Browsing by Author "Pokharel, A"
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Publication Pemphigus herpetiformis : A rare clinical variant of pemphigus(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2015) Shrestha, P; Tajhya, R B; Pokharel, AAbstract: Pemphigus herpetiformis is an autoimmune blistering disease. We report a case of pemphigus herpetiformis, a generalized form, manifested as pruritic grouped vesicles at extremities and trunk, in a seventy years old man. Neutrophil dominant inflammatory substrate was seen in histopathology. Direct immunofluorescene revealed IgG reactivity in net like pattern at upper epidermis, confirming pemphigus. The patient responded well to prednisolone and colchicine combination initially and maintained remission later on colchicine alone. Colchicine has anti-mitotic, anti-inflammatory and immunosuppressive mechanism of actions and proven benefits in neutrophilic dermatoses. Therefore we recommend colchicine as mono therapy or in combination with immunosuppressive, for the treatment of pemphigus herpetiformis where neutrophil is predominant inflammatory infiltrate histologically. Keywords: Pemphigus, Herpetiform, Pruritic, VesiclesPublication Prescribing regimens of prophylactic antibiotic used in different surgeries(Kathmandu University, 2004) Palikhe, N; Pokharel, AAim and Objective: The main objective was to study the different types of regimen of prophylactic antibiotic in different surgeries in hospitals of western region, particularly, Pokhara valley and the hospitals were Western Regional Hospital (WRH) and Manipal Teaching Hospital (MTH). Methodology: A descriptive, quantitative, retrospective study were used to evaluate the patients’ undergone surgery in the year 2059 BS (15 th April 2002 – 14 th April 2003). The total of 950 patients, 450 from WRH and 500 from MTH were taken from the medical record for the study. Data about different types of prophylactic antibiotic regimen was collected. Conclusion: The most common surgery in MTH is dilatation and curettage (D and C) and in WRH is caesarean section (CS). In both hospitals Ampicillin+Cloxacillin was the most commonly used regimen, 12.4% in WRH and 34% in MTH. In WRH ciprofloxacin and cefotaxime was also used by 12.4%. Ciprofloxacin and gentamicin (12%) combination was the third commonly used regimen in WRH where as ciprofloxacin (28.4%), Ampi+Cloxa and gentamicin (22.4%) in MTH. Key words: Antibiotic prophylaxis, SurgeryPublication Study on Developmental- Behavioural Pediatrics Training Experiences of Pediatricians and Pediatric Trainees Working in Nepal(Kathmandu University, 2013) Rimal, HS; Pokharel, A; Saha, VABSTRACT Background There are growing concerns about developmental, behavioural, social and emotional wellbeing of children throughout the world. A huge gap exists between the instructions provided on medical disciplines and on areas of Developmental- Behavioural Pediatrics (DBP) during pediatric training in our region. Objective This study aims to evaluate the Developmental –Behavioural pediatrics (DBP) training experiences of pediatricians and pediatric trainees during their post graduate training in pediatrics. Methods Questionnaires were sent to the pediatricians / trainees and data was analyzed using SPSS software. Result More than 56 % of respondents were satisfied in 10 out of 11 medical disciplines where as more than 56% were unsatisfied in 10 out of 11 developmental behavioural pediatrics disciplines. This Study has demonstrated that between 50-60 % of pediatricians did not see the cases of ADHD, Learning difficulty and family dysfunction for a period of three months prior to the survey which are relatively common conditions. Even in post graduate training nearly 66 % of pediatricians were unsatisfied with their instructions in DB pediatrics. Conclusion Pediatricians working in Nepal have difficulties in addressing the issues of developmental pediatrics, raising a question about the need to review the curriculum of post graduate training in Pediatrics. KEY WORDS Developmental pediatrics, evaluation, multidisciplinary team, training