Browsing by Author "Gautam, Sujan"
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Publication Efficacy and Safety of Intralesional Immunotherapy with Tuberculin Purified Protein Derivative among Cutaneous Wart Patients(Nepal Health Research Council, 2022) Shrestha, Sanju Babu; Bhusal, Mohan; Jwarchan, Jayanti; Gautam, Sujan; Shrestha, Prashanna RajAbstract Background: Cutaneous warts are common skin problems caused by Human Papilloma Virus. Conventional therapies are mostly ablative and limited by recurrences and side effects. Immunotherapy using bacterial, fungal, and viral antigens is an emerging and safer technique to treat warts at local and distant sites. The objective of this study was to measure the efficacy and safety of intralesional immunotherapy with tuberculin purified protein derivative among cutaneous wart patients in the dermatology department of a tertiary care centre. Methods: A cross sectional, time series design, was conducted between October 2019 and September 2020 among 77 patients of cutaneous warts attending Dermatology out-patient department using convenience sampling. Percentage response was evaluated for patients treated with tuberculin purified protein derivative for eight weeks at an interval of two weeks into complete response (100% clearance), partial response (50-99% clearance), no response (0-49% clearance). Side effects were also recorded. Statistical Package for the Social Sciences version 20.0 was used for data analysis. Results: Out of 77 patients, complete response (100%) was seen in 53.2% patients, partial response (50-99%) in 14.3% and no response (0-49%) was seen in 32.5%. Side effects noted were pain and erythema (19.50%), blisters (2.60%) and flu like symptoms (1.30%). Conclusions: Intralesional PPD is an effective and safer therapeutic option for the treatment of cutaneous warts. Keywords: Immunotherapy; intralesional injections; purified protein derivative of tuberculin; warts Author Biographies Jayanti Jwarchan, Gandaki Medical College Lecturer, Department of Dermatology Sujan Gautam, Kathmandu Medical College Resident, Department of Dermatology Prashanna Raj Shrestha, Kathmandu Medical College Lecturer, Department of DermatologyPublication Low Dose Oxybutin in Primary Hyperhydrosis: A Prospective Study from a Tertiary Care Center in Nepal(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2023) Aryal, Eliz; Shrestha, Prashanna Raj; Gautam, SujanAbstract: Introduction: Hyperhydrosis is a clinical condition where there is excessive sweating beyond the physiological need of the patient’s body. This can directly or indirectly affect the quality of patients life. Oxybutin is widely used in urology as anticholinergic medication for bladder urge incontinence. It can be used safely at a high doses (over 15 mg/day) to treat urological disorder. It also acts against excessive sweating and can be used in cases of hyperhidrosis. Objectives: To evaluate effectiveness of oxybutin at low dose and to assess the Hyperhidrosis Disease Severity Scale (HDSS) . Materials and Methods: This is a hospital based cross-sectional study in primary hyperhydrosis. Oxybutin was prescribed to all patients of primary hyperhydrosis with gradual increment of dosage of 2.5 mg orally once a day to 5 mg twice a day. Patients were evaluated at zero wk (baseline), 4 wk, 8 wk, 12 wk and follow-up in 16 wks with Hyperhidrosis Disease Severity Scale (HDSS) along with adverse effects were noted. Results: There was a significant difference in HDSS at zero wk (baseline) and 4th wk (p=0.001) at a dose of 2.5 mg once a day of oxybutynin. Also, a significant difference was noted (p=0.022) in HDSS between zero wk (baseline) and 12 wk. Similarly, a significant difference between HDSS at zero wk (baseline) versus the 16th wk was also noted. Conclusion: Oxybutin is an anticholinergic drug with an emerging role in hyperhydrosis. Low doses have shown significant results with minimal side effects. The dose requirement varies among authors. Studies with long-term follow-ups with ideal protocol need to be established in the future.