboratory services are prompt giving results 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 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. Thus one can be assured of the services provided by the Emergency at BPKIHS and regard it as one of the best example of critical care in grounds of limited resources.

DOTS TB Clinic

DOTS (Directly observed treatment shortcourse) clinic was started at BPKIHS from 1st Bhadra 2057 BS as a main center of Dharan Municipality. This program is being run in association/collaboration with the National Tuberculosis program and involving Municipality of Dharan and District Health Office, Sunsari. The commitment of each stakeholder has been clearly spelt out. BPKIHS runs a DOTS clinic and provides facility for diagnosis, treatment and management of complications. It also facilitates to 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.

The DR TB management clinic was started from 2064 as main centre in BPKIHS. There are 3 sub centres in Siraha District Hospital, itahari PHC and Ramnagar Mirchaiya PHC.

Public Health and Social Services

The public health section has been entrusted with the responsibility of coordinating the field activities of various departments. In addition, coordination with governmental as well as non-governmental organisations is also the responsibility of the unit. A calendar of operations is prepared and the field activities are launched according to the schedule. Multi departmental outreach clinics are also conducted at the community level.

The four main avenues of work of this unit are: - Strengthening the district health system - Teaching district program facilitation - Field Based academic activities - Other community based and social service activities

Institutional Practice

The institution has allowed faculty to practice privately in the institute, without hampering the routine teaching learning and patient services activities. Paying OPD starts from 3 pm in the afternoon and Paying OTs have their owntime schedules. Separate Paying Ward has also been established for the services of the same.

Radiology and Laboratory Services

Radio-diagnostic services at BPKIHS run through advanced digital radiological equipments. Services provided 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.

Fully automated clinical chemistry analyser (Roche Hitachi Cobass C3-11) has been installed in CLS for 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. are provided by the biochemistry department alongside the routine biochemistry lab services.

In the laboratory, through the department of Microbiology, various bacteriological, parasitological, mycological, mycobacterial and serological tests are also 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.

Histopathology, Cytopathology (FNAC/USG Guided FNAC/CT guided FNAC/PAP Smears/Fluids/Sutum/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, Glood grouping, G6PD, BM Cytology, PS for Cytology, etc.), Special staining and chemistry, Cyto Special Staining (AFB/PAS/Mucicaramine), Histo special staining (AFB, PAS, Giemsa, Oil Red O, Masson Trichome, Congo Red, Reticulin, Melanine 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, Thyrogobulin, CEA, AFP, etc) is also done.

Clinical lab services like EEG, NCV, EMG and VEP are 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 ENT department.

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, Pediatric surgery, Neurosurgery, Endourology surgery and Laparoscopy Surgery. Major Operations are performed in ten sessions in major OT and 4 sessions per week in day care OT. Laparoscopic surgeries are routine in this institute and laparoscopic and lap assisted surgeries are becoming more commonnow. Endourology services are now in full swing with procedures like: cystoscopy, optical internal urethrotomy, TURBT, TURP, Ureteroscopy and Intra-corporal shock wave lithotripsy (ICSWL). Minor OT procedures under department of Dermatology are skin biopsies, electrocautery, molluscum needling, pairing, intralesional steroid, chemical peeling/cautery, slit skin smear for AFB, comedone extraction, radiocautery, CO2 laser, podophylline application, nail avulsion/biopsy, patch and photopatch test, KOH mounting, PUVA/NB-PUVA, dressing, vitiligo surgery, etc.

Cardiology services provided are ECG, TMT, ABPM, Holter, ECHO, Coronary Angiography, Coronary Angiography + Angioplasty, Renal Angiography, PTMC, PPI, TPI, TPI + PPI, Pericardiocentesis etc. Endoscopy and Colonoscopy are performed under Gastro-hepatologyservices. 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 + PIOL, ECCE +IOL, Phacoemulsification, Cataract surgery, DCR, Penetrating Keratoplasty, Amniotic Membrane transplantation, Orbitomy, eyelid reconstruction, contracted socket, enucleation, evisceration, Contact Lens application, YAG laser,Oculoplasties, 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. Electroconvulsion Therapy (ECT) is routinely performed by the Psychiatry department.

OPD Services

Out Patient Department (OPD) Services at BPKIHS runs daily from Sundays to Thursdays (Full time) and on Fridays (half day). The OPD runs for half a day on selected Public Holidays too.

Patients get services through General OPD and Special OPD at BPKIHS. Patients get comprehensive care at the general OPD and are referred to special OPD if specialized care is needed. Special OPD comprises of all major and minor departmental services including services from the Dental College. Super-speciality services are also run by departments.

OPD Services are provided for general check-up and comprehensive care; Pediatric and adult chest, heart, gastro-hepatic, neurological and endocrinology; general and specialized surgery; female health problems and obstetrics care; skin and sexually transmitted diseases; mental health issues and de-addiction; pre-anaesthesia check-up Orthopaedic check-up and surgery; head, neck, ear and nose clinic; eye clinic and whole range of oral and maxillofacial services.

Super-Specialized care is provided by each department in the form of super-speciality clinics. Medicine OPD runs tropical and infectious disease clinic, adult chest clinic, cardio clinic, diabetes and endocrinology clinic and gastro-enterology and hepatology clinic. Urology and Gastro-biliary surgery are run as different super-speciality clinic under General Surgery. Well baby clinic, immunology clinic, Nephrology, Neurology and Genetics clinics are run by the Pediatrics department as a part of enhancing super-speciality care. Infertility clinic is run by the Gynaecology OPD. Vertigo clinic is run by the ENT OPD. Separate Leprosy, Allergy, Sexually Transmitted Disease, Dermatosurgery and cosmetology, pigmentary, pediatric and geriatric skin disease clinics are run by the department of dermatology. Pain clinic is run by Anaesthesiology. Ophthalmology OPD runs Glaucoma, Cornea clinic, Diabetes and Retina clinic.Super-specialized services have been made available by the department of Orthopaedicsin form of Spinal surgery, Hip surgery, Knee surgery, orthopaedic oncology, pediatric orthopaedics, Traumatic surgeries, Illizarov Procedures, Bone marrow densitometry and Rehabilitation services.

Physiotherapy and rehabilitation, Speech Therapy, Yoga clinic and De-addiction clinics are also fully functioning at BPKIHS. With an average of around 1000 patients per day at OPD, the service remains the busiest but nevertheless most effectively run with the presence of the huge manpower and expert consultants and experienced staffs.


B.P. Koirala Institute of Health Sciences
Dharan, Nepal
Tel : 977-25-525555
Fax: 977-25-520251
[email protected]
[email protected]