Browsing by Author "Joshi, Smita"
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Publication A Hospital Based Cross Sectional Study Evaluating Haemoglobin, Iron Profile and Thyroid Function Tests in Women with Telogen Effluvium, Female Pattern Hair Loss, and Alopecia Areata(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2021) Amatya, Bibush; Joshi, SmitaAbstract: Introduction: Hair loss is one of the most frequent complaints for which patients see a dermatologist. The three most common causes of hair loss in women are telogen effluvium, alopecia areata and female pattern hair loss. Objectives The aim of this study was to investigate haemoglobin, iron profile and thyroid function tests in women with telogen effluvium, alopecia areata and female pattern hair loss. Materials and Methods: This was a hospital based cross sectional study conducted at the Department of Dermatology and Venereology, Nepal Medical College and Teaching Hospital (NMCTH). We recruited female patients with telogen effluvium, alopecia areata or female pattern hair loss who presented to our outpatient department between June 2019 and July 2020. Clinical and demographic data were collected and haemoglobin, serum iron profile and thyroid function investigated. Results: A total of 80 patients were recruited in the study period. The most common diagnosis was telogen effluvium (49, 61.25%) followed by alopecia areata (18, 22.5%) and female pattern hair loss (13, 16.25%). Although mean haemoglobin levels were within normal limits, inadequate ferritin levels for normal hair cycle were found in 77.55% of patients with telogen effluvium, 88.89% with alopecia areata and 84.61% with female pattern hair loss. Thyroid abnormalities were less commonly observed with more than 75% of the patients being euthyroid. Conclusion: Haemoglobin levels are not representative of true iron status in females with acquired alopecia. We therefore recommend investigating iron profile in all females with telogen effluvium, alopecia areata or female pattern hair loss. Keywords: Alopecia areata, Diffuse alopecia, Iron, Thyroid diseasePublication Clinico-epidemiological Profile of Women with Non-venereal Vulval Diseases: A Hospital-based Observational Study(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2019) Joshi, Smita; Shrestha, Shristi; Joshi, AnshumalaAbstract: Intorduction: Vulval disorders can be of venereal and non-venereal etiology. Establishing non-venereal causation of vulval disorder helps in alleviating fears in patients with the condition. These patients are better dealt in a multidisciplinary clinic as patients with these disorders frequently visit dermatologists and gynecologists for the treatment. Objectives: To study the clinico-demographic profile of women with non-venereal vulval disorders and to determine their relative frequency. Materials and Methods: This is an observational, descriptive study done at the Departments of Dermatology and Venereology and Gynecology and Obstetrics, Nepal Medical College Teaching Hospital. All consenting female patients with problems pertaining to female external genitalia were recruited for the study after excluding venereal diseases. Details of the patients were obtained and entered in a predesigned proforma. Results: Seventy-five females were recruited during a period of 20 months with a mean age of 34.79±17.90 years. Majority were married, uneducated and homemakers. Duration of disease ranged from 3 days to 35 years. Itching was the commonest presenting complaint (82.67%) followed by redness (32.00%), burning sensation (26.67%), white lesions (24.00%) and pain (24.00%). Commonest diagnosis was lichen sclerosus (17.33%), followed by candidiasis (14.67%). Patients presenting with vulval symptoms without lesions were diagnosed with non-specific vulval pruritus (9.33%) and vulvodynia (2.67%). Conclusion: Itching is the most common presenting complaint and contrary to the popular belief, inflammatory disorders especially lichen sclerosus, rather than infections were common diagnoses in females with non-venereal vulval disorders. Keywords: Lichen Sclerosus et Atrophicus, Pruritus Vulvae, VulvodyniaPublication Dermatological Practice in Nepal during COVID-19 Crisis: Recommendations of National Panel of Experts(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2020) Parajuli, Sudip; Pokhrel, Dinesh Binod; Agrawal, Sudha; Kumar, Ajay; Pokhrel, Kumar; Bastola, Anup; Bhattarai, Sabeena; Shrestha, Shristi; Shrestha, Manisha; KC, Shekhar; Joshi, Smita; Das, Anil Kumar; Shah, Mahesh; Joshi, Shambhu Dutta; Paudel, Sushil; Hirachan, Shashi; Paudel, Upama; Neupane, SaraswotiAbstract: Introduction: Novel Coronavirus disease has caused a substantial halt to the ongoing world in every aspect. There are medical and social implications of the disease. Cutaneous manifestations have been reported to be a part of the disease as well. Dermatologists globally are in dilemma with the clinical practice because of the fear of acquiring the disease. Objectives: This article aims to recommend best practice measures that can be followed in local scenario for re-opening up of dermatological services in the context of Nepal. Materials and Methods: A preliminary draft for guidance on Dermatological services based on recommendations of American Academy of Dermatology, International league of Dermatological societies, National recommendations from Ministry of Health, Nepal was sent to a panel of national experts to determine the level of consensus in first week of April, 2020. A preliminary survey was sent to all the members of Society of Dermatologists, Venereologists, and leprologists of Nepal on first week of June and a second draft was subsequently formed which was sent again to experts and revised based on the opinions of national experts. Results: A total of 19 experts participated in the preparation of draft and reached a national consensus after a series of revisions in preliminary draft. Conclusion: Agreements regarding the opening of practice in dermatology discipline have been summarized. Recommendations have been made for opening of dermatological services – opening of outpatient department, performing dermatosurgical and cosmetic procedures as well as strategies on triage of patients and use of masks. Keywords: Coronavirus, Dermatology, Disease, Nepal