Browsing by Author "Amatya, A"
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Publication A Comparative Study of Azithromycin Versus Doxycycline in the Treatment of Acne Vulgaris(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2012) Amatya, A; Chaudhary, M K; Khan, D K; Rajouria, E ANA Keywords: Acne vulgaris, Azithromycin, Body dysmorphic disorder, DoxycyclinePublication A simple new technique of performing myomectomy for a predominantly subserosal myoma quickly within few minutes(Kathmandu University, 2007) Rana, A; Gurung, G; Amatya, A; Khatri, RRemoving a degenerated myoma located around the uterine cornu by an innovative technique shelling the myoma a little away from the base by choice of a low placed incision, advantageous in terms of no requirement of blood transfusion because of the reduction in the surgical time is described in a 24 years old lady demanding a fertility conserving surgery.Publication Bowen's disease: Response to topical 5% imiquimod and cryotherapy(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2015) Rajouria, Eliz Aryal; Amatya, A; Karn, DAbstract: We present a case of persistent and progressive Bowen's disease (squamous cell carcinoma in situ) in right inner thigh, skin type V in 65 years age female from Ramechap in 2014. Treatment with imiquimod 5% cream was effective when applied once a day for three consecutive days for three month followed by maintenance with cryothrerapy for further three month. Keywords: Benign disease, Liquid nitrogen, Cryotherapy, lmiquimod, Bowen's diseasePublication Comparative Study of 5 % Potassium Hydroxide Solution Versus 0.05% Tretinoin Cream for Molluscum Contagiosum in Children(Kathmandu University, 2011) Rajouria, EA; Amatya, A; Karn, DABSTRACT Background Molluscum contagiosum is one of the commonest cutaneous viral infections in children. All treatment modalities are associated with substantial pain, tissue destruction, and frequent recurrence. Objectives To compare the efficacy and side effects of KOH 5% solution with tretinoin 0.05% cream for the treatment of molluscum contagiosum in children. Methods Fifty patients were randomly divided into 2 groups; 25 each for 5% KOH solution and 0.05% tretinoin cream. The given medication was applied at bed time over molluscum lesions. The assessment of response and side effects were performed weekly for 4 weeks. Results At the end of 4 weeks, the mean lesion count decreased from 9.48±3.00 SD to 1.67±0.58 SD and from 8.35±2.82 SD to 2.00±1.00 SD in patients treated with 5% KOH solution and 0.05% tretinoin cream respectively. Conclusion The result of both KOH and tretinoin showed good response, well tolerated by children but between the two, KOH showed fast recovery and most lesions were resolved before 4 week. The side effects could be minimized if applied as stated above. On the other hand, tretinoin showed delayed response and even some of lesion extended beyond 4 week but the side effect were less, and hence can be used in recurrent cases. KEY WORDS Molluscum, Potassium Hydroxide, tretinoinPublication Comparative Study of Effectiveness of Oral Acyclovir with Oral Erythromycin in the Treatment of Pityriasis Rosea(Kathmandu University, 2012) Amatya, A; Rajouria, EA; Karn, DKABSTRACT Background Pityriasis rosea is an acute, self-limiting disease, probably infective in origin, affecting mainly children and young adults, characterized by distinctive skin eruptions and minimal constitutional symptoms. Both oral Erythromycin and oral Acyclovir have been used in its management. Objectives To compare the effectiveness of oral Erythromycin and oral Acyclovir in the treatment of Pityriasis rosea. Method Forty two patients with clinical diagnosis of Pityriasis rosea were enrolled. They were randomized into two groups. One group was given high-dose oral Acyclovir and another group oral Erythromycin in standard dose. The participants were evaluated one, two, four, six and eight weeks and six months after commencement of the study. Results Forty two patients including 26 males and 16 females completed the study. After 8th week, all patients showed complete response in both the groups. The response to oral Acyclovir compared with that to oral Erythromycin was better and was statistically significant in 1st, 2nd, 4th and 6th weeks. Conclusion Although it is a self-limiting disease which resolves within three weeks to three months, this study reveals that both oral Acyclovir and oral Erythromycin are helpful in decreasing the severity and duration of Pityriasis rosea. Moreover, the study also indicates that oral Acyclovir is more effective than oral Erythromycin in reducing the severity and duration of Pityriasis rosea. KEY WORDS Acyclovir, Erythromycin, HHV-6, HHV-7, Pityriasis roseaPublication Comparative study of Methotrexate and Cyclosporine in the treatment of Psoriasis(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2010) Karn, D; Amatya, A; Khatri, RAbstract Background Psoriasis is a chronic skin disease characterized by sharply demarcated, erythematous squamous lesions, with an estimated worldwide prevalence of 0 to 11.8%. Methotrexate (MTX) and cyclosporine (CsA) are well known systemic therapies for moderate to severe chronic plague psoriasis. Objective The aim of this study is compare the efficacy of methotrexate and cyclosporine in the treatment of Psoriasis. Methods A prospective randomized study was conducting at the Dhulikhel Hospital, KUTH, Dhulikhel during November 2008 to July 2009 with the objective to compare the effectiveness, side effects and cost of MTX and CsA treatment in a context reflecting normal clinical practice. Results A total of 64 patients (33 receiving MTX and 31 receiving CsA) were enrolled. These patients were followed every week for first month and their PASI score and side effects were recorded at 0, 1st, 2nd and 3rd month interval. In the study, the mean (± S.E) PASI score at base line was 23.34 ± 1.12 for MTX and 21.25 ± 1.07 for CsA group. After 12 weeks of treatment the mean ± S.E PASI score found to be 5.37 ± 0.42 for MTX and 4.56 ± 0.41 for CsA group. The difference in the response between the groups acquired statistically not significance (p=0.160 > 0.05) meaning there is no difference in the effectiveness of MTX and CsA. Conclusions The efficacy, side effects, ease of administration (once weekly vs. twice daily treatment) and cost, it seems that treatment of psoriasis patient with systemic therapy using MTX is preferable than CsA even though, both have similar clinical efficacy. Keywords Methotrexate; Cyclosporine; Psoriasis.Publication Darier White disease(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2010) Amatya, A; Karn, D; Aryal, E; Makaju, R; Shakya, A; Priyadarshinee, AAbstract Darier’s disease was described inependently by Darier and White in 1989 AD. Reported prevalence varies from 1/100,000 in Denmark to 1 in 30- 35,000 in northern England and Scotland.1 Darier’s disease has been reported from other parts of the world, however,there has been no reported cases in Nepal. It is an inherited autosomal dominat disease characterized by dark crusty lesions over the seborrheic areas of the skin. We are reporting a case of Darier’s disease in a Nepalese patient who developed skin leison’s over his face and body at the age of 12 years. We took skin punch biopsy from the leisons, which showed findings suggestive of Darier’s disease. Our case was treated with isotrerenoin and topical keratolytics. He responded with the given treatment within two weeks of therapy.Publication Oral Tranexamic Acid for the Treatment of Melasma(Kathmandu University, 2012) Karn, D; KC, S; Amatya, A; Razouria, EA; Timalsina, MABSTRACT Background Melasma poses a great challenge as its treatment is unsatisfactory and recurrence is high. Treatment of melasma using tranexamic acid (oral, topical or intralesional) is a novel concept. Objective To compare the efficacy of oral tranexamic acid with routine topical therapies for the treatment of melasma. Methods It is a prospective, interventional, randomized controlled trial conducted among 260 melasma patients. Patients were divided into two groups consisting of 130 patients each. First group (Group A) was given routine treatment measures and oral Tranexamic Acid while second group (Group B) was treated only with routine topical measures. Capsule Tranexamic Acid was prescribed at a dose of 250 mg twice a day for three months and cases were followed for three months. Response was evaluated on the basis of Melasma Assessment Severity Index (MASI). Mean scores between the two groups were then compared. Results Statistically significant decrease in the mean Melasma Assessment Severity Index from baseline to 8 and 12 weeks was observed among group A patients (11.08±2.91 vs 8.95±2.08 at week 8 and vs. 7.84±2.44 at week 12; p<0.05 for both). While among group B patients the decrease in mean score was significant at 8 weeks and insignificant at 12 weeks follow up (11.60±3.40 vs 9.9±2.61 at 8 weeks and vs. 9.26±3 at 12 weeks; p<0.05 for former but p>0.05 for later). Conclusion Addition of oral tranexamic acid provides rapid and sustained improvement in the treatment of melasma. KEY WORDS Melasma, tranexamic acidPublication Prevalence of Sexually Transmitted Infections in a Tertiary Care Centre(Kathmandu University, 2011) Karn, D; Amatya, A; Aryal, ER; KC, S; Timalsina, MABSTRACT Background The burden of sexually transmitted infections is huge and is disproportionately affecting developing nations. In Nepal, recent available data on sexually transmitted infections are mostly targeted to high risk population. A prevalence study was thus done to explore the pattern of sexually transmitted infection syndromes among general population of Nepal. Objectives To highlight the prevalence and changing pattern of sexually transmitted infections among general population. Methods A retrospective study. The study was conducted among 145 patients attending Department of Dermatology and Venerology, Dhulikhel Hospital Kathmandu University Hospital, for voluntary counseling and testing from April 2010 to April 2011. Syndromic case management approach was used for the classification and treatment of the patients. Results 106 patients were suffering from Sexually Transmitted Infections and 2 patients were positive for Human Immunodeficiency Virus. The most common diagnosis was genital viral infections (41.7%). Prevalence was highest among drivers/conductors (26.9%) and migrating workers (23.1%). Age group 20 to 24 years was the maximum sufferers (37%). Unsafe sexual activity (66.7%) was the most potential exposure and majority of the patients were not consistent in using condom. Conclusions Genital viral infections constitute the major bulk of sexually transmitted infections. Majority of the patients suffering from sexually transmitted infections were in the age group 20 to 24 years and were mostly drivers, conductors or migrating workers by occupation. In the background of few available baseline data, the results are expected to assist successful target interventions in the near future. KEY WORDS prevalance, sexually transmitted infectionPublication Q-Switched Neodymium-Doped Yttrium Aluminum Garnet Laser Therapy for Pigmented Skin Lesions: Efficacy and Safety(Kathmandu University, 2012) Karn, D; KC, S; Amatya, A; Razouria, EA; Timalsina, M; Suwal, AABSTRACT Background Nepalese population with Fitzpatrick skin types III-V has high prevalence of pigmentary disorders and it is a growing cosmetic concern. Q-Switched Neodymium- Doped Yttrium Aluminum Garnet (QS Nd-YAG) laser is an efficacious tool in the treatment of pigment disorders. Objective To highlight the efficacy and safety profile of various pigment disorders. Methods A prospective study done in Dhulikhel Hospital, Kathmandu University Hospital from January 2009 to January 2011. Patients undergoing laser for pigmented skin lesions were followed for response and safety profile. We included total 270 patients in the study with various disorders especially nevus, tattoos and melasma. Settings were repeated at 3-4 weeks interval and response was evaluated on clinical basis. Efficacy was then evaluated according to various parameters. Results For nevus, total 840 treatment sessions had been performed with an average of 6.88 sessions (range 3-11). Nd: YAG laser was very efficacious in removal of blue and black colored tattoos with an average of 7.9 and 9.5 sessions respectively. However, red mixed with blue and or green tattoos were relatively resistant to treatment and required average 10.33 treatment sessions. Melasma and freckles both responded to the therapy but recurrence rate was high. Conclusion Our results indicate that QS Nd: YAG laser is an effective modality for pigment disorders among Nepalese population. Nevus and melasma respond well but recurrence rate of melasma is high. Blue tattoos respond well while mixed colored tattoos are quite resistant to Nd: YAG laser alone. Transient pain and temporary hyperpigmentation are common side effects. KEY WORDS Laser, melasma, nevus, tattooPublication