Browsing by Author "Karn, Dharmendra"
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Publication A Clinico-histopathological Diagnosis of Trichoadenomas on Nose: A Case report Authors(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2025) Shrestha, Elisha; Pradhan, Namrata; Thapa, Diksha; KC, Sharnawi; Karn, DharmendraAbstract: Trichoadenoma of Nikolowski is a slow-growing, well-differentiated, rare, benign tumor closely resembling the infundibular portion of the hair follicle. Reporting such cases adds to the limited literature and helps clinicians better recognize and understand the condition. Due to its clinical and histopathological resemblance to other skin tumors, accurate diagnosis can be challenging. Reporting cases aids in refining diagnostic approaches. We report a case of a 51-year-old female with slow-growing skin-colored nodules over the tip of the nose and left nasal ala, with characteristic histopathological features suggestive of trichoadenoma.Publication A Comparative Efficacy and Adverse Clinical Events of Methotrexate versus Azathioprine with Steroid Mini Pulse Therapy in the Management of Moderate to Severe Alopecia Areata: A Tertiary Centre Based Interventional Study(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2022) Mishra, Aditi; KC, Shekhar; Shrestha, Elisha; Pandey, Chandranshu; Karn, DharmendraAbstract: Introduction: Alopecia areata is a T cell-mediated autoimmune disorder of hair follicles resulting in partial or total hair loss. Treatment of alopecia areata is difficult, and it has variable severity. Objectives: To compare the clinical efficacy and adverse clinical events of azathioprine versus methotrexate with steroid minipulse therapy in managing moderate to severe alopecia areata. Materials and Methods: Prospective non-blinded clinical trial conducted for 6 months in Department of Dermatology at Dhulikhel Hospital. Dermoscopic evidence of alopecia areata patients treated according to group assigned and effects and adverse event were noted. Results: There was a total of 36 patients enrolled. Twenty patients were in Group A (AZT+MPT) and 16 in group B (MTX+MPT). There was a significant improvement in SALT score at 6 months (Group A p-value: 0.03; group B p-value: 0.001). Treatment efficacy (percent scalp hair regrowth) in group A was 79.2%, and in group B was 89.01%. Conclusion: Both treatment regimens showed marked improvement with SALT score reduction; however, methotrexate with steroid minipulse therapy showed slightly higher treatment efficacy than azathioprine with steroid minipulse therapy.Publication Editor-in-Chief(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2009) Karn, DharmendraNAPublication Prevalence of Aeroallergens in Allergic Rhinitis in a Tertiary Care Hospital(Nepal Medical Association, 2020) Pokharel, Monika; Shrestha, Bikash Lal; Karn, Dharmendra; Dhakal, Ashish; K.C., Abha Kiran; Shrestha, Krishna Sundar; Shakya, SushanAbstract: Introduction: The prevalence of allergic rhinitis has increased significantly globally over the last two decades. Detection of sensitizing aeroallergens plays a crucial role in the diagnosis and management of this troublesome disease. This study aims to investigate the spectrum of aeroallergens sensitization in patients with allergic rhinitis in a tertiary care hospital. Methods: A descriptive cross-sectional study conducted in the Department of Otorhinolaryngology of our hospital between January 2016 to December 2019. Ethical approval was taken from the Institutional Review Committee (No: 210/19). Patients diagnosed with allergic rhinitis were enrolled using the convenience sampling technique. Data entry and analysis was done using IBM Statistical Package for Social Sciences version 20.0. Results: Among 170 patients, altogether 103 (60.6%) patients yielded positive responses on the skin prick test. The most prevalent aeroallergens were Lepidoglyphus 86 (50.60%), Dermatophagoides pteronyssinus 85 (50%), Dermatophagoides farina 82 (48.20%), Thyrophagus 50 (29.40%), Blomia 46 (27.10%), Acarus 43 (25.30%), cat dander 26 (15.30%), dog dander 24 (14.10%), cow and buffalo dander 20 (11.8%), ragweed 20 (11.8%), grass pollen 18 (10.60%) and mugwort 17 (10%). Conclusions: This study highlights that the frequency of aeroallergens based on skin prick test in patients presenting to a tertiary care hospital which showed the dominance of house dust mites, dog and cat hair, pollen, and grasses. Reduced exposure and training of patients about protection against these agents will possibly help in controlling the severity of allergic rhinitis in this region.Publication Profile of Clients of HIV Testing and Counseling in a Tertiary Care Center and Need of Testing in Tuberculosis(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2019) Shrestha, Smriti; Karn, Dharmendra; Tamrakar, Dipesh; Madhup, Surendra; Karmacharya, Biraj ManAbstract: Introduction: Sexually transmitted infection is public health issue that amplifies HIV burden globally. At National Center of AIDS and STD Control, annual reported STI are rising steeply recently. Incidence of HIV is 0.03% while prevalence in adult population is less than 1%. National HIV testing guidelines 2017 recommends HIV tests should be performed in tuberculosis and medical conditions. However, it is not routinely done in Nepal. Objective: To assess profile of STI and HIV among patients attending HIV testing and counseling center of tertiary hospital, and to assess fraction of tuberculosis patients undergoing HIV testing. Materials and Methods: All patients attending HIV testing and counseling center were tested for HIV. Tests for STI were done based on patient symptoms. Data collected were analyzed with SPSS. Results: Suspected STI (41.1%) was commonest cause of HIV testing. Among STI, gram positive diplococcic were noted in 11.5% and 3.4% had PCR positive Chlamydia. Only 19.4% (7 out of 36) of total tuberculosis patients in hospital were screened for HIV, among which, 57.14% (4 out of 7) were seropositive for HIV, which is noteworthy. Conclusion: Our study shows patterns of STI, and that gonorrhea and chlamydia could be underdiagnosed in Nepal. Every patient with tuberculosis should routinely be screened for HIV. But only small fraction of tuberculosis patients underwent HIV screening, out of which HIV positivity was high, reflecting the gap and need for routine HIV screening in TB patients. Keywords: Acquired Immunodeficiency Syndrome, HIV infections, Sexually Transmitted Diseases, Tuberculosis