Browsing by Author "Gurung, CK"
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Publication An open, randomized, comparative study of efficacy and safety of risperidone and haloperidol in schizophrenia(Kathmandu University, 2006) Tamrakar, SM; Nepal, MK; Koirala, NR; Sharma, VD; Gurung, CK; Adhikari, SRObjectives: In the last decade there have been numerous randomized controlled trials comparing the efficacy and safety of second generation antipsychotics and conventional antipsychotics in the treatment of schizophrenia, but most of them have been conducted in the western population. This study compared the efficacy and safety of risperidone versus haloperidol in the Nepalese context, in order to add on to the very few literatures available on this topic in the South East Asia region and compare them. Methods: Patients with the diagnosis of schizophrenia were randomly assigned to receive risperidone 4-6 milligrams (mg) per day and haloperidol 10-20 mg per day, and were followed up for 6 weeks. Assessment were done on the day of the diagnostic interview and days 7, 14, 28 and 42 (end point). During the assessment periods Positive and Negative Syndrome Scale (PANSS) was administered to monitor the progress in psychopathology and Udvalg for Kliniske Undersogelser (UKU) side effects rating scale was applied to rate the treatment emergent adverse effects. Results: Both risperidone and haloperidol were associated with substantial baseline- to- endpoint reduction in symptom severity. After one week of treatment, the improvement in schizophrenia with risperidone was significantly better than haloperidol in terms of PANSS- total Score (-45.4 versus –29.5), negative subscale score (-14.3 versus -6.68) and general psychopathology subscale score (-20.9 versus –13.7). At the end point of the study, the benefit was maintained in total score (-52.1 versus –43.1), though the negative subscale score still showed tendency for greater improvement in psychopathology with risperidone. The side effects profile did not show significant differences except in extrapyramidal symptoms. Thirty-eight percent of risperidone treated patients had to resort to anti-parkinsonian treatment compared to 78% in haloperidol treatment group. Conclusion: Similar to the studies in the western countries, Asia and Indian subcontinent, both risperidone and haloperidol were effective in the reduction of psychopathological symptoms in this group of Nepalese population with the diagnosis of schizophrenia. However, risperidone was quicker and better then haloperidol and risperidone had a better safety profile. This is important, because extrapyramidal side effects of neuroleptics are responsible for non-compliance and increased cost in terms of us of anti-parkinsonian medication. Key words: schizophrenia, antipsychotic, risperidone, haloperidol, positive and negative syndrome scale (PANSS).Publication Correlation of Calcium, Phosphorus, Uric Acid and Magnesium Level in Serum and 24 hours Urine of Patients with Urolithiasis(Kathmandu University, 2011) Gyawali, PR; Joshi, BR; Gurung, CKABSTRACT Bakcground Urinary stones disease is common pathology encountered in urological practice in Nepal. Supersaturated urine and its stagnation are well known facts for the development of urolithiasis. Metabolic disorders like hypercalciuria, hyperuricaemia, hypocitraturia are also responsible for formation of urolithiasis. Objective The aim of this study was to identify the level of calcium, phosphorus, uric acid, and magnesium in the blood and urine of Nepalese patients with urinary stones. Methods This study was conducted over a period of six months (From May to November 2010). It is a descriptive cross sectional study and quantitative method was used for analysis. Primary data were collected and utilized from 79 cases. Results: The prevalence of urolithiasis in male patients was 65.8% and 34.2% in female patients (p<0.05). Serum calcium in stone former and non-stone former was 8.3±1.2 and 7.5±1.5 (p<0.01) respectively. Serum phosphorus and uric acid in both groups were statistically not significant (p value 0.269 and 0.597 respectively) though in 24 hours urine of stone formers value of phosphorus was 447.9±182.4 but in non-stone formers it was 186.5±118.7 (p<0.001). Magnesium level in urine was 48.1±69.7 and 131.4±86.9 (p<0.001) respectively. Conclusion Higher level of calcium in serum was found in patients with urolithiasis in our population. Though phosphate level in blood serum was not different in the both groups but in urine phosphate and magnesium levels were significantly different. KEY WORDS hypercalciuria, hyperphosphaturia, hyperuricosuria, hypocitraturia, urolithiasisPublication Implementation of Active Case Detection of Visceral Leishmaniasis along with Leprosy through Female Community Health Volunteers in Sarlahi District, Nepal(Kathmandu University, 2019) Singh, VK; Joshi, AB; Gurung, CK; Banjara, MRABSTRACT Background Visceral leishmaniasis (VL) and leprosy are important public health problem in Nepal. Female Community Health Volunteers (FCHVs) play pivotal role to promote community based health services. Therefore, we designed an implementation research to assess the effectiveness of active case detection (ACD) and information education and communication (IEC) campaign of Visceral leishmaniasis cases along with leprosy cases through Female Community Health Volunteers in Visceral leishmaniasis endemic 10 Village Development Committees of both Visceral leishmaniasis and leprosy prevalent Sarlahi district of Nepal. Objective To determine the effectiveness of active case search strategy of visceral leishmaniasis along with leprosy through Female Community Health Volunteers in Sarlahi district. Method One hundred fifty one Female Community Health Volunteers of twelve Village Development Committees were oriented on detection, identification and referral of Visceral leishmaniasis and leprosy patients. They were oriented on referring the patients to district hospital for confirmatory diagnosis and treatment. The intervention was continued up to ten months after training of Female Community Health Volunteers. Data on number of Visceral leishmaniasis and leprosy patients detected and referred by Female Community Health Volunteers and detected through passively at district hospital were collected and indicators was calculated. Result Altogether 151 Female Community Health Volunteers were trained from 12 (Village Development Committees) VDCs of Sarlahi district. Their knowledge on leprosy and Visceral leishmaniasis related information subsequently increased after training. None of the Visceral leishmaniasis or leprosy cases were detected actively through Female Community Health Volunteers. However, two leprosy cases were detected through household screening. Conclusion Female Community Health Volunteers should be provided sufficient knowledge to use them in community based active case detection of Visceral leishmaniasis and leprosy. KEY WORDS Active case detection, Female community health volunteers, Information education and communication campaign, Leprosy, Visceral leishmaniasisPublication Monitoring Iodine Deficiency in a District Hospital, Nepal(Kathmandu University, 2020) Singh, VK; Joshi, AB; Gurung, CK; Pant, KR; Banjara, MRABSTRACT Background Iodine deficiency possesses serious threat to pregnant women and infants. During pregnancy, iodine deficiency can result in stillbirth while in infants it can lead to impaired brain development. Objective This study was conducted to assess the status of iodine deficiency among pregnant women and infants. Method Ninety seven pregnant women seeking antenatal check-up (ANC) from Chautara Hospital Sindhupalchowk were included to analyze urine iodine. Thirty one mothers and their children were followed-up for their clinical status. Additionally, the infants were assessed for their urine iodine excretion and the mothers were assessed for their awareness about iodine and iodine deficiency disorder (IDD). Result Urinary iodine excretion revealed 25.2% of pregnant women and 20% children below one year of age had insufficient iodine intake while 42.9% of pregnant women and 24% children had iodine level above normal. Almost all households were found using iodized salt, 80% respondents had heard about iodized salt, 13% mothers were aware of benefits of iodized salt, 41.9% had knowledge of iodine deficiency diseases and 38.4% cognized the source of iodine. Conclusion Though awareness about iodine and iodine deficiency disorder was satisfactory, pregnant women and children were at risk of iodine deficiency and excessive iodine disorder. Therefore, to improve health of pregnant women and newborn, their nutrition must be prioritized which ultimately will help reduce morbidity and mortality. KEY WORDS Infant, Iodine deficiency, Pregnant women, Urine iodine