Browsing by Author "Shrestha, Sanju Babu"
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Publication Clinico-epidemiological profile of childhood cutaneous tuberculosis(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2015) Shrestha, Sanju Babu; Pokhrel, G P; Pradhan, S BAbstract: Introduction: Although cutaneous tuberculosis constitutes a small percentage of extra pulmonary tuberculosis, it has not been fully documented in Nepal and more so in the pediatric population. Objectives: The aim of the study was to assess the epidemiology and clinical profile of childhood cutaneous tuberculosis at Kathmandu Medical College and Teaching Hospital, Nepal. Material and Methods: Children (below 15 years of age) with cutanesous tuberculosis who attended the teaching hospital between April 2008 and March 2014 were studied. Results: A total of 17 children with skin tuberculosis were identified during the study period, which constituted 34% of all patients with skin tuberculosis. There were 11 boys and 6 girls with a mean age of 8.8 years. The duration of the lesions ranged from 1 month to 4 years and 13 (76.5%) were brought for medical help after six months of onset of the disease. Lower limb was the most common site of involvement. Of the various patterns of cutaneous tuberculosis; scrofuloderma was the most common 7 (41.2%) followed by lupus vulgaris 6 (35.3%), erythema nodosum 2 (11.7%) and gumma 1 (5.8%). Combination of lupus vulgaris and scrofuloderma was noted in one patient. Three patients (17.6%) had internal organ involvement as pulmonary tuberculosis. Keywords: Clinical profile, Skin tuberculosis, Nepalese children Conclusion: The pattern of skin tuberculosis had wide variation with a few of them having systemic involvement. Therefore, these patients need a thorough evaluation or an uniform standard therapeutic regimen to cover both internal organ and cutaneous tuberculosis.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 Iatrogenic Cushing Syndrome due to Application of Potent Topical Corticosteroid: A Case Report(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2019) Bhusal, Mohan; Aryal, Eliz; Bhattarai, Sabina; Shrestha, Sanju Babu; Rajouria, AlarkAbstract: Corticosteroids are over the counter and cheaper drugs available in every medical stores in Nepal. Iatrogenic Cushing syndrome due to topical steroids application is a very rare phenomenon in adults.A 32 year female from Janakpur presented with complaints of swelling of face, weight gain, excessive facial hair and fatigue since two years that gradually increased over last one year. She had a past medical history of on and off application of multiple potent topical corticosteroids for disseminated Tinea infection. She was obese with moon facies, buffalo hump and multiple striae over her abdomen. Her blood pressure was raised and her blood sugar was in pre-diabetic range. Laboratory studies were consistent with iatrogenic Cushing syndrome. Patient recovered after discontinuation of topical corticosteroids and treatment with antifungals.Although iatrogenic Cushing syndrome following application of topical corticosteroid is a rare phenomenon in adults, this can happen in a setup like ours where corticosteroids are prescribed as over the counters and patients have very little knowledge about their use. Therefore, we emphasize that patients and pharmacist should be well educated about the consequences of their prolong application and their side effects. Keywords: Adrenocorticotropic hormone, Clobetasol, Pituitary-adrenal system