NepMed Repository :: Browsing by Author "Parajuli, S"

Browsing by Author "Parajuli, S"

Now showing 1 - 15 of 15

Apocrine Carcinoma Developing in a Naevus Sebaceous of Scalp
(Kathmandu University, 2012) Paudel, U; Jha, A; Pokhrel, DB; Gurung, D; Parajuli, S; Pant, A
ABSTRACT Apocrine skin carcinoma is an aggressive cutaneous tumour. We report a case of apocrine carcinoma developing in a naevus sebaceous of scalp in a 45 years old male. Malignant transformation of Naevus sebaceous is a rare complication usually found in elderly patients. Most of these tumours are basal cell carcinoma or squamous cell carcinoma. Only few cases of apocrine carcinoma on naevus sebaceous have been previously reported. This report highlights the potential of naevus sebaceous for malignant transformation. KEY WORDS Apocrine, Basal cell carcinoma, carcinoma, hamartoma, nevus, Sebaceous of Jadassohn, skin.
Chronic Spontaneous Urticaria: Clinical Profile, Autologous Serum Skin Test Positivity and Associated Impairment in Quality of Life in Nepalese Patients
(Kathmandu University, 2022) Paudel, S; Parajuli, N; Sharma, R; Parajuli, S
ABSTRACT Background Chronic Spontaneous Urticaria is considered to be an autoimmune phenomenon in half of the total cases. Autologous serum skin test is a simple screening test for the presence of auto-antibodies in chronic urticaria. Significant impairment in quality of life have been observed in autologous serum skin test positive cases. There are limited literatures on chronic spontaneous urticaria, autologous serum skin test and associated Dermatology Life Quality Index in Nepal till date. Objective To find the proportion of autologous serum skin test positive cases in chronic urticaria and impairment in quality of life in such patients. Method This was a retrospective review of outpatient records of patients diagnosed with chronic spontaneous urticaria, from January 2018 to December 2019, from a tertiary care hospital in Kathmandu, Nepal. Details of the patients, autologous serum skin test and dermatology life quality index scores were analyzed and presented. Result Among the total 114 cases positive autologous serum skin test was seen in 48.2% of cases. The mean total Dermatology Life Quality Index score was 8.06±6.64. A significantly higher quality of life impairment was observed in in patients with positive autologous serum skin test as compared to the negative ones. The odds of finding a positive autologous serum skin test in patients with angioedema was 2.1, however the difference was not statistically significant. Conclusion Chronic spontaneous urticaria was more common in females as compared to males. A positive autologous serum skin test was present in half of the patients which was in turn associated with a greater impairment of quality of life. KEY WORDS Autologous serum skin test, Chronic urticaria, Dermatology life quality index, Quality of life
Clinical and Endoscopic Findings in Patients Presenting with Upper Gastrointestinal Bleeding at a Tertiary Care Hospital
(Kathmandu University, 2024) Sharma, P; Sapkota, P; Pathak, S; Lamsal, A; Joshi, S; Parajuli, S; Rajak, S; Gautam, S; Tamang, A
ABSTRACT Background Upper gastrointestinal (UGI) bleeding is a severe medical condition that requires prompt evaluation and management. Understanding the clinical and endoscopic findings in patients presenting with upper gastrointestinal bleeding is essential for accurate diagnosis and effective treatment. Objective To investigate the age and sex composition, clinical presentations, and endoscopic findings of patients with upper gastrointestinal bleeding at a tertiary care hospital. Method A total of 561 patients with upper gastrointestinal bleeding were included in the study. Data on age, sex, and clinical presentation were collected for each patient. Endoscopic findings were recorded, and the relative frequency of various upper gastrointestinal lesions was analyzed. Result The age distribution of patients revealed that 40.82% were between 15 and 45 years, 32.98% were aged 46 to 65 years, and 26.20% were above 65 years. Among the patients, 73.08% were male and 26.92% were female. Hematemesis was observed in 248 cases, while melena was present in 136 cases, and both were present in 171 cases. Recent onset anemia with positive occult blood was reported in 6 patients. The most common endoscopic finding was varices (39.39%), followed by ulcers (15.51%). Mallory Weiss tear was noted in 5.53% of cases. Conclusion According to our findings, varices are the most common endoscopic finding in individuals with upper gastrointestinal bleeding rather than peptic ulcer disease. The considerable increase in varices emphasizes the critical importance of early identification and care in high-risk individuals, as well as contributing to a better understanding of upper gastrointestinal bleeding. KEY WORDS Bleeding, Endoscopy, Esophageal varices, Gastric varices, Gastrointestinal hemorrhage, Upper gastrointestinal tract
Clinical and Pathological Features of Primary Cutaneous Lymphomas in Nepal: A retrospective cohort study from a dermatology referral centre
(Kathmandu University, 2024) Paudel, U; Parajuli, S
ABSTRACT Background Primary cutaneous lymphomas (PCLs) are rare diagnoses in Nepal and are not well characterized till date. Objective To evaluate clinical and pathological features of Primary cutaneous lymphomas in Nepal. Method We retrospectively reviewed outpatient and inpatient records of a dermatology referral centre of Kathmandu, Nepal for clinical and pathological findings of cases diagnosed as cutaneous lymphomas from July 2010 through July 2020. The final diagnosis was made based on 2008 World Health Organization classification and its update 2018. Result There were 12 cases of Primary cutaneous lymphomas diagnosed during this period. The age of presentation ranged from 19 years to 81 years (Mean: 53.4 years ± 21.5 years, SD). There were ten cases of cutaneous T-cell lymphoma (CTCLs) and two cases of cutaneous B- cell lymphomas (CBCLs). Among cutaneous T-cell lymphoma, there were four cases of primary cutaneous anaplastic large- cell Lymphoma (PCALCL), two cases of classic (patch/plaque) mycosis fungoides (MF), two cases of folliculotropic mycosis fungoides (FMF), and one case each of primary cutaneous aggressive epidermotropicCD8+ T-cell lymphoma and lymphomatoid papulosis. Among cutaneous B- cell lymphomas, there was one case of primary cutaneous marginal zone B- cell lymphoma, and one case of primary cutaneous follicle centre lymphoma. Most cases of MF presented at stage IB (75%), and three patients of primary cutaneous lymphomas died during this period. Conclusion Primary cutaneous lymphomas appear to be very rare in this study and presentations ranged from classic Mycoses Fungoides to aggressive T-cell lymphomas. Cutaneous T-cell lymphomas appeared to be more common than cutaneous B- cell lymphomas in this study. KEY WORDS Anaplastic, B-cell, Cutaneous, Lymphoma, T-Cell
Clinico-bacteriological profile and antibiotic sensitivity pattern in pyodermas: A Hospital Based Study
(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2013) Paudel, U; Parajuli, S; Pokhrel, DB
No Abstract Keywords: Antibiotic sensitivity pattern, bacteriological profile, Pyodermas
Cutaneous Leishmaniasis in Natives of Central Region of Nepal
(Kathmandu University, 2019) Paudel, U; Parajuli, S; Poudel, AS; Paudel, V; Pokhrel, DB
ABSTRACT We report two cases of cutaneous leishmaniasis in natives of central region of Nepal. The first patient in our series, an adult female, presented with a small nodule on the philtrum of upper lip and the second case, a male child, presented with two crusted plaques on forehead. The final diagnosis was based on histopathological findings; however, species characterization was not possible because of its unavailability in the country. These patients responded well to the treatment with Miltefosine (First case) and Fluconazole (second case). Moreover, these cases sparks a question about the origin of diseases in this region and calls for further research in future to find out the cause and prevalence of this disease in Nepal. This case report also emphasizes to consider cutaneous leishmaniasis as differential diagnosis for granulomatous presentations in our context. KEY WORDS Cutaneous leishmaniasis, Fluconazole, Miltefosine
In patient dermatology: characteristics of patients and admissions in Tribhuvan University (TU) Teaching Hospital
(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2013) Parajuli, S; Paudel, U; Pokhrel, DB
No Abstract Keywords: Inpatient dermatology, patterns, Nepal
Intermediate syndrome in organophosphorous poisoning-A case report
(Kathmandu University, 2005) Parajuli, S; Jayakumar, J; Dham, SK
A case of organophosphorous poisoning in a 29 year old male who developed intermediate syndrome manifested by features of respiratory depression as evidenced by marked weakness of the respiratory muscles, tachypnoea, and drop in oxygen saturation despite reversal of nicotinic and muscarinic effects of organophosphorous poisoning. The case highlights its early recognition and prompt institution of mechanical ventilation with continuation of anticholinergic drugs. The mechanical ventilation had to be continued for 9 days with successful outcome.
Leflunomide Induced DRESS Syndrome: A Case Report
(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2012) Parajuli, S; Chaudhary, D; Pandey, S; Baral, S; Pokhrel, D B
NA Keywords: Leflunomide, Dress syndrome
Managing Deep Mycoses in Nepal is still a challenge: case report of actinomycetoma, a neglected tropical disease
(Institute of Medicine, 2018) Paudel, U; Sharma, R; Parajuli, S
Abstract Deep mycoses are frequent diagnoses in Nepal. Most of the cases remain undiagnosed because of unavailability of specific diagnostic services in our setting. We report a case of deep mycosis, in a 60-year-old male, who presented with multiple nodules and scars on his neck and chest, and was histopathologically diagnosed as actinomycosis.The culture was negative. The patient did not respond to treatment with penicillin initially, however, on starting co-Trimoxazole , the lesions resolved in two months, thus pointing towards diagnosis of actinomycetoma. The patient remained disease free at last follow- up at two years. The case highlights importance of considering actinomycetoma as one of the differential diagnosis of such presentation and also need of developing well set reference laboratory in order to reach to a proper diagnosis. Key words: Actinomycetoma, cotrimoxazole, deep mycoses, Neglected diseases
Non-necrotising Scleritis and Spherophakia in Marfan Syndrome: A Rare Situation Adhering to Hickam’s Dictum
(Kathmandu University, 2025) Parajuli, S; Sharma, S; Shrestha, R; Chapagain, S
ABSTRACT Marfan syndrome is an autosomal dominant, connective tissue disorder that affects various systems of the body including the eyes. We present a case of a 22 year old man with Marfan syndrome presented with a painful red left eye. On examination he was diagnosed to have non-necrotising scleritis and microspherophakia. Non-necrotising scleritis with microspherophakia is a rare and arduous situation. This is an interesting case where Hickam’s dictum prevails over its counter argument of Occam’s razor principle. KEY WORDS Marfan syndrome, Non-necrotising scleritis, Spherophakia
Patterns and Outcomes of Cutaneous Adverse Drug Reactions in a Hospital Based Study
(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2017) Paudel, Upama; Parajuli, S; Pokhrel, DB
Abstract: Introduction : Drug reactions are one of the common reasons for admission in the Dermatological beds. Data on the culprit drugs and patterns of reaction are very scarce in Nepal. Objective:To determine the patterns of drug reactions admitted in Tribhuwan University (TU) Teaching hospital, the causes of drug reactions, duration of hospital stay, duration of steroid use and the outcome of the treatment. Material and Methods: This was a retrospective study done in TU Teaching Hospital. The admissions and discharge record of admitted patients from 15th April 2008 to 14th April 2012 were analyzed for the variables mentioned above. Results: There were 61 new patients of drug reactions; however only files of 42 patients could be studied.The mean age of the patients was 32.26 ± 15.26 with male to female ratio of 1.8:1. Stevens Johnson’s syndrome (35.7%) was the commonest cause of admission followed by drug induced erythroderma (16.7%) and toxic epidermal necrolysis (11.9%). Carbamazepine, Phenytoin and allopurinol were the most common drugs for the reactions. The median time for the appearance of the lesions was 20.07 days. The median duration of hospital stay was 7 days. Steroids were used for initial treatment for around 4.9 ± 1.7 days. 83.3% of the patients improved while 11.9% succumbed despite optimal management. Conclusion: Severe drug reactions were the common reasons for admissions in our hospital. Anti-epileptics were the leading cause for the reactions. Steroids were used for initial period and rapidly tapered off in short duration. Overall, the outcomes of the treatment were good. Keywords: cutaneous drug reactions, steroids, steven-johnson syndrome, toxic epidermal necrolysis
Photophobia as a Presenting Feature in Adie’s Tonic Pupil
(Kathmandu university, 2022) Parajuli, S; Sharma, S; Shrestha, R; Chapagain, S; Singh, P; Shrestha, R
ABSTRACT A 34 years old female presented with complains of photophobia since 6-7 months. On examination, she had anisocoria of 4 mm in room light which increased in bright light. The left pupil was dilated and unresponsive to direct and indirect light stimuli. It did however, constrict slowly on near fixation followed by slow re- dilatation on distance fixation. A diagnosis of Adie’s tonic pupil was made since left pupil constricted with instillation of dilute pilocarpine 0.1%. Her symptoms of photophobia and blurred vision immediately resolved. Photochromatic glasses and dilute pilocarpine 0.1% three times a day were prescribed. Prompt symptomatic relief of photophobia and blurred vision was observed. KEY WORDS Adie’s, Anisocoria, Dilated pupil
Profile of Vitiligo in Western Nepal
(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2010) Kumar, A; Neupane, S; Parajuli, S; Gurung, D
Abstract Background Vitiligo is common worldwide. The highest incidence is reported from Indian subcontinent. However, there are only few studies available on epidemiology of vitiligo from Nepal Objective To determine the clinical patterns of vitiligo, the associated sociodemographic factors and its associated disorders among patients attending dermatology outpatient department of Manipal Teaching Hospital, Gandaki Medical College Teaching Hospital and Fishtail Hospital and Research Center Pokhara. Methods All patients presenting with signs and symptoms suggestive of vitiligo over a period of one-year (from march 2009 to march 2010 ) at the out-patient clinics in the Dermatology Department of Manipal Teaching Hospital, Gandaki Medical College Teaching Hospital and Fishtail Hospital and Research Center, Pokhara were included in the study. Socio-demographic details regarding age, sex, marital status, education and occupation were recorded .A detailed clinical history related to the presenting complain and clinical examination findings were recorded. Relevant available investigations were ordered based on signs and symptoms to determine if any associated disorders. Results Two hundred and twenty four patients with clinical diagnosis of vitiligo were studied. Males constituted 102 (45%) patients and females 122 (55%) of the total number of patients. Duration of disease at the time of presentation ranged from two weeks to 40 years. The lower limb was the initial site of onset of vitiligo in majority 77 (34.37%) of the patients, followed by the upper limbs, head and neck, trunk and mucosae in decreasing order of frequency. The commonest clinical pattern found was vitiligo vulgaris followed by acrofacial, segmental and mucosal types. Lesions showing leukotrichia were observed in 40 (18.87%) patients and koebnerization was observed in 42 (18.75%) patients. Eleven children had halo nevi. Associated abnormalities included alopecia areata (13 patients), diabetes mellitus (12 patients) and one patient had atopic dermatitis. A positive family history was obtained in 14(6.25%) of the patients. Conclusion Vitiligo vulgaris is on of the common clinical-type skin disorder observed in Nepal. There w e re associated disorders/abnormalities in some patients such as alopecia areata , diabetes mellitus and atopic dermatitis. Keywords Clinical Profile; Vitiligo; Western Nepal.
Study on Acute Renal Colic and Comparison of Diclofenac and Ketorolac in Pain Management in University Hospital, Kavre, Nepal
(Kathmandu University, 2019) Shrestha, SK; Parajuli, S; Nyaupane, SP; Joshi, HN
ABSTRACT Background Acute renal colic is the most frequent clinical presentations of renal stone and a common cause of patient visits to emergency departments worldwide. The prevalence of the renal stone disease has increased steadily over the past decades. Objective To describe the prevalence, epidemiological features and clinical management of renal colic patients at emergency department in Kathmandu University Hospital, Kavre, Nepal. Method Two hundred and thirty-six patients with acute renal colic presented in emergency department during a six-months period were included in the study. Using a standard predesigned proforma, demographic characteristics, presenting symptoms, practice of pain management and outcome were investigated. Renal colic attacks in patients were defined according to International Classification of Diseases, Tenth Revision, and Clinical Modification-10. Result Prevalence of renal colic was 2.61%. Mean age of the patients was 33.9±13.7 years. More than half of participants were male (54%). Majority of the patients (47.9%) were from Kavrepalanchowk district. The most common presenting symptom of the patients was flank pain on affected side (79.2%). In almost 43% of patients, diclofenac sodium was administered as a first line analgesic. There was no significant difference between diclofenac and ketolorac with respect to the need of second line analgesic (Chi-square value: 0.19, p value = 0.664). Conclusion Prevalence of renal colic was 2.61% at Dhulikhel hospital. More male pateints were affected and the most common presenting symptom was flank pain on the affected. Diclofenac and ketorolac are equally effective for the pain management of renal colic patients. KEY WORDS Diclofenac, Emergency department, Epidemiology, Renal colic

Browsing by Author "Parajuli, S"

Results Per Page

Sort Options