Browsing by Author "Shrestha, Rima"
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Publication Effect of Low dose Isotretinoin on Lipid Profile and Liver enzymes in Acne Patients: A Cross Sectional Study(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2024) Jha, Ayush; Shrestha, Rima; Khadka, Anupa; Wagle, AshmitaAbstract: Introduction: Oral isotretinoin remains the most clinically effective anti-acne therapy. However, a myriad of adverse effects are associated with isotretinoin use. Elevated liver enzymes and an altered lipid profile are well documented side effects of prolonged oral isotretinoin usage. Objectives: To assess the alteration in liver enzymes and lipid profiles of acne patients on isotretinoin therapy. Materials and Methods: The current prospective hospital based study, was carried out from September 2022 to December 2023, and included 150 patients with acne vulgaris on isotretinoin therapy. All consenting patients were then subjected to a detailed history and clinical examination. Subsequently, baseline Alanine aminotransferase (ALT), Aspartate aminotransferase (AST), Triglyceride (TG), Low density Lipoprotein (LDL), and High density Lipoprotein levels (HDL) levels were measured. Patients were then started on oral isotretinoin therapy at conventional dosages. Levels of ALT, AST, TG, LDL and HDL were repeated at 3- month and 6- month follow-up visits. A self-designed proforma was used to collect all relevant data. The collected data was analyzed as per standard statistical protocol. Repeated measures analysis of variance was used to compare means between 3 groups (baseline, 3-month, and 6-month values). Results with a p<.05 were considered statistically significant. Results: The mean age of patients was 22.31(±SD 4.44) years. Females comprised the majority of our study subjects (n = 95; 63.33%). Levels of Alanine (F2,226=30.73, p<.0005) and Aspartate transaminase (F2,232=13.13, p<.0005) were increased significantly at 3 and 6 month follow up visits. Levels of TG were, also, increased significantly at follow up visits (F2,239=14.45, p<.0005). Similarly, levels of low density lipoprotein increased significantly when compared to baseline levels (F1,215=38.43, p<.0005). High density lipoprotein levels were decreased significantly when compared to baseline levels (F1,209=105.83, p<.0005). Conclusion: Our study has highlighted the significant alterations that occur in liver function tests and lipid profiles in patients on isotretinoin therapy.Publication Pseudoxanthoma Elasticum a Rare Genetic Disorder : A Case Report(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2024) Pandit, Shashwata Raj; Khadka, Anupa; Jha, Ayush; Shrestha, Rima; Shrestha, Ravina BadeAbstract: Pseudoxanthoma elasticum (PXE) is a rare hereditary condition marked by the accumulation of fragmented and calcified elastic fibers in the body's tissues, leading to skin, vascular, and ocular involvement. In clinical practice, the most prevalent and typically earliest indication of PXE is observed through skin manifestations, which include laxity and the presence of yellowish papules and plaques. Here we report a case of a 40-year-old woman from Nepal presenting with yellowish multiple papules and plaque around the neck and axilla for 20 years, slowly increasing in size and number. A skin biopsy revealed fragmented eosinophilic elastic fibers in the dermis, consistent with PXE. Echocardiography, slit lamp, and indirect ophthalmoscopic examination were done.Publication Serum Levels of 25-Hydroxyvitamin D in Chronic Plaque Psoriasis(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2023) Jha, Ayush; Basukala, Manisha Singh; Shrestha, Rima; Dawadi, RojiAbstract: Background: Psoriasis is an immune mediated inflammatory disease that involves the innate and acquired arm of immunologic system. The regulatory role for vitamin D in immune system is suggested by presence of vitamin D receptors on activated lymphocytes and suppressive or inhibiting effect of 1,25-dihydroxyvitamin D in different autoimmune diseases. Hence, the current proposed study aims to study the 25-hydroxyvitamin D status of patients with psoriasis. Objective: The primary objective of this study was to analyze the 25-hydroxyvitamin D status of patients with chronic plaque psoriasis in comparison to healthy control subjects. Materials and Methods: A comparative cross-sectional study, including forty patients with chronic plaque psoriasis and forty age- and sex-matched control subjects, was conducted from April 2021 to December 2022, at our dermatology department. After informed consent, all patients were subjected to detailed clinical and anthropometric examination. Serum concentration of 25-hydroxyvitamin D was evaluated in chronic plaque psoriasis cases and healthy control subjects. Data was be analyzed as per standard statistical protocol. Results: The mean serum 25-hydroxyvitamin D level in psoriatic group and control group were 18.02 (±SD 9.82) ng/ml and 24.47 (±SD 6.77) ng/ml, respectively. (p=.001) Serum 25-hydroxyvitamin D was negatively correlated with Psoriatic area and severity index (PASI) score (r=-.11). However, this correlation was not significant (p=.493). Conclusion: Serum 25-hydroxyvitamin D levels were significantly lower in psoriatic patients than in control subjects.