Browsing by Author "Jha, Amit"
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Publication Clinico Socio-Demographic Profile of Children with Autism Spectrum Disorder from a Mental Health Clinic in Nepal: An Observational Study(Nepal Medical Association, 2025) Karki, Utkarsh; Jha, Amit; Parajuli, Samjhana; Sharma, Anil; Gurung, Bhupendra; Bhattarai, DipeshAbstract Introduction: Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder with symptoms manifesting in early childhood. There is limited information regarding the clinical scenario of ASD within Nepal. The study aims to determine the clinical and socio-demographic profile and evaluate the association between clinical and socio-demographic parameters in children with ASD. Methods: This was an observational cross-section study which examined the records of children diagnosed with ASD at a Mental Health Clinic in Nepal. Approval for the study was granted by NHRC. The analysis focused on data extracted from clinic records of ASD patients spanning from 16 September 2022 to 15 March 2024 encompassing one and a half years. Data were entered and analyzed using SPSS Statistics for Windows, version 16.0 (SPSS Inc., Chicago, Ill., USA). Results:A total of 138 children were diagnosed with ASD, with a mean age of diagnosis at 42.94 ±17.49 months.Among the participants, there were 110 (79.69%) male, 105 (76.01%) first born with a male to female ratio of 3.9:1 and 114 (82.59% ) were going to regular school. Parents' 39 (28.29%) and relatives' 25 (18.01%) concerns were the primary reasons for seeking a diagnosis followed by referrals from pediatricians 19 (13.79%). The mean Childhood Autism Rating Scale (CARS) score of 34.33±3.99 was indicative of mild to moderate symptoms of ASD. The mean Vineland Social Maturity Scale (VSMS) score of 69.02±13.25 was indicative of mild impairment in socio-adaptive functioning. Conclusions: The study shows higher rate of ASD among males and first-born children. Early age at diagnosis is encouraging and is associated with better outcomes.Publication Clinico-Demographic Profile of Children and Adolescents with Attention Deficit Hyperactivity Disorder Presenting to a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2024) Karki, Utkarsh; Sherchan, Supriya; Sharma, Anil; Jha, AmitAbstract Introduction: Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in children. ADHD leads to significant impairment in overall functioning of the child. There is limited information concerning the clinical scenario of ADHD within Nepal. The study aims to determine the clinico-demographic profile and pattern of medication use in the treatment of ADHD. Methods: This study retrospectively examines the records of children diagnosed with ADHD at the Child and Adolescent Psychiatry (CAP) Unit, Kanti Children’s Hospital (KCH), Nepal. Approval for the study was granted by KCH's Institutional Review Board. The analysis focused on data extracted from hospital records of ADHD patients spanning from 1 January 2021 to 30 June 2023 encompassing two and a half years. Results: A total of 585 children were diagnosed with ADHD, with a mean age 7±3.04 years. The majority 501 (85.64%) were male, and 377 (64.44%) were from the school going age group (6 to 11 years). The prevalent psychiatric comorbidities included Autism Spectrum Disorder (ASD) at 102 (17.43%), Intellectual Disability (ID) at 93(15.89%), and Oppositional Defiant Disorder (ODD) at 36 (6.15%). The commonly used medication was Clonidine 165 (28.20%) followed by Atomoxetine 154 (26.32%) and Risperidone 65 (11.11%). Conclusions: The study indicates that ADHD is highly prevalent in Nepal. Comorbidities like ASD and ID are frequently seen which further necessitates the need for structured assessments and multidisciplinary approaches to address ADHD. In our context with limited treatment options, the management of ADHD is extremely challenging.Publication Resistant Catatonia in a 10-year-old Child: A Case Report(Nepal Medical Association, 2023) Jha, AmitAbstract Catatonia is a psycho-motor disorder associated with various psychiatric, neurological, and medical illnesses. It is due to alteration in GABAergic circuits and basal ganglia. Management includes identifying the underlying cause and handling complications with supportive treatment. It can cause life-threatening complications like dehydration and cardiac arrest. The risks are more in children and adolescent populations. Benzodiazepines and electro-convulsive therapy are treatment modalities. In this case report we discuss about a child who was resistant to both lorazepam and electroconvulsive therapy. Resistance to both first-line management is a rare phenomenon. We were able to manage with a combination of antipsychotics and antidepressants. Catatonia in children may respond late to treatment. Symptomatic treatment, ruling out organic causes, and judicious use of pharmacotherapy can be beneficial in resistant cases.