Browsing by Author "Baral, S"
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Publication A Fatal Presentation of Dermatomyositis(Kathmandu University, 2012) Khatiwoda, P; Kayastha, SR; Khatiwada, P; Giri, A; Baral, S; Bista, D; Pant, PABSTRACT Dermatomyositis (DM) is an autoimmune disease that mainly affects the skin, muscle, and lung. The pathogenesis of skin inflammation in DM is not well understood. We present a 40-year-old male who presented with four months history of generalized skin lesion, pain and weakness. He had elevated transaminases with detectable muscle weakness. This case highlights the need to consider dermatomyositis with skin lesion and weakness; and the use of aggressive immunosuppressive therapies due to its associated vasculopathies. KEY WORDS Cutaneous lesions, dermatomyositis, idiopathic, myopathy, vasculitisPublication A Spatial Model of Socioeconomic and Demographic Determinants of Dengue Hemorrhagic Fever in Nepal(Kathmandu University, 2025) Mahato, RK; Htike, KM; Yadav, A; Baral, S; Yadav, RK; Kafle, A; Sharma, VABSTRACT Background Dengue hemorrhagic fever (DHF) has re-emerged across the global South, particularly in tropical and subtropical urban areas, driven by environmental changes alongside local demographic and socioeconomic factors. Objective To investigate the spatial patterns and socioeconomic determinants of dengue fever in Nepal from 2020 to 2023. Method Using Geographic Information Systems (GIS), Gi* cluster analysis, and Local Moran’s I statistics, the study examined the relationship between socio-economic variables and dengue incidence across districts. Key factors analyzed included population density, urbanization, and night-time light (NTL) intensity. Result Bivariate Local Indicators of Spatial Association (LISA) analysis showed fluctuating correlations between dengue hemorrhagic fever incidence and factors such as population density, urbanization, and night-time light intensity. Moran’s I value for population density were -0.083 in 2020, -0.082 in 2021, 0.526 in 2022, and -0.020 in 2023. Similarly, for urbanization, Moran’s I values shifted from -0.103 in 2020 to -0.090 in 2021, 0.458 in 2022, and 0.007 in 2023. Night-time light intensity also demonstrated changing correlations, with Moran’s I values of -0.091 in 2020, -0.102 in 2021, 0.415 in 2022, and -0.068 in 2023. A notable shift from negative to positive correlations occurred between 2020 and 2022. In 2022, high-incidence dengue hemorrhagic fever clusters emerged in densely populated areas, while distinct spatial patterns were observed in 2020 and 2021. Conclusion Dengue hemorrhagic fever risk spatial models are useful tools for detecting high-risk locations and driving proactive public health initiatives. The study emphasized the importance of dynamic, targeted public health interventions based on spatial and socio-economic factors to effectively manage evolving dengue outbreak patterns. KEY WORDS Dengue, Gi* statistics, Local indicators of spatial association, Socio-economic status, Spatial analysisPublication Leflunomide Induced DRESS Syndrome: A Case Report(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2012) Parajuli, S; Chaudhary, D; Pandey, S; Baral, S; Pokhrel, D BNA Keywords: Leflunomide, Dress syndromePublication Unilateral Pheochromocytoma in Von Hippel-Lindau Syndrome Revealed by a Hemangioblastoma(Kathmandu University, 2024) KC, S; Poudyal, H; Baral, SABSTRACT Von Hippel–Lindau (VHL) syndrome is characterized by the occurrence of both benign and malignant tumors, with typical manifestations such as cerebellar hemangioblastoma, Renal cell carcinoma (RCC) and pheochromocytomas.1 Additional tumors that may be associated include pancreatic cysts; neuroendocrine tumours; epididymal cysts and endolymphatic sac tumors.1 This case report details a 29-year-old male who arrived at the Emergency Department (ED) with a one-month history of headaches accompanied by dizziness and vomiting. A Computed Tomography (CT) scan of the head followed by Magnetic Resonance Imaging (MRI) suggested cerebellar hemangioblastoma. Further workup showed multiple tumors, including unilateral pheochromocytoma and pancreatic cysts, which aligned with a diagnosis of von Hippel-Lindau (VHL) syndrome. Notably, the patient’s catecholamine and vanillylmandelic acid (VMA) levels were within normal limits. The patient underwent surgical intervention for the cerebellar hemangioblastoma, and the postoperative recovery was uneventful. This case is noteworthy due to its characteristic findings and the rarity of the condition. KEY WORDS Hemangioblastoma, Pheochromocytoma, Von Hippel-Lindau syndrome