Browsing by Author "Pokharel, S"
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Publication Acute Primary Tuberculous Ulcer of Glans Penis(Kathmandu University, 2019) Pandey, D; Agrawal, S; Pokharel, SABSTRACT Acute primary tuberculous ulcer of glans penis is a rare entity even in the endemic region. We present a 55 year old male with multiple undermined ulcers for short duration of 4 weeks with raised erythrocyte sedimentation rate, negative Mantoux test and histopathology revealed a diagnosis of tuberculous ulcer which responded well to antitubercular therapy. KEY WORDS Acute primary tuberculous, Glans penis, Tuberculous ulcerPublication Assessing the Level of Knowledge in the Preconceptional Use of Folic Acid Supplement among Primigravida Women(Kathmandu University, 2018) Koirala, S; Pokharel, SABSTRACT Background Folic acid deficiency is one of the most common vitamin deficiencies among women of childbearing in developing countries. Folic acid intake prior to, and during, the first months of pregnancy significantly reduces the risk of fetal neural tube defects. Objective To find out the level of knowledge regarding the benefits and use of preconceptional folic acid supplements among pimigravida women. Method A hospital based cross-sectional study was conducted among 250 primigravida women attending obstetric outpatient department of Kathmandu Medical College Teaching Hospital. A pretested questionnaire was administered using systematic random sampling technique and data was analysed by SPSS version 16.0 using descriptive and inferential statistics. Result Study revealed that 10.8% respondents had good knowledge whereas, 65.6% had poor knowledge about preconceptional folic acid supplementation. 87.2% had taken folic acid at some point of pregnancy and 17.6 % of pregnant women had taken preconceptional folic acid. 21.2% had heard about folic acid supplement and 20% had known about benefits of preconceptional folic acid. 17.6% knew that it should be taken one month before conception and 16% answered that it could prevent neural tube defects. Conclusion Majority of primigravida women lack the knowledge of preconceptional folic acid. Most women planning to get pregnant are also not taking folic acid supplementation. KEY WORDS Folic acid, Neural tube defect, Preconception, Primigravida, SupplementPublication Complex Regional Pain Syndrome(Kathmandu University, 2024) Shakya, S; Amatya, S; Thapa, S; Thapa, P; Pokharel, SABSTRACT Complex regional pain syndrome is chronic pain condition involving hyperalgesia and allodynia of extremities. The pathophysiology of CRPS is thought to be combination of different factors that take place at the time of initial injury. Sixty two years female presented to us with severe leg pain after intravenous cannulation during her spine surgery and associated with hyperalgesia and allodynia. On examination, there was shinny skin and nail changes on right leg and significant surface temperature difference between two legs. Patients were managed conservatively with patient education, physical therapy, pharmacological management, and psychological therapy with diagnosis of complex regional pain syndrome. Diagnosis is a clinical finding based on the Budapest diagnostic criteria. Early treatment with multidisciplinary approach to pain management is necessary to achieve complete recovery and prevent damage. Complex regional pain syndrome is life altering condition but understanding the etiological factors helps us to an early diagnosis and a better implementation of treatment. KEY WORDS Allodynia, Budapest criteria, Complex reginal pain syndrome, HyperalgesiaPublication Tearfilm immunoglobulin E (IgE) level in vernal keratoconjunctivitis by ELISA(Kathmandu University, 2009) Pokharel, S; Shah, DN; Joshi, SN; Choudhary, MAbstract Background: Vernal keratoconjunctivitis (VKC) is recurrent chronic allergic conjunctivitis occurring in the prepubertal age-group with secondary involvement of the cornea and is self-limiting in character. The disease is prevalent world- wide but it shows predominance in the areas with dry and warm climate including the South Asia. VKC represents about 3% of the serious ophthalmic disease in some parts of the world where the prevalence is rate is high.Type I hypersensitivity reaction which is IgE-dependent and type IV hypersensitivity reaction have been implicated for the pathogenesis VKC. Objective: To determine level of immunoglobulin E (IgE) in the tear film of patients with Vernal Keratoconjunctivitis (VKC) attending outpatient department of BP Koirala Lions Centre for Ophthalmic Studies (BPKLCOS). Materials and methods: Thirty-four VKC patients and thirty-four controls were included in this study. Tear samples were collected using micro- capillary glass tube method and tear IgE levels were measured using an enzyme – linked immunosorbent assay (ELISA). Results: There was high concentration of tear IgE level in VKC (95.09IU/ml) than in controls (1.63IU/ml) though the difference was not statistically significant (p=0.16). No statistically significant difference was observed in male and female gender within VKC group and when compared with control group (in male group, p=0.21 and in female group, p=0.26). There was no statistically significant difference observed in tear IgE level in different age groups within VKC group and when compared with control group (p=0.30). The result did not show any significant difference in tear IgE level with respect to the duration of the disease (p=0.23).There was no statistically significant difference in tear IgE level with different episodes of VKC (p=0.69). No statistically significant difference of IgE concentration in tear was seen among different types of VKC (p=0.53) and grades of tarsal and limbal papillae (p= 0.72). Conclusion: There was high concentration of tear IgE level observed in VKC. Key words: Vernal keratoconjunctivitis, Tearfilm, IgE level, Type I hypersensitivity reaction, Type IV hupersensitivity reaction.Publication Vernal keratoconjunctivitis: Modes of presentation in Nepalese population(Kathmandu University, 2007) Pokharel, S; Shah, DN; Choudhary, MAbstract Objective: To determine pattern of clinical presentation in Vernal Keratoconjunctivitis (VKC) in our context. Methods: Thirty-four VKC patients were included in this study. Results: The study revealed prepubertal onset with male preponderance and most frequently encountered symptom in the study among VKC cases was itching (100%) followed by redness of eyes and discharge (76.5% each) and the commonest sign was tarsal papillae (100%) followed by conjunctival hyperemia (91%) in 68 eyes of 34 cases of VKC. Conclusion: The clinical presentation of VKC cases in our country is very much similar to the findings of other parts of the world.