Browsing by Author "Thakur, D"
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Publication A Study of F Wave Latencies, Chronodispersion and Persistence in Healthy Medical Undergraduates at BPKIHS(Kathmandu University, 2018) Subedi, P; Limbu, N; Thakur, D; Khadka, R; Gupta, SABSTRACT Background The F wave is a CMAP (compound muscle action potential) evoked by a supramaximal stimulation of a motor nerve. F waves are particularly useful for the diagnoses of polyneuropathies at a very early stage and proximal nerve lesions. F waves have a very high diagnostic role in neurophysiology; we would like to study different F wave parameters and effect of anthropometric variables on F wave parameters in normal healthy individuals. Objective To study the effect of anthropometric variables on F wave latencies, chronodispersion and persistence Method Healthy males (n=64) and females (n=26) medical students of BPKIHS with age 21.64±1.19 years were enrolled in the study. Anthropometric parameters and maximum and minimum F wave latencies, F persistence and chronodispersion of bilateral median, ulnar and tibial nerves were recorded in Neurophysiology Lab II of BPKIHS. Descriptive analysis was done for anthropometric and F wave parameters. Unpaired t test was applied for comparing anthropometric and F wave variables between males and females. Pearson correlation was applied between anthropometric variables and F wave parameters. Result Age, height and weight of the subjects were 21.64±1.19 years, 165.61±5.4 cms and 64.07±5.5 kg respectively. Minimum F wave latencies (ms) of right median, ulnar and tibial nerves were 24.09±1.95, 24.02±1.76 and 44.34±3.02 while on the left side were 23.92±1.96, 24.11±1.92 and 44.07±2.83 respectively. Anthropometric variables of male and females were statistically significant. Also, F wave latencies between groups were different which were statistically significant. F persistence was above 80% for all tested peripheral nerves. Height and weight showed a significant effect on F wave latencies (p<0.001). However, age did not show any significant effect on F wave parameters. Conclusion Males have prolonged latencies as compared to females. Height and weight showed a significant relationship with the F wave latencies of the tested peripheral nerves. KEY WORDS Anthropometric, Chronodispersion, F wave, PersistencePublication Clinical and Electroencephalographic Profile Of Children(Kathmandu University, 2013) Limbu, N; Paudel, BH; Thakur, DABSTRACT Background Reports on pediatric electroencephalogram of Nepalese patients are rare. Objective We aimed to study the relationship between provisional clinical and electrophysiological diagnoses of pediatric patients with documentation of demographic profiles, and type and frequency of the disorders/diseases. Methods Electroencephalographic reports of 634 children from 2006 to 2009 were analyzed at neurophysiology laboratory, department of Basic and Clinical Physiology, B. P. Koirala Institute of Health Sciences, Dharan, Nepal, retrospectively. Chi-Square test was applied after detail descriptive statistics. Results Male and female were 72.2 % (n=458/634) and 27.76 % (n=176/634) respectively. Most frequent EEG abnormality was seizure disorder (n=370, 59.39%), then febrile seizure (n= 94, 15.08%) and birth asphyxia with hypoxic-induced encephalopathy (n=68, 10.91%). Electroencephalogram showed significant epileptiform discharges in seizure disorder (p=0.001, OR= 2.26, 95 % CI= 1.61 to 3.18) and in cerebral palsy (p=0.049, OR=6.88, 95 % CI=0.89 to 145.95), specifically in 6 to 12 (p=0.001, OR=2.94, 95 % CI=1.43 to 6.06) and one to five (p=0.019) years, respectively. Electroencephalogram detected significantly less epileptiform discharges (p=0.001, OR=0.25, 95 % CI= 0.15 to 0.42) in febrile seizure specifically in 1 to 5 years (p=0.003, OR=0.16, 95 % CI= 0.04 to 0.63). Conclusion Predominant Electroencephalographic abnormality was seizure disorder, followed by febrile seizure and birth asphyxia with hypoxic-induced encephalopathy respectively. Electroencephalographic abnormality was highly associated with seizure disorder and cerebral palsy but was not associated with febrile seizure. KEY WORDS Children, EEG, epileptiform dischargesPublication Nerve Conduction study in healthy individuals a preliminary age based study(Kathmandu University, 2010) Thakur, D; Paudel, BH; Jha, CBABSTRACT Background Nerve conduction study assesses peripheral nerve functions and has clinical implication. Objectives To study the effect of age on nerve conduction study variables in healthy adults. Methods Cross sectional study was done from Jan 2006 to Dec 2006 in department of Physiology, BP Koirala Institute of Health Sciences, Dharan, Nepal. The study was done in 34 (younger, n= 18, 17 to 29 years; older, n= 16, 30 to 57 years) consenting healthy adults of either sex. The compound muscle action potential and sensory nerve action potential were recorded using standard technique. Due to the non-normal distribution of data, the effect of age on nerve conduction study variables was analyzed using Mann Whitney U test. Results Younger vs. older individuals: older had lower Compound Muscle action potential amplitude (mV) in all motor nerves except radial and left ulnar nerves. Compound Muscle action potential duration (ms) was shorter in older (p<0.05) in ulnar, tibial, right median and left common peroneal motor nerves than the younger: right median (6.92±1.3 vs. 8.5±1.88), right ulnar (7.09±1.54vs. 8.2±1.31), left ulnar (10.56±1.44 vs. 12.06±1.5), right tibial (6.28±0.81vs. 7.28±1.12), and left tibial (9.58±1.52vs.10.78±1.71). Sensory nerve actional potential amplitude (μV) was smaller in older as compared to younger: right median (19.01±7.83 vs. 26.97±10.63), right ulnar (10.9±3.44 vs.16.09±5.85) and right radial (14.31±4.34 vs.19.72±6.47). SNAP duration (ms) was longer in older: right ulnar (1.34±0.17 vs.1.26± 0.18), left ulnar (1.46±0.14 vs. 1.29±0.26), and left median (1.11± 0.14 vs. 1± 0.14). Conclusions Age has definite effects on amplitude and duration of motor and sensory nerves. Different nerves have different timing of aging. Without adjustment for age, the sensitivity and specificity of nerve conduction study will decrease whenusing the same reference data in patients with different age. Key Words age, compound muscle action potential, nerve conduction study, sensory nerve action potential