Browsing by Author "Gupta, S"
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Publication A Study of F Wave Latencies, Chronodispersion and Persistence in Healthy Medical Undergraduates at BPKIHS(Kathmandu University, 2018) Subedi, P; Limbu, N; Thakur, D; Khadka, R; Gupta, SABSTRACT Background The F wave is a CMAP (compound muscle action potential) evoked by a supramaximal stimulation of a motor nerve. F waves are particularly useful for the diagnoses of polyneuropathies at a very early stage and proximal nerve lesions. F waves have a very high diagnostic role in neurophysiology; we would like to study different F wave parameters and effect of anthropometric variables on F wave parameters in normal healthy individuals. Objective To study the effect of anthropometric variables on F wave latencies, chronodispersion and persistence Method Healthy males (n=64) and females (n=26) medical students of BPKIHS with age 21.64±1.19 years were enrolled in the study. Anthropometric parameters and maximum and minimum F wave latencies, F persistence and chronodispersion of bilateral median, ulnar and tibial nerves were recorded in Neurophysiology Lab II of BPKIHS. Descriptive analysis was done for anthropometric and F wave parameters. Unpaired t test was applied for comparing anthropometric and F wave variables between males and females. Pearson correlation was applied between anthropometric variables and F wave parameters. Result Age, height and weight of the subjects were 21.64±1.19 years, 165.61±5.4 cms and 64.07±5.5 kg respectively. Minimum F wave latencies (ms) of right median, ulnar and tibial nerves were 24.09±1.95, 24.02±1.76 and 44.34±3.02 while on the left side were 23.92±1.96, 24.11±1.92 and 44.07±2.83 respectively. Anthropometric variables of male and females were statistically significant. Also, F wave latencies between groups were different which were statistically significant. F persistence was above 80% for all tested peripheral nerves. Height and weight showed a significant effect on F wave latencies (p<0.001). However, age did not show any significant effect on F wave parameters. Conclusion Males have prolonged latencies as compared to females. Height and weight showed a significant relationship with the F wave latencies of the tested peripheral nerves. KEY WORDS Anthropometric, Chronodispersion, F wave, PersistencePublication A Study of the Efficacy of Skin Needling and Platelet Rich Plasma in the Treatment of Acne Scars(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2017) Ranjan, Shivani; Gupta, RS; Gupta, SAbstract: Introduction: Permanent scars are the major complications of acne. Correction of scars is the priority for acne patients. Platelet-rich plasma (PRP) may be useful in the treatment of atrophic acne scars by promoting collagen deposition. Skin needling also releases growth factors, initiate a cascade of wound healing resulting in collagen production. Hence, skin needling and PRP should act synergistically to improve acne scars. Objective: To assess the effectiveness of the combined use of skin needling and PRP application in acne scar treatment. Material and Methods: The study enrolled 10 patients of acne scars. Platelet rich plasma therapy with needling was given to them at monthly interval for a therapeutic period of 6 months. The effects of therapy were evaluated based on photographic assessment and patient’s satisfaction. Results: Mean age of the patients was 28.10 ± 5.065. Twenty percent of patients showed excellent response, 80% showed good response. The results were found to be significant with p value < 0.014. Pain and edema were major complaints which subsided in 1-2 days. Conclusion: Platelet rich plasma therapy combined with skin needling is a safe and effective treatment for management of acne scars. Keywords: platelet rich plasma, skin needling, dermaroller, acne scarsPublication Anaesthetic management of a parturient with severe kyphoscoliosis(Kathmandu University, 2008) Bansal, N; Gupta, SAbstract Use of neuraxial block in a patient with severe kyphoscoliosis is controversial. We describe the anaesthetic management by spinal anaesthesia of a parturient with severe kyphoscoliosis in obstructed labour. The perioperative course was uneventful. We suggest that a patient with severe kyphoscoliosis may be successfully managed by spinal anaesthesia for caesarean section.Publication Cross-cultural Adaptation and Psychometric Properties of Nepali Version of Developmental Coordination Disorder Questionnaire(Kathmandu University, 2023) Shrestha, N; Thapa, A; Gupta, S; Lepcha, L; Adhikari, SPABSTRACT Background Revised developmental coordination disorder questionnaire (DCDQ’07) is the best available population-based screening tool to identify developmental coordination disorder and being a parent reported tool, it needs to be available in Nepali language for its application in Nepali population. Objective The objective of this study was to cross-culturally adapt developmental coordination disorder questionnaire into Nepali (DCDQ-NP). The psychometric properties of Nepali version of Developmental coordination disorder questionnaire were established. Method The adaptation was done following Beaton’s guideline and the psychometric properties was studied in the community sample of 165 parents of school going children of 5-15 years. Fifty parents were asked to refill the questionnaire after the two weeks period. The study determines internal consistency, test retest reliability, floor and ceiling effect and construct validity. Result Significant cultural adaptation was required to obtain relevant Nepali version. The Nepali version of Developmental coordination disorder questionnaire demonstrates high internal consistency (α = 0.912), excellent test-retest reliability (IC = 0.901) and the floor and ceiling effect were acceptable. Principal component analysis showed three factor structure accounting 62% of variance. Conclusion The developmental coordination disorder questionnaire into Nepali were successfully translated and culturally adapted preserving its original concept. It showed good psychometric properties in a Nepali population. The adapted questionnaire shall be of significance in carry out further research in developmental coordination disorder in Nepal. KEY WORDS Cross cultural adaptation, Developmental coordination disorder, Parent reported, School going children, ScreeningPublication Differential Analysis of Heart Rate Variability in School Going Adolescents: Comparing Healthy Individuals with Those Experiencing Depression and Anxiety(Kathmandu University, 2024) Thapa, B; Kumar, S; Laskar, NB; Bhandari, SS; Gupta, SABSTRACT Background Adolescents often struggle with depression and anxiety, which can greatly affect their well-being and functioning. Early detection is crucial for timely intervention and long-term health. Objective The objective of this study is to compare heart rate variability between depressed and anxious adolescents and their healthy peers. Method In this cross-sectional study, adolescents aged between 13-18 years were randomly selected from various schools. Participants were assessed for depression and anxiety using the Revised Child Anxiety and Depression Scale-25 (RCADS-25). Heart Rate Variability was measured using Power lab, with recorded variables including Median normal to normal interval (NN), Standard deviation of the normal-to-normal interval (SDNN), Root Mean Square of the Successive Differences (RMSSD), Percentage of successive normal to normal interval differing by more than 50 milliseconds (pNN50), Low frequency power % (LF), High frequency power % (HF), and the LF:HF ratio. Result Reduction in certain time domain HRV parameters was observed among the subset of depressed students in Classes XI and XII, such as NN interval (p=0.019), SDNN (p=0.024), and RMSSD (p=0.034). Anxious adolescents showed a significant reduction in HRV compared to their healthy counterparts [(NN, p<.001), (SDNN, p=0.011), (RMSSD, p=0.017), (pNN50, p=0.016). Students with symptoms of both depression and anxiety demonstrated significantly reduced HRV parameters compared to the healthy group, affecting NN, (p<.001), SDNN, (p=0.003), RMSSD, ( p<.001), pNN50, (p< .001), HFP %, (p< .001) and LF: HF (p=.005). This association was observed in both males and females. Conclusion Adolescents with depression and anxiety have lower HRV than their healthy peers. Monitoring HRV may help to objectively detect these conditions. KEY WORDS Adolescents, Anxiety, Depression, Heart rate variabilityPublication Does Choice of Different Surgical Intervention Play a Role in the Recurrence of Pterygium?(Kathmandu University, 2023) Yadav, R; Das, SS; Gupta, S; Agrawal, NABSTRACT Background There are a wide range of pterygium excision techniques in practice. However, choosing the best possible option is an important factor to prevent its recurrence. Objective To compare the recurrence rate of different excision techniques and understand if a surgeon can alter the recurrence rate. Method A retrospective data of pterygium surgeries operated by a surgeon at Sagarmatha Choudhary Eye Hospital, Nepal from the year 2016 to 2018 was investigated for recurrence. The recurrence was measured by an independent Optometrist with the help of clinical photo and slit-lamp examination. A telephonic directory was maintained for every patient’s follow up reminder. Result Altogether 916 individuals with mean age 56.20 years had undergone pterygium excision. Bare Sclera 280 (30.56%), Pterygium Extended Conjunctival Transplantation (PERFECT) 305 (33.29%), Conjunctival auto graft (CAG) 262 (28.60%), Simple Pterygium excision 60 (6.55%) and Amniotic Membrane Graft (AMG) 9 (0.98%), jointly formed the total study sample and surgical techniques. Recurrence for Bare sclera was 172 (61.42%), simple pterygium excision 34 (56.66%), Pterygium extended conjunctival transplantation 0 (0%), and conjunctival auto graft 2 (0.76%). Compared conjunctival auto graft with pterygium extended conjunctival transplantation and simple pterygium with bare sclera revealed similar recurrence rate comparatively. The p-value obtained were p = 0.2148 and p = 0.8152 (p > 0.05, 95% CI) respectively. Conclusion The loss of limbal stem cells in Bare sclera technique acts as stimulant for pterygium recurrence, in addition the remains of pterygial matter in simple pterygium excision acts as precursor for recurrence. Pterygium extended conjunctival transplantation indeed acts as barrier but needs fine surgical skills to perform. Conjunctival auto graft can be opted as an alternative technique for minimal recurrence as compared to Pterygium extended conjunctival transplantation. KEY WORDS Bare sclera, Conjunctival auto graft, Pterygium surgery, RecurrencePublication Nonclassical focal nodular hyperplasia of the liver in a chronic alcoholic: A diagnostic dilemma on FNAC(Kathmandu University, 2009) Pai, R; Khadilkar, UN; Diaz, E; Prabhu, S; Gupta, SNAPublication Synchronous RCC with NHL: A case report(Kathmandu University, 2007) Khadilkar, U; Prasad, K; Gupta, S; Prabhu, GLA 55year old man presented with cervical adenopathy of two months duration.Biopsy of the node showed T-cell lymphoma, which was confirmed by immunohistochemistry. An abdominal CT done for the staging work-up of the lymphoma, revealed a left renal mass which histologically proved to be renal cell carcinoma [RCC], gradeII, stage I. An association between RCC and lymphoma is rare and this case is documented for the synchronous and concurrent occurrence of non-Hodgkin’s lymphoma [NHL] of T-cell type and RCC. Key words: RCC, Synchronous, NHLPublication The Comparative Accuracy of BISAP and PANC3 Scoring System for the Disease Severity and Outcome in Acute Pancreatitis in Tertiary Care Hospital from North India(Kathmandu University, 2023) Gupta, S; Dhillon, HS; Gupta, NABSTRACT Background Acute pancreatitis has local and systemic manifestations, so it’s important to assess the severity by various scoring system. Among them bed side index for severity of acute pancreatitis and pancreatitis three score have been considered to be more predictive and easier. Objective To determine the comparative prognostic value of bed side index for severity of acute pancreatitis and pancreatitis 3 score and its correlation with the outcome. Method A prospective observational study was conducted on 50 cases of acute pancreatitis. The patients were assessed clinically, radiologically and biochemically and were categorised into mild, moderate and severe category as per Atlanta Classification. Bed side index for severity of acute pancreatitis and pancreatitis 3 score was calculated at the time of admission and followed till the time of discharge or they had mortality. Result Receiver operating characteristic curve, showed bed side Index for severity of acute pancreatitis score had sensitivity (66.67%), specificity (84.09%), diagnostic accuracy (84%) while pancreatitis 3 score had sensitivity (50%), specificity (81.82%), diagnostic accuracy (80%) for the severity of acute pancreatitis. Bed side index for severity of acute pancreatitis had sensitivity (100%), specificity (66.67%) and Pancreatitis 3 score had sensitivity (66.67%), specificity (80.85%) for predicting the mortality in acute pancreatitis. Conclusion Bed side index for severity of acute pancreatitis and pancreatitis 3 score are both simple, bedside tool for assessing the severity and mortality but bed side index for severity of acute pancreatitis score had better sensitivity, specificity for assessing the severity and mortality as compared to pancreatitis three score. KEY WORDS Acute pancreatitis, Bed side index for severity of acute pancreatitis, Pancreatitis 3 scoring system