Browsing by Author "Chapagain, M"
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Publication Comorbid psychiatric illness and its association with glycemic control among adults with diabetes mellitus: a hospital based cross sectional study in Nepal(Institute of Medicine, 2016) Pant, SB; Ojha, SP; Chapagain, M; Tulachan, P; Dhungana, SAbstract Introduction: People diagnosed with diabetes are more likely than people without diabetes to have psychiatric illness, the management of which is important for the management of diabetes itself. The aim of the study was to estimate psychiatric illness among people with diabetes mellitus attending endocrinology outpatient department of Tribhuvan University Teaching Hospital. Methods: Patients with diabetes mellitus attending endocrinology OPD of Tribhuvan University Teaching Hospital were selected by simple random sampling technique. Patients were assessed using semi structured sociodemographic data form followed by General health questionnaire -12 (GHQ-12), which was used to screen psychiatric illness. Those with a score of three or more were considered as having psychiatric caseness which designated over all psychiatric illness. Results: Among 158 patients, 122 (77.2%) were cases of type 2 diabetes while 36 (22.8%) were type 1 diabetes and overall estimate of psychiatric illness among them was 48.7% (n = 77) Significant relationship was found between psychiatric caseness and meal plan (p = 0.007) psychiatric caseness and regular exercise (p = 0.031) psychiatric caseness and type of diabetes medication used (p < 0.001) . psychiatric caseness and diabetes medication doses missed per week (p < 0.001) psychiatric caseness and glycemic control. (p < 0.001) Conclusion: This study showed that comorbid psychiatric illness is common in patients with diabetes which affects overall glycemic control. Hence, screening for psychiatric illness is an indispensable component of diabetes management planPublication Depression and its association with glycemic control in Nepalese adults with diabetes mellitus(Institute of Medicine, 2016) Pant, SB; Ojha, SP; Chapagain, M; Tulachan, P; Dhungana, SAbstract Introduction: Depression is reported more common among people with diabetes mellitus which if not addressed, may lead to poor diabetes outcomes. The purpose of the study was to explore depression among people with diabetes mellitus attending endocrinology outpatient department of Tribhuvan University Teaching Hospital and to find its association with glycemic control. Methods: Patients with diabetes mellitus (n=158) attending endocrinology OPD of Tribhuvan University Teaching Hospital were chosen by simple random sampling technique. A self- designed semi structured proforma was devised to obtain the socio- demographic characteristics of the study population. 'General health questionnaire -12' was applied and those with a score of three or more considered as achieving 'psychiatric caseness and among them depression was diagnosed with ICD-10 DCR criteria and HAM-D scale was used to verify it objectively. Results: Among the patients, 122(77.2%) belonged to type 2 diabetes and 36 (22.8%) belonged to type 1 diabetes. Estimate of depression was found to be 29.11% (n=46) which was almost similar in both types of diabetes. The duration of diabetes were less than 5 years in 38% of patients. Level of depression showed significant associationand a positive correlation with glycemic control. Conclusion: This study concluded that depression is common in both type 1 and type 2 diabetes patients and calls the need for screening of depression for comprehensive diabetes management. Keywords: Depression, diabete smellitus, General Health Questionnaire-12, glycemic control, HAM-D, ICD-10 DCRPublication Depression in survivors of female trafficking in shelter homes of Kathmandu Valley(Institute of Medicine, 2017) Pradhan, G; Ojha, SP; Sharma, VD; Chapagain, M; Tulachan, P; Dhungana, S; Pant, SBAbstract Introduction: Human trafficking is the recruitment and movement of individuals most often by force, coercion, or deception for the purpose of exploitation. There is very limited evidence on the health consequences of human trafficking. This study were to find out the prevalence of depression among survivors of female trafficking in the shelter homes of Kathmandu valley and also to find out severity of depression (mild, moderate and severe) among the survivors of female trafficking. Methods: A cross- sectional design was implemented. A total of 67 participants was collected from 4 different NGOs working in the field by using probability proportion to size method and from each NGOs the participants were taken using purposive sampling. The consent was taken and strict inclusion and exclusion criteria were applied during participant's selection. The semi- structured proforma was filled with adequate information. Clinical diagnosis of depression was made according to ICD-10 classification of Mental and Behavioral Disorders-Diagnostic Criteria for Research (WHO-1992) in patients and Hamilton Rating Scale for Depression (HAM-D) was used to assess the severity of depression (mild, moderate and severe). Finally, information obtained from demographic profile, clinical features, and rating scale was analyzed by using suitable statistical tools. Results: The study showed out of all 67 female human trafficking victims interviewed from 4 major shelter homes in Kathmandu valley a majority were found to be from the 16 to 20 years age group during the time of interview. Most victims were found to be trafficked at a young age, 11-15 years. A majority of them were lured with job proposals mostly by their own family members. Victims were mostly lead to India for trafficking as sex workers. Based on ICD 10 DCR 61.2% of the victims were found to be suffering from depression among which according to HDRS 16.4% had severe and 4.5% had very severe depression. Conclusion: Despite a dramatic increase in the profile of human trafficking over the past decade, the evidence on trafficked people's experiences of violence and of depression and other mental health problems is extremely limited. Depression is quite common and more information is needed on trafficked people's health needs and experiences, including evidence on interventions to mitigate the physical and psychological damage associated with this global crime.Publication Escitalopram Induced Priapism(Institute of Medicine, 2014) Tulachan, P; Chapagain, M; Ojha, SP; Dhungana, SAbstract Priapism, a rare but potentially dangerous condition has been linked with numerous psychotropic agents. Trazodone is already well known for this side effect, followed by antipsychotics. In last two decades there have been few individual reports of SSRI induced priapism. Escitalopram a relatively new selective serotonin reuptake inhibitor (SSRI) becoming widely administered. We report here on the first instance to our knowledge, a case of priapism which occurred following use of Escitalopram. Thus, this case highlights need for clinicians to become aware of this association and its subsequent severe morbidity. Keywords: SSRI, escitalopram, priapismPublication Neuropsychiatric presentation of Wilson's disease(Institute of Medicine, 2016) Dhungana, S; Ojha, SP; Chapagain, M; Tulachan, P; Pant, SBAbstract Wilson's disease is a rare autosomal inherited disorder with various manifestations. Initial manifestations could be hepatic, neurological or psychiatric and there is invariable delay coming to the correct diagnosis. Exact frequency of children and adolescents presenting with psychiatric complaint as the initial manifestation is not known. It is recommended that detailed medical evaluation be done in any child presenting with psychiatric complaints. We hereby present a case of an eight-year old girl who presented with anxiety and subsequently diagnosed to have Wilson's disease. Keywords: children, neuropsychiatric presentation, Wilson's disease