Browsing by Author "Agrawal, S."
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Publication Common Contact Sensitizers among Patients with Hand Eczema: A Multicenter-Study in Nepal(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2016) Bhattarai, S.; Rijal, A.; Agrawal, S.Abstract: Introduction: Allergic contact dermatitis in Nepal is not an uncommon disorder. Patch testing is a well established method of diagnosing allergic contact dermatitis. Patients with contact dermatitis are well known to have impaired quality of life which often leads to frequent dermatological consultations. Objective: Lack of data from Nepal has prompted us to undertake this study with the aims to know the frequency of allergic contact dermatitis and the commonest contact allergens among the patients with Hand eczema attending the out-patient department of dermatology, B.P. Koirala Institute of Health Sciences and Kathmandu Medical College Teaching Hospital. Material and Methods: A total of 256 patients were included in the study. Out of them 195 with hand eczema agreed to participate and undergo patch testing. The antigens used included the Indian standard series of patch test allergens approved by Contact and Occupational Dermatoses Forum of India. Results: Hundred and ten cases (56.4%) were patch test positive (PTP) at 48 as well as 96 hours to at least one allergen. PTP was seen more commonly in females. The most common allergen in females was nickel sulphate followed by cobalt chloride, gentamicin and mercapto mix while males were positive to potassium dichromate, followed by epoxy resin, fragrance mix and nickel sulphate. Conclusion: Patch testing has proved a useful tool for the detection of allergic contact dermatitis and for identification of contact allergens. When positive reactions correlate with environmental exposure the test usually assists the physician in establishing the cause of dermatitis, hence treating the patients and improving their quality of life. Keywords: Hand Eczema, Contact Allergen, Patch testPublication Methotrexate Versus Methotrexate Plus Folic Acid in the Treatment of Moderate to Severe Plaque Psoriasis: A Randomized Clinical-Trial(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2016) Khadka, D.K.; Agrawal, S.; Dhali, T.K.Abstract: Background: 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 methotrexate versus combination of methotrexate plus folic acid in the treatment of psoriasis has been rarely assessed. Objectives: To compare the efficacy of methotrexate versus methotrexate plus folic acid in the treatment of moderate to severe chronic plaque psoriasis Material and Methods: Eighty patients with moderate to severe chronic plaque psoriasis were randomized to receive either methotrexate (group A) or methotrexate plus folic acid (group B). End point of treatment was 75% reduction in Psoriasis Area and Severity Index (PASI 75) score or upto 3 months, whichever was earlier. Patients were then followed up for a period of 12 weeks for assessment of relapse, DLQI and adverse effects. Results: Of 80 patients, 71 completed the treatment and follow up period (33 in group A, and 38 in group B). PASI 75 was achieved in 34/40(85%) patients in group A and 32/40(80%) patients in group B (P < 0.142). There was statistically significant number of patients who had greater adverse effect in methotrexate than in methotrexate plus folic acid (p=0.020). There was significant difference in the number of patients who relapsed during the follow-up period (P = 0.013) with more relapse in group B. Conclusion: Combination of methotrexate and folic acid developed lesser adverse effect and greater relapse in comparison to methotrexate alone. Keywords: DLQI, Folic acid, Methotrexate, PASI, PsoriasisPublication Periorbital Hyperpigmentation: Overcoming the Challenges in the Management(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2018) Agrawal, S.NA Keywords: Dermatology curriculum