Browsing by Author "Chapagain, Laxman"
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Publication Clinical Profile and Treatment Outcome of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis at a Tertiary Hospital of Nepal(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2025) Khadka, Anupa; Mishra, Punam; Chapagain, Laxman; Gartaula, Manisha; Gupta, Pooja; Shrestha, Dwarika PrasadAbstract: Introduction: Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are severe forms of severe cutaneous adverse reactions (SCAR) with high morbidity and mortality. Due to its rarity and severe acute nature, there is limited data from controlled trials. This study seeks to contribute to the existing knowledge on the etiology and treatment outcomes of SJS/TEN. Objectives: To assess the clinical profile and treatment outcomes of SJS and TEN patients. Materials and Methods: A retrospective analysis of patients’ admissions and discharge records was done from April 2020 to November 2024. The variables analyzed included the clinical types (SJS, TEN, SJS/TEN overlap), causative drugs, treatment undertaken, mean duration of hospital stay, and treatment outcome. Results: Among 27 patients, SJS accounted for 81.48% (n=22), TEN 14.8% (n=4), and SJS/TEN overlapped 3.70% (n=1) of the cases. Non-steroidal anti-inflammatory drugs (NSAIDs) were the most commonly implicated culprit drugs, followed by amoxicillin. The mean time of appearance of the lesion after the medication was 29.14±22.93 days. All the patients received steroids-hydrocortisone 81.48% (n=22); hydrocortisone and dexamethasone 7.40% (n=2) and methylprednisolone 7.40% (n=2) with supportive management. The mean duration of hospital stay was 12.03±10.52 days, and the recovery rate without complication was 88.89% (n=24). Conclusion: SJS is the most common clinical type in the SJS-TEN spectrum. NSAIDs and antibiotics were the common causes of SJS/TEN. Corticosteroids proved beneficial in managing SJS/TEN in our patients.Publication Clinical Profile of Leprosy in Post-elimination Era in a Tertiary Care Hospital(Institute of Medicine, 2024) Gurung, Tsering Dolma; Chapagain, Laxman; Paudel, UpamaABSTRACT Introduction: Leprosy is a chronic disease that primarily affects peripheral nerves and skin. It has a long incubation period and clinical presentations are variable leading to deformities and social stigma. Leprosy was eliminated in Nepal in 2010 AD. This study was undertaken to determine the demographic and clinical profile of Leprosy in the past three years. Methods: A retrospective observational study was conducted in the Department of Dermatology and Venereology, Tribhuvan University Teaching Hospital. Records of all the newly diagnosed leprosy patients attending the Out-Patient Department from April 2021 to March 2023 were reviewed retrospectively and analyzed. Results: There were 109 newly diagnosed leprosy cases among which majority were males. The maximum clinical diagnosis was lepromatous leprosy and 100 (91.74%) cases were multibacillary. Type 1 lepra reaction was seen in 11 (10.09%) patients and 12 (11%) patients had type 2 lepra reaction. Slit skin smear was positive in 75 (68.80%) patients. On clinical examination, peripheral nerves were palpable in 92 (84.4%) patients with ulnar nerve being the most common palpable peripheral nerve. Type 1 deformity was present in 55 (50.45%) patients and 18 (16.51%) patients had type 2 deformity. Claw hand was the most common type 2 deformity observed. Conclusion: Though leprosy has been eliminated in Nepal, there are still considerable cases of Leprosy. Higher number of cases with multibacillary disease and increasing number of Lepra reaction is an alarming sign. Keywords: Lepra reaction; leprosy; multibacillaryPublication Recurrent Angioedema: A Case Series of C1 Esterase Inhibitor Deficiency(Perinatal Society of Nepal (PESON), 2025) Paudel, Upama; Parajuli, Sudip; Chapagain, Laxman; Sharma, AshuAbstract: We report a case series of recurrent angioedema, hereditary and acquired, diagnosed after a long period of time. The first and the second patient presented initially at the age of 13 years and were diagnosed finally at the age of 27 years and 18 years respectively. The third case is reported in an adult and was finally diagnosed as case of acquired angioedema. The patients were managed with danazol and tranexamic acid in absence of standard recommended drugs. The cases highlight the importance of diagnosing cases during childhood and emphasize the need of standard drugs in our scenario.