Browsing by Author "Parajuli, Sudip"
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Publication A Clinical Study of Steroid Induced Dermatoses(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2018) Parajuli, Sudip; Paudel, Upama; Poudyal, Amod Kumar; Pokhrel, Dinesh BinodAbstract: Introduction: Steroid induced dermatoses on face are one of the common presentations in Dermatological practice. Objectives: 1) Understand the clinical patterns of adverse effects of long term abuse of topical steroid on face and 2) Assess the factor which promotes its abuse. Materials and Methods: This was a descriptive exploratory cross-sectional study carried out from December, 2013 through November, 2014. A total of 39 patients fulfilling the inclusion criteria were enrolled into the study. All the study variables were recorded using preformed structured questionnaire and analyzed. Results: The following effects of steroid abuse on face were seen: pruritus (38.5%), burning (15.4%), eythema (74.4%), telangiectasias (66.7%), acneiform eruptions (59%), comedones (35.9%), xerosis (55.1%), photosensitivity (51.3%), rebound phenomenon (38.5%) and others (38.5%). Most of them used steroids on recommendation of their friends (38.5%) and pharmacists (20.5%). All of them used steroid for different dermatoses on their face. Limitations: This is a hospital-based small-scale study and might not be true picture of problem in the community. Conclusion: Long term use of steroid on face results in different clinical presentations. Most of the patients used steroid on recommendation of their friends facilitated by easy availability of the drug over- the -counter. Keywords: Comedones, erythema, non prescription drugs, papules, pustules, rosacea, steroidsPublication 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, NepalPublication Leprosy in Post Elimination Period: An Experience in a Single Tertiary Care Centre in Kathmandu, Nepal(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2019) Paudel, Upama; Parajuli, SudipAbstract: Introduction: Leprosy elimination was declared by Government of Nepal almost a decade back. Objective: To evaluate the clinical and epidemiological profiles of leprosy patients in post elimination period Material and Methods: Analysis of medical records of all clinically diagnosed and newly registered cases of leprosy attending Dermatology outpatient department of Tribhuvan University Teaching Hospital, Kathmandu, Nepal from 1st April 2017 to 31st March 2018 was done. Results: Hospital based prevalence of Leprosy was found to be 0.24%, with males outnumbering females (63.6% vs 36.4%).The most common age group affected was 45-59 years with hypo-aesthetic patches/plaques and erythematous anaesthetic /hypoaesthetic patches (36.4% each) being the most common presentation. Overall, borderline leprosy was the most common diagnosis (borderline tuberculoid ,29.5% , borderline borderline, 6.8%, borderline lepromatous,11.36%). Slit skin smear positivity was found in 50% of cases. Conclusion: Leprosy still remains a challenge for clinicians in Nepal though elimination has been achieved. A constant evaluation, monitoring and case detection should be still pursued with health education in order to make timely diagnosis and prevent deformities. Keywords: Leprosy, Nepal, Public healthPublication Severity of Stress in Acne Patients Attending Dermatology Outpatient Department of Tertiary Hospital in Kathmandu(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2021) Shrestha, Amrita; Pokhrel, Dinesh Binod; Parajuli, Sudip; Chapagain, Manisha; Shrestha, RabinaAbstract: Introduction: Stress persists when a person is unable to cope with the situations of the past, present or future. Stress may be associated with physical and psychological abnormalities. Acne vulgaris is a chronic inflammatory disease of the pilo-sebaceous units with prevalence of more than 85% in adolescent age group. Materials and Methods: Three hundred one patients were recruited in the study. Inclusion criteria included new acne patients of age 16 years and above as well as those who were using but not improving with topical or oral acne therapies. Exclusion criteria included patients receiving sedatives, antidepressants, or glucocorticoids, patient suffering from chronic illnesses like diabetes, hypothyroidism, chronic kidney disease, migraine and other diseases. This questionnaire included biodata of the patients, clinical history and their perceived stress scale. Global Acne Grading System (GAGS) was used to assess acne severity in relation to stress using the Perceived Stress Scale (PSS). Results: The results indicated an increase in stress severity positively correlated with an increase in acne severity, which was statistically significant (p<0.01). Most of the patients were students. Subjects with higher stress scores, determined using the PSS, had higher acne severity when examined and graded using the GAGS. Conclusions: The results showed that there is a positive correlation between severity of stress and grade of acne. Stress management should be a part of acne management. Keywords: Acne, Severity, StressPublication SODVELON News, Events and Transactions(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2012) Parajuli, SudipNA Keywords: SODVELON, Nepa