Journal Issue: Volume: 17, No. 1 (2019)
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Volume
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Issue Date
2019
Journal Title
Journal ISSN
ISSN 2091-0231 eISSN 2091-167X
Journal Volume
Articles
Topical Corticosteroids Misuse: A Burning Issue
(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2019) Neupane, Saraswoti
Abstract:
Since the introduction of hydrocortisone into dermatology, a tremendous development has occurred in the field of topical corticosteroids. With the growing use of topical corticosteroids, a serious concern for its misuse is to be highlighted. This matter is of a great concern. Proper guidelines and legislation on the use of topical corticosteroids are warranted to combat this serious issue.
Keywords: Glucocorticoids, Hydrocortisone, Nepal, Nonprescription drugs
Upcoming Therapeutic Modalities for the Treatment of Keloids: An Update
(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2019) Keyal, Uma; Bhatta, Anil Kumar
Abstract
Introduction: Keloids are benign dermal tumors that generally form by local fibroblast proliferation and excessive collagen production following skin trauma. Several methods have been described for the treatment of keloid, often with suboptimal results and recurrences.
Objective: To update literature that provides information regarding upcoming therapeutic modalities for the treatment of keloids, including lasers, radiofrequency (RF), photodynamic therapy (PDT), and ultraviolet A1 (UVA1) irradiation.
Materials and Methods : A systematic review of the literature was performed for the original articles related to the treatment of keloids. The search terms ‘keloids’ and ‘lasers’ or ‘radiofrequency’ or ‘PDT’ or ‘UVA1’ was entered into a search of the National Library of Medicine’s PubMed Database.
Keywords: Collagen, Fibroblasts, Keloid, Photochemotherapy, Ultraviolet therapy
Result: The search returned a total of 188 sources, of which, 26 articles met our inclusion criteria.
Conclusion: Combination approach is superior than solo therapy in the treatment of keloid. However, it is highly desirable that new emerging therapies undergo large-scale studies with long-term follow-up before being recommended conclusively as alternative therapies for the treatment of keloid. Moreover, lack of randomized clinical trials (RCTs) needs to be taken into consideration urgently.
Patch Testing In Nepalese Population: A Single Center Study From Kathmandu, Nepal
(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2019) Paudel, Sushil; Pun, Guma; Parajuli, Niraj; Sharma, Rabindra
Abstract:
Introduction: Patch testing is a diagnostic tool used in investigation to identify specific allergens in allergic contact dermatitis (ACD). It helps find the prevalence and the trends of contact sensitization in the community.
Objective: To report the two year patch test results from a central hospital in Kathmandu.
Materials and Methods: Consecutive consenting patients of suspected ACD were patch tested with an Indian standard Series (Systopic) from June 2014 to August 2016.
Results: Out of 141 patients tested, 89 were female (63.12%) and 52 were male (36.88%). Hand eczema was the commonest pattern (53 patients) followed by persistent and recurrent eczema (44 patients) and face eczema (25 patients). Fifty- five patients (39%) had at least 1 positive allergic reaction. Among these, 16.31% were male and 22.70% were female. The most common allergen was nickel sulfate (19.9%) followed by fragrance mix (7.8%) and paraphenyldiamine (PPD) (6.4%). Out of total positive cases 27 (21 females and 6 males) had shown strong positive reactions (++). The Nickel Sulfate was responsible in majority of cases (18/27 cases). Farmers had the highest (57.14%) rate of positive allergic reactions followed by housewives (39.62%). According to the regional eczema, patients with persistent and recurrent eczema of different parts of body had the highest rate of positive allergic reactions (47.72%). Almost half of patient with facial eczema (40%) had positive patch test.
Conclusion: Larger studies are required in the different parts of the country to find a more accurate data regarding the sensitization pattern in Nepalese population.
Keywords: Allergens, Dermatitis, Allergic Contact, Eczema, Nickel sulfate
Association between Serum Zinc Level and Cutaneous Viral Warts: A Case Control Study
(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2019) Ranjit, Annu; Rajbhandari, Sudharshan Lal; Gautam, Narayan; Poudyal, Yogesh
Abstract:
Introduction: Cutaneous viral warts are one of the common skin disorders in general population which can affect any age group and any gender in any country and pose a significant health problem. A possible association with zinc has been suggested in previous studies. Zinc is known to be required for efficient functioning of immune system.
Objective: To find out the association between serum zinc level and cutaneous viral warts.
Materials and methods: In this case-control study, total of hundred patients were enrolled. Among them 50 (males – 27, females – 23) with cutaneous viral warts were taken as cases and 50 (males – 25, females – 25) healthy individuals were taken as controls after matching the age and sex. The patients were selected from Dermatology outpatient Department of Universal College of Medical Sciences Teaching Hospital, Bhairahawa, Nepal. The serum zinc level was measured using spectrophotometry principle.
Results: The mean serum zinc level in the cases and controls were 80.50±37.24 mg/dl and 104.31±25.31 mg/dl respectively. Significant difference in serum zinc level was observed between cases and controls (p=0.0001). There was a strong association between low serum zinc level and cutaneous viral warts (OR=7.37; 95% CI=1.98 – 27.31; p=0.0028).
Conclusion: Serum zinc level in patients with cutaneous viral warts was significantly low as compared to the healthy controls.
Keywords: Immune system, micronutrients, papillomaviridae, warts, zinc
Profile of Clients of HIV Testing and Counseling in a Tertiary Care Center and Need of Testing in Tuberculosis
(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2019) Shrestha, Smriti; Karn, Dharmendra; Tamrakar, Dipesh; Madhup, Surendra; Karmacharya, Biraj Man
Abstract:
Introduction: Sexually transmitted infection is public health issue that amplifies HIV burden globally. At National Center of AIDS and STD Control, annual reported STI are rising steeply recently. Incidence of HIV is 0.03% while prevalence in adult population is less than 1%. National HIV testing guidelines 2017 recommends HIV tests should be performed in tuberculosis and medical conditions. However, it is not routinely done in Nepal.
Objective: To assess profile of STI and HIV among patients attending HIV testing and counseling center of tertiary hospital, and to assess fraction of tuberculosis patients undergoing HIV testing.
Materials and Methods: All patients attending HIV testing and counseling center were tested for HIV. Tests for STI were done based on patient symptoms. Data collected were analyzed with SPSS.
Results: Suspected STI (41.1%) was commonest cause of HIV testing. Among STI, gram positive diplococcic were noted in 11.5% and 3.4% had PCR positive Chlamydia. Only 19.4% (7 out of 36) of total tuberculosis patients in hospital were screened for HIV, among which, 57.14% (4 out of 7) were seropositive for HIV, which is noteworthy.
Conclusion: Our study shows patterns of STI, and that gonorrhea and chlamydia could be underdiagnosed in Nepal. Every patient with tuberculosis should routinely be screened for HIV. But only small fraction of tuberculosis patients underwent HIV screening, out of which HIV positivity was high, reflecting the gap and need for routine HIV screening in TB patients.
Keywords: Acquired Immunodeficiency Syndrome, HIV infections, Sexually Transmitted Diseases, Tuberculosis