Browsing by Author "Risal, A"
Now showing 1 - 5 of 5
Results Per Page
Sort Options
Publication A Cross-Sectional Comparison of Drinking Patterns, Alcohol Use and Related Medical Morbidities in a Secondary Versus Tertiary Setting(Kathmandu University, 2013) Risal, A; Tharoor, HABSTRACT Background Alcohol Dependence exists in different spectrums at different settings and associated with various medical morbidities, disability and health care utilization costs. Objectives To study the drinking patterns, alcohol use disorders and alcohol related medical morbidities in patients diagnosed with Alcohol Dependence Syndrome (ADS) and attending out / in-patient psychiatry services at secondary and tertiary care centre. Methods A cross-sectional comparative study was done among the patients diagnosed with ADS attending psychiatry services at District hospital, Udupi and Kasturba Hospital, Manipal. Serial sampling was done. Patients having any other psychiatric illnesses were excluded. The two groups were compared in relation to socio-demographic variables, drinking related variables, patterns of drinking and alcohol related medical morbidities identified. Results Significant differences in some socio-demographic parameters among the patients from the two different treatment centers were found with secondary level hospital (N=50) having more illiterate, laborers and below the poverty line population in comparison to the tertiary level hospital (N=75). Maximum frequency of gastro- intestinal morbidities was seen in both the hospital population, irrespective of the patterns of drinking. Conclusion Alcohol use disorders and alcohol related medical morbidities show some variations in their presentations in the different treatment centers. KEY WORDS Alcohol dependence, medical morbidities, treatment centerPublication Common Mental Disorders(Kathmandu University, 2011) Risal, AABSTRACT Common mental disorders are a group of distress states manifesting with anxiety, depressive and unexplained somatic symptoms typically encountered in community and primary care settings. Risk factors for these disorders are mainly lower socio- economic status, psychological illnesses, poor reproductive health, gender disadvantage and physical ill-health. WHO has recommended that treatment of all these disorders should be based in primary care to be more effective and accessible to all the community people. The structure of mental health care in primary care is generally understood in terms of the “pathways to care” model and it plays a major role in countries like ours where community-based mental health services do not exist. Both the psychological and pharmacological therapies are found to be equally effective for treating these disorders. Integration of mental health into primary care can be considered as the stepping stone in the way forward to tackle the barriers and problems in effective management of common mental disorders in the community. The acute shortage of mental health professionals and the relatively low levels of awareness about mental disorders make it mandatory that primary health care should remain the single largest sector for mental health care in low and middle income countries like ours. KEY WORDS anxiety, depression, mental disordersPublication Psychiatric Illness in the Paediatric Population Presenting to a Psychiatry Clinic in a Tertiary Care Centre(Kathmandu University, 2010) Risal, A; Sharma, PPABSTRACT Background A variety of psychiatric manifestations can be seen in children below the age of 18 years. Such cases rarely present directly to psychiatric care. Methods Retrospective study in Tertiary care hospital . The study population included all the patients of paediatric age group presenting to Psychiatry Outpatient Department of Dhulikhel Hospital directly or referred by a paediatrician or other specialists from October 2008 to October 2010. Results Among the paediatric population evaluated in the psychiatry clinic for two years from October 2008 to October 2010 (N=168), 66.7% were in the age group 15-18 years {mean = 14.77 (±2.99)}, 71.4% were female and 42.3% belonged to Brahmin cast. The highest number of (15%) patients was seen during the month of August 2010. Six months analysis of the psychiatric illnesses of the patients from April 2010 up to October 2010 (n=80) showed dissociative disorder (15%), and seizure disorder (15%) to be the most common diagnoses, followed by depressive disorder and intentional self harm (ISH) (13.8% each). 15% of patients were found to be treated by magico-religious means, with the majority of patients (66.7%) diagnosed as having dissociative disorder. Conclusion The majority of the paediatric population presenting to a psychiatry clinic were in the age group 15-18 years and of female sex. Dissociative disorder was the most common diagnosis followed by depressive disorders. The majority of patients with dissociative disorder had previously been treated by magico-religious means. Key Words dissociative disorder, paediatric population, psychiatric profilePublication Study of Poisoning Cases in a Tertiary Care Hospital(Kathmandu University, 2012) Karki, RK; Risal, AABSTRACT Background Poisoning is one of the leading causes of morbidity and mortality in Nepal and also a major public health problem worldwide. A thorough review of the risk factors helps to decrease the incidence and mortality. The study evaluates the cases admitted in Dhulikhel Hospital, Kavre, Various parameters like age, sex, marital status, time of ingestion, month of occurrence, agent responsible for incidence; type of poisoning, psychosocial problem, outcome and duration of treatment are analyzed. Objectives The objectives of this study are to determine the pattern and severity of poisoning cases admitted to Dhulikhel Hospital. Methods A hospital based study was carried out in the patient admitted to Dhulikhel Hospital with the history of poisoning for the period of one year between April 2011 to March 2012. Various parameters were analyzed and compared with other study. Results There were 137 cases during the one year duration and maximum case belonged to second and third decade of life. Most common manner of poisoning was suicidal and the incidence was mainly during evening hours. Organophosphorus was the most commonly abused substance. Most of the cases had arrived hospital after one hour of exposure and duration of hospital stay in many cases were less than four days. Conclusion Based on these findings preventive measures like precaution taken at various levels, restriction in free sale of the poisons and promoting Poison Information Centers along with public awareness and proper psychosocial management to decrease the incidence and mortality in poisoning cases can be suggested. KEY WORDS Poisoning, morbidity, mortalityPublication The Utilization of Health Care Services and their Determinants Among the Elderly Population of Dhulikhel Municipality(Kathmandu University, 2012) Sanjel, S; Mudbhari, N; Risal, A; Khanal, KABSTRACT Background Population ageing is a common problem faced in many countries world-wide. Due to physiological and biochemical changes in the elderly, increased incidence of diseases is observed. There is often low use of health services by the elderly for a variety of reasons. Objective To examine the status of health care utilization and to determine the factors associated with utilization of health care among the elderly population of Dhulikhel Municipality. Methods A quantitative descriptive-cross sectional study, with a total number of 200 elderly people residing in Dhulikhel Municipality, was selected for the study. Data were collected across the months of June - July 2011 applying two-staged cluster and systematic random sampling method. Both descriptive and inferential statistics were measured. Results Sixty eight percent of the elderly visited medical personnel in the past year. Eight percent of them visited the emergency department where most of them reported with symptoms attributed to heart disease. Among 200 elderly, 12.5% of them were admitted to the hospital and 53.0% utilized diagnostic services. Age, marital status, activities of daily living, and regular medication showed significant association with health services utilization at 95% level of confidence (p >0.05). Conclusion Marital status, daily living habits, existence of chronic disease, and regular medication demonstrated significant association with the utilization of health care. Social support services, informal education, and awareness programs targeting the senior citizens and studies covering a diverse population are recommended. KEY WORDS Elderly, Senior Citizens, Utilization of health care