SHAPU (Seasonal Hyperacute Pan-uveitis) EYE DISEASE in Nepal

Around 34 patients of SHAPU(Seasonal hyper-acute panuveitis) has been reported in pokhara since one month.SHAPU has not been reported outside Nepal until now.The prevalence of disease is highest in Pokhara , from where the disease has originated in 1975.Most of the cases are reported in end of monsoon season (August-September).Only timely treatment can prevent blindless.

SHAPU is a rare entity occurring in odd years since 1975 in Nepal.It is increasing at an alarming rate in Gandaki province since beginning of this september.It mostly affects child of 5 to 15 years of age.It can rapidly cause destructive intra-ocular inflammation.It can progress to blindness if not treated.The etiology of SHAPU is not clear yet but it has strong associations with Gazalina moth.The dust on scale of the moth when comes in contact with eyes can cause damage to retina and pupil.Studies are being done to find out if SHAPU is due to auto-immune response to the moth antigens or by pathogens delivered by moth. Characteristics features of SHAPU are red eye,leukocoria,fibrinous exudates in anterior chamber and inability to dilate pupil with little or no pain.No standard treatment protocol has been developed against SHAPU till now.So to cover both infectious and immunological aspects,broad spectrum antibiotics and steroids are used for its treatment.Vitrectomy has been considered a useful procedure for treatment of SHAPU.

The fact that it commonly affects children is not well understood.The blame can be given to their low immunity than adult but no proof of state of immunocompromised has been found till date.

Nipah Virus-Recent death in Kerala,India.

A 12 year old boy of kerala,India died of Nipah virus on September 5,2021.It is after 3 years that kerala reported  a case of Nipah virus after the outbreak was contained in 2018.

Nipah virus is a zoonotic virus that means the transmission occurs between animals and human.Bats are the natural reservoir of Nipah virus.The virus is known to infect pigs and human.It can cause  from mild illness to encephalitis and ultimately death.In 1999,an outbreak of the disease in malaysia and singapore caused 300 human cases and more than 100 deaths.About one million pigs were killed to control the virus.It is now a disease of concern because man to man transmission are seen in caregivers of infected people in Bangladesh and India.

Nipah virus can be transmitted via

1.Direct contact with infected animals(pigs,bats)

2.Eating food products that are contaminated with body fluids of infected bats

3.Body fluids of an infected person(respiratory droplet,urine or blood)

Sign and symptoms of Nipah virus are very similar to Covid 19.It ranges from subclinical cases to acute respiratory infection to fatal encephalitis.Infected people usually develop symptoms after 4 to 14 days of exposure to the virus that means the incubation period of Nipah virus is 4-14 days.It initially presents with fever,headache,malaise,myalgia,sore throat and vomiting which progresses rapidly to dizziness,drowsiness,altered consciousness (neurological manifestations of encephalitis).Encephalitis and seizures occur in severe casses.The patient may progress to coma.The case fatality rate is 40-80 % that means death may occur in 40 - 80 % of cases. Persistent convulsions have been reported in survivors of Nipah virus.

The diagnosis of this virus is difficult due to its non-specific symptoms.The tests used to diagnose are real time polymerase chain reaction (RT-PCR) and ELISA.Early diagnosis helps in limiting the transmission of the Nipah virus.

There is no specific treatment or vaccine against Nipah virus.Management is supportive care with hydration,rest and symptomatic treatment as they occur.

Best Dermatologists in Nepal

 1.Dr. Anil Kumar Bhatta,PhD

Speciality:Dermatologist, Venereologist and Aesthetician

Dr. Anil Bhatta knows his work in Botox, Dermal filler and face lifting. All kinds of skin care treatment are provided at his clinic.Remember Dr. Anil Kumar Bhatta for Cost effective treatment.

Visit website here

Contact:01-5908320

2.Dr. Sabina Bhattarai,MD

Speciality:Venereologist and cosmetic Laser Surgeon

She has good practice of dermatology procedures like ablative lasers, photo therapy, cryotherapy, radiofrequency, electrocautery, ionotophoresis, skin biopsies, excision of moles, scar revision.

Visit Website here

Contact:9848841000

3.Dr. Vikash Paudel,MD

Speciality:Dermatologist, Venereologist.

He is one of the best pediatric dermatologist in Nepal.He also treats hair loss very well.

Visit Website here

Contact: 9849948600

4.Dr. Kamal Raj Dhital, MD

He is one of the best established dermatologist in Kathmandu,Nepal.He works in the field of dermatology, cosmetic surgery, Dermato-surgery and hair transplant surgery.He along with his team provide following services: 

Hair transplant surgery in Kathmandu, Nepal

Hairloss treatment in Nepal

Non surgical hair restoration

PRP therapy for hair loss

Laser hair removal with US FDA approved triple wavelength laser

Tattoo removal , freckles removal

Melasma and pigmentation treatment

Fillers

Botox injections

Acne and acne scar treatment

Vitiligo Treatment

Visit Website here

Contact number:9815959413

5.Dr. Uma Keyal, PhD

Speciality: Dermatologist, Aesthetician & Laser Expert

She has good experience in diagnosing and managing the problems related to skin, hair, nails and sexually transmitted infections.In addition, she has good skill in botox injection, dermal fillers, and different types of laser.she has a good exposure to skin diseases and sexually transmitted infections.

 Visit Website here

Contact number:9860999780

Scrub typhus in Nepal

Scrub typhus is a disease caused by Orienta tsutsugamushi.It is endemic in South east asia and some other places.More than one million cases are reported annually.This infection is transmitted to man through the bite of infected trombiculid mite larvae (chiggers).

The incubation period of scrub typhus is about 9 days.

How is diabetes diagnosed?

Diabetes is a disease condition when body is unable to produce or utilize produced insulin from pancreas.This lead to accumulation of glucose in blood called as hyperglycemia.Chronic hyperglycemia has deleterious effect on different tissue system including Cardiovascular system,renal,ocular and neurological tissues.

TYPES OF DIABETES

1.Type 1 Diabetes-It usually occurs at young age.It is due to auto-immune reaction which means that body itself starts destroying beta cells of pancreas.This lead to little or no production of insulin ultimately.

2.Type 2 Diabetes- It is usually diagnosed at