Browsing by Author "Khalid, Abdul"
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Publication A study of patients with epilepsy attending T.U. Teaching Hospital(Institute of Medicine, 1999) Koirala, Naba Raj; Khalid, Abdul; Regmi, Shishir K; Pokharel, AnupamKeywords: Epilepsy, TUTH, ICD-10 Abstract There have been only few studies on Epilepsy in Nepal. The present work was undertaken with the aim of studying socio-demographic and diagnostic profile of patients presenting with Epilepsy in Tribhuvan University Teaching Hospital, Kathmandu. It was a prospective, cross-sectional, descriptive study, and the sample comprised all patients of Epilepsy attending the Psychiatric Outpatient Department of Tribhuvan University Teaching Hospital for the first time during one year study period from August 1997 to July 1998. The majority of the patients were less than 40 years of age (91.98%), more than half of the patients were single and students outnumbered other professionals. Most of the patients were diagnosed as Generalized idiopathic epilepsy and epileptic syndromes (85.02%). Only one-fourth of the patients sought treatment within one month of the onset of epilepsy. There is a need for general public education programmes to create awareness and destigmatize the disease so that early recognition and management maybe possible.Publication An assessment of financial and social cost of alcohol use(Institute of Medicine, 2000) Koirala, Naba Raj; Sinha, Uday K; Sharma, Vidya Dev; Khalid, Abdul; Nepal, Mahendra K; Bhusal, Choplal; Pokharel, Anupam; Sharma, Subhash CAbstract Alcohol has been treated as a normal commodity in the modern societies. Alcohol consumption has risen in developing countries, where it takes a heavy toll. Various problems directly or indirectly related with excessive alcohol use are increasingly identified. Economic impact of alcohol is thus an important issue and the present work aims to study the direct cost of alcohol as well as various adverse consequences due to its use in the patients attending the facility. This prospective-descriptive study included 40 patients admitted in the Psychiatry Ward, TUTH due to alcohol-related problems over a period of six months. Thirty-nine (97.5%) were males, thirty-five (87.5%) were married, and 24 (60%) were farmers. The mean age of the patients was 37.7�10.3 years, and the mean duration of alcohol abuse was 14.65�9.51 years. The direct cost of alcohol was calculated as Rs. 57056 per year per person and an estimated Rs. five billion being spent by the Nepali nationals in alcohol over a period of one year. Alcohol use was found to be associated with marital, social, financial, occupational and legal problems. Adverse effects as well as consequence of alcohol is thus found to take heavy toll in the society. Keywords: Alcohol, complications, costPublication An Exploratory Study of Emotional and Behavioral Problems in Physically Disabled Children and Adolescents(Institute of Medicine, 2000) Ojha, Saroj P; Nepal, Mahendra K; Regmi, Shisir K; Khalid, Abdul; Koirala, Naba Raj; Gurung, Chitra KAbstract A two-stage study was carried out to estimate the prevalence of emotional and behavioural problems in physically disabled children and adolescents and also to study the patterns of psychiatric morbidity among them. A stratified random sample of 100 institutionalized and non-institutionalized disabled children and adolescents aged 4 to 18 years from among a total of 618 disabled children and adolescents were evaluated by using CBCL questionnaires, which were completed, by their parents or caretakers in the first stage study. All high scorers (above 98th percentile) and 20 percent of low scorers (below 98th percentile) on CBCL scores were interviewed by using DSM-IV criteria for diagnosis in the second stages. The weighted prevalence of DSM-IV disorders among the physically disabled children and adolescents was 35.20 per cent. Boys were more often having problems than girls (1.6:1.0). Similarly, the prevalence of psychiatric morbidity was higher in non-residential compared to the residential based group. The most common psychiatric disorder among these children and adolescents were depressive disorders (39.2%), enuresis (21.8%) and panic disorder (13.25). Females were more likely to suffer from depressive and panic disorders in contrast to the enuresis in males. Emotional and behavioral problems as well as psychiatric disorders in the physically disabled children and adolescents in Nepal are much more common than those reported in the Western and Indian literatures. Keywords: Child Behavior CheckList (CBCL), childhood psychopathology, epidemiology, disabled children and adolescents, Diagnostic Criteria from DSM-IV.Publication Factor analysis of clinical signs in stupor(Institute of Medicine, 2001) Pokharel, Anupam; Nepal, Mahendra K; Regmi, Shishir K; Khalid, Abdul; Sharma, Vidya Dev; Koirala, NabarajAbstract Despite various signs in stupor are associated with different nosological groups, diagnostic significance of the associations are yet not clear. Present work was undertaken with the aim to find out any relation of stupor/stupor-like states with various objective cross-sectional clinical findings. A total of 24 patients presented in stupor and stupor-like states admitted in the psychiatry ward of a tertiary level hospital in Nepal were included in the study. Only 16 out of 36 items in Modified Rogers Scale and 17 out of 32 items in Present State Examination (sections 18-20) were scored. Eight items were common between to rating scales. Factor analysis of thus obtained 25 items revealed 10 factors with eigenvalue more than one. Only three factors were suggestive but none were diagnostic of any of nosological groups. The cross-sectional clinic findings do not seem to have definite diagnostic significance and we thus support a holistic clinical evaluation of patients in stupor to reach a diagnosis. Keywords: catatonia, principle component, varimax rotation, clinical evaluationPublication Neurocysticercosis presenting with hypersexuality(Institute of Medicine, 1998) Sharma, Vidya Dev; Khalid, AbdulAbstract Neurological disorders can produce paraphilic behaviour and alterations in sexual drive. Lesions of the temporal lobe have been classically associated with sexual disorders. We are reporting a 20-year old girl who presented with marked hypersexuality for five years and had history of generalized tonic-clonic seizures about seven years back. EEG record showed localised spike discharges with phase reversal in the leads corresponding to left parietal lobe. MRI scan revealed calsifications with no perifocal oedema in both parietal lobes and right occipital lobe, suggestive of healed neurocysticercosis. The patient showed significant improvement with carbamazepine. Keywords: Hypersexuality, neurocysticercosis, epilepsyPublication Postnatal Depression: A study of prevalence and associated socio-demographic factors(Institute of Medicine, 1999) Regmi, Shishir K; Khalid, AbdulAbstract Perinatal psychiatry is an important aspect of modern clinical practice. Postnatal psychiatric states maybe divided into three categories, which overlap to some extent, that is, maternity blues, postnatal depression, and puerperal psychosis. In the West, studies have reported that significant postnatal depressive disorders occur in up to 10 percent of women. The present work was undertaken with the aim to study the prevalence of postnatal depression and to study the socio-demographic profile of women suffering from postnatal depression. The sample for the present study was drawn from women who attended postnatal clinic (Mondays and Wednesdays) of T.U. Teaching Hospital and were in 4-12 weeks postnatal period. All the selected women were asked to rate Edinburgh Postnatal Depression Scale. A total of 100 women in 4-12 week postnatal period were screened and twelve women scored above the cut-off score and were found to be suffering from postnatal depression. Thus the estimated prevalence of postnatal depression in females attending postnatal clinic of TUTH is 12%. The mean age of females was 23.92+3.29 years. The majority of them were housewives, belonged to Hindu religion and came from middle socio-economic strata. Though the sample for the present study was relatively small, it may still be inferred that the prevalence of postnatal depression in Nepal maybe the same as that in the world. Further large-scale community studies are recommended. Keywords: Postnatal depression, prevalenc, socio-demographic profilePublication Psychiatric emergencies in a general hospital setting(Institute of Medicine, 1999) Khalid, Abdul; Regmi, Shishir K; Koirala, Naba Raj; Nepal, Mahendra K; Pokharel, AnupamAbstract A psychiatric emergency is any disturbance in thoughts, feelings, or actions for which immediate therapeutic intervention is necessary. For a variety of reasons, such as the growing incidence of violence, the increased appreciation of the role of medical disease in altered mental status, and the epidemic of alcohol dependence and other substance related disorders- the number of emergency patients is on rise. The present work was undertaken with the aim to study socio-demographic and diagnostic profile of patients for whom psychiatric evaluation was sought in the Emergency Room [ER] of Tribhuvan University Teaching Hospital, Kathmandu during a three-month period. It was a prospective, cross-sectional, descriptive study. Majority of the patients were of age 11-30 years (57.7%), more than half of the patients were married (64.4%,) and patients coming from Kathmandu valley (62.5%) outnumbered patients coming from outside. Only 46% of the patients attended the ER within 24 hours of onset of current problem. Out of the patients who received the diagnosis of Category F- Mental and Behavioural disorders of the ICD-10 (79.8%), 43.4% were suffering from the Neurotic, stress-related and somatoform disorders and 20% were suffering from Mood disorders. Out of the remaining 20.2% patients, one third each belonged to those who committed intentional self harm, who were suffering from neurological disorders, and who were found to be suffering from systemic diseases. Emergency psychiatry is yet to draw attention of administrators and policy makers, which is reflected by the fact that only TUTH provides 24 hours psychiatric emergency services in the whole country. Keywords: Emergency, Psychiatric emergencies, TUTH, ICD-10Publication Tardive dystonia: a troublesome side-effect of conventional antipsychotic medicines(Institute of Medicine, 2000) Pokharel, Anupam; Koirala, Naba Raj; Sharma, Vidya Dev; Khalid, AbdulAbstract Tardive dystonia is a frustrating condition encountered after prolonged use of conventional dopamine receptor antagonist drugs. The present case report illustrates the development of tardive dystonia after 24 months of continuous use of haloperidol, which was managed well with olanzapine and tetrabenzine in combination. Less promising outcome of various treatment modalities is discussed and cautious use of dopamine receptor antagonist drugs is advocated. Keywords: tardive dystonia, dopamine receptor antagonist, tetrabenazine, olanzapinePublication The Cri du Chat syndrome in a 6-year-old boy(Institute of Medicine, 2000) Koirala, Naba Raj; Sharma, Vidhya Dev; Khalid, Abdul; Nepal, Mahendra K; Pradhan, Sudarshan N; Pokharel, AnupamAbstract The partial deletion of short arm of chromosome 5, which is known as Cri du Chat syndrome, although rare is a major cause of mental retardation in children. This case report describes the cognitive and behavioural profile of a six-year old boy who displayed evidences of severe mental retardation, behavioural problem and seizure disorder. Keywords: Cri du Chat, deletion, chromosome, epilepsy