Browsing by Author "R, Shrestha"
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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 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.Publication Removal of central venous catheter fragment embolus in a young male(Kathmandu University, 2006) PB, Thapa; R, Shrestha; DR, Singh; SK, SharmaA 22 years male admitted with severe pancreatitis with central venous catheter implanted for central venous pressure monitoring and for providing total parental nutrition developed catheter fragment embolus due to accidental fracture of the same while manipulating it. Non surgical retrieval of the same was done by radiological intervention without any complication. Key words: intravascular catheter fragments, transfemoral venous approach, interventional procedures