Browsing by Author "Rijal, A."
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Publication Common Contact Sensitizers among Patients with Hand Eczema: A Multicenter-Study in Nepal(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2016) Bhattarai, S.; Rijal, A.; Agrawal, S.Abstract: Introduction: Allergic contact dermatitis in Nepal is not an uncommon disorder. Patch testing is a well established method of diagnosing allergic contact dermatitis. Patients with contact dermatitis are well known to have impaired quality of life which often leads to frequent dermatological consultations. Objective: Lack of data from Nepal has prompted us to undertake this study with the aims to know the frequency of allergic contact dermatitis and the commonest contact allergens among the patients with Hand eczema attending the out-patient department of dermatology, B.P. Koirala Institute of Health Sciences and Kathmandu Medical College Teaching Hospital. Material and Methods: A total of 256 patients were included in the study. Out of them 195 with hand eczema agreed to participate and undergo patch testing. The antigens used included the Indian standard series of patch test allergens approved by Contact and Occupational Dermatoses Forum of India. Results: Hundred and ten cases (56.4%) were patch test positive (PTP) at 48 as well as 96 hours to at least one allergen. PTP was seen more commonly in females. The most common allergen in females was nickel sulphate followed by cobalt chloride, gentamicin and mercapto mix while males were positive to potassium dichromate, followed by epoxy resin, fragrance mix and nickel sulphate. Conclusion: Patch testing has proved a useful tool for the detection of allergic contact dermatitis and for identification of contact allergens. When positive reactions correlate with environmental exposure the test usually assists the physician in establishing the cause of dermatitis, hence treating the patients and improving their quality of life. Keywords: Hand Eczema, Contact Allergen, Patch testPublication Occurrence of Acanthosis Nigricans, A Benign Condition or Associated with Systemic Disease. A Case-Control Study(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2016) Acharya, R.; Rijal, A.Abstract: Background: Acanthosis nigricans (AN), a common cutaneous finding, characterized by hyperpigmentation and velvety hyperplasia of the epidermis affecting flexures. Its exact prevalence varies according to age, race, degree of obesity and endocrinopathy. Objectives: Though previous studies have identified AN as marker of hyperinsulinemia and its common association with obesity, this study was done to see if AN occurs as benign condition or has any underlying disease and also to identify the possible risk factors associated with it. Material and methods: Clinically diagnosed cases of AN (n=55) were included with equal number of healthy control. Height, weight, abdominal circumference, body mass index (BMI), level of Blood Sugar and Lipids were measured. Comorbidities were defined as hypertension: Blood pressure ≥ 140/90 mmHg; Diabetes mellitus: Fasting Blood sugar (FBS) >125mg/dl, Post prandial >160mg/dl, Obesity grading as per WHO criteria and Metabolic Syndrome: ATP III criteria. Data were assessed using univariate analysis with crude odds ratio and 95% confidence intervals. Variables with p-value ≤ 0.05 were tested in multivariate model. Results: Of 55 cases of AN, 94.5% had one or more underlying disease. Obesity (89.09%) was the most common associated condition followed by dyslipidemia (87.2%), metabolic syndrome (56%), hypertension (38.18%), diabetes (18.8%) and hypothyroidism (14.54%). There was a strong association of AN with increased waist circumferences (OR 7.93), BMI (OR 6.8), metabolic syndrome (OR 6.79), family history (OR 4.6) and FBS (OR 3.98). High densitiy lipid (HDL) was found to have protective role (OR 0.36) in AN. Conclusion: Findings strongly support that patients with AN are at higher risk for having metabolic syndrome with all components than those without AN. Keywords: Acanthosis nigricans, Hyperinsulinemia, Obesity