Browsing by Author "Agrawal, S"
Now showing 1 - 13 of 13
Results Per Page
Sort Options
Publication Clinico-epidemiological Profile of Rosacea at a Tertiary Care Hospital in Eastern Nepal(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2012) Bhattarai, S; Agrawal, S; Rijal, ANA Keywords: Rosacea, epidemiology, aggravating factorsPublication Comparison of Oxidant-Antioxidant Status in Patients with Vitiligo and Healthy Population(Kathmandu University, 2014) Agrawal, S; Kumar, A; Dhali, TK; Majhi, SKABSTRACT Background Vitiligo is a well-recognized pigmentary disorder of the skin and /or mucous membrane characterized by circumscribed ivory or chalky white macules devoid of identifiable melanocytes. The pathogenesis of vitiligo is complex and still not well understood. According to autocytotoxic hypothesis, oxidative stress has been suggested to be the initial pathogenic event in melanocyte degeneration. The role of free radicals and oxidative damage in the pathophysiology of vitiligo has been documented in recent studies. Objective To evaluate the role of oxidative stress in patients with vitiligo and of healthy controls by measuring levels of the oxidant malondialdehyde (MDA) and antioxidants vitamin C and vitamin E in serum and catalase (CAT) in erythrocytes. Method A total of 80 clinically diagnosed cases of vitiligo and 80 control subjects were included in the study to assess the activity of MDA, vitamin C and vitamin E in serum and CAT in erythrocytes of patients and controls by using the spectrophotometric assay. Result There was statistically significant increase in the levels of MDA in patients with vitiligo compared to the control group (p<0.001). No significant difference was found in the levels of vitamin C (p=0.411) and vitamin E (p=0.771) between the patients with vitiligo and control group. The levels of CAT in the vitiligo patients were found to be significantly lower than those of controls (p<0.001). Conclusion Increased oxidative stress and decreased catalase have been observed in vitiligo patients and the data suggesting that the free radicals may be involved in the destruction of melanocytes or dysregulation of melanogenesis. KEY WORDS Antioxidants, oxidants, vitiligoPublication Do Contacts have a Role in the Transmission of Leprosy?(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2012) Rijal, A; Agrawal, S; Bhattarai, SNA Keywords: Contact, Transmission, LeprosyPublication Efficacy of tazarotene cream plus clindamycin gel vs tretinoin cream plus clindamycin gel in treatment of mild to moderate acne vulgaris: a randomised trial(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2013) Paudel, S; Agrawal, S; Dhali, TKNo Abstract:Publication Impact of Patch Testing on Quality of Life in Patients with Hand Eczema: A Follow-up Study(Kathmandu University, 2013) Agrawal, S; Rijal, A; Bhattarai, SABSTRACT Background Patch testing has previously been shown to influence the quality of life, although a very few studies have shown if this is dependent on the result of the patch tests. Objective To assess the impact of patch testing on the quality of life (QOL) in patients with hand eczema (HE). Methods A total of 50 patients diagnosed of hand eczema at the time of patch testing, aged 16 years and above participated in this study. Detailed demographic information and diagnosis of hand eczema were collected on the day of the patch test. After six weeks, the patients were asked about the hand eczema, knowledge of their allergies and change in their life style to avoid the relevant allergens demonstrated on the patch test. Dermatology Life Quality Index (DLQI) was used to measure the QOL on both occasions. Results The patch test positivity was found in 68% of patients to one or more allergens. The sum score of DLQI at baseline was 12.16 ± 5.58 with median 12.0. HE had most impact on symptoms and feelings. Patients with both positive patch test (mean baseline= 11.94± 5.88; mean at six weeks=2.81± 2.01; P<0.001) and negative patch test (mean baseline=12.63± 5.03; mean at 6 weeks=5.4± 3.56; P=0.001) showed significant improvement in DLQI scores, however it was more improved in patients with positive patch test than in patients with negative patch test. Conclusions Hand eczema had an appreciable impact on the QOL. Patch testing had been beneficial to most patients in improving patient quality of life considerably. KEY WORDS Dermatology life quality index (DLQI), hand eczema, patch test, quality of life (QOL)Publication Leprosy after the Elimination: A BPKIHS experience(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2013) Bhattarai, S; Agrawal, S; Rijal, A; Marahatta, SNo Abstract:Publication Methotrexate plus narrow band ultraviolet B (NBUVB) versus methotrexate alone in the treatment of moderate to severe plaque psoriasis: A randomized clinical trial(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2015) Khadka, Dhan Keshar; Agrawal, S; Dhali, T KAbstract: Introduction: Psoriasis is a chronic, recurring inflammatory disease affecting the skin, joints and nails that has a significant negative impact on the quality of life. Efficacy of combination of methotrexate/narrowband ultraviolet B (NBUVB) phototherapy in the treatment of psoriasis has been rarely assessed. Objectives: To compare the therapeutic efficacy of methotrexate plus NBUVB phototherapy combination vs. methotrexate in the treatment of moderate to severe chronic plaque psoriasis. Material and methods: Seventy-nine patients with chronic plaque-type psoriasis (body surface area involvement >2%) were randomized to receive either methotrexate/NBUVB phototherapy (group A) or methotrexate (group B). End point of treatment was 75% reduction in Psoriasis Area and Severity Index (PASI75) Score or up to 12weeks, whichever was earlier. Patients were then followed up for a period of 12 weeks for assessment of adverse effect, DLQI and relapse. Results: Of 79 patients, 69 completed the treatment period and follow-up. PASI 75 was achieved in 35/39(89%) patients in group A and 34/40(85%) patients in group B (P=0.052). The mean number of weeks (P = 0.031), the mean cumulative dose of NBUVB (8.2±3.5J/cm2)) and the mean number of phototherapy sessions (12±3)) required to achieve PASI 75 were less in group A compared with group B. There was no significant difference in the number of patients who relapsed during the follow- up period (P = 0.68). Conclusion: Combination of methotrexate and NBUVB phototherapy provides more rapid clinical improvement compared with methotrexate monotherapy in the treatment for chronic plaque-type psoriasis. Keywords: DLQI, Methotrexate, NBUVB, PASI, PsoriasisPublication Postherpetic Trigeminal Trophic Syndrome: An under recognized condition(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2010) Dhali, TK; Agrawal, SAbstract: NA Keywords: Postherpetic Trigeminal Trophic Syndrome, under recognized conditionPublication Quality of Life Among HIV Positive Individuals in Kathmandu Valley and Eastern Region of Nepal(Kathmandu University, 2012) Agrawal, H; Mourya, R; Shrestha, RK; Agrawal, SABSTRACT Background The alarming increase of HIV/AIDS, inability to afford highly active anti-retroviral therapy, disability and stigma associated with the disease, loss of productivity due to illness, and chronic nature of the disease has made HIV/AIDS one of the most important public health problems in developing countries. The Quality of life assessment is focused on humanistic element and intervention resulting from this result may lead to better overall patient well being. Objective The aim of our study was to assess and compare the quality of life among HIV positive individuals in Kathmandu Valley & Eastern region. Methods The study was conducted among 228 HIV positive individuals from Eastern Nepal and 213 from Kathmandu valley and they were compared with an equal number of age-sex matched controls from the community. The instrument used was the WHO QOL-BREF Nepali questionnaire. Results The HIV positive individuals had significantly lower (P<0.001) QOL scores than the controls in the overall QOL and all the domains of life: Physical, Psychological, Social and Environmental. HIV positive individuals from Kathmandu valley scored significantly better (P<0.001) scores in the Physical and Environmental domains when compared to HIV positive individuals from Eastern region. HIV positive females had a significantly higher (P<0.02) QOL scores for overall QOL and overall perception of health than the males. Conclusion These findings suggest that HIV positive individuals have a poorer quality of life than the general population in Kathmandu valley & Eastern region of Nepal and interventions could be targeted to improve this aspect of their health. KEY WORDS HIV/AIDS, QOL, NEPAL, WHO QOL-BREFPublication Socioeconomic and Nutritional Status of Children with Pyodermas(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2012) Kharel, C; Pandey, S S; Agrawal, S; Bhattarai, MNA Keywords: Pyoderma, socio-economic status, nutritional factorPublication The Study of Prevalence of Helicobacter Pylori in Patients with Acne Rosacea(Kathmandu University, 2012) Bhattarai, S; Agrawal, S; Rijal, A; Majhi, S; Pradhan, B; Dhakal, SSABSTRACT Background Acne rosacea is an inflammatory disease affecting the central part of the face characterized by erythema, papules, papulo pustules and telangiectasias of unknown etiology. More recently numerous studies have described an association with Helicobacter pylori (Hp) and the extra gastric symptoms of cutaneous origin. Objectives To establish the prevalence of Helicobacter pylori (Hp) infection in the stomach in patients with rosacea based on standard Hp serological test. Methods All patients with the clinical staging of 2, 3 and 4 rosacea attending the Dermatology Out Patient Department from May 2009 – April 2010 were included in the study. Quantitative serological test using the SERION ELISA classic Helicobacter pylori IgG was done. Result A total of 26 patients were enrolled in the study with the age ranging from 26- 82 years. There were 14 males and 12 females and the male: female ratio was 1.6:1. Three (11.53%) patients presented with Grade IV rosacea, a severe clinical presentation and symptoms suggestive of acid peptic diseases were found in 14/26 (53.8%) patients. A positive serology to H. pylori was found in 17/26 (65.4%) of patients. A statistically significant correlation was found when association of H.pylori positivity in patients of rosacea compared with the seropositivity in controls. However correlation in the seropositivity was not found amongst the patients having gastritis and rosacea. Conclusion There still proves to find a correlation of Hp infection with patients with rosacea but it can still be hypothesised as a cutaneous manifestation of an internal peptic ulcer disease . KEY WORDS H.pylori, rosaceaPublication Understanding Of Nepalese Patients With Vitiligo About Their Disease(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2014) Agrawal, S; Kumar, A; Shyngwa, PMAbstract: Introduction: Vitiligo, a pigmentary disorder, may influence considerably patients’ health-related quality of life (QoL) and psychological wellbeing. Previous reports indicated that the patients' illness understandings influence adherence behaviors and actions in various chronic dermatological conditions. Objectives: To know the understanding of Nepalese patients with vitiligo about their disease by using illness perception questionnaire and also to investigate the potential factors that might influence it. Material and Methods: The illness perception questionnaire consisting of 25 questions about causes, timeline, consequences and control of disease were given to 154 patients with vitiligo of 13 years or more age attending the dermatology OPD. Results: A total of 146 patients completed the questionnaire. The belief about the causes of vitiligo was considered as “germs or virus” by 64.4% patients while half of the patients believed that vitiligo was due to “chance or fate”. Vitiligo was considered to be a serious condition (83.6%) and have had serious consequences on their life (63%). Approximately half of the patients believed that their disease had serious economic and financial consequences more so in female patients and in those with generalized disease. Although 43.8% patients believed that their illness was likely to be permanent rather than temporary, 75% patients believed that vitiligo would improve with the time and their treatments were effective (75.3%). However, females felt that there were very little that could be done to improve their vitiligo. Conclusion: The knowledge about vitiligo is unsatisfactory and needs accessible, accurate, community based education about the natural history of vitiligo and the effectiveness of treatment. Keywords: Illness perception questionnaire, VitiligoPublication Variation of intraocular pressure in patients with leprosy(Kathmandu University, 2005) Javvadhi, SS; Das, H; Badhu, BP; Agrawal, SIntroduction: There are various controversial reports on intraocular pressure (IOP) in patients with leprosy. Purpose: The current study was undertaken to study the level of intraocular pressure in leprosy patients and its association with the risk factors. Materials and methods: This was a prospective cross sectional comparative study. An ophthalmologist and a dermatologist evaluated consecutive 93 patients with leprosy. The risk factors studied were age, gender, bacillary index, clinical diagnosis, duration of disease and treatment; and ocular complications. The IOP in these patients was compared with healthy age and sex matched controls. Results: A total of 186 leprosy patients (93) and healthy controls (93) were studied. The mean applanation IOP for the right and left eyes in leprosy patients was 12.87 ± 1.20 mm of Hg and 13.22±2.70 mm of Hg respectively. This was found to be significantly lesser (p<0.001) than in the controls (RE=15.14±2.58 and LE=15.41±2.36mmHg). The untreated leprosy patients had significantly lower IOP than those with treatment (p<0.001). None of the risk factors were found to be independently associated with the decrease in IOP. The duration of treatment, however, showed a trend towards having a significant association (p=0.057) with the lower level of IOP. Conclusion: The level of IOP is lower in leprosy patients than in the healthy controls. Age, gender, bacillary index and presence of ocular complications due to leprosy are not independently associated with the decrease in IOP. The untreated leprosy patient tends to have a lower IOP. This finding can be used to monitor effectiveness of treatment of leprosy. Key words: Leprosy and intraocular pressure