Browsing by Author "Shrestha, P"
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Publication Cutaneous leishmaniasis: a case report(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2009) Kayastha, BMM; Shrestha, P; Shrestha, R; Jahan, RAbstract Cutaneous Leishmaniasis (CL) is a vector-borne protozoal infection of the skin. It is endemic in the tropics and neotropics. Several species of Leishmania cause this disease in the Old World. It is manifested as chronic nodular to ulcerative lesions of the skin, which last for many months and may be disfiguring. Despite its increasing worldwide incidence, it is infrequently reported from Nepal. We are reporting a case of CL in a man who acquired the disease while working in Saudi Arabia and who was successfully treated with Sodium Stibogluconate injections. Keywords: Cutaneous leishmaniasisPublication Dermatologic Manifestations In Chronic Kidney Disease Patients On Hemodialysis(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2014) Shrestha, P; Mathur, MAbstract: Introduction: Dermatologic changes are frequently seen in chronic kidney disease (CKD) patients. Early identification of these manifestations helps timely institution of treatment and prevention of progression of CKD. Objectives: The aim of this study was to evaluate the frequency and pattern of dermatologic problems among CKD patients who are on maintenance hemodialysis in our population. Material and Methods: A hospital based cross sectional comparative study was conducted. Fifty patients with CKD on hemodialysis were compared with the same number of non CKD patients. All the patients were clinically examined. Complementary diagnostic measures such as skin biopsy, gram stain, potassium hydroxide mounting and culture sensitivity of the lesions were carried out when necessary. Results: At least one dermatologic manifestation was present in 86% of the patients and changes were seen commonly in CKD patients who had GFR <15ml/min (83.8%). Cutaneous manifestations were significantly associated with CKD patients than control (p<0.001) but not with the duration of CKD and duration of hemodialysis. Thirty seven patients (74%) were having cutaneous lesions, commonest being xerosis (52%) followed by pruritus (40%) and hyperpigmentation (32%). Nail, mucous membrane and hair changes were present in 56%, 22% and 12% respectively, commonest being white nail (30%), furred tongue (18%), telogen effluvium (10%) respectively. Conclusion: In our study, dermatologic manifestations were common in CKD patients with GFR <15ml/min. Cutaneous and nail changes were seen in 74% and 56% of the CKD patients undergoing hemodialysis, commonest changes being xerosis and white nail respectively. Keywords: Dermatologic manifestations, CKD, HemodialysisPublication Profile of renal diseases in Nepalese children(Kathmandu University, 2008) Bhatta, NK; Shrestha, P; Budathoki, S; Kalakheti, BK; Poudel, P; Sinha, A; Singh, RAbstract Aim and Objectives: To find out the profile of renal diseases in children hospitalized in the pediatric department of the tertiary care university teaching hospital in Eastern Nepal. Materials and Methods: A retrospective chart review of all the patients admitted at the department of paediatric from April 2002 to March 2007 was carried out for the presence of any renal diseases on the basis of their clinical presentation, laboratory findings and final diagnosis. Results: A total number of 10396 children were admitted during the study period out of which 651 (6.3%) children had renal disease. Among them, nephrotic syndrome seen in 222 patients (34.1%) was the commonest renal disease, followed by post streptococcal nephritis in 187(28.7%) and haemolytic uremic syndrome 66(10.1%), other renal diseases seen were acute renal failure in 25 (3.9%), lupus nephritis 24 (3.7%), urinary tract infection in 23 (3.5%) Henoch-Schönlein Purpura (HSP) nephritis 26 (4%), chronic renal failure in 27 (4.2%) and other miscellaneous causes 51 (7.8%). Conclusion: A substantial number of children are hospitilsed with renal diseases, and current trends indicate that majority of them are preventable. In near future, there is a need to develop a comprehensive service for the children with kidney diseases in Nepal. Key words: Renal Disease, Children, Nephrotic Syndrome, Poststreptococcal Glomerulonepritis, Renal BiopsyPublication Sweet's Syndrome: a case report(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2009) Kayastha, BMM; Lama, L; Shrestha, P; Shrestha, R; Karki, AAbstract Sweet's syndrome is a disorder characterized by fever and painful skin lesions. The condition starts suddenly with the appearance of red, slightly raised tender plaques, usually on the back, arms, face or neck. Women are most at risk of Sweet's syndrome, predominantly between 30-50 years of age who have recently had an upper respiratory tract infection. Here we present a 70 years old lady who came with fever and tender erythematous plaques on trunk and limbs. On investigation, leucocytosis with raised ESR was found and the skin biopsy was consistent with Sweet's syndrome. There was dramatic improvement with systemic corticosteroid. Keywords: Sweet's SyndromePublication Typhoid fever in Dhulikhel hospital, Nepal(Kathmandu University, 2004) Sharma, N; Koju, R; Karmacharya, B; Tamang, MD; Makaju, R; Nepali, N; Shrestha, P; Adhikari, DOne hundred and twelve cases of typhoid fever presenting in outpatient and emergency department of Dhulikhel Hospital in Nepal were studied. In this study, it was found that 71% typhoid fever cases were less than 30 years of age group with male to female ratio of 3:1. Fever over 5 days followed by headache and chills were major presenting symptoms. Widal test and blood culture for Salmonella typhi were positive in 59% and 49% cases respectively. Two third of our study population had total leucocyte count of normal range. The fever clearance time was significantly better with ofloxacin compared to ciprofloxacin (p<0.05) and ceftriaxone compared to chloramphenicol (p<0.05). The release from treatment was significantly shorter with ceftriaxone compared to ofloxacin, ciprofloxacin and chloramphenicol (p<0.01). Ceftriaxone was found to be 100% sensitive to salmonella typhi. Amoxicillin was only 52.1% sensitive to Salmonella typhi. Early diagnosis and institution of appropriate antibiotic therapy is of paramount importance in the management of typhoid patients. Key words: Typhoid fever, salmonella typhi, fever clearance time, release from treatment