Browsing by Author "Upadhyaya, S"
Now showing 1 - 6 of 6
Results Per Page
Sort Options
Publication A statistical analysis of patient deaths in NMC teaching hospital(Nepal Health Research Council, 2006) Upadhyaya, S; Chhetri, M R; Aryal, U R; Dhakal, P; Shrestha, SPublication Clinical outcome of patients with psychiatric illness following Electroconvulsive therapy in a teaching hospital in Kathmandu(Institute of Medicine, 2018) Pant, SB; Upadhyaya, S; Ojha, SP; Chapagai, M; Tulachan, P; Dhungana, SAbstract Introduction: Electroconvulsive therapy (ECT) is a safe and effective procedure used for treatment of variety of psychiatric illness. In spite of its proven efficacy ECT is underutilized due to stigma and prejudice attached to it among patients, their families and even among mental health service providers. The purpose of the study was to evaluate the clinical outcome of patients diagnosed with psychiatric illness following electroconvulsive therapy. Methods: This is a retrospective hospital based study of patients who underwent electroconvulsive therapy at department of Psychiatry and Mental health, Tribhuvan University Teaching hospital during 1 year duration. Pre-ECT and Post-ECT BPRS and GAF were obtained and the data were analyzed subsequently. Results: A total of 39 patients underwent Electroconvulsive therapy during the study period. There were 16 males and 23 females. Among all cases receiving ECT, mean BPRS scores at the time of admission and discharge were 74.41±9.61 and 47.31±7.27 respectively whereas mean GAF scores at the time of admission and discharge were 20.21±6.03 and 57.95±11.05 respectively. The most common diagnosis for which ECT was used was Schizophrenia 14(35.89%). All patients showed statistically significant functional and symptomatic improvement except those with organic psychosis (GAF p<0.05 and BPRS p<0.05). Conclusions: ECT is found to be effective in the treatment of patient diagnosed with various psychiatric illnesses. Keywords: Brief Psychiatric Rating Scale, Electroconvulsive therapy, Global Assessment of FunctioningPublication Combination treatment with carbamazepine and clonidine in a case of epilepsy with ADHD(Institute of Medicine, 2017) Adhikari, S; Upadhyaya, S; Pant, SB; Dhungana, S; Tulachan, P; Chapagai, M; Ojha, SPAbstract In a child with epilepsy, Attention Deficit Hyperactivity Disorder (ADHD) is found to be more prevalent in comparison to general population. In western literature for the management of ADHD, stimulants like Methylphenidate and non-stimulant like Atomoxetine are considered the first line drugs. Although no any robust findings are found that support the use of such drugs in cases of epilepsy with ADHD, still they recommend using these drugs in such cases. In our scenario availability of such drugs is a major hindrance for which second line drugs like alpha agonists are the only options available to us. Here in this case report we have used Clonidine along with Carbamazepine in the management of a 12 years child presented in our centre with episodes of seizure and ADHD and had shown significant improvement with these medications. Keywords: ADHD, Carbamazepine, Clonidine, EpilepsyPublication Impact of Albendazole Therapy on Clinical and Radiological Outcomes at One Month in Patients with Active Solitary Neurocysticercosis Patients(Kathmandu University, 2022) Bhattarai, S; Thapa, L; Maharjan, AMS; Shrestha, AM; Shrestha, S; Ghimire, MR; Upadhyaya, S; Thapa, MABSTRACT Background Cerebral neurocysticerosis is a common parasitic disease of human nervous system but evidence on duration of albendazole therapy and their outcomes in this condition is inadequate Objective To evaluate the impact of varying duration of albendazole therapy on the clinical and radiological outcomes at one month in patients with active solitary neurocysticercosis. Method This is an interventional study conducted at Upendra Devkota Memorial National Institute of Neurological and Allied sciences, Bansbari over 1 year (2017 March - 2018 February). One hundred eighteen patients with new onset seizure secondary to active solitary cysticercal granuloma either received albendazole therapy for 1, 3, 9 or 21 days with the usual care or only received the usual care. Clinical and radiological outcomes were observed at one month follow-up. The difference in the proportion of the outcome measures between intervention and control groups were assessed using chi-square test. Result Our study included 118 patients with male predominance of 61.9%. Albendazole therapy for 3, 9 and 21 days reduced headache by 57.2%, 70.0% and 63.1% respectively which was higher than those with 1-day therapy or without the therapy. This difference in the proportion was statistically significant at p=0.001. Though seizure recurrence also declined but the difference was not significant (p=0.406) between groups. However, at one-month follow-up, majority of patients who received albendazole for 9 days (14, 70%) and 21 days (14, 73.7%) had normal lesion, while most calcified lesion (21, 67.7%) was observed in those who did not receive albendazole therapy. The difference between lesion among the groups was significant (p < 0.001). Conclusion Albendazole therapy in patients with active solitary neurocysticercosis for 9 days is as effective as 21 days and better than 3 days in headache control and lesion dissolution but seizure control could be achieved irrespective of the treatment. KEY WORDS Albendazole, Headache, Lesion dissolution, Neurocysticercosis, New-onset seizurePublication Philtral Column and Nostril Shape Pattern in Nepalese Population: Comparative Study between Two Ethnic Groups of Nepal(Kathmandu University, 2024) Chaurasia, NK; Upadhyaya, C; Mahantha, S; Upadhyaya, S; Shakya, M; Upreti, S; Bhandari, A; Baral, IABSTRACT Background Knowledge of the normal appearance of lip-nose complexes in a particular ethnicity or race helps to plan and modify surgical techniques for their deformity. Objective To determine the shape of the philtral column and nostril in children of two ethnic groups (Aryans and Mongoloids) of the Nepalese population and compare them to see if any variation exists. Method The present prospective study was carried out between December 2021 to January 2023 among 200 children of age 5-12 years. The children meeting our inclusion criteria were divided equally into Aryan and mongoloid groups based on the caste system in Nepal. Facial photographs were obtained in frontal and basal views. They were analyzed to determine the shape of the philtral column and nostril shape based on Mori’s classification system. Result Out of 200 children, 123 were males and 77 were females. The most common type of philtral and nostril shape in the Nepalese population was triangular and teardrop respectively. Triangular and concave type philtral shape was predominant in Aryans whereas triangular and parallel type was predominant in Mongoloids however the variation was not significant. Similarly, teardrop nostrils were most common in both ethnic groups. Conclusion The results provide a morphological pattern and variation in the philtral and nostril shape in the two major ethnic group of Nepalese population. KEY WORDS Aryans, Mongoloids, Nostril shape, Philtral shapePublication Self castration in trance and possession disorder: a case report(Institute of Medicine, 2017) Adhikari, S; Pant, SB; Ojha, SP; Chapagai, M; Tulachan, P; Dhungana, S; Upadhyaya, SAbstract Castration is a rare event that is commonly associated with psychotic disorders. However, such injuries have also been reported from non-psychotic patients as a result either from bizarre autoerotic acts. attempts at crude sex change operation by transsexuals or secondary to complex religious beliefs and delusions regarding sexual guilt. We report a case of 35 years male from rural Nepal with history of trance and possession spells for last 7 years and self-inflicted scrotal injury with amnesia for that period. After two days, surgical orchiectomy was done and postoperative outcome was uneventful. Such case of self castration in dissociative disorder is rarely reported and worth to bring in notice. Keywords: castration, dissociative disorder, psychotic, trance and possession