Browsing by Author "Kayastha, Bhaskar MM"
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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 Blistering Diseases in a Tertiary Care Hospital: A 10-year Audit(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2020) Parajuli, Niraj; Lama, Laila; Karki, Anupama; Shrestha, Rushma; Tiwari, Sumida; Kayastha, Bhaskar MMAbstract: Introduction: Cutaneous blisters can occur in variety of conditions. They are broadly classified as immunobullous or non-immunobullous. Immunobullous blistering diseases can further classify as intraepidermal or subepidermal. Non-immunobullous blistering disease are commonly due to infections, drugs among others. Some of the blistering disease carry significant mortality and morbidity. There are only limited data on blistering diseases from Nepal, so this study will provide details on the prevalence of this rare dermatological disease from one of the tertiary care referral hospital in the country. Objective: To assess the clinical pattern and prevalence of various blistering diseases in a tertiary care referral hospital. Materials and Methods: All of the data were obtained from the admission register maintained at department of dermatology and venereology, National Academy of Medical Sciences. All the patients admitted with blistering disease from year April 2008 till March 2018 were included. The details including age, sex, type of blistering disease and length of hospital stay were recorded. Results: A total of 710 patients were admitted in the dermatology ward over the period of 10 years. There were a total of 193 blistering disease admitted during this period. Autoimmune blistering disease was diagnosed in 59 patients whereas 100 patients had non-immunobullous disease. The age grouped range from 4- 93 years with the mean age of 43± 19.71 years. The average number of hospital stay of all blistering diseases was 11.73±11.36 days. Conclusion: Blistering diseases are one of the most common conditions requiring admission in dermatology ward. Some of these diseases carry a significant morbidity and mortality. So, prompt diagnosis and treatment is of utmost importance. Keywords: Autoantibodies, Fluorescent Antibody Technique, Pemphigoid, Bullous, Pemphigus, Skin Diseases, Vesiculobullous,