Browsing by Author "Paudel, Vikash"
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Publication Clinico-mycological Study of Dermatophytosis and Their Antifungal Susceptibility, A Hospital Based Study(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2021) Pradhan, Manish Bhakta; Paudel, VikashAbstract: Background: Dermatophytosis refers to superficial fungal infections of keratinized tissues caused by keratinophilic dermatophytes. It is the most common of the superficial fungal infections. Nowadays, these fungal infections are at a rise and run a prolonged course despite of treatment due to resistance to conventional antifungal agents. There is a felt need to conduct an epidemiological studies to know the change in the pattern and causes of widespread resistance. Objectives: This study was aimed at identifying clinico-mycological patterns of dermatophytic infections in patients attending the dermatology outpatient department of a tertiary care hospital in Birgunj and the adjoining areas. Methods: The study included cases of clinically diagnosed dermatophytosis from the outpatient department of Dermatology of National Medical College, Birgunj. Clinical and epidemiological data were collected as per proforma and skin scraping, hair plucking, and nail clipping were done and materials were examined microscopically by KOH mount then cultured on Sabouraud dextrose agar and antifungal susceptibility were done by disk diffusion test. Results: here were 349 patients recruited in the study, with a male: female ratio of 1.6:1. The most commonly affected age group was 20–29 years (27.3%). Tinea corporis was the most common type observed (38.1%). Potassium hydroxide positivity was seen in 228 samples (65.3%) and culture positivity was found in 202 samples (57.9%). The most common species identified was Trichophyton rubrum (55%). The most sensitive drug was itraconazole, and more number of resistances was noted with fluconazole. Conclusion: Dermatophytic infection is ecumenical in distribution with increased frequency in tropical and subtropical countries with variable epidemiology. Inadequate and irregular use of antifungal drugs has led to the emergence of resistant strains, which cause poor treatment outcomes. Thus, it is essential to test for antifungal sensitivity to check for resistance to antifungals. Keywords: Dermatophyte, Dermatophytosis, Tinea, Trichophyton, Antifungal susceptibilityPublication COVID-19 and Dermatologist: A Scenario from Nepal(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2021) Thapa, Deeptara Pathak; Paudel, VikashAbstract: Corona virus disease-2019 (COVID-19) had impacted the healthcare sector severely. The impact of pandemic had a foothold even on dermatology practice and dermatology residency teaching programs. Patients with dermatological diseases, few diseases arising due to COVID-19 and patients with immunosuppressive for chronic dermatological conditions were affected. In the midst of this pandemic, all dermatologist should learn and contribute to the mankind with precaution at all level either in healthcare or society.Publication Dexamethasone Pulse Therapy in Pemphigus Vulgaris Associated Myocardial Infarction in Resource-Limited Settings(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2022) Paudel, VikashAbstract: Pemphigus vulgaris is an autoimmune blistering disorder where biologics are the cornerstone of therapy. In resource-limited settings, a dermatologist should rely on systemic steroids. Dexamethasone pulse therapy is a cheap and established treatment of pemphigus where a supra-pharmacological dose of dexamethasone is used. High dose of dexamethasone is supposed to have atherogenic potential which could promote a hypercoagulable state. Here, we report a case of a 30-year-old woman in the resource-limited setting of Nepal, who was under monthly dexamethasone pulse therapy for pemphigus vulgaris, who had an acute episode of ST-segment elevated myocardial infarction. In such setting, although steroids are the cornerstone of therapy in various disorders, physicians should be equally cautious in using a high dose of steroids which might lead to fatal complications. This could probably be the first case report of steroid-induced acute myocardial infarction during treatment of pemphigus worldwide.Publication Incorporating and Emphasizing Sexual Health in Medical Curriculum of Nepal: Need of the Hour(Nepal Medical Association, 2022) Poudel, Reet; Paudel, VikashAbstract Sexual health requires a positive and respectful approach to sexuality and sexual relationships. It is one of the most neglected parts of an individual's health. Sexual health is not adequately covered in the medical education curriculum of Nepal. There is a lack of clinicians practising sexual medicine, which provides a fertile field for quacks in this arena. Sexual health needs to be included and incorporated into medical education. The policymakers and stakeholders need to address this need in sexual health urgently and effeciently. Comprehensive sexual education should be included for children, adolescents and young adults.Publication Letter to Editor on Dual Anti-Epileptics Induced Stevens-Johnson Syndrome: A Case Report(Nepal Medical Association, 2024) Paudel, VikashPublication Prevalence of Venereophobia among Patients of Non-Venereal Genital Conditions- a Cross-Sectional Hospital Based Study from Nepal(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2021) Paudel, Vikash; Chudal, Deepa; Paudel, Upama; Shrestha, Dwarika PrasadAbstract: Background Venereophobia is the fear of getting venereal diseases or sexually transmitted diseases. This study was carried out to determine the prevalence and describe the varying clinical pattern of dermatoses among patients with venereophobia in non-venereal genital conditions. Materials and Methods This was a hospital-based, prospective, cross-sectional observational study conducted in a tertiary center in Kathmandu, Nepal, over a period of one year. A nonprobability purposive convenient sampling technique was used to select the samples. Two hundred patients were enrolled in the study. Ethical approval was taken prior to the study. A detailed history along with a complete cutaneous examination was carried out in all patients and recorded in preformed proforma. Patients with symptoms and clinical signs of sexually transmitted infections were excluded from the study. Results The prevalence of venereophobia among non-venereal dermatosis was 18%. The mean age of the patient with non-venereal genital dermatosis was 29.5 ± 15 years. The male to female ratio was 17:2. About 72% of the total patients were married. The most common symptoms of patients with venereophobia were genital itching, whereas about 44% were asymptomatic. The common dermatological disorders associated with venereophobia were pearly penile papules, genital vitiligo, irritant contact dermatitis. Three fourth of the patient with venereophobia had multiple sexual exposures. Conclusions Venereophobia is an important issue to be focused on patients with genital dermatosis and a significant number of patients might have venereophobia even in non-venereal genital dermatoses. A proper genital and psychiatric evaluation might prevent misdiagnosis and complications.Publication Tele-Dermatology in Clinical Management of Suspected Cutaneous Leishmaniasis in COVID-19 Pandemic(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2020) Paudel, VikashAbstract: The COVID-19 pandemic has changed the world dynamics in various prospects. It led to the restricted mobility of dermatological patients and helped telemedicine platform to flourish than ever. Though teledermatology has its own pros and cons, it’s being used in treatment of various skin disorders. Cutaneous leishmaniasis is an emerging disease in Nepal whose diagnosis is primarily clinical and histological. We are reporting a case of suspected cutaneous leishmaniasis from far western hilly region of Nepal who was empirically treated with fluconazole with the help of teledermatology platform with outstand outcomes. Keywords: COVID-19; Fluconazole; Leishmaniasis, Cutaneous; Pandemics; TelemedicinePublication The Challenges of COVID-19 in Medical Education in Nepal(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2021) Paudel, Vikash; Neupane, SaraswotiAbstract: The Coronavirus Disease-2019 (COVID-19) pandemic has caused an unparalleled disruption in all forms of scientific learning process including medical education. It has presented a challenge for scientists, educators, and students.Widespread interruptions to medical education, scientific discussions, conference, and seminars have also been seen at times of major conflicts and pandemics in the past as well, which resulted in major changes in medical curriculum. This editorial discusses the medical education and how COVID-19 has affected medical education in Nepal. Besides, it also explores the potential implications of COVID-19 for the future of medical education. Keywords: COVID-19, Education, Medical, Pandemics, Nepal