Browsing by Author "Shrestha, Prashanna Raj"
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Publication Efficacy and Safety of Intralesional Immunotherapy with Tuberculin Purified Protein Derivative among Cutaneous Wart Patients(Nepal Health Research Council, 2022) Shrestha, Sanju Babu; Bhusal, Mohan; Jwarchan, Jayanti; Gautam, Sujan; Shrestha, Prashanna RajAbstract Background: Cutaneous warts are common skin problems caused by Human Papilloma Virus. Conventional therapies are mostly ablative and limited by recurrences and side effects. Immunotherapy using bacterial, fungal, and viral antigens is an emerging and safer technique to treat warts at local and distant sites. The objective of this study was to measure the efficacy and safety of intralesional immunotherapy with tuberculin purified protein derivative among cutaneous wart patients in the dermatology department of a tertiary care centre. Methods: A cross sectional, time series design, was conducted between October 2019 and September 2020 among 77 patients of cutaneous warts attending Dermatology out-patient department using convenience sampling. Percentage response was evaluated for patients treated with tuberculin purified protein derivative for eight weeks at an interval of two weeks into complete response (100% clearance), partial response (50-99% clearance), no response (0-49% clearance). Side effects were also recorded. Statistical Package for the Social Sciences version 20.0 was used for data analysis. Results: Out of 77 patients, complete response (100%) was seen in 53.2% patients, partial response (50-99%) in 14.3% and no response (0-49%) was seen in 32.5%. Side effects noted were pain and erythema (19.50%), blisters (2.60%) and flu like symptoms (1.30%). Conclusions: Intralesional PPD is an effective and safer therapeutic option for the treatment of cutaneous warts. Keywords: Immunotherapy; intralesional injections; purified protein derivative of tuberculin; warts Author Biographies Jayanti Jwarchan, Gandaki Medical College Lecturer, Department of Dermatology Sujan Gautam, Kathmandu Medical College Resident, Department of Dermatology Prashanna Raj Shrestha, Kathmandu Medical College Lecturer, Department of DermatologyPublication Immunotherapy with Intralesional Vit D injection in Recalcitrant wart at a Tertiary Care Center: A Descriptive Cross sectional Study(Nepal Medical Association, 2024) Aryal, Eliz; Bhari, Jyoti; Shrestha, Prashanna RajAbstract Introduction: Recalcirant warts are resistant to conventional therapeutic option with high recurrence rate. In recent year, treatment of warts with different immunotherapeutic agent has shown good results, as it regulate epidermal cell proliferation and are involved in the formation of anti microbial peptides. Hence, this study was undertaken to evaluate the efficacy of immunotherapy with intralesional vitamin D in wart. Methods: A descriptive cross-sectional study was conducted from 1 January 2021 to 2 February 2023 at Kathmandu Medical College after approval from the Institutional Review Committee (Reference number: 0110202002). Ninety - two patients with recalcitrant wart of varying sizes and duration were included in the study. Injection vitamin D ( 600000 IU, 15mg/ ml) was injected about (0.2-0.5 ml) to the base of the wart. Maximum of five warts were injected per month, and was repeated after 4 weeks for 3 sessions. Results: Among 92 patient, complete response was seen in 70 patient (76.08%), partial response was seen in 17 patients ( 18.47%) and 5 patient(5.43%)showed no response. Mild pain as observed at the time of injection. Signs of hypervitaminosis D was not observed. Conclusions: Intralesional administration of Vitamin D is an effective treatment option for reclacitrant warts and is, highly effective, cost-efficient, with minimal adverse effects, and can be perfomed in our clinical set up