Browsing by Author "Giri, Uma"
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Publication A Hospital Based Study of Association of Chronic Spontaneous Urticaria with Autologous Serum Skin Test(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2020) Giri, Uma; Kayastha, Bhaskar MM; Shakya, Nabin BhaktaAbstract: Introduction: Chronic Spontaneous Urticaria (CSU), is spontaneous occurrence of wheals for more than 6 weeks. CSU patients with autoreactivity as indicated by positive Autologous serum skin test (ASST) have severe disease requiring higher doses of antihistamines and even immunomodulatory agents. Objective: The objective of this study was to observe the association between CSU and ASST. Materials and Methods: Over a period of one year, 104 CSU patients were enrolled in the study. Autologous serum skin test was done using 0.05 ml of patient’s serum, with 0.05 ml of histamine as positive control and normal saline as negative control. Prevalence of positive ASST in CSU patients was determined. Clinical and demographic characteristics were compared in both ASST positive and negative patients. Results: The ASST was positive in 68 patients (65.4%). Mean age (SD) of the patients in ASST positive group was 33.78 (14.38) versus 35.64 (14.47) in ASST negative group (p=0.533). Male:Female ratio in ASST group was 1:2.7 versus 1:1.1 in ASST negative group (p=0.033). Patients with positive ASST had significantly longer duration of wheals (p=0.002), generalized distribution (p=0.020) and high rmean urticaria activity score, 4.66 versus 3.28 in ASST negative patients, p<0.001. Angioedema was more common in ASST positive patients (p < 0.001). Conclusion: ASST was significantly positive in CSU patients and more common in females. ASST positive patients had more severe clinical manifestations and it can be a simple test to detect severe form of CSU. Keywords: Angioedema, Chronic Urticaria, Histamine, Skin TestsPublication Dermatomyositis in an Elderly with Respiratory Presentation: A Case Report(Nepal Medical Association, 2022) Maharjan, Srijana; Giri, Uma; Jha, Anushree; Rijal, Roshan; Bista, Roshani; Lama, Andi TamangAbstract: Dermatomyositis is an idiopathic inflammatory disease that affects the skin and proximal skeletal muscles. To our best knowledge, there are very few cases of Dermatomyositis reported in Nepal and almost none with respiratory manifestation. We present to you the case of dermatomyositis complicated with interstitial lung disease of a 74 years old male patient with a three-week history of generalized weakness, weight loss, Gottron's papule, and heliotrope rash, with features of interstitial lung disease such as shortness of breath, fever, and productive cough, later confirmed by high-resolution computed tomography. We monitored his serum creatine kinase/creatine phosphokinase level for two consecutive days which showed a progressive increase (281 U/L to 290 U/L). His antinuclear antibody test was positive. He was managed with standard treatment of dermatomyositis. This report might help understand the presentation of disease in our setting which can help in early diagnosis and early initiation of treatment.Publication Profile of Neurosyphilis Patients Admitted to a Tertiary Care Centre of Nepal: An Observational Study(Nepal Medical Association, 2025) Giri, Uma; Tangbetani, Laila Lama; karki, Anupama; Ghimire, Jagat JeevanAbstract Introduction: Neurosyphilis is a rare complication of untreated syphilis with limited literature.We aimed to look for demographic characters and clinical presentation of patients admitted with the diagnosis of neurosyphilis. Methods: This was an observational cross-sectional study that included analysis of records of neurosyphilis patients admitted to the National Academy of Health Sciences, Kathmandu, Nepal, from May 2015 to April 2024. All patients diagnosed with neurosyphilis were included, while those with incomplete data were excluded. The Centers for Disease Control and Prevention criteria were used to define and categorize neurosyphilis. Continuous variables were summarized as mean ± standard deviation for normally distributed data or as median and interquartile range for skewed data. Categorical variables were described using numbers and percentages. Results: A total of 53 cases were included in the study, with 31 (58.49%) males. The median age was 46 years (interquartile range: 37–60 years). Decreased vision was ovserved in 30 (56.60%) patients, and redness of the eye in 11 (20.75%) and headache in 4 (7.55%). Eye signs were observed in 43 (81.13%) patients. Cerebrospinal fluid Venereal Disease Research Laboratory (VDRL) test was positive in 11 (20.75%) cases. Based on Centers for Disease Control and Prevention criteria, 11 (20.75%) patients had verified neurosyphilis, 34 (64.15%) had likely neurosyphilis, and 8 (15.09%) had possible neurosyphilis. Iintramuscular benzathine penicillin was administered in 26 (49.06%) patients. Conclusions: There were more male patient with Neurosyphilis in our population. Decreased vision was the most common presentation. Likely neurosyphilis was most common diagnosis among studied population.