Browsing by Author "Bajracharya, SR"
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Publication Acquisition of history taking, physical examination and communication skills through early clinical exposure among pre-clinical students(Institute of Medicine, 2015) Khanal, S; Bhusal, M; Sigdel, MR; Bajracharya, SRAbstract Introduction: Early Clinical Exposure (ECE) has been shown to be an effective method in teaching history-taking, physical examination and communication to pre-clinical students. Medical students in their preclinical years at IOM, MMC have been undergoing two year ECE course since 1978, but there is no provision of formative and summative assessment to check its effectiveness. This cross-sectional study was undertaken to fill this gap in evidence. Methods: A 17-station Objective Structured Clinical Examination was administered to 17 pre-clinical students. Of the 17 stations, seven, six and four stations were designed to test their skills in history- taking, clinical-examination and communication domains respectively. Modified borderline regression method was used to calculate the pass-marks for each station. The pass-marks of all the stations were averaged to determine the pass-marks for the entire OSCE. Results: One student passed the entire OSCE whereas four and eight students passed the history taking and communication skills domains; while none could pass the physical examination skills domain. Repeated measure one-way Analysis Of Variance (ANOVA) and post-hoc test using the Bonferroni correction showed that scores in history taking (M = 44.36, SD = 11.09) and communication skills (M= 44.40, SD = 12.12) were significantly better than in physical examination (M = 29.35, SD = 10.50), (p < 0.001 and p = 0.007, respectively). Conclusions: Despite enormous teaching hours allocated to the ECE course, pre-clinical students’ performance in an OSCE did not meet the expectation of the curriculum suggesting that the ECE course at MMC, IOM is not fulfilling its objectives. Keywords: Communication, early clinical exposure, medical history taking, physical examination, medical educationPublication Antiepileptic Effects of Amlodipine in Mice(Institute of Medicine, 2016) Bajracharya, SR; Rao, KN SathyanarayanaAbstract Introduction: Epilepsy is a disorder of the brain characterized by an enduring predisposition to generate epileptic seizures with at least two unprovoked seizures occurring >24 hours apart. It is one of the most common neurological diseases globally. Earlier studies revealed that a potent calcium channel agonist induced convulsion and calcium channel antagonists produced antiepileptic activities. Hence, this study was carried out to assess antiepileptic effects of amlodipine since it holds a good safety profile among calcium channel blockers.Methods: Inbred Swiss albino mice of both sexes weighing between 20-30 g were used. Antiepileptic effects were assessed using Maximal Electroshock Seizure (MES) test and Pentylene tetrazole (PTZ) induced seizure test. Mice were arranged into 5 groups, each containing 6 mice: Tween-80 (Negative control). Amlodipine at the doses of 1 mg/kg, 2 mg/kg. 4 mg/kg and Sod. valproate (Positive control). Comparison between the test and control was done using Mann-Whitney U test and dose-dependent effects by regression analysis. P value of less than 0.05 was taken as significant.Results: In MES Test, Amlodipine in the dose of 2 mg/kg and 4 mg/kg significantly decreased the duration of tonic hind limb extension (P<0.01) with significant dose dependent effect (r = 0.96).In PTZ test, Amlodipine in the dose of 2 and 4 mg/kg significantly increased the latent period (P<0.05) with dose dependent increase in the latent period (r² = 0.97).However, protection offered in both the seizure models are lower with amlodipine even in higher dose as compared to Sodium valproate. Conclusion: Amlodipine is effective to control seizure in animal models of epilepsy especially in higher doses. Amlodipine can be a good add-on drug to sodium valproate rather than an alternative to it. Keywords: Amlodipine, Antiepileptic, Electroshock, Pentylenetetrazole