GALIDRAA (greet, ask, listen, identify, discuss, recommend, agree, and appoint), an interpersonal communication method, is used in health and nutrition behaviour change programmes to structure communication between front-line workers (FLWs) and beneficiaries. However, programmatic experiential evidence and monitoring and evaluation of the method are scarce. Suaahara aims to address maternal and child undernutrition, in part by influencing household-level behaviours. Suaahara trained both government and programme FLWs in GALIDRAA for use during counselling. This study investigates their adherence to the GALIDRAA method 2 years later, using quantitative and qualitative data from a 2014 process evaluation study. Descriptive and thematic analyses were conducted to assess adherence to GALIDRAA. We found variation in adherence to each of the eight GALIDRAA steps among both Suaahara field supervisors (FSs) and Nepal's female community health volunteers (FCHVs). The prevalence of FLWs identifying a beneficiary's problem, discussing, questioning, and probing for constraints with the beneficiary, and, only then, recommending a doable solution, that is, the process of personalized nutrition counselling, was substantially higher among Suaahara FSs than FCHVs. However, both FCHVs and FSs counselling skills, particularly regarding adherence to each step of the GALIDRAA approach, have room for improvement. This highlights the need for additional training and post-training follow-up including supportive supervision related to appropriate counselling methods such as GALIDRAA and may indicate that there are additional FLWs constraints, beyond knowledge, that programmes need to address.

Introducti on: Tenia Cruris is the commonest dermatophyte infecti on which is common in men and aggravated by warm humid conditi on Teniarubrum is the main species for the disease 1,2 . Itraconazole and Terbinafi ne are the bett er newer drugs for the therapeuti c opti on due to their effi cacy, convenient and less side eff ect. Itraconazole is a wider spectrum Thiazole group of fungistati c drugs which inhibit sterol 14 α demethylase impairing biosynthesis of fungal ergosterol. Similarly Terbinafi ne is broad specturmallylamine group of fungicidal acti vity which inhibits squalene 2, 3 epoxidase enzyme thus inhibit fungal biosynsthesis of ergosterol [3][4][5] . These two drugs have been needed conventi onally as a pulse and conti nuous therapy. The main aim of this study is to compare the effi cacy of both drugs and to recommend the eff ecti ve treatment in case of Teniacruris. Methods:In this randomized comparati ve study, the effi cacy and safety of oral itraconazole (n=35) and terbinafi ne (n=35), each given for 2weeks, was compared in pati ents with ti neacruris within the period of 1 year study. Results:The fi nal evaluati on at week 4 showed a cure rate of 91.4% for itraconazole and 82.9% for terbinafi ne. No defi nite adverse eff ect was noted. Conclusions:Itraconazolehas high cure rate and less failure rate without side eff ects in comparision toTerbinafi ne.

Introduction: Dermatological conditions make up a significant burden of hospital visits. This study aims to calculate the prevalence of different dermatological conditions among OPD visits in a tertiary care hospital in Kathmandu, and describe the variation of those conditions with demographic variables and seasons. Methods: This study was performed retrospectively using the data collected in the OPD register of a tertiary level hospital from 14th April 2017 to 13th April 2018. Analysis was conducted using MS Excel 2016 and Statistical Package for the Social Sciences (SPSS) v25. Results: A total number of 24,332 OPD visits were recorded in the year. 54.3% of the visits were made by males and 45.7% by females and most common age group seeking dermatological consultation was 25 to 34 years. Noninfectious dermatoses were more common than infections. The most common noninfectious dermatoses were dermatitis/eczema, urticaria, angioedema and hypersensitivity, and pigmentary disorders in descending order of frequency. The common infectious dermatoses in decreasing order of frequency were fungal, viral, and parasitic/protozoal conditions. The infectious dermatoses were found to be significantly higher in males (p<0.05) while pigmentary disorders, urticaria and angioedema, autoimmune cutaneous disorders, disorders of pilosebaceous units and xerosis were significantly higher in females (p<0.05). Bacterial, fungal and viral infections, eczemas, urticarial/angioedema, papulosquamous disorders, xerosis, neoplasms and vasculitis showed significant seasonal variation. Conclusions: Eczemas and fungal infections are the most common dermatoses. Infectious dermatoses and several non-infectious dermatoses vary significantly with seasons.

Acrodermatitis enteropathica is rare congenital autosomal recessive disorder. Premature are particularly risk and disease is caused by zinc deficiency due to a specific absorptive defect. This disease manifests in child as peevish, withdrawn and photophobia and develop vesicobullous dermatitis on hands, feet and perioroficial areas and alopecia. Diarrhea is often present. This also presents as shunted growth and decrease resistance to infection. Poor wound healing. A low plasma zinc level and Serum alkaline phosphatase are useful indicator of zinc status. DOI: http://dx.doi.org/10.3126/mjsbh.v10i2.6461 Medical Journal of Shree Birendra Hospital July-Dec 2011 10(2) 32-34

Introduction: Chronic Spontaneous Urticaria (CSU), is spontaneous occurrence of wheals for more than 6 weeks. CSU patients with autoreactivity as indicated by positive Autologous serum skin test (ASST) have severe disease requiring higher doses of antihistamines and even immunomodulatory agents. Objective: The objective of this study was to observe the association between CSU and ASST. Materials and Methods: Over a period of one year, 104 CSU patients were enrolled in the study. Autologous serum skin test was done using 0.05 ml of patient’s serum, with 0.05 ml of histamine as positive control and normal saline as negative control. Prevalence of positive ASST in CSU patients was determined. Clinical and demographic characteristics were compared in both ASST positive and negative patients. Results: The ASST was positive in 68 patients (65.4%). Mean age (SD) of the patients in ASST positive group was 33.78 (14.38) versus 35.64 (14.47) in ASST negative group (p=0.533). Male:Female ratio in ASST group was 1:2.7 versus 1:1.1 in ASST negative group (p=0.033). Patients with positive ASST had significantly longer duration of wheals (p=0.002), generalized distribution (p=0.020) and high rmean urticaria activity score, 4.66 versus 3.28 in ASST negative patients, p<0.001. Angioedema was more common in ASST positive patients (p < 0.001). Conclusion: ASST was significantly positive in CSU patients and more common in females. ASST positive patients had more severe clinical manifestations and it can be a simple test to detect severe form of CSU.