Browsing by Author "Pokhrel, DB"
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Publication Apocrine Carcinoma Developing in a Naevus Sebaceous of Scalp(Kathmandu University, 2012) Paudel, U; Jha, A; Pokhrel, DB; Gurung, D; Parajuli, S; Pant, AABSTRACT 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.Publication Assessment and Comparison of Quality of Life in Patients with Melasma and Vitiligo(Kathmandu University, 2019) Amatya, B; Pokhrel, DBABSTRACT Background Melasma is an acquired hyperpigmentary condition that is characterized by development of irregular brown to black macules occurring predominantly on the face. Vitiligo is an acquired depigmenting skin disease characterized by progressive loss of inherited skin colour, which leads to appearance of white patches. Both the conditions occur more frequently in people with racially pigmented skin resulting in psychological morbidities and impacting the quality of life. Objective To evaluate and compare the quality of life in patients suffering from melasma or vitiligo, which represent two opposite ends of pigmentary disorders using the Dermatology Life Quality Index (DLQI). Method This was a hospital based cross sectional study that was conducted at the Department of Dermatology and Venereology, Tribhuwan University Teaching Hospital from September 2016 to August 2017. The study population included adult patients of either sex with melasma or vitiligo, who consented to participate in the study. Result There were a total of 100 patients each in both melasma and vitiligo groups. While females outnumbered their male counterparts by a ratio of 9:1 in melasma, the gender distribution was more equal in vitiligo. Melasma had a mean DLQI score of 5.64 ± 5.41 and a median score of 4 while vitiligo had a mean DLQI score of 4.13 ± 3.74 and a median score of 3. Conclusion Melasma patients had a higher impairment in quality of life compared to vitiligo patients. The quality of life in both the conditions varied based on age, gender, duration and distribution. KEY WORDS Comparison, Dermatology Life Quality Index, Melasma, Quality of Life, VitiligoPublication Awareness about Sexually Transmitted Infections and Human Immunodeficiency Virus Infection among Patients with Genital Symptoms(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2017) Gyawalee, Madhu; Paudyal, BP; Pokhrel, DBAbstract: Introduction: Sexually transmitted infections (STIs) are a major cause of public health problem. In developing countries, human immunodeficiency virus (HIV) infection is spreading rapidly, with sexually transmitted infections acting as a cofactor for the spread of HIV. Yet adequate awareness regarding these infections is lacking. Objective: To explore the knowledge and awareness about STIs and HIV infection in patients visiting Dermatology and Venereology Clinic of Institute of Medicine, Tribhuvan University Teaching Hospital (TUTH) with genital symptoms. Material and Methods: A cross sectional descriptive study was carried out in the department of dermato-venereology, TUTH for a period of one year. Total of 130 consecutive cases were enrolled. After taking consent and assuring confidentiality they were interviewed regarding awareness of STIs and HIV/AIDS. Results: Out of 130 cases, 95% and 98.5% had heard of an STI and HIV/AIDS respectively. Only 43.8% could mention discharge from genitalia as a symptom of STI whereas 38.5% could mention none. Most (91.5%) knew about the sexual mode of transmission of both STIs and HIV. None could mention about mother to child transmission of an STI, whereas 15% knew that an infected mother can transmit HIV to her baby. About 58% were aware that condoms could protect them from acquiring an STI, 63% perceived this as best method of prevention from HIV. When only 26% knew that being faithful to one partner is the best mode of prevention from an STI, 45% mentioned avoiding contact with multiple partners could prevent them from HIV transmission. Conclusions: Awareness programme on STIs as a whole could improve knowledge and awareness on HIV and STIs and hence prevent both. Keywords: knowledge, awareness, STIs, HIVPublication 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, DBNo Abstract Keywords: Antibiotic sensitivity pattern, bacteriological profile, PyodermasPublication Cutaneous Leishmaniasis in Natives of Central Region of Nepal(Kathmandu University, 2019) Paudel, U; Parajuli, S; Poudel, AS; Paudel, V; Pokhrel, DBABSTRACT 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, MiltefosinePublication 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, DBNo Abstract Keywords: Inpatient dermatology, patterns, NepalPublication Pachydermoperiostosis ('Touraine-Solente-Gole' Syndrome)(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2013) Sharma, R; Pandey, S; Choudhary, D; Pokhrel, DBNo Abstract Keywords: Pachydermia, primary hypertrophic osteoarthropathy, clubbingPublication Pattern Of Sexually Transmitted Infections And Sexual Behavior In Patients With Genital Symptoms(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2014) Gyawalee, M; Pokhrel, DBAbstract: Background: Sexually transmitted infections are a major cause of acute illness, infertility, long-term disability, economic loss and death throughout the world. Despite the availability of effective treatment and preventive measures, incidence of STIs is increasing even in developed countries. STIs, acting as a facilitator for the spread of HIV have become a globally important issue at present context. Objectives: To determine the pattern of sexually transmitted infections along with their sexual behaviour in patients presenting with genital symptoms. Material and Methods: A cross sectional, descriptive study was carried out in the department of dermato-venereology, TUTH. During one year period, a total of 130 consecutive cases were enrolled in this study. The diagnosis of infections was made clinically with relevant laboratory investigations and they were interviewed for their sexual behaviour after taking consent and assuring confidentiality. Results: The average age of this population was 27.84 years. Majority belonged to age group 15-24 years, with male to female ratio of 3.19:1. Many (52.3%) were married. The most common infection was condyloma accuminata (29.2%). The mean age of sex debut was 18.95 years and majority (50.8%) belonged to 15-19 years group. The median number of life time partners was 2.0. Only 43 (33.1%) were on monogamous relationship. The 15-34 age groups had maximum number of sexual partners. Married person living singly had more frequent extramarital contact. Only 10 (7.7%) used condom consistently. Conclusions: Younger people should be educated about monogamous relationship along with correct and consistent use of condom for the prevention of STIs Keywords: Sexually transmitted infections, Sexual behaviorPublication 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, DBAbstract: 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 necrolysisPublication Sexually Transmitted Infections, Sexuality and STI Stigma among Nepalese youth and adults(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2009) Pokhrel, DBAbstract: NAPublication Sexually Transmitted Infections, Sexuality and STI Stigma among Nepalese youth and adults(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2009) Pokhrel, DBAbstract NA