Browsing by Author "Gahalaut, Pratik"
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Publication Antifungal Susceptibility Pattern of Non - Dermatophytic Fungi Causing Onychomycosis(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2020) Kaushal, Apurva; Gahalaut, Pratik; Goyal, R K; Agarwal, Neni; Mishra, Nitin; Rastogi, Madhur KantAbstract: Introduction: Non-dermatophytic molds (NDM) are filamentous fungi or yeast, commonly found in nature as saprophytes and plant pathogens. The incidence of onychomycosis due to NDM is 1.45 – 16.6%. NDMs are usually resistant to conventional antifungal treatment. Objective: To know the anti-fungal susceptibility pattern of non-dermatophyte fungi causing onychomycosis. Materials and Methods: A prospective hospital based cross-sectional study was done on non - dermatophytic isolates from patients with clinical suspicion of onychomycosis. All non – dermatophytic isolates were subjected to anti-fungal susceptibility against terbinafine, itraconazole, fluconazole and griseofulvin by micro broth dilution method. Results: NDM were isolated in 20.2% cases of clinically suspected onychomycosis, among which Fusarium species was the most common followed by Aspergillus species and Candida species. MIC50 (Mean Inhibitory Concentration) for overall non - dermatophytic isolates for terbinafine, itraconazole, fluconazole and griseofulvin was 0.25μg/mL, 0.5μg/mL, 32μg/mL and 2μg/mL respectively and the order of sensitivity was Itraconazole (74.7%) > terbinafine (68%) > Fluconazole (60%) > Griseofulvin (51.6%) of the study samples. For Fusarium species, the sensitivity for terbinafine was (73.5%) > itraconazole (67.6%) > fluconazole (64.7%) and griseofulvin (64.7%). For Aspergillus species, the sensitivity for itraconazole was 79.1% > fluconazole (58.3%) > terbinafine (54.1%) > griseofulvin (50%). For Candida species, the sensitivity was fluconazole (83.3%) > itraconazole (75%) > terbinafine (41.6%), while no candida species was found sensitive to griseofulvin. Conclusion: Non-dermatophytes play a significant role in onychomycosis. On in vitro estimation, Itraconazole was the most sensitive drug, followed by terbinafine, fluconazole and griseofulvin. Keywords: Antifungal Agents, Fluconazole, Itraconazole, Onychomycosis, TerbinafinePublication Clinicoepidemiolgic Profile of Dermatophytosis in the Elderly: A Hospital Based Study(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2021) Gahalaut, Pratik; Mehra, Mriganka; Mishra, Nitin; Rastogi, Madhur Kant; Bery, VasudhaAbstract: Introduction Superficial tinea infections are some of the most common dermatological conditions in the elderly. Recently, few studies done showed an abrupt increase in dermatophytic infection in adults; however, similar recent studies describing dermatophytosis in the elderly are lacking. The aims and objectives of this study were to identify the epidemiological profile of dermatophytoses among the elderly population. Materials and Methods This was a single centre, observational cross-sectional study conducted at a tertiary care Medical College Hospital in North India over 12 months including patients of dermatophytosis (KOH confirmed) aged 60 years or more. Results A total of 192 patients were enrolled, among which 68.7% were males. The extensive disease was present in 56.2%. History of topical steroid usage was present in 79.2%. The mean duration of disease was 23.8 weeks among which chronic disease was seen in 25%. Various other demographic characteristics were identified. Various risk factors for extensive disease, like gender, topical steroids use, urban residence, higher socioeconomic status, longer duration of disease, positive family history, diabetics, regular alcohol and tobacco consumption, were also noted in the present study. Conclusion The present concludes increased prevalence in women, delay in seeking treatment among them, a rising proportion of chronic and extensive dermatophytosis, rising atypical clinical presentation and higher predilection for tinea cruris and onychomycosis.Publication Comparing the Clinical Efficacy of Topical Application of Virgin Coconut Oil and 1% Clotrimazole Cream as an Adjuvant to Systemic Antifungal in Chronic Dermatophytoses: A Randomized Controlled Trial(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2023) Chawla, Aakriti; Rastogi, Madhur Kant; Gahalaut, Pratik; Dubey, Varsha; Mahajan, Vasvi; Deshmukh, RahulAbstract: Introduction: Dermatophyte infections have become a common entity with a prevalence ranging from 36.6-78.4%. Majority of the patients are from low socioeconomic background who favour topical treatment. High treatment costs of antifungal medication and consequent poor compliance have given rise to the need of an effective and economical topical preparation. Objectives: To compare efficacy of topical 1% clotrimazole versus virgin coconut oil application as an adjuvant to systemic antifungals in dermatophytosis. Materials and Methods: A total of 100 patients presenting to the dermatology outpatient department and diagnosed with tinea infection clinically and by potassium hydroxide mount were taken up for the study. The patients were randomized into two groups with 50 patients in each group. One group received virgin coconut oil while the other group received 1% clotrimazole cream twice daily application as the topical preparation. Mycological cure was assessed by potassium hydroxide mount and clinical improvement was assessed objectively by severity score for itch, changes in clinical signs and symptoms and subjectively by Dermatology Life Quality Index questionnaire. Statistical analysis was analyzed using SPSS software version 17. Results: Virgin coconut oil and 1% Clotrimazole had equivocal response after 12 weeks of treatment with respect to potassium hydroxide mount positivity, itch severity, clinical improvement and changes in Dermatology Life Quality Index scores when used along with systemic antifungal. Conclusion: Virgin coconut oil can be easily used as a topical emollient and antifungal preparation along with systemic antifungals in the treatment of dermatophytosis.Publication Enzymatic Oxidative Stress Indicators and Oxidative Stress Index in Patients of Leprosy(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2018) Raka, Ishita; Rastogi, Madhur Kant; Gahalaut, Pratik; kaur, Jaspreet; Mishra, NitinAbstract: Introduction: Leprosy is a chronic granulomatous disease caused by Mycobacterium leprae. Oxidative stress caused by Reactive oxygen species (ROS) plays a crucial role in the pathogenesisis of leprosy. Objective: To measure the enzymatic oxidative stress indicators and oxidative stress index in patients of leprosy and compare them with healthy age & sex matched controls. Materials and Methods: In this prospective study 30 untreated leprosy patients were included in the study and matched with 60 healthy controls. Biochemistry estimation was done with blood samples and MDA (lipid peroxidation), Nitric oxide (NO), (SOD) Superoxide dismutase (antioxidant enzyme), total oxidant status (TOS), total antioxidant status(TAS) and oxidative stress index (OSI) were estimated. Results: Highly significant rise (p<0.0001) in serum MDA, NO, TOS and OSI was seen in leprosy patients when compared with controls with highly significant decline in SOD and TAS. Conclusion: The study confirms the oxidative stress in leprosy and suggests antioxidant therapy may be used as an adjuvant in the treatment of leprosy along with MDT. Keywords: Lipid peroxidation, Mycobacterium leprae, oxidants, reactive oxygen species, superoxide dismutasePublication Evaluation of Serum Cortisol Level in Chronic Superficial Dermatophytosis(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2024) Dubey, Varsha; Rastogi, Madhur Kant; Mishra, Nitin; Gahalaut, Pratik; Singh, Amar; Dudea, AarujAbstract: Introduction: The epidemic-like scenario of superficial fungal infections in India has been complicated by the rampant use of systemic and topical potent steroids. In this study, we hypothesize that the unjudicial use of topical corticosteroids can cause Hypothalamic pituitary axis suppression in chronic dermatophytosis patients. Objectives: To estimate morning serum cortisol levels in chronic superficial dermatophytosis patients. Materials and Methods: A total of 208 individuals were enrolled in this study. In which, 104 (50%) patients had Chronic superficial dermatophytosis (case group) and 104 (50%) patients were healthy (control group). Their clinical details and laboratory investigations including KOH and serum cortisol, were recorded on a pre-designed proforma. Results: The mean S. Cortisol level was 7.27±5.34 μg/ml in cases and 11.21±5.92 μg/ml in the control group. The mean S. Cortisol level was significantly lower in cases as than controls (p <0.001).Conclusion: This study shows that patients with chronic superficial dermatophytosis have low serum cortisol compared to healthy controls.Publication Generalized ILVEN or Blaschkoid Psoriasis: A Persistant Dilemma(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2019) Kaushal, Apurva; Gahalaut, Pratik; Mishra, Nitin; Rastogi, Madhur KantAbstract: A 24-year-old man presented with itchy verrucous, scaly red-brown papules, & linear plaques distributed in a blaschkoid pattern all over the body since last 20 years associated with itching. A skin biopsy was consistent with ILVEN (inflammatory linear verrucous epidermal nevus). Histopathologically, it can be difficult to distinguish it from linear psoriasis. It may respond to conventional anti-psoriatic therapies like potent topical corticosteroids applied under occlusion, or systemic treatments like acitretin. Keywords: Interleukin-1, Isotretinoin, Musaicism, Nevus, PsoriasisPublication Quality Of Life In Patients With Chronic Dermatophytosis(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2020) Varshney, Ajitesh Prakash; Gahalaut, Pratik; Pardal, Pavan Kumar; Mishra, Nitin; Rastogi, Madhur Kant; Thapa, ManishaAbstract: Introduction: The term “chronic dermatophytosis” can be described as patients who have suffered tinea infections for more than 6 months, with or without recurrence. Since last few years we are facing an onslaught of chronic and recurrent dermatophytosis. These infections are increasingly becoming debilitating with severe symptoms like itching and increasingly showing lack of response to traditional treatment, hence it has become utmost important to assess impact of dermatophytosis today on quality of life of patients. Objectives: To determine quality of life in patients with chronic dermatophytosis using Dermatology Life Quality Index (DLQI). Materials and Methods: Adult literate patients having chronic dermatophytosis which was confirmed by KOH mount were included in the study. History, clinical features and other relevant details were included in a proforma. All patients were asked to fill DLQI questionnaire in Hindi. Controls having disease for less than six months were also included. Data thus obtained was collected and tabulated. The data was analysed using SPSS software and relevant statistical tests were used. Results: Total number of cases collected were 263, 137 controls were also included. In gender distribution, cases had 71.86% males and 28.14% female while controls had 63.5% males and 36.5% females. Mean DLQI of cases was 14.28+/-5.16 and controls was 11.56+/-3.60. DLQI distribution of cases -162(61.6%) had very large effect, 64(24.33%) had moderate effect, and 32(12.17%) had extremely large effect on DLQI. Domains of Symptoms and feelings (72.67%), work and school related activities (69%) and treatment related problems (67.67%) posed maximum impairment. Quality of life derangement increased significantly with presence of lesions on both exposed and non exposed sites and increase in body surface area. Conclusion: While superficial dermatophytosis affects quality of life (QoL) in all patients, chronic dermatophytosis has a significantly more derogatory effect on the QoL of a person with some of the patient also showing extremely large effect on QoL. Keywords: Antifungal Agents, Dermatology, Pruritus, Quality of Life