Browsing by Author "Gautam, M"
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Publication The Effectiveness of Accelerated Skill Acquisition Program for Upper Extremity Motor Training in Bilateral Stroke(Kathmandu University, 2019) Adhikari, SP; Gautam, MABSTRACT The bilateral stroke is an added challenge for functional recovery. The evidence of effective therapy intervention for bilateral stroke is rare. A protocol of 30 hours (5 hours/week for 6 weeks) of accelerated skill acquisition program (ASAP) has been administered to a patient with bilateral ischemic middle cerebral artery syndrome at sub-acute stage. Two sessions per day (separately for right and left) were administered. Nepali Wolf Motor Function Test (WMFT) was used to evaluate performance time before and after the treatment. The performance time on Wolf Motor Function Test got largely and consistently reduced on all items of both extremities. There was improvement in grip strength and weight lifting items. Bilateral hand items and turn key in lock were successfully completed after the treatment. Thus, the accelerated skill acquisition program yielded large reduction in performance time, improved hand skills and demonstrated functional improvement of both upper extremities in individual with bilateral stroke. KEY WORDS Accelerated skill acquisition program, Bilateral Stroke, Motor trainingPublication Variation of total serum cholesterol among the patient with thyroid dysfunction(Kathmandu University, 2010) Risal, P; Maharjan, BR; Koju, R; Makaju, RK; Gautam, MAbstract Background: Thyroid hormone has its effect in the lipid metabolism. Thus, thyroid disorder is usually associated with the dyslipidaemia. Hypercholesterolemia is an established risk factor for the cardiovascular disease (CVD) and therefore in case of overt hypothyroidism which is associated with hypercholesterolemia, CVD is most likely to occur. Objectives: controversies still persist about the hypercholesterolemia and sub clinical hypothyroidism. Hence, we conducted our study to elucidate the relation of thyroid hormone with cholesterol in different thyroid disorder. Material and Method: All patients suspected of thyroid disorder within a period of one year were included in the study and free thyroxine-3 (fT3), free thyroxine-4 fT4, Thyroid Stimulating Hormone (TSH) and total cholesterol (TC) in the serum were estimated. Statistical analysis was carried out by using SPSS. 13. Results: Among the 169 cases, 32.5% of the patients were having thyroid disorder. In which 8.3% were of hypothyroid, 7.1% were of sub clinical hypothyroid, 8.3% were of hyperthyroid, 7.7% were of sub clinical hyperthyroid and 1.2% cases were of pan hypothyroid. We observed significant negative correlation between TC & fT3(r = -0.226, p = 0.003), significant negative correlation between total cholesterol & fT4(r = -0.197, p = 0.010) and significant positive correlation between TC & TSH(r = 0.365, p = 0.000). Total cholesterol was significantly raised in hypothyroidism (Mean ±SD 283±53, p = 0.000) in comparison to euthyroid population (mean ±SD, 195±58). But cholesterol was not significantly increased in sub clinical hypothyroidism (mean ±SD, 240±46) Conclusion: Our results show that total cholesterol level in serum is affected by the blood thyroid hormone level. Therefore, screening for hypercholesterolemia could be useful in patients with hypothyroidism to reduce associated disease. Key words: Thyroid hormone, Cholesterol, Nepal