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The world needs to know - Doctors of Nepal Earn less than $400 per month

 

22nd November, 2021

What comes in your mind when you think of Doctors? A smart looking energetic person with formal attire who is calm, composed and someone who deserves respect for selfless service? Or someone who earns hefty amount of money for the work they do? The world needs to know that doctors of Nepal earn less than $400 per month, which happens to be the salary of government doctors of Nepal (for 8th Level Medical Officer and Dental Surgeon), and MD/MS/MDS graduate earns about $30-$40 more per month, And that salary is subject to taxation. Even with incentives for the extra duty hours and procedures performed, median income is below $500 per month. That is the case for government hospital doctors, the scenario is worse for doctors working in a private hospital/medical college/polyclinics (are paid around $250 per month).

This is not in any perspective proportional to the living cost in Nepal. For your reference, here are price of some goods and services in Nepal.
- 1 kg apple = 350 NPR = $3
- Gold Hallmark - 10g ( छापावाल सुन )= Nrs. 80,335.00= $677= more than 1 month salary
- Suzuki Alto 800 STD (796cc) Rs. 19.09 Lakhs = $16080  = (32 months salary of Govt hospital doctor)
- Apple MacBook Air 13-inch M1 chip/512GB - Rs. 189000= $1592 (3 months' salary)
- Median house price = 2 crores = $168467 = (337 months' salary= 28 years' salary)

Which means, if inflation is essentially zero, (which is not, it is 7-8% for Nepal, and the salary doesn't increase proportionally to inflation every year) then a doctor has to work for 28 years and save every penny he earns, just to own a house. If he can manage to save only 50 percent of what he earns, it takes 56 years to own a house.

With private sectors leading the healthcare sector and medical education sector in terms of reach as well as revenue generation, government hospitals in Nepal are known to be understaffed and overcrowded by patients all the time. Old buildings, old equipment that often stops functioning, unavailability of adequate staffs at government hospitals, always irritated and ill mannered staffs are the pictures that come in the general public's mind when they think of government hospitals. Large corporate owned hospitals exploit even harsher making the health professionals work for peanuts charging a hefty fees to the patients which makes it a very alluring business. If you want to make money quickly, you open a polyclinic/hospital or preferably a medical college here in Nepal.

What quality doctors will such institutions produce? Till when the international healthcare industry can rely on quality of Nepalese doctors? What sorts of unethical practices can a doctor be involved in just to make a good living? Is $400 per month a good pay after 5 years of hectic medical school? Not to mention, 5.5 year MBBS course costs $40000-$70000 and BDS course costs $25000-$35000 excluding the educational materials and living costs. Can those doctors be bribed easily by the pharma companies? Can those doctors be bribed easily by surgical items manufacturers? Can they be bribed easily by the owners of nearby private hospitals/laboratories/imaging centers? 

What should be the minimum basic salary of a doctor so that his/her integrity cannot be bought easily, so that he/she can choose to live being truly ethical to his self? Please have your say.

Dr. Raman Dhungel
BDS, BPKIHS
Email: raman.dhungel@gmail.com





MCQs in Orthodontics - Cephalometry


# Frankfort's horizontal plane (FHP) is formed by joining:
A. Porion and Orbitale
B. Nasion and Sella
C. Porion and Sella
D. Porion and Nasion

# Most anterior part of the chin is:
A. Gonion
B. Pogonion
C. Menton
D. Gnathion

Lok Sewa Aayog 2071 Key A - 8th Level Dental Surgeon Question Paper

WATCH THIS VIDEO WITH ALL ANSWERS TO THESE QUESTIONS FOR A QUICK REVISION




 1. Petechial hemorrhage is characteristic of which of the following condition?
A. Agranulocytosios
B. Neutropenia
C. Pernicious anemia
D. Thrombocytopenic purpura


2. A patient with mitral valve replacement  will require which of the following preoperatively?
A. Benzathene Penicillin
B. Tetracycline
C. Procaine penicillin
D. Vibramycin


3. Cyanosis of lips is a common finding in all EXCEPT:
A. Polycythemia
B. Sickle cell anemia
C. Iron deficiency anemia
D. Congenital heart disease


4. Most common oral change of nutritional anemia is:
A. Atrophic glossitis
B. Leukoplakia
C. Lichen planus
D. Hypertrophic glossitis


5. Chemotherapeutic agent has following side effects EXCEPT:
A. Hair loss
B. Diarrhoea
C. Hypertension
D. Mucositis

Unit 1- Genetics, Growth and Development and Immunology - BPKIHS Past Questions Collection

ANATOMY

 2016
1. Mention the types of chromosomal structural aberrations. 5
2. Draw a well labeled any 5 symbols used in making the pedigree. 5
3. Draw a labeled histological diagram of lymph node. 5
4. List the ethical principles in genetics. 5
5. List the indications for prenatal diagnosis. 5

2015
1. Mention splenic circulation with well labeled diagram. 5
2. Draw any five symbols of pedigree chart. 5
3. Mention the criteria for X-linked recessive disorders and any two examples of it. 5
4. Mention the indications for prenatal diagnosis. 5
5. Write any five chromosomal structural aberrations. 5

2014
1. Explain the pattern of inheritance in Autosomal Recessive inheritance with example. 5
2. Write a short note on age related histological changes in thymus. 5
3. Discuss about the splenic circulation. 5
4. Elaborate the process of Karyotyping. 5
5. List the indication of prenatal diagnosis. 5

2013
1. Classify chromosomal disorders. 5
2. Define genetic counseling and list its procedures. 5
3. Draw a labeled histological diagram of Thymus. 5
4. Write the theories of Splenic circulation. 5
5. List the indications for prenatal diagnosis. 5

2012
1. List the entities in white and red pulp of spleen and illustrate these in a labelled diagram. 2+2+1=5
2. Describe the structure of a splenic venous sinusoid. 5
3. Mention any five structural chromosomal aberrations with diagrams. 5
4. List the criteria for autosomal dominant inheritance. And list four examples of autosomal dominant disease conditions. 2.5+2.5=5
5. Classify lymphoid organs with examples. Write the relations of spleen. 2+3=5

2011
1. Illustrate with a labeled diagram of the histological features of:
a. Lymph node 4
b. Spleen 4
c. Tonsil 4
d. Name two clinical conditions associated with any two of the above organs. 1.5x2=3
2. Enumerate the indications for prenatal diagnosis. Mention at least five indications. 5
3. What is karyotyping? Name the cells commonly used in Karyotyping. 1+4=5

2010
1. Classify chromosomal disorders with examples of each. 5
2. Describe genetic screening and genetic counselling. 5
3. Draw a labeled diagram of spleen. 5
4. Write the criteria and examples of X-linked dominant disorder. 5
5. Mention the basis of lymph formation and its final destination. 5




PHYSIOLOGY

2016
1. Explain the mechanism by which complement system provides innate immunity. 5
2. Illustrate with the labeled diagram the role of helper T cells in immune response. 5
3. Define aging. Describe briefly about the free radical theory of aging. 5

2015
1. Describe the role of helper T cells in acquired immunity. 5
2. List the theories of aging. Describe briefly the most acceptable one. 5
3. Describe how complement system is activated and list their functions. 5

2014
1. Draw a growth curve depicting the growth of any two organs/systems up to the age of 20 years. List any three important factors involved in growth of a child. 3+3=6
2. Describe the role of T helper cells in acquired immunity. 4
3. Define innate immunity. Describe function of skin as innate immunity. 5

2013
1. Explain the pattern of growth in different parts of body with the help of labeled diagram. 5
2. With the help of flowchart explain how bacterial infection leads to antibody synthesis in peripheral lymphoid organs. 5
3. Explain the effect of aging in blood and immune mechanisms. 5

2012
1. Mention any three age related changes in nervous system. 3
2. Define growth and development. Describe the role of thyroid hormone on it. 2+3=5
3. Define innate immunity. Mention the role of gastric secretion as innate immunity. 1+3=4
4. Mention any three functions of helper T cells. 3

2011
1. Name the abnormalities of growth due to hormonal factors.   5
2. Describe the process of phagocytosis by the neutrophils. 5
3. What is the role of T lymphocytes in immunity? 5

2010
1. Explain the role of helper T cells in the formation of antibodies and regulation of immunity. 4
2. Define growth and development. Describe the physiological changes that occur in a newborn during progress towards adulthood. 2+4=6
3. State the theories of aging. Describe one of them. 2+3=5



BIOCHEMISTRY
2016
1. What is gene therapy? Explain any one mode of gene therapy.
2. Write a short note on epigenetics.
3. Describe the process of termination in prokaryotic transcription.
4. Explain in brief about prokaryotic gene regulation with a suitable example.
5. Describe the steps involved in polymerase chain reaction. Add a note on the biomedical importance of this technique.
6. Enumerate four post-translational modifications with suitable examples.
7. Describe the endocytic mode of antigen processing and presentation.
8. Enlist the different types of mutation. Shortly describe the various DNA repair mechanism occurring in our body.
9. Write the difference between Prokaryotic and Eukaryotic DNA replication.


2015
1. Differentiate cell mediated immunity from humoral mediated immunity. 3
2. Explain point mutation with an example. 3
3. What are histones? Explain their role in the nucleus. 3
4. Illustrate Prokaryotic gene regulation with the help of suitable example. 4
5. Describe Cytosolic pathway (Endogenous antigen) of antigen processing and presentation by T cell. 4
6. How is recombinant DNA prepared in a laboratory? 4
7. Describe the different methods involved in termination of transcription. 4
8. Describe the steps involved in PCR. Add a note on the biomedical importance of this technique. 5
9. List three DNA repair mechanism and explain any one of them with example. 5

2014
1. Explain the mechanism of regulation of gene expression using Lac Operon Model. 5
2. List the steps of PCR. Explain the uses of PCR in medicine. 5
3. Draw an illustrated diagram the regions of eukaryotic typical gene. 5
4. Explain the role of post-translational modifications with two examples. 5
5. Write a brief note on genomic library. 5
6. Explain the molecular defects in xeroderma pigmentosum. 5
7. Define Satellite DNA. How is it categorized? 5

2013
1. Explain the terms affinity, avidity and adjuvants related to immune system. 3
2. What are restriction endonucleases? Highlight their roles in recombinant DNA technology. 4
3. Write the mechanism involved in switching to IgM to IgE. 4
4. Explain the roles of signals that help in termination of RNA synthesis in prokaryotes. 4
5. “Newly replicated two anti-parallel strands of DNA occur simultaneously but in opposite directions.” Justify this statement with the mechanisms involved in it. 5
6. Mention three antigen presenting cells. Explain how class II MHC molecules present antigens. 5
7. Outline the causes of DNA damage and give a brief account of DNA repair system. 5
8. Give a detailed account of the causes, types and effects of mutation. 5

2012
1. Illustrate with a diagram the structural organization of a typical immunoglobulin. 3
2. Explain the role of histones protein in DNA organization. 3
3. Draw a labelled diagram depicting the secondary structure of a typical tRNA muscle and mention the function of the different arms. 3
4. With the help of suitable diagram, describe the regulation of lac-operon in E. coli. 5
5. How are protein synthesized within ribosomes get targeted to the cell membrane?
6. Illustrate diagrammatically the phases of the cell cycle with their regulatory points.
7. What are MHC molecules and state one important application of determination of its expression in cells?
8. Describe the steps involved in Southern blotting and mention its application. 3+2=5
9. What is gene therapy? Describe any two modes of gene therapy. 2+3=5

2011
1. Describe the process involved in replication of DNA.
2. Discuss the types of DNA repair mechanisms.
3. Discuss the process involved in DNA transcription.
4. Define gene therapy. Explain any one mode of gene therapy.
5. Explain the principle of polymerase chain reaction and mention its utility. 5
6. How is the technique of DNA fingerprinting applied in medical sciences?
7. How is an antigen from viral protein processed and presented by antigen presenting cell?
8. Draw a labeled diagram of immunoglobulin G(IgG).

2010
1. Name vectors and its utility in molecular biology.
2. Describe the properties of genetic code.
3. State the steps of recombinant DNA technology? Enlist its two applications in medicine.
4. State the key steps and materials required for PCR.
5. Describe the role of Rho proteins in the termination of translation.
6. Define point mutation. Describe the various consequences of point mutation.
7. Define gene therapy. Explain any one mode of gene therapy.



MICROBIOLOGY
2016
1. Define antigen. Tabulate the differences between T cell dependent and T cell independent antigen. 5
2. In a tabulated form compare and contrast live and inactivated vaccine. 5
3. Write short notes on: 5x2=10
a. Profone phenomenon
b. Opsoniztion

2015
1. List antigen antibody reactions. Describe one type of it with appropriate examples. 5
2. Write short notes on: 5x3=15
a. Innate immunity
b. Complement pathway
c. Immunoglobulin M (IgM)

2014
1. Write short notes on: 5x2=10
a. Role of different non culture techniques used as diagnostic tool in laboratory
b. Live attenuated vaccine.
2. Define complement. Write briefly on its biological functions. 5
3. With a labeled diagram describe the structure of immunoglobulin G. 5

2013
1. Write note on the following:
a. Alternate pathway for the complement activation. 5
b. Biological structures of immunoglobulin G. 5
2. Lab diagnosis of opportunistic mycoses. 5
3. Labelled diagram of HIV. 5

2012
1. List antigen-antibody reactions. Write the principle and application of any one of the reactions. 5
2. Tabulate the difference between live attenuated and killed(inactivated) vaccine. 5
3. Draw a labeled diagram of immunoglobulin. 5
4. Write briefly on characteristics of antigens. 5

2011
1. Define antigen and antibody. Describe any three types of antigen-antibody reactions. 2+3=5
2. Describe any two non-cultural methods for microbial identification. 2.5+2.5=5
3. Describe the different mechanism involved in innate immunity to micro-organisms. 5
4. Draw a well labeled diagram of immunoglobulin G and mention any two biological functions of immunoglobulin. 3+2=5

2010
1. Life cycle of Leishmania donovani. 5
2. Write short note on vaccine. 5
3. Write short note on:
a. Non cultural techniques for diagnosis of Microbial infection. 5
b. Biological properties of IgG. 5


PATHOLOGY
2016
1. Enlist any four structural changes that can be seen in chromosomes. Define any one. 2+1=3
2. Describe the pathogenesis of HIV infection in brief. 3
3. Define hypersensitivity reaction. List the types of it and mention the involved mechanism in them. 1+3=4

2015
1. Explain the mechanism of tissue damage by Type III (three) hypersensitivity reaction. 5
2. Enlist primary immunodeficiency disorders. 5

2014
1. Enumerate the types of hypersensitivity reactions. Give at least two examples of each. Write briefly about the Type II hypersensitivity reaction. 2+1+2=5
2. Mention the effect or mechanisms of Allograft Rejection. Write down the morphological changes which occur in case of kidney. 2.5+2.5=5

2013
1. Define autoimmunity. Describe the mechanism of autoimmunity explaining the concept of central and peripheral tolerance. 1+4=5
2. Name Diagnostic tests for genetic disorders. 5

2012
1. Define Hypersensitivity Reaction. What are its type? Describe each of them with examples. 1+1+3=5
2. Write a short note on Amyloidosis. 5

2011
1. Discuss the pathogenesis of Lysosomal Storage Diseases (LSD). 5
2. Enumerate the different types of Hypersensitivity reactions with an example each. 5

2010
1. Mention about the pathogenesis of Lysosomal storage disease. 5
2. Write in brief the morphology of Transplant rejection reactions(kidneys). 5


PHARMACOLOGY
2016
1. Write the mechanism of action, common side effects, uses and contraindication and precaution of Sirolimus. 5

2015
1. How Azathioprine is effective as immunosuppressive agents? 2.5
2. Why anti-D immunoglobulin is not given to Rho-D positive mother? 2.5

2014
1. Mention the hazards of immunosuppressive therapy. 3
2. Explain the nephrotoxic effects of cyclosporine. 2

2013
1. Write pharmacological effects,side effects, uses and contraindication and precaution of Cyclosporine. 5

2012
1. Mention immunosuppressive agents. Write mechanism of action, side effect, uses and contraindication of Tacrolimus. 5

2011
1. Explain the rationale behind the administration of immunosuppressants in organ transplantation. Name four immunosuppressant agents. 5
2010
1. Write the mechanism of action, common side effects and therapeutic uses of Azathioprine. 5

CLICK HERE TO VIEW ALL PAST QUESTIONS COLLECTIONS

Lok Sewa Aayog, Dental Surgeon 8th Level - Second Paper 2070/04/01


 Public Service Commission
Nepal Health Service, Dentistry, 8th Level, Dental Surgeon
Competitive Written Examination
2070/04/01

Time: 3 hours                                                                                               Full Marks: 100

Paper: Second
Subject: Dentistry

Answers to these Questions should be written in separate answer papers according to their respective sections.


Section A

1. Describe the mechanism for the natural arrest of hemorrhage and discuss the investigation of a patient suspected of a bleeding diathesis.  (5+5=10)

2. Give the WHO classification of Salivary Gland Tumors. Enlist the clinical features of pleomorphic adenoma. Add a note on the histopathological features of pleomorphic adenoma.   (3+3+4=10)


Section B

3. A 45 years old male brought to emergency department with history of road traffic accident. What is your line of management from dentofacial trauma aspect?   10

4. Write short notes on:  (2*5=10)
a) Ludwig's angina
b) Trismus

5. Describe acute necrotizing ulcerative gingivitis with its cause, clinical feature, and management in detail.   (2+4+4=10)

Section C

6. What do you mean by functional appliances? Explain in brief about oral screen.  (4+6=10)

7. Write down the name of five different types of impression material along with their composition and uses. (5+5=10)

8. Define dental implants. Enumerate its advantages and disadvantages. (2+4+4=10)

Section D  

9. Write in Brief: (2*5=10)
a) Black classification of cavities
b) Pulp capping and Pulpotomy

10. a) Name 10 possible causes of malocclusion.   (5)
      b) What do you mean by DMF and DEF in dental survey?    (5)

                                                                 THE END



Past Question Collection of Lok Sewa Aayog Nepal - 8th Level Officer BDS - Dental Surgeon

 CLICK ON THE QUESTION PAPER YOU WOULD LIKE TO VIEW. 



# 2071 Key A Lok Sewa Aayog Dental Surgeon - 8th Level

# 2072 Key C Lok Sewa Aayog Dental Surgeon - 8th Level

Lok Sewa Aayog 2073 Key B - 8th Level Dental Surgeon Question Paper

WATCH THIS VIDEO WITH ALL ANSWERS FOR A QUICK REVISION

 



Lok Sewa Aayog Nepal 2073 Key B
MCQs
For 8th Level Dental Surgeon



1. Which of the following medication is required preoperatively for a patient with mitral valve replacement?
A. Ampicillin
B. Cloxacillin
C. Benzathine penicillin
D. Procaine penicillin


2.  A patient comes with severe pain in an extraction socket after 3 days of extraction. Which of the following drugs would you prescribe?
A. Amoxicillin
B. Metronidazole
C. Diclofenac
D. Tramadol


3. The ideal time for repair of a cleft lip is:
A. Immediately after birth
B. 3 weeks to 3 months
C. 3 months to 3 years
D. After puberty


4. In unilateral TMJ ankylosis, the chin is deviated to:
A. The contralateral side
B. The affected side
C. No deviation seen
D. Side where growth is occurring


5. The recurrent ranula is best treated by:
A. Electrosurgery
B. Cryosurgery
C. Marsupialization
D. Sublingual gland excision


6. Dry socket commonly occurs after:
A. 24 hours
B. 2 days
C. 3-4 days
D. 10-15 days


7. Farmer’s lip is also known as:
A. Actinic cheilitis
B. Cheilitis granularis
C. Oral submucous fibrosis
D. Noma


8. Cheilitis granulomatosa, facial paralysis and scrotal tongue is seen in:
A. Miescher syndrome
B. Melkersson-Rosenthal syndrome
C. Apert syndrome
D. Peutz-Jeghers syndrome


9. Which of the following is also known as trench mouth?
A. Noma
B. ANUG
C. Herpes gingivostomatitis
D. Herpes zoster


10. The pain on swallowing or turning the head associated with elongated styloid process is known as:
A. Tic douloureux
B. Gorham syndrome
C. Costen syndrome
D. Eagle’s syndrome


11. All are risk factors EXCEPT:
A. Tobacco smoking
B. Microbial tooth deposit
C. Diabetes
D. Bleeding on probing


12. Nikolsky’s sign is a feature of:
A. Lichen planus
B. Pemphigus
C. Herpes simplex
D. Lupus erythematosus


13. A known case of anhidrotic ectodermal dysplasia is brought to hospital for treatment. Which area of body do you find mostly affected in this case?
A. Spleen
B. Skin or ectoderm
C. Kidney
D. Thyroid gland


14. If one of your patient is having Fordyce’s granules in his buccal mucosa, what will be your line of treatment?
A. Excision
B. No treatment needed
C. Topical application of steroids
D. Surgery followed by radiotherapy


15. The earliest radiographic sign of osteomyelitis is:
A. Solitary or multiple small radiolucent areas
B. Increased granular radiopacity
C. Blurring of trabecular outlines
D. Formation of sequestrum appearing as radiopaque patches


16. Best X ray view for TMJ is:
A. Lateral skull
B. Lateral oblique
C. Transpharyngeal
D. Panoramic


17. Orthodontic correction of which of the following is most easily retained?
A. Anterior crossbite
B. Spacing
C. Diastema
D. Crowding


18. The ‘ugly duckling stage’ is characterized by:
A. Distoangular axial inclination of the crown of maxillary incisors
B. Deep overbite
C. Mandibular lateral incisors erupting lingual to mandibular central incisors
D. Maxillary lateral incisors erupting lingual to maxillary central incisors


19. When a simple tipping force is applied to the crown of an incisor, the center of rotation is usually located:
A. At the apex
B. At the incisal edge
C. At the cervical line
D. One third the root length from the apex


20. Which of the following conditions is always present in a class II div 2 malocclusion?
A. Open bite
B. Cross bite
C. Deep bite
D. Closed bite


21. In a lateral cephalogram, facial plane runs from:
A. Nasion to pogonion
B. Nasion to gnathion
C. Sella to gnathion
D. Nasion to ANS