Browsing by Author "Sharma, Vidya Dev"
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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 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 Geriatric Psychiatry: Socio-demographic Characteristics and Diagnostic Profile among senior citizens attending the psychiatric outpatient department of a tertiary health care facility in Nepal(Institute of Medicine, 2000) Koirala, Naba Raj; Mahat, Pashupati; Nepal, Mahendra K; Ojha, Saroj P; Sinha, Uday K; Pokhrel, Anupam; Sharma, Vidya DevAbstract A retrospective study of patients, aged 60 years and over, attending the psychiatric outpatient Department of T.U. Teaching Hospital, during the study period of one-year (1999 April to 2000 March) has been carried out with the aim of studying the socio-demographic characteristics and diagnostic profile. Result revealed that the average age of elderly patients attending geriatric clinic was 67.33 years with the standard deviation of 6.32 years. The average duration of illness was 1030 weeks. The highest number of the patients were illiterate (54.2%). There were more females than males. In other socio-demographic variables, the highest number of the patients was seen in nuclear family (62%), Brahmin in cast (43.8%) and lower socio-economic strata [i.e. income less than Rs. 3000 per month (34.67%)]. Diagnostic profile indicated higher prevalence of mood disorder (30.7%) followed by organic brain disorder (28%) and tension headache (9.3%). The majority of the patients were referred from "other agencies" (28%) and only 44% of the elderly patients gave the history of their illness themselves. This study has important implications in the planning of psychiatric services for the population in this age group, but the findings has to be substantiated in a larger sample of the elderly population. Keywords: geriatric psychiatry, senior citizens, ICD-10 DCR, T. U. Teaching HospitalPublication 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, olanzapine