Browsing by Author "Pandey, Prajwal"
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Publication A Cross-sectional Study on Patients' Perspective Towards Dermatology Outpatient Services from a Tertiary Care Center in Nepal(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2024) Pandey, Prajwal; Shah, Raju; Rani, SwatiAbstract: Introduction: Patient-centered care has received greater prominence in recent years, and it is paramount to assess the patient’s satisfaction to improve the quality of healthcare services. The present study is aimed at understanding the patients’ perspectives regarding dermatology outpatient services offered at a tertiary care center to determine the areas for improvement for better patient satisfaction. Objective: This study is intended to understand the patients’ perspectives regarding a typical dermatology OPD setup and to identify the areas for improvement in a tertiary center in Nepal. Materials and Methods: The descriptive cross-sectional study was carried out using a content-validated, pre-tested, standardized, and translated questionnaire. All the patients who visited the outpatient department of Dermatology tertiary care center during the month of April 2022 and were willing to participate in the study were included. Result: A total of 157 patients participated in the survey. The majority of the participants were males (56.7%) and belonged to urban domiciles (80.9%). Nearly 42% of the subjects were seeking dermatology consultation for the first time, and 68.2% responded that the duration of consultation was sufficient. The details of symptoms, clinical results, and medication were clearly understood by 89.8%, 82.2%, and 73.9% of the subjects, respectively. Maintenance of privacy was reported by 76.4% of the participants. However, 25.5% of the subjects reported a waiting time of ≥4 hours for consultation, and 34.4% suggested the need for more manpower. Conclusion: The majority of the patients had a high degree of satisfaction. The areas of improvement include the adoption of technology-based appointment booking system, ensuring a good waiting ambience, increasing manpower, and reducing waiting time for consultations.Publication Anthropometric and Nutritional status of Chronic Obstructive Pulmonary Disease presenting in Acute Exacerbation in Tertiary care Hospital in Eastern Nepal(Nepalese Respiratory Society, 2024) Uprety, Augraj; Pantha, Srijan; Gurung, Kum Bahadur; Aryal, Prakash; Timsina, Anup; Mandal, Dipesh; Hamal, Sangita; Chaudhary, Sabnam; Thakur, Aanad Lohar; Yadav, Krishna Chandra; Shah, Nensi; Yadav, Dipendra; Pandey, Prajwal; Dahal, Sweta; Shahi, Rejina; Mishra, Deebya Raj; Bhatta, NarendraAbstract: Background: There is scarcity of data regarding the nutritional status of COPD patients presenting in exacerbation in our setup, thus this observational study was conducted. Methods: We performed an observational study of patients with acute exacerbation of COPD, who were admitted in the Department of Pulmonary, Critical care and Sleep Medicine in tertiary hospital in eastern Nepal from April 2023 to June 2023. Results: During the study period, a total of 154 patients of COPD with exacerbations were admitted in our department. The baseline anthropometric parameters, lab parameters as well as the malnutrition scores were determined. The mean BMI was 21.82 ± 3.92 kg/m2 and only 29% had BMI < 18.5 kg/m2.The mean hemoglobin, mean cell volume, serum protein, serum albumin, serum calcium, phosphorus and vitamin D level were 12.43 ± 2.32 g/dL, 84.4 ± 9.41 fL, 6.42 ± 1.74 g/ dL, 3.32 ± 0.34 g/dL, 8.98 ± 0.63 mg/dL, 3.02 ± 0.42 mg/dL, 18.48 ± 8.22 pg/mL and 40%, 12%, 28%, 41%, 31%, 42% and 49% of these values were below the lower normal limit respectively. The nutritional status tool used NRS-2002, MUST and MNAS-F screened malnutrition in about 68%, 51% and 54% respectively. There shows a discrepancy between the evaluation of the malnutrition assessed by BMI with that of nutritional assessment score. Conclusion: COPD who present in exacerbations are malnourished, but use of sole BMI to rule out malnutrition in such group of patients can cause false negative result.Publication Better Disease Control by Multidrug Regimen in Scabies: A Randomized Controlled Trial(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2022) Pandey, Prajwal; Agrawal, SudhaAbstract: Introduction: Scabies is a highly resilient condition with varying morbidity worldwide. The treatment options widely used for the disease include topical permethrin 5% and oral Ivermectin with similar efficacy. Treatment failure due to non-compliance is a major problem with the current treatment modalities. Objectives: This study was designed to compare the efficacy of combination to the gold standard treatment regimen of scabies. Materials and Methods: A randomized controlled trial was done with 212 patients, divided randomly into two groups Group 1 and Group 2. Group 1 were treated with two-time application of 5% permethrin one week apart while Group 2 were treated with a combination of 5% permethrin and oral ivermectin (200μg/kg) on a single day. Patients were followed up every week for 4 weeks to assess the efficacy and adverse events. Results: The treatment efficacy in group 2 was more compared to group 1 after 2 weeks of follow up (72.6% vs 65.1% after 1 week; 89.6% vs 80.2% after 2 week) however it was not statistically significant. After 4 weeks of follow up, the treatment efficacy in both the groups was similar. The reduction in intensity of itching was almost similar in both the groups at every follow up. Conclusion: The combination of 5% topical permethrin and oral ivermectin showed earlier resolution of clinical symptoms compared to 5% topical permethrin alone repeated in 1 week. The reduction in intensity of itch was similar in both the groups.Publication Efficacy of Autologous Injectable Platelet Rich Fibrin in Facial Atrophic Acne Scars in Combination with Microneedling: A Randomized Clinical Trial(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2024) Pandey, Katyayani; Agrawal, Sudha; Pandey, PrajwalAbstract: Introduction: Several modalities for treating acne scars exist. The combination of microneedling and injectable platelet-rich fibrin (i-PRF) is a synergistic approach. Objective: The aim was to compare the efficacy of microneedling alone versus microneedling with iPRF in post acne atrophic scars. Materials and Methods: This study was a hospital-based randomized clinical trial conducted at B P Koirala Institute Health Sciences, Dharan, Nepal. Twenty patients with postacne atrophic scars underwent four sessions of microneedling with-iPRF and microneedling alone, monthly. The Goodman and Baron quantitative score and Goodman and Baron qualitative scores were assessed at zero, four, eight, twelve, and sixteen weeks. The Facial Acne Scar Quality of Life questionnaire (FASQoL) was also evaluated. Result: The Goodman and Baron quantitative score was reduced from 23 to 14 in microneedling + i-PRF group (p=0.005) and from 16 to 11.50 for microneedling only group (p=0.005).The percentage reduction in the Goodman and Baron quantitative score after the 16th week was 39.13% for group A and 28.12 % for group B. There was a statistically significant difference in the net reduction of the Goodman and Baron quantitative score from the baseline to the 16th week between group A and group B (p=0.004). Conclusion: Injectable platelet rich fibrin (i-PRF) in combination with microneedling was found effective in reducing lesion count, Goodman and Baron quantitative score, and qualitative grade.Publication Varicella Pneumonia in Young Adult Male: A Case Report(Nepalese Respiratory Society, 2024) Uprety, Augraj; Pantha, Srijan; Gurung, Kum Bahadur; Aryal, Prakash; Timsina, Anup; Mandal, Dipesh; Yadav, Krishna Chandra; Shah, Nensi; Yadav, Dipendra; Pandey, Prajwal; Dahal, Sweta; Shahi, Rejina; Mishra, Deebya Raj; Bhatta, NarendraAbstract: Varicella infection is a common disease in pediatric age group but is uncommon in adult. Varicella pneumonia is the dreaded complication in these patients leading to mortality, which is more pronounced in adult patients. This is a case report of a young adult male, presenting with Varicella pneumonia in severe hypoxic respiratory failure, which was successfully managed with oxygen therapy, acyclovir, and steroids.