Browsing by Author "Sharma, SC"
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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 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 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.Publication Entry knowledge and situational feedback of MBBS students(Kathmandu University, 2005) Sharma, SC; Maharjan, SIntroduction: A need has been felt to acquire knowledge of students at Kathmandu Medical College (KMC) who have decided to take up a medical career and have enrolled at KMC after completing two years of basic sciences. Objective: The intent was to (i) find out the entering status with regard to general knowledge, (ii) get feedback from the students about the facilities provided by the management both at basic sciences complex at Duwakot and clinical sciences at Sinamangal and (iii) get feedback regarding the teaching learning activities provided by various departments in KMC. This attempt at getting their point of view was for trying to improve upon the facilities by taking up their suggestions and doing away with the weaknesses. Preference was given to hostel students as they would be able to comment on living conditions. Methodology: A total of 150 students from three consecutive batches from basic and clinical sciences were included in the study. Survey questionnaires were distributed and all the forms were returned. The obtained data was analyzed using SPSS 11.5 version for Windows. Results: It was found that the entry knowledge on general issue was better in 6 th batch of students (87.08±17.41) than 5 th batch (82.19±17.43) and 7 th batch (78.93±20.60), but not significant (p=0.164>0.05). The students in different batches differed in their rating of various facilities provided by KMCTH. The most liked departments in terms of teaching learning activities were departments of Anatomy and Pathology. Discussion: Entry knowledge of the students of three batches was found to differ but not significant, correlating with the amount of teaching and learning received at KMC. The facilities provided by KMC were perceived as more satisfactory by the students who enrolled at KMC in later years. The earlier students had to cope with more difficulties as KMC was trying to improve on various facilities it provided to its students. Conclusion: Level of entry knowledge got better as the students attained more and more years of teaching and learning activities. It was also seen that the student’s perception of the quality of facilities provided by KMC got better overtime. Key words: Student, Knowledge, Aptitude, facilities, KMC, feedback, course