Browsing by Author "Pradhan, SN"
Now showing 1 - 5 of 5
Results Per Page
Sort Options
Publication A prospective study of comorbidity of alcohol and depression(Kathmandu University, 2008) Pradhan, SN; Adhikary, SR; Sharma, SCAbstract Objective: The aim of the work was to study the socio-demographic variables and their co-morbidity to alcohol consumption and presence of depressive symptomatology. Design: This was a prospective cross-sectional study. Materials and methods: The study was carried out in 53 patients, who were admitted in the wards of Kathmandu Medical College Teaching Hospital (KMCTH) with the diagnosis of mental and behavioural disorder due to the use of alcohol according to ICD-10. The patients were taken from 1st February 2006 to 30th December 2006. All patients were rated using Hamilton Depression Rating Scale (HDRS). Comparison of alcohol intake, depressive symptomatology and their associations with various socio-demographic variables were done using standard statistical procedures. Results: The present study has shown that more than 94.3% of the patients were suffering from depressive episode. Among all the patients, 11.3% were suffering from severe depressive episode. Alcohol intake was more signi cantly correlated (p = .002) with Brahmin and Chhetri caste. The other signi cant correlation of alcohol intake and sociodemographic variable was Nuclear family (p=.001). Among these patients the severity of depression was signi cantly (p= .001) associated with duration of alcohol intake. Marital status was another important factor affecting comorbidity of alcohol intake and presence of depressive symptoms (p =.002). Students of 10th to 12th grades of school were found to be using alcohol more often (45.3%). Middle socio-economic status (60.4%) was using alcohol more frequently than other socio- economical classes. Conclusion: Severity of depression and alcohol intake was found to be signi cantly associated with various socio-demographic variables such as caste, family structure, marital status and educational status. Key words: Co-morbidity, ICD-10, Depression, alcohol-related disordersPublication A study of severity of intention of suicide in various psychiatric diagnoses(Kathmandu University, 2009) Pradhan, SN; Adhikary, SRAbstract Background: Suicidal intent has been described as the seriousness or intensity of the patient’s wish to terminate his or her life. Suicide has become an important public health issue throughout the world. It is important to evaluate the intentions of suicide attempts and various psychiatric diagnostic perspectives to understand the multiple dimensions of suicide. Aims: The aim of the work was to study the severity of suicidal intention among suicide attempters in different psychiatric diagnoses and different mode of attempted suicide. Materials and methods: This study was carried out in the patients, who attempted suicide, by various modes, who were admitted in the wards of KMCTH during 1st January 2007 to 30th December 2007. Suicide Intent Scale (SIS) was used in all the cases that had attempted suicide. Results: Total numbers of patients was 43. Mean SIS was 13.88. The results have shown that majority of cases were female 69.8% (n=30) and male were 30.2% (n=13).The commonest mode of suicide was poisoning 83.7% (n=36) in which moderate suicide intent was 58.3% (n=21); mild suicide intent 33.3% (n=12) and severe suicide intent 8.3% (n=3). Pesticide (organophosphorus) ingestion was the commonest mode of suicide 44.4% (n=16), followed by pharmacological drugs 33.3% (n=12). The commonest psychiatric diagnosis was depressive disorders 62.9% (n=27), in which moderate suicide intent was found to be maximum 70.4% (n=19) followed by mild suicide intent 14.8% (n=4) and severe suicide intent 14.8% (n=4). Conclusion: The increasing problem of pesticide poisoning and drug overdose demands strict legal scrutiny in the availability of common means of attempting suicide. Key words: Attempted suicide, Suicide intent scale, Organophosphorous poisoning, psychiatric diagnosesPublication A Study of the First 350 Cases Referred for EEG in Kathmandu Medical College Teaching Hospital(Kathmandu University, 2004) Shrestha, R; Pradhan, SN; Sharma, SC; Shakya, KN; Karki, DB; Rana, BBS; Joshi, LNElectroencephalography 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 Comparative study of esmolol and labetalol to attenuate haemodynamic responses after electroconvulsive therapy(Kathmandu University, 2007) Shrestha, S; Shrestha, BR; Thapa, C; Pradhan, SN; Thapa, R; Adhikari, SObjective: The study was designed to evaluate the hemodynamic effects of Esmolol and labetalol in patients undergoing electroconvulsive therapy. Materials and Methods: Ninety patients undergoing electroconvulsive therapy treatment were studied according to randomized, double blind placebo controlled protocol. Ninety patients were divided into three groups with thirty patients in each group. Patients received either Esmolol (1mg/kg), Labetalol (0.25mg/kg) or Normal Saline (placebo) intravenously just after induction with propofol. The baseline heart rate and blood pressure were recorded. Hemodynamic parameters before and after drug therapy and after the ECT current application, were recorded at different time intervals. Results: It was found that Esmolol significantly attenuated the degree of tachycardia and hypertension after ECT in comparison with placebo in the first three minutes (p<0.05), whereas the rise in HR and blood pressure was significantly blunted in the labetalol group in comparison to placebo, from three minutes onward till ten minutes. (pPublication Diagnostic variability and therapeutic efficacy of ECT in Nepalese sample(Kathmandu University, 2008) Adhikari, SR; Pradhan, SN; Sharma, SC; Shrestha, BR; Shrestha, S; Tabedar, SAbstract Background: Though electroconvulsive therapy (ECT) has been used in Nepal for last twenty years, researches regarding its use, its efficacy and other data are non-existent. Aims: The objective of this study was to know about diagnostic variability and therapeutic efficacy of the use of ECT in hospitalized patients. Methods: This is a prospective comparative study between patients who received ECT and who did not using ICD- 10 as diagnostic confirmation. Psychopathology was evaluated using Brief Psychiatric Research Scale (BPRS), Hamilton Depression Rating Scale (HAM-D) and Young Mania Rating Scale (YMRS) between the groups at admission, at discharge, at 1 Assistant Professors, Department of Anaesthesia, Kathmandu Medical College, Sinamangal, Kathmandu, Nepal st month, at 6th month and at 12th month. Functional assessment of patients was done using Global Assessment of Function (GAF). Modified ECT was performed using general anaesthetic agent. Results: 47 patients received ECT as compared to 78 patients who were non-receivers. The patients with most common five diagnosis were paranoid schizophrenia (14.4%); psychotic depression (13.6%) ; undifferentiated schizophrenia (8.8%) ; bipolar mania (7.2% ) ;severe depression without psychosis (5.6%) . There was significant decrease in BPRS in ECT receiver as compared to non-receivers at discharge (p=0.0001), 1st month (p=0.0001), 6th month (p=0.0001) and 12th month (p=0.0001) ; in YMRS at discharge (p=.008), 1st month (p=.002) and at 12th month (p=.015) ; in HAMD-M at discharge (p=0.0001), at 1st month (p=0.0001), at 6th month (p=0.0001) and at 12th month (p=0.0001) ; in GAF at discharge (p=0.0001), at 6th month (p=0.0001) and at 12th month (p=0.0001). Conclusion: There was significant improvement in overall psychopathology of patients who received ECT as compared to non-receivers. The improvement was shown by decrement in scores in BPRS, YMRS, HDRS and GAF at the time of discharge, 1st month, 6th month and 12th month which were statistically significant. Day to day functional status of patients also improved as shown by GAF. The efficacy of ECT was very significantly shown in this study with all the psychiatric spectrum disorders. Key words: ECT, YMRS, HAM-D, BPRS, GAF, Diagnostic variability.