scholarly journals Clinical Profile of Severe Cutaneous Drug Eruptions in a Tertiary Care Hospital

2019 ◽  
Vol 15 (3) ◽  
pp. 156-159
Author(s):  
Rupak Bishwokarma Ghimire ◽  
Sabina Bhattarai ◽  
Govinda Pokharel ◽  
Eliz Aryal ◽  
Prashanna Raj Shrestha
Keyword(s):  
Toxic Epidermal Necrolysis ◽  
Drug Eruption ◽  
Tertiary Care ◽  
College Teaching ◽  
Intracerebral Hematoma ◽  
Care Hospital ◽  
Medication History ◽  
Cross Sectional ◽  
Dermatology Department ◽  
Drug Eruptions

Background: An adverse cutaneous reaction caused by a drug is any undesirable change in the structure or function of the skin, its appendages or mucous membranes and it encompass all adverse events related to drug eruption, regardless of the etiology.  Methods: This is a retrospective descriptive cross-sectional study done fom April 2017 to March 2019 at dermatology department of Kathmandu Medical College Teaching Hospital. Sample size was calculated as 42 with prevalance of severe cutaneous drug eruption as 3%. After the medication history was taken, all suspected causative drugs were discontinued. For the initial 5 to 7 days, all patients were treated with intravenous corticosteroids and oral antihistamines. Follow up after one week, 2 weeks and one month were suggested for assessment of outcomes. Results: Out of 42 patients, 22 (52.38%) were females and 20 (47.62%) males. Most were in age groups 16-39 & 46-60 counting to 14 (33.33%) in each group. Acute morbilliform eruption was the most common presentation 20 (47.6%) followed by Steven Johnson Syndrome-Toxic Epidermal Necrolysis in 16 (38.1%). The most common offending drug group in this study was antileptics 9 (21.43%), followed by NSAIDs 8 (19.05%), antibiotics 7 (16.67%), allopurinol 4(9.52%%). Patients were discharged after 7 days with tapering dose of oral prednisolone upto 6 weeks for all patients. However, three patients died due to Toxic Epidermal Necrolysis along with comorbid conditions like intracerebral hematoma, COPD with pneumonia. Conclusion: Adverse cutaneous drug reactions should be recognized early for timely intervention. Previously sensitized patients should be made aware about fatal outcomes, symptoms, cross reactivites as well as over the counter preparations.

scholarly journals Clinicoepidemiological Profile of Pityriasis Versicolor in a Tertiary Care Hospital in Kathmandu, Nepal

2019 ◽  
Vol 21 (4) ◽  
pp. 294-300
Author(s):  
S Shrestha ◽  
P Koirala ◽  
U Timothy
Keyword(s):  
Seborrheic Dermatitis ◽  
Tertiary Care ◽  
College Teaching ◽  
Cross Sectional Study ◽  
Pityriasis Versicolor ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Predisposing Factor ◽  
Cross Sectional ◽  
Dermatology Department

Pityriasis versicolor (PV) also known as Tinea versicolor is a benign, chronic superficial fungal infection of the skin caused by Malassezia furfur. It is characterized by dyspigmented macules with fine branny scales. The purpose of this study was to assess the epidemiological profile and clinical pattern of PV in a group of patients visiting a tertiary care centre of Nepal. A descriptive cross-sectional study was carried out including 150 patients diagnosed to have PV at the outpatient dermatology department of Nepal Medical College Teaching Hospital. Patients with the diagnosis of PV were included in the study. A detailed history was taken and it was followed by a thorough clinical examination. The findings of history and clinical examinations were documented in a predesigned proforma. Statistical Package for the Social Sciences (SPSS) version 16 was used to tabulate the data and analyze the results. There was a slight male preponderance with maximum patients of the age group 11 – 20 years. A majority of patients were students. Forty three (28.7%) patients had similar problem in close contacts and 42% had recurrent disease. Wearing of occlusive synthetic clothing was the commonest predisposing factor. Upper chest and upper back were the most involved sites. Hypopigmented macules were the commonest lesions in 72.7%. Coexisting seborrheic dermatitis (commonly pityriasis capitis ) was present in 44.67% of patients. Clinicoepidemiological profile of PV in our setting is similar to many studies done mostly in India. But few findings differ which indicates the need for further studies in Nepal especially from Terai regions where the prevalence is expected to be more.

scholarly journals Study on Corticosteroids use Pattern in Dermatological Practice and Investigating Adverse Effect of Corticosteroids Including its Associated Factors

2017 ◽  
Vol 13 (3) ◽  
pp. 261-267
Author(s):  
S. Shakya Shrestha ◽  
M. Bhandari ◽  
R. Shrestha ◽  
S.R. Thapa ◽  
A. Karki ◽  
...  
Keyword(s):  
Adverse Effect ◽  
Adverse Effects ◽  
Tertiary Care ◽  
Common Adverse Effect ◽  
Cross Sectional Study ◽  
P Value ◽  
Care Hospital ◽  
Cross Sectional ◽  
Dermatology Department ◽  
Use Pattern

Background Corticosteroids are highly effective drugs with anti-inflammatory and immunosuppressive properties. Due to this, they have become a mainstay of pharmacotherapy in dermatology. However, improper and long term uses are associated with a number of serious adverse effects.Objective To investigate the corticosteroids use pattern, adverse effects and various factors associated with adverse effects in dermatological practice.Method A cross-sectional study was conducted in a dermatology department of tertiary care hospital. All patients using at least one corticosteroids, either topically or systemically or the combination were included in this study. Informed consent was taken from the patients and interviewed using structured questionnaire. Statistical analysis was performed by using SPSS 20. p-value < 0.05 was considered as statistically significant.Result Among the 60 participants under this study, 81.67% of them were females. The mean (±SD) age of the patients was 31.03 years (±15.0). A majority (58.30%) of the patients was prescribed with topical corticosteroids with low potency (25%). Most of them had used corticosteroids for urticaria. Adverse effects were reported by 33.30% of the patients. The most common adverse effect reported was the shedding of skin. Adverse effects was significantly associated with gender; use of systemic corticosteroids; regular use of corticosteroids; discontinuation of dose abruptly; and missed dose. However, there was no significant association between adverse effects and the duration of use of corticosteroids.Conclusion In conclusion, the present study suggested that the proper counselling and clear instruction regarding the use of corticosteroid should be provided to the patients for avoiding the abrupt discontinuation of the prescribed medication leading to treatment failure.

scholarly journals Study of indications and post-operative complications of primary caesarean section in tertiary care hospital in Nepal

2018 ◽  
Vol 7 (3) ◽  
pp. 835 ◽  
Author(s):  
Sanyukta Rajbhanadary ◽  
Veena Rani Shrivastava
Keyword(s):  
Caesarean Section ◽  
Post Partum ◽  
Elective Caesarean Section ◽  
Tertiary Care ◽  
College Teaching ◽  
Care Hospital ◽  
Maternal Complications ◽  
Cross Sectional ◽  
Continuous Increase ◽  
Fetal Complications

Background: Caesarean section performed for appropriate obstetric or medical indications are life saving for both mother and new born. But its advantage does not justify its continuous increase as it is a major surgical procedure associated with maternal and fetal complications. The main objective of this study was to study the indications of primary caesarean section and its maternal and fetal complications in Nepal medical college teaching hospital (NMCTH).Methods: This is a hospital based cross sectional study carried out for a period of one year from 1st October 20113 to 30th September 2014 in department of obstetrics and gynecology in NMCTH Nepal. The study included 183 primary caesarean cases enrolled as per the inclusion criteria. The indications for caesarean section, associated maternal and fetal complications were noted.Results: The rate of caesarean section during the study period was 21.40%. The study included 183 patients who underwent primary caesarean section, 162 (88.5%) cases were emergency cases and 21 (11.5%). Cases were elective cases. The most common indications were fetal distress (n-74, 40.4%) followed by cephalo pelvic disproportion (n-27, 14.8%). The maternal complications seen were urinary tract infection (n-34, 68%), wound infection (n-12, 24%), post-partum hemorrhage (n-3, 6%). The common fetal complications noted were apgar score of less than 7 (n-7, 31.8%), transient tachypnea of newborn (n-6, 27.27%) and meconium aspiration syndrome (n-4, 18.18%).Conclusions: Emergency primary caesarean section was proportionally higher than elective caesarean section. It was also associated with more maternal and fetal complications.

scholarly journals Drug utilization pattern in dermatology outpatient department at a tertiary care hospital in Navi Mumbai

2017 ◽  
Vol 6 (3) ◽  
pp. 559
Author(s):  
Arun Patil ◽  
Darshana Dighe ◽  
Shrikrishna Kolte ◽  
Pradeep R. Jadhav ◽  
Y. A. Deshmukh
Keyword(s):  
Drug Utilization ◽  
Skin Diseases ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Outpatient Department ◽  
Care Hospital ◽  
Prescribing Pattern ◽  
Cross Sectional ◽  
Dermatology Department ◽  
Essential Drug List

Background: Skin diseases are common and cause a huge disease burden globally. Different class of drugs and combinational products are available in dermatology for treatment. Periodic prescription analysis in the form of drug utilization study can improve the quality of prescription and curb the menace of irrational prescribing. Aim and objective of the study were to study the prescribing pattern and drug utilization trends in Dermatology outpatient department at a tertiary care hospital in Navi Mumbai.Methods: A cross-sectional, observational study was conducted over a period of three months in dermatology department of a tertiary care teaching hospital, Navi-Mumbai. A total of 102 adult patients visiting dermatology OPD were included and their prescriptions were analyzed with WHO prescribing indicators and additional indices.Results: Analysis showed that the average number of drugs per prescription was 3.27. Percentage of drugs prescribed by generic name was 31.1%. Percentage of drugs prescribed from National Essential drug list (NEDL) was 44.2%. The commonest prescribed drugs were antihistaminics followed by antifungals. Oral tablets were the commonest prescribed dosage form.Conclusions: Antihistaminics and antifungals dominated the prescribing pattern in this study with restraint on polypharmacy, but showed ample scope for improvement to prescribe generic and selection of essential drugs.

scholarly journals Prevalence of Community-Acquired Pyoderma in Dermatological Outpatient Department of A Tertiary Care Hospital

2019 ◽  
Vol 57 (217) ◽  
Author(s):  
Rupak Bishwokarma Ghimire ◽  
Khilasha Pokhrel ◽  
Sanjubabu Shrestha
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
College Teaching ◽  
Cross Sectional Study ◽  
Hair Follicles ◽  
Outpatient Department ◽  
Point Estimate ◽  
Care Hospital ◽  
Cross Sectional ◽  
Institutional Review

Introduction: Pyoderma is defined as any purulent skin disease and represents infections inepidermis and dermis or hair follicles. This study aims to find out the prevalence of communityacquired pyoderma in dermatological outpatient department of a tertiary care hospital. Methods: A descriptive cross-sectional study was carried out among patients who presented atdermatology outpatient department of Kathmandu Medical College Teaching Hospital betweenDecember 2018 and March 2019 after ethical clearance from institutional review committee.Convenience sampling method was done. Data was collected and analysis was done using SPSSsoftware, point estimate at 95% CI was calculated along with frequency and proportion for binarydata. Results: Out of 385 cases, 72 (18%) cases were of community-acquired pyoderma. Prevalence ofcommunity-acquired pyoderma is 72 (18%) at 95% CI(). Primary pyoderma was seen in 49 (12.72%)mainly folliculitis 17 (4.41%), furunculosis 16 (4.15%), impetigo 6 (1.55%), abscess 6 (1.55%) andbacterial paronychia 4 (1.03%). Staphylococcus aureus was the most common organism isolated in 42(58.3%) cases and Staphylococcus epidermidis was isolated in 3 (4.17%) cases. Staphylococcus aureuswas most sensitive to Vancomycin 42 (100%) followed by Gentamycin 40 (95.2%), Ciprofloxacin 40(95.2%) and Ceftriaxone 40 (95.2%). Highest resistance was seen to Azithromycin in 13 (30.95%),followed by Cloxacilllin in 11 (26.19%). Males were affected predominantly in 49 (68.06%) ascompared to females in 23 (31.94%). Conclusions: Prevalence of community-acquired pyoderma is high among patients visitingdermatological outpatient departments of a tertiary care hospital compared to other studies.Antibiotic resistance of commonly used antibiotics are increasing and thus proper cultureand sensitivity reports may be required to guide our treatment

scholarly journals Fungal Infections among Teledermatology Consultations in Dermatology Department of a Tertiary Care Hospital: A Descriptive Cross-sectional Study

2021 ◽  
Vol 59 (243) ◽  
pp. 1094-1097
Author(s):  
Sagar Mani Jha ◽  
Anil Kumar Singh Dangol ◽  
Bhabendra Suwal ◽  
Jyotshna Yadav
Keyword(s):  
Confidence Interval ◽  
Binary Data ◽  
Tertiary Care Hospital ◽  
Fungal Infections ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Dermatology Department

Introduction: Teledermatology provides virtual consultation to patients using telecommunication technology. Using this method dermatologists can diagnose a condition with the help of pictures of the lesions and short history. During the COVID-19 pandemic, practicing this method has become more relevant. Providing teleconsultations to patients with fungal skin infections can prevent inadvertent use of topical corticosteroids. The objective of this study was to find the prevalence of fungal infections among teledermatology consultations done in a tertiary care hospital. Methods: It was a descriptive cross-sectional study where the store and forward and real-time methods were used between February 2020 to July 2020. Ethical clearance was taken from the institutional review board (reference number: 245). Data of those patients who wanted consultations from this department were sent by medical officers deployed in military hospitals that are under the central army hospital located in Kathmandu. Convenient sampling was used. The collected data was entered and analyzed in the Statistical Package of Social Sciences version 20. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage for binary data. Results: A total of 451 (33.45%) (30.93-35.97 at 95% Confidence Interval) were diagnosed with fungal infections out of 1348 patients who were enrolled for the study. About 361 (80%) of the patients suffering from fungal infections belonged to the Terai region and 90 (20%) belonged to mountainous areas. Conclusions: The prevalence of fungal infection among teledermatology consultation was lower than the findings from a similar international study.

scholarly journals Medical complications during inpatient rehabilitation in patients with ischemic stroke in a tertiary care hospital in Nepal

2020 ◽  
Vol 8 (3) ◽  
pp. 162-166
Author(s):  
Krishna Dhungana ◽  
Dipesh Shakya ◽  
Rabindra Shrestha ◽  
Sabnam Bhatta ◽  
Sabbu Maharjan
Keyword(s):  
Urinary Tract Infection ◽  
Ischemic Stroke ◽  
Urinary Tract ◽  
Tract Infection ◽  
Tertiary Care ◽  
College Teaching ◽  
Inpatient Rehabilitation ◽  
Care Hospital ◽  
Cross Sectional ◽  
Management Of Complications

Background: Complications are common in patients with ischemic stroke and hinder successful rehabilitation. Timely identification and management of complications are key factors in the management of patients with ischemic stroke. Objectives: The aim of this study is to find the occurrence of different types of complications in patients admitted with the diagnosis of ischemic stroke and to find the risk factors associated with the occurrence of complications. Methodology: The study is a cross sectional descriptive study. A total of 96 patients with ischemic stroke admitted to the Department of Neurology of Kathmandu Medical College Teaching Hospital over a period of six months (July 2018 to December 2018) were recruited. Data was recorded according to a designed proforma and analysed using Statistical Package for the Social Sciences version 20. Results: The age group ranged from 25 to 91 years with the mean age of 64.36 years and 50 (52.1%)patients were male. A total of 62 (64.6%) patients developed at least one complication during hospital stay. Pneumonia and urinary tract infection were the most common complications occurring in 22(22.9%) patients. The occurrence of complications was positively correlated with National Institutes of Health Stroke Scale and Glasgow Coma Scale. Conclusion: Pneumonia and urinary tract infection were the most common complications in our study and were similar to those quoted in the western literature. Severity of stroke had positive correlations with occurrence of complications.

scholarly journals A study and evaluation of cutaneous adverse drug reaction in the patients attending dermatology department of tertiary care teaching hospital in Eastern Uttar Pradesh

2021 ◽  
Vol 10 (6) ◽  
pp. 664
Author(s):  
Dharmender Gupta ◽  
Bikash Gairola ◽  
Bijay Kumar ◽  
Masuram Bharath ◽  
Mohd Shadab Ansari
Keyword(s):  
Adverse Drug Reaction ◽  
Drug Reaction ◽  
Health Care Professionals ◽  
Tertiary Care ◽  
Drug Reactions ◽  
Cross Sectional ◽  
Dermatology Department ◽  
Drug Eruptions ◽  
Cutaneous Drug Reactions ◽  
Cutaneous Adverse Drug Reaction

Background: Cutaneous adverse drug reactions (CADRs) are most frequently reported type of ADRs and can be caused by variety of drugs. The clinical patterns of adverse cutaneous drug reactions and the drug responsible for them is changing every year due to the emergence of newer molecules and changing trends in the use of drugs.Methods: This was a prospective, cross-sectional and observational study done for a period of 6 months to evaluate the clinical pattern of CADRs and their causative drugs in the tertiary health care.Results: Over all 55 patients were detected with cutaneous adverse drug reaction. The majority of CADRs were in the age group of 18-35 years (63.46%). Fixed drug eruptions (FDE) being the most common adverse cutaneous drug reaction (34.68%) followed by maculopapular rash (23%), NSAIDs being the most common, followed by antimicrobial agents.Conclusions: Knowledge of these drug eruptions, the causative drugs are essential for the clinicians and implementing the ADRs reporting and monitoring system, one can promote drug safety and better patients care, among health care professionals.

scholarly journals Attitude of Interns towards Family Medicine as a Career in a Tertiary Care Hospital

2019 ◽  
Vol 57 (219) ◽  
Author(s):  
Anu Kushwaha ◽  
Anuj Raj Kadel
Keyword(s):  
Family Medicine ◽  
Social Services ◽  
Teaching Hospital ◽  
Tertiary Care ◽  
College Teaching ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Cross Sectional ◽  
Medical College ◽  
Time Period

Introduction: Family medicine is a relatively overlooked specialty in Nepalese medical education. It is unclear how many interns are actually interested in Family medicine as a career and how many non-medical individuals are aware of its existence. The aim of this study is to assess information, expectation and perception among interns regarding family medicine and its choice as a career. Methods: This is a descriptive-cross sectional study carried out in Kathmandu Medical College Teaching Hospital from July 2018 to December 2018. Whole sampling was done. All interns of Kathmandu Medical College Teaching Hospital posted in different departments during the time period was the inclusion criteria. Chronic absentees was the exclusion criteria. Factor like age, sex, their residency of choice, and whether they consider family medicine as a potential career were considered. Data was entered in with Statistical Package for Social Services version 16 and necessary calculations were done. Results: Thirty three interns preferred internal medicine as their career of choice, 20 preferred surgery while only three preferred in family medicine. Eighty eight interns, including the three who had family medicine as their career of choice, said that they could consider family medicine as a potential career. Eighty eight out of the 100 interns in the study mentioned that their family had knowledge that a specialty called family medicine existed. Conclusions: Despite being the career of choice of only a few, majority considered family medicine as a potential career for them. And the knowledge about existence of family medicine was high among families of interns.

scholarly journals Frequency of Different Types of Arthritis in patients of Psoriasis

2021 ◽  
Vol 15 (6) ◽  
pp. 1331-1334
Author(s):  
A. Ashraf ◽  
M. S. Aman ◽  
A. Z. K. Chachar ◽  
M. A. Bukhari ◽  
U. Sarwar ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Joint Involvement ◽  
Care Hospital ◽  
Cross Sectional ◽  
Dermatology Department ◽  
Psoriatic Arthropathy ◽  
Different Types ◽  
Distal Interphalangeal

Background: Psoriatic arthritis (PsA) is type of inflammatory arthritis associated with psoriasis. There are multiple patterns of joint involvement in patients with psoriasis Aim: To determine the frequency of arthritis and its different types in patients of psoriasis presenting at a tertiary care hospital in Lahore Methods: This cross Sectional study was conducted in Dermatology Department of Services Hospital, Lahore from 11th April, 2017 to 10th October, 2017. Two hundred and sixty patients having psoriasis were enrolled in the study, Patients’ detailed history about psoriasis, duration of psoriasis and joint pain or stiffness was taken. After written and informed consent Physical examination was done to determine the type of psoriasis and nail involvement. All the joints were examined for tenderness and deformities to assess the evidence of arthritis and its different types according to the site of involved joints. Results: Total numbers of patients included in the study was 260; in which 176 (67.7%) patients were males and 84 (32.3%) were females with the total mean age of 38 ±13.22 years. Out of 260 patients, 62(23.8%) patients had psoriatic arthritis (PsA), Out of these 62 patients having PsA, 23(37.1%) patients had Oligoarthritis, followed by Symmetric arthritis 19(30.6%) patients, Distal interphalangeal arthritis (DIP) in 15 (24.2 %). Conclusion: Our study concluded that almost one fourth of psoriasis patients had arthritis, asymmetrical oligoarthritis/monoarthritis came out to be the most common type in our study followed by symmetric polyarthritis, distal interphalangeal arthritis (DIP), Arthritis mutilans and axial arthritis Keywords: Psoriasis, types of psoriasis, arthritis, psoriatic arthropathy

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