Dr. Pawan Sharma

Consultant Psychiatrist, Department of Psychiatry, Patan Academy of Health Sciences, School of Medicine

[Dr. Pawan Sharma @DrPawan60]

I was invited to contribute to discussion on ABC Radio National, alongside Willoughby Britton and Pierce Salguero, exploring the less-discussed adverse effects of meditation, including anxiety, insomnia and psychosis.

https://t.co/2yZ1nE8nTB

[Dr. Pawan Sharma @DrPawan60]

बो��ौं, बुझौं, बचाऔंः जीवन बचाउने हाम्रो भूमिका - Health Aawaj - a health news portal in Nepal https://t.co/S6taTKlTkN

[Dr. Pawan Sharma @DrPawan60]

In this research article we explore practices and attitudes regarding restraint of psychiatric patient among mental health professionals of Nepal
#uncrpd #psychiatrist #restraint #mentalhealthact #MentalHealthMatters
https://t.co/uFLB2SZyjI

[Dr. Pawan Sharma @DrPawan60]

Our recently published content analysis of newspaper articles on Child Sexual Abuse showed that there is a gross lack of information about the causes of sexual abuse and steps to prevent .
https://t.co/DE7bt9NJNK

[Dr. Pawan Sharma @DrPawan60]

Dhat syndrome as a clinical entity has not been commonly described in females. In this chapter, we intend to summarize the evidence about female Dhat syndrome in terms of its historical evolution, nosology, assessment and management. @singh_swarn91

https://t.co/JM0TrsZeV5

[Anirudh Kala @anikala]

Arranged marriages and Severe Mental Illness: A Societal Scam
Both arranged marriages and mental illness are very common and not surprisingly sometimes overlap. Very frequently families marry off their sons/daughters who have severe mental illness without informing the other party.
Psychiatrists see a large number of young people with bipolar disorder or schizophrenia in day to day practice, and when the patient has been well on treatment for a while, the inevitable question gets asked , “Can we get her(or him) married now?”
The answer by the psychiatrist is standard and consists of two components. You have to tell the prospective groom and the in laws, about the nature of the illness. And that the medicines cannot be stopped without medical advice because a relapse is likely.
Somewhere hovering in parents' mind is also this notion that sex would cure mental illness.
And then you do not see the patient for a month or two till she is brought again. The girl you remember as a bubbly youngster in jeans and T-shirt is a married woman with a half-heartedly applied makeup, a trailing saree and no husband. As it transpires, the in laws were either not told anything at all or were told casually that she sometimes get headache and has to take a medicine; which in the celebratory atmosphere of a wedding being fixed seemed something minor and went unquestioned. The wedding happens as scheduled and the bride is packed off with her dowry and a month’s supply of medicines kept by the mother in the inner pocket of her golden purse, after being instructed repeatedly not to miss the dosage. In the new house full of noisy strangers and being the centre of back to back celebrations, the bride forgets to take the medicines and since she is so happy and everything so great, she does not think it is now even necessary.
A week or two later she is sleeping less, talking nonstop and in her excitement tells all to her husband. And a full-fledged brouhaha ensues. The medicines are found and taken to a doctor who tells the family no these are not headache pills; these are medicines which psychiatrists prescribe.
A delegation of relatives from the in laws and the sheepish middleman bring the girl to her parents’ house and leave her there. A lawyer steps in and advises the girl’s family to file a police report that the girl was tortured for dowry and that is what caused the mental illness putting paid to any chances of reconciliation that might have existed.
As far as the young marriageable boys on treatment are concerned, their parents out of entitlement, do not even ask the psychiatrist before getting them married. The new wives, if they are not working or otherwise financially independent, try their best to make a bad situation work if other things are alright, although this was certainly not what they had signed up for. Others go to court. The whole phenomenon is a humongous tragedy. When the girl is brought to me the second time, for restarting the treatment, I scold the father and remind him of what I had advised about full disclosure.
But I have no answer when he says, “In that case nobody would ever be willing to marry her. ” That is true and I do not even have the heart to remind him everybody would still have been much happier. Sometimes families innovate, they find a boy or a girl from a family lower in economic status and disclose everything. "Thorha neecha jhukna parha par sab theek ho gaya (we had to bend low but things turned out alright)" ," is how I get told next time. The groom comes with the patient to follow up visits, carrying responsibly the case file, which the father used to carry before, which is ironic and sad.

[TheLiverDoc™ @theliverdoc]

You maybe interested in knowing that:

1️⃣A glass of wine/alcohol was never good for the heart. It was the healthy lifestyle of light drinkers that went along with it that helped them survive longer than those who did not drink

2️⃣Wine and beer are also alcohol. There is no safer alcohol, safe alcohol or harmful alcohol. All alcohol is unsafe and there is no safe limit ofalcohol that benefits health

3️⃣Alcohol (ethanol) is one of the most potent cancer causing substances there is, on Earth. So much that at low doses of alcohol consumption (i.e., ≤1 drink/day) the risk is increased by about 20% for oral and throat cancer and 30% for esophageal (food pipe) squamous cell cancer

4️⃣One glass of alcohol daily can damage specific centers in your brain that prevents you from making new and established memories

5️⃣The only "liver detox" that works to heal the liver from alcohol-liver injury is abstinence from alcohol

6️⃣In those with metabolic disease (diabetes, high blood pressure, high lipids, overweight/obesity) even occassional use of alcohol can promote cirrhosis of liver and worse, predispose to >20 types of cancer

7️⃣Just because you grand-uncle chugged alcohol his whole life and died at 101 years does not mean you'll live to see that age by consuming alcohol. Your uncle had those very rare "good genes" that you and many of us may not have. You could die at 30 years of age with alcohol use.

8️⃣If you are having one alcohol drink a year, that does not mean you are fine, it means that you are at risk of having low quality sperms, DNA damage to sperms, increased risk of cancer, including breast cancer, and brain degeration, once a year.

9️⃣Avoiding alcohol consumption can reverse fatty liver disease (due to alcohol) in 2 weeks time, only for it to come back if you restart drinking again

🔟Once liver scarring (fibrosis) sets in due to continued use of alcohol, even the scarring can be reversed and liver nursed back to normal just by avoiding alcohol

1️⃣1️⃣In those with advanced scarring and cirrhosis due to alcohol use, avoiding alcohol results in regression/reversal of cirrhosis - yes, the liver is a marvellously conquering organ if you give it a chance

[Anirudh Kala @anikala]

Clinical Depression.
Start treatment early. 'Cause' or no cause.
About fifty years back Clinical Depression was classified into two varieties ie Endogenous and Reactive. Later the psychiatrists discovered that whatever the trigger or even when there was no trigger the managemen and outcome remained the same. Since then that particular division of depression into reactive and endogenous is not used. The answer to the question why is he depressed is important at least in the minds of friends and family but lack of an answer does not have to hold the treatment back.
Often Clinical Depression has no antecedent stress and sometimes a minor trigger can seem to be the whole cause. And manytimes an extrovert, life of the party person becomes quiet, in low spirits, becomes monosyllabic words avoids company . He himself is perplexed at the change in him.
Many times, what seems to be the cause, is the result of early Depression. The adolescent, who was always a good student did not develop Depression because he failed but he failed because he was already depressed. The man was not Depressed because he lost his job, he lost his job because he was Depressed. The break up was not the cause of depression it was the result of the partner giving up try talking to a morose person who would not even reply to her questions .
Often the cause and effect become tangled and cannot be neatly teased out from each other.
In any, case treatment of Clinical Depression is the same ie treat the depression and the surrounding stress if any with medication or therapy or both. Both together work better than anyone.
The exact sequence if any may unravel later.

[Dr. Pawan Sharma @DrPawan60]

@bhattaraias Thought block ta Schizophrenia ko first rank symptom ho dai!!!

[Rishab Gupta, MD @RishabGupta_84]

https://t.co/D6mbuyZyGz

[Dr. Pawan Sharma @DrPawan60]

In this recent paper, we found the prevalence of depression and anxiety symptoms among people living with leprosy is higher than that in the general population. Sigma is a significant correlation for both.
@singh_swarn91
https://t.co/QeYFzZ7jPM

[Deep lamichhane @Deeplamichhane3]

IV PPI is not to be used routinely, it has some defined indications.
Small effort by the team just to highlight the issue.
Oral PPI is almost a part of every prescription which is also not desirable (not a subject of this study though)
https://t.co/buX14Y7W0B

[Dr. Pawan Sharma @DrPawan60]

In this metaanalysis we found higher rates of suicide attempts in the lifetime in Nepal (10%) and Bangladesh (9%) as compared to India (4%) and Indonesia (5%) among students of South East asia
https://t.co/ftPEDhy2po

[Deep lamichhane @Deeplamichhane3]

Permit to organize marathon in the center of city should be banned. There is early morning disturbance in ktm for marathon.
Pls try to maintain easy travel in roads, a symbol of properly maintained city.
@valleytraffic @Ktmmetropolitan

[Dr. Pawan Sharma @DrPawan60]

@singh_swarn91

[Dr. Pawan Sharma @DrPawan60]

In this paper we explored the potential ethical, data safety, and privacy issues associated with using apps for depression.There is an urgent need to improve the accessibility and usability of privacy policies by app developers.
@sundarpichai
@GooglePlay
https://t.co/0O7Qs7er5X

[Mushtaq Bilal, PhD @MushtaqBilalPhD]

One of the most efficient apps to kickstart your literature review: Inciteful

Here's how to use it 👇

[Dr. Pawan Sharma @DrPawan60]

https://t.co/S7ONswWQHs

[Dr. Pawan Sharma @DrPawan60]

Found somewhere and this is interesting take

[Yatan Pal Singh Balhara @yatan_balhara]

#Internet -Based Learning for Professionals in #Addiction #Psychiatry @ Nishtha Chawla Shreeya Gyawali ⁦@DrPawan60⁩ Sharma https://t.co/Rdtx5nYtQ5