Browsing by Author "Gurung, P"
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Publication A study on fine needle aspiration cytology of epididymal nodules(Institute of Medicine, 2018) Thapa, R; Gurung, P; Kafle, N; Pradhanang, S; Hirchand, S; Lakhey, M; Joshi, RAbstract Introduction: Fine needle aspiration cytology (FNAC) is a rapid and relatively inexpensive technique used extensively in the diagnosis of a large variety of neoplastic and nonneoplastic lesions in many organs.There are very few literature reports documenting the role of fine needle aspiration cytology (FNAC) in the evaluation of epididymal nodules. The aim of this study was to highlight the cytomorphologic features of FNAC in epididymal nodules. Methods: A descriptive study was carried out in all the patients presented with palpable epididymal nodules for FNAC over a period of two and half years in department of pathology, Kathmandu Medical College Teaching Hospital, Sinamangal, Kathmandu. FNAC was performed using 23 gauge needle with 10ml syringe. Smears were routinely stained with PAP, Giemsa stain and Special stains whenever needed. Results: A total of 31 cases of non – neoplastic lesions were identified. Age ranged from 15 to 52 years. Majority of cases were of tuberculous epididymitis accounting for 38.70%. Conclusions: FNAC serves as an important tool to screen and diagnose all palpable epididymal nodules and provides information for further management. Keywords: Fine needle aspiration cytology, epididymal nodules, neoplastic, non-neoplastic lesionsPublication Clinical and epidemiological profile of bacterial pathogens isolated from infected lesions in Kathmandu University Hospital(Institute of Medicine, 2018) Sherchan, JB; Gurung, P; Bhusal, N; Pote, N; Tamrakar, SR; Malla, BR; Tamrakar, RAbstract Introduction: Treatment of thepatient with wound infected with multidrug resistantorganismis a major burden and challenge to the health care persons. This study was conducted to identify the clinical and epidemiological profile of such patients. Methods: The study was a cross-sectional study conducted between November 2017 to June 2018 in Kathmandu University Hospital. Wound swabs, pus samples collected from patients during the study period were included. Specimen collection, culture, identification tests were done following standard guidelines and patient information was collected after informed consent. Results: Total number of patients observed for wound infection was 2,763. 1,550(56.10%) were postoperative wound and 1213(43.90%) were non-post-operative wound. Pathogenic bacteria were detected in 252(9.12%) samples. 167(66.27%) were multidrug resistant. Conclusion: Since, limited data is available in Nepal,determination ofclinical and epidemiological profile ofwound infection might become a useful tool to prepare guidelines for controlling and treating infected wound in healthcare centers and community. Keywords: Clinical epidemiology profile, bacterial pathogens, drug resistant, hospitalPublication Diagnostic role of fine needle aspiration cytology in the evaluation of salivary gland lesions(Institute of Medicine, 2017) Hirachand, S; Kafle, N; Thapa, R; Gurung, PAbstract Introduction: Fine needle aspiration cytology (FNAC) is a popular method for diagnostic evaluation of salivary gland lesions due to their superficial nature and easy accessibility for the procedure. The technique is simple and cost effective. The present study was conducted to evaluate the diagnostic accuracy of fine needle aspiration cytology in various salivary gland tumors, which helps in an early diagnosis and appropriate therapeutic management. Methods: The study was conducted in the Department of Pathology in Kathmandu Medical College and Teaching Hospital, Sinamangal, Kathmandu, Nepal from October 2014 to September 2016 (2 years). A total of 48 fine needle aspirations of salivary gland lesions were done, of which histopathological conformation of diagnosis was available in 34 cases. A standard cytological and histopathological staining were used and examined. Results: Forty eight cases of salivary gland lesions were included in the study. The age of patients ranged from 6 to 88years, with a mean age of 46years. Male: female ratio was 1.4:1 with common site being the parotid gland. Histopathological conformation of diagnosis was available in 34 cases. Pleomorphic adenoma was found to be the most common benign tumor (50%) and mucoepidermoid carcinoma (14.70%) was the commonest malignant tumor. The overall diagnostic accuracy of FNAC in diagnosing salivary gland lesions was 89.47% with a sensitivity of 77.77 and a specificity of 93.10%. Conclusion: Fine needle aspiration cytology is an important and useful diagnostic tool for diagnosing salivary gland lesions. Proper sampling of lesions and adequate cellularity of the smears are the pre- requisites for accurate diagnosis. Hence, the appropriate therapeutic management could plan earlier. Keywords: Cytology, Fine needle aspiration cytology, Salivary gland lesionsPublication Digital Subtraction Angiography a Door Opener for Neurosurgical Residents who want to Perform Neurointerventional Procedures(Kathmandu University, 2021) Rajbhandari, P; Gurung, P; Rajbhandari, S; Shrestha, D; Acharya, S; Shrestha, R; Shrestha, P; Shrestha, J; Sharma, U; Mali, S; Rajbhandari, R; Neupane, A; Pant, BABSTRACT Digital subtraction angiography (DSA) has been a fluoroscopic golden investigative tool to know the vascular angiography of the brain and spinal cord. The technique in performing this procedure exposes residents in accessing the major vessels, branches of the arch of aorta, selective angiography and diagnosing different vascular anomalies of brain and spine. They are also exposed to the knowledge of different diagnostic catheters, its manipulation, use of dye and radiation exposure and safety. We would like to share our experience in training and disseminating the knowledge of digital subtraction angiography to the residents. KEY WORDS Digital subtraction angiography, Neurosurgical residents, NeurointerventionPublication Efficacy of bronchial cytology in diagnosing lung lesions and its correlation with bronchial biopsy(Institute of Medicine, 2018) Hirachand, S; Sthapit, RR; Gurung, P; Acharya, SAbstract Introduction: Neoplastic and non-neoplastic lung lesions have a high rate of morbidity and mortality. Lung cancer is the frequently diagnosed cause for cancer related deaths and tuberculosis is still the leading cause of death in developing countries. Timely detection of disease plays an important role in the management and long term survival of patients. For early diagnosis different diagnostic modalities are available which include bronchoalveolar lavage, bronchial brush, fine needle aspiration cytology and bronchial biopsy. Bronchoalveolar lavage and bronchial brush are very effective in the diagnosis and differential diagnosis of lung cancers. Bronchial brushings often offer excellent specimens and accurate information about the site of the lesion. Better diagnostic yield is often obtained when cytologic techniques are used together with bronchial biopsy.The present study was undertaken to ascertain the role and diagnostic utility of bronchoalveolar lavage, bronchial brush and bronchial biopsy in diagnosing lung lesions. Method: A prospective study was conducted in the Department of Pathology in Kathmandu Medical College and Teaching Hospital, Sinamangal, Kathmandu, Nepal from January 2016 to December 2017 (2 years). A total of 48 cases were included in the study. Bronchoalveolar lavage, bronchial brush and bronchial biopsy slides were stained with routine cytological and histological staining and examined. Results: Out of 48 cases, bronchoalveolar lavage smears revealed 24 non-neoplastic, 19 neoplastic and 5 suspicious cases. Bronchial brush smears revealed 24 neoplastic, 22 non-neoplastic and 2 suspicious cases. Bronchoscopic biopsy revealed 31 neoplastic and 17 non-neoplastic lesions. The bronchial brush cytology showed sensitivity of 82.76%, specificity of 89.47% and accuracy of 85.42%. Conclusion: Combination of bronchial cytology and biopsy can be considered as the best procedures for the diagnosis of lung lesions. Keywords: Bronchoalveolar lavage, Bronchial brush, bronchial biopsy, non-neoplastic and neoplastic lung lesionsPublication Publication Utility of Rapid Brilliant Cresyl Blue Stain in Routine Fine Needle Aspiration Cytology(Institute of Medicine, 2017) Gurung, P; Hirachand, S; Thapa, R; Pradhanang, S; Kafle, N; Acharya, S; Sedhain, MAbstract Introduction: Rapid on-site evaluation is commonly performed by pathologists to check for cellular adequacy of fine needle aspirate smears to reduce hospital visits of patients and to make preliminary diagnosis. For rapid evaluation, laboratories use Romanowsky stain, Hematoxylin and Eosin stain, supravital stains and ultra-fast Papanicolaou stain. The aim of the study is to evaluate fine needle aspirate smears on-site for sample adequacy using supravital stain Brilliant Cresyl Blue (BCB), to make preliminary cytological diagnosis and to compare with the routine cytological Papanicolaou stain (Pap) and Giemsa stain. Methods: The study was carried out in the Department of Pathology, Kathmandu Medical College Teaching Hospital from 1st December, 2014 to 31st December, 2015. A total of 115 cases referred from OPD for FNAC were included in the study. FNA was performed under aseptic conditions with a 23-guage needle. Samples were collected for routine stains (Papanicolaou and Giemsa stain) and one air-dried slide was stained with Brilliant Cresyl Blue and examined immediately while patient was in waiting room. Results: Of the 115 cases, the age of patients ranged from 15 to 83 years in which male and female ratio was 1.5:1. There were 35 (30.4%) cases of enlarged lymph nodes, 28 (24%) cases of thyroid lesions, 20 (17.3%) cases of breast lesions, 7 (6%) cases of soft tissue lesion, 3 (3%) cases of salivary gland lesions, 1 (1%) case of lung mass, 1 (1%) case of epididymal swelling and others 20 (17.3%) cases. On rapid staining with brilliant cresyl blue, case sample adequacy was 104 (90%). Repeat aspiration was done in 11 (10%) of cases .Upon rapid staining, 92 (80%) of the cases were benign, 19 (17%) cases were malignant, 4 (3%) cases were inconclusive. After observation of papanicolaou and giemsa stains, there were 94 (82%) benign cases and 21 (18%) malignant cases. Conclusion: On-spot Brilliant Cresyl Blue staining is a good stain to check for sample adequacy and to reduce reaspirations. It is as good as the conventional stains in exhibiting cytomorphology of cells. Keywords: Brilliant Cresyl Blue, cytomorphology, fine needle aspiration cytology, Giemsa stain, Papanicolaou stain