Browsing by Author "KN, Shakya"
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Publication A Study of the First 350 Cases Referred for EEG in Kathmandu Medical College Teaching Hospital(Kathmandu University, 2004) R, Shrestha; SN, Pradhan; SC, Sharma; KN, Shakya; DB, Karki; BBS, Rana; LN, JoshiElectroencephalography or EEG is a neurological test that uses an electronic monitoring device to measure and record electrical activity in the brain. Epilepsy is defined as a recurrent tendency to unprovoked seizure. About 0.5% to 2% of the population has epilepsy. Material and Methods This is a retrospective study of the first 350 odd cases referred for EEG at Kathmandu Medical College Teaching Hospital, Kathmandu during period November 2002- September 2002 (Mangsir 2058- Bhadra 2059). Results Most patients fall in the age group of 11-20 years and more than 50% referred cases fall in the prime of life, i.e., 11- 30 years. 16% of patients with the history of seizure did not use any AED and 32 % who though had no history of seizures were actually using AED. It is seen that out of 149 reported normal, 57 (38%) had history of seizure; but out of 208 reported abnormal in EEG only 92 (42%) had history of seizure. Discussion EEG is not a very sensitive or a specific tool; however, in our study it was seen to be more sensitive than specific. It is till very useful in classifying seizure types, in locating epileptic focus prior to surgery or in some confusing situation when movement disorder may simulate seizure disorder or vice versa. Conclusion Although EEG is not a very sensitive or specific investigation, it is more sensitive than specific.Publication Efficacy and tolerability of Ketotifen in Nepalese asthmatic children: a clinical study(Kathmandu University, 2003) KN, Shakya; P, Joshi; A, Piya; MR, BaralObjective To assess the efficacy of Ketotifen in asthmatic children and to record its adverse effects, if any. Design Prospective clinical trial. Setting Pediatric asthma follow up clinic of a teaching hospital. Participants 23 asthmatic children between 3 and 15 years; 100% completed the trial on full protocol. Interventions Ketotifen 1mg (adjusted according to body weight, 50 mcg/kg/dose) orally twice daily for 9 months. Main Outcome measures Primary outcome: Decrease in frequency of asthmatic attacks and severity of exacerbations with improvements in peak expiratory flow rates (PEFR). Other measures included decrease in bronchodilator requirement, steroid doses and parental perception regarding patient quality of life. Results 34.78% children were symptom free by the end of 2nd 3 months and 65.21% had no further attack by the end of 3 rd 3 months of Ketotifen prophylaxis. Those children with activity and sleep ‘affected’ (8.69%) and ‘may be affected’ (30.43%) together improved to ‘may be affected’ group (21.73%) by the end of 2nd 3 months and further reduced to 8.69% by the conclusion of 3 rd 3 months. The duration of exacerbations was reduced in the remaining cases. Variability of PEFR decreased from 26.08% to 8.69% of children after the 3 rd 3 months of Ketotifen prophylaxis. No significant adverse effect of therapy was observed during the study. Conclusion Oral Ketotifen is effective and well tolerated for use in prophylactic treatment of bronchial asthma in children. Key Words: Ketotifen, Asthma, Prophylaxis, Efficacy.Publication Epilepsy in children: an epidemiological study at Kathmandu(Kathmandu University, 2003) KN, Shakya; R, Shrestha; MR, BaralObjectives: To analyze the relative frequencies of various epileptic seizures and to study the age at onset ofdifferent seizure types in Nepalese children. Design: Prospective study. Setting: Hospital outpatient based inKathmandu, Nepal, between November 2001 to October 2002. Participants: 50 children diagnosed as epilepsyexcluding neonatal and febrile seizures. Main outcome measure: Diagnosis and classification of casesaccording to the International Classification of Epilepsy of the International League Against Epilepsy [ILAE]and number of patients in each category with various ages at first seizure. Result: Generalized seizures (78%)were 3.54 times commoner than partial seizures (22%). Most frequent seizure types were generalized tonicclonic (36%), tonic (16%), complex partial (14%), atonic (12%) and absence (10%). Generalized clonic, simplepartial and partial with secondary generalization, each had less than 5% frequencies. In 40% cases the firstseizure occurred when aged between 2-5 years. In partial seizures the peak age at onset was observed below 6years while primary generalized seizure was more frequently seen in age group 2-10 years. Conclusion: Morepaediatric patients with primary generalized seizures (78%) were observed than with partial seizures (22%). Inthis age group, the most frequent seizure type was generalized tonic clonic (36%) with the peak frequency ofage at onset of seizures in 2-5 years.Key words: Epilepsy, Frequency, Age at onset.