NepMed Repository :: Browsing by Author "Gurung, P"

Browsing by Author "Gurung, P"

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A Histopathological Study of Gastrointestinal Polyps in Tertiary Care Hospital, Nepal
(Institute of Medicine, 2014) Gurung, P; Hirachand, S; Pradhanang, S; Lama, S
Abstract Introduction: Gastrointestinal polyps may be non-neoplastic or neoplastic lesions. They are mostly asymptomatic and are common in the colon but may occur anywhere in the gastrointestinal tract. Some polyps have an increased risk for malignancy, so it is important to determine the histologic type and characteristics for treatment. This study was undertaken to determine the histomorphological spectrum of polyps, their potential risk for malignancy, and frequency in our center. Methods: This is a descriptive study which was carried out at Kathmandu Medical College Teaching Hospital for a period of three years from 1st January 2011 to 31st December 2013. A total of 67 polypectomy specimens were received and processed in the Pathology Department. Hematoxylin and Eosin stained slides were examined. Results: 47 (70.1%) gastrointestinal polyps were non-neoplastic, 19 (28.3%) were neoplastic and 1 (1.6%) was an infarcted polyp. Most of the patients presented with rectal bleeding. The age of patients for non-neoplastic and neoplastic polyps ranged from 3-74 and 23-78 years, respectively. Amongst the non-neoplastic polyps, 21 (44.7%) were retention polyps, 14 (29.8%) were inflammatory polyps, 10 (21.3%) were hyperplastic polyps, 1 (2.1%) benign gastric polyp and 1 (2.1%) non-categorized polyp. The neoplastic polyps had 16 (84.1%) adenomatous polyps, 1 (5.3%) mixed polyp, 1 (5.3%) fundic gland polyp, and 1 (5.3%) moderately differentiated adenocarcinoma. 11 (68.8%) adenomatous polyps had mild dysplasia, 2 (12.5%) moderate dysplasia, and 3 (18.7%) severe dysplasia. Size of the non-neoplastic polyps ranged from 0.2-5.0 cm and size of neoplastic polyps ranged from 0.3-6.0 cm in diameter. Some patients presented with more than one polyp. Conclusion: Polyps have a diverse histomorphology and there is a risk of malignancy in the adenomatous polyps so it is important to screen patients for treatment and cancer prevention. Keywords: adenomatous polyps, hyperplastic polyps, inflammatory polyps, retention polyps
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, R
Abstract 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 lesions
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, R
Abstract 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, hospital
Clinico-Haematological Profile of Megaloblastic Anaemia
(Institute of Medicine, 2014) Hirachand, S; Singh, R; Gurung, P; Thapa, R
Abstract Introduction: Megaloblastic anaemia is one of the important causes of anaemias. It is a macrocytic anaemia resulting from abnormal maturation of hematopoietic cells due to faulty DNA synthesis. Two vitamins, cyanocobalamin (vitaminB12) and folic acid are essential for DNA biosynthesis. Deficiency of either vitamin results in abnormal nuclear maturation with normal cytoplasmic maturation, apoptosis, ineffective erythropoiesis, intramedullary haemolysis, pancytopenia and typical morphological abnormalities in blood and marrow cells. Methods: This descriptive study was carried out for two and a half years (July 2011 to December 2013) in the department of Pathology, Star hospital, Kathmandu, Nepal. Out of 885 anaemic patients 55 diagnosed as megaloblastic anaemia were included in the study. Complete blood count, reticulocyte count, peripheral smear and bone marrow examination were performed. Serum vitamin B12 and folic acid estimation was done in 32 cases. Results: Out of 55 cases of megaloblastic anaemia, 31 were female and 24 were male with a female to male ratio of 1.3:1. Age range was 18 to 80 years. Pallor was the predominant clinical finding in these cases. Twenty cases (36.36%) presented with only anaemia while others presented with pancytopenia or bicytopenia. Of the 55 cases of megaloblastic anaemia,32 had assays done for cobalamin and folate, of which 15 (46.88%) had cobalamin deficiency, 4 (12.5%) had folate deficiency and 13 (40.62%) had combined deficiency. Conclusion: Megaloblastic anaemia can present with varied clinical manifestations. Strong suspicion of megaloblastic anaemia should be entertained by clinicians to improve clinical outcome. Prompt diagnosis is important as it is a completely curable condition. Keywords: Anaemia, Cobalamin and folate deficiency, Megaloblastic anaemia
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, P
Abstract 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 lesions
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, B
ABSTRACT 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, Neurointervention
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, S
Abstract 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 lesions
Era of Targeted Therapy
(Institute of Medicine, 2016) Gurung, P
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Histopathological study of ovarian cystic lesions in Tertiary Care Hospital of Kathmandu, Nepal
(Institute of Medicine, 2013) Gurung, P; Hirachand, S; Pradhanang, S
Abstract Introduction: Ovarian cysts are commonly encountered lesions. They are amongst the most frequent cause of hospitalization and surgery in gynecological practice. One cannot confidently distinguish a benign lesion from a malignant one on the basis of clinical, radiological or gross characteristics along so a histopathology examination is a must as it guides therapy. The study was undertaken to determine the morphologic spectrum of the cystic lesions of the ovary. Methods: This is a descriptive study which was carried out at Kathmandu Medical College Teaching Hospital for a period of two years from 1st January 2011 to 31st December 2012. A Total of 135 cases of ovarian cysts were received and processed in the Pathology Department. Hematoxylin and Eosin stained slides were examined. Results: Among the 135 ovarian cystic lesions, 119 cases (88.15%) were unilateral and 16 cases (11.85%) were bilateral. There were 59 cases (43.7%) of benign cysts, 69 cases (51.1%) of benign tumors, 5 cases (3.7%) of malignant tumors and 2 cases (1.5%) of borderline epithelial tumors. The age of patients ranged from 13 years to 73 years with mean age of presentation of 43 years. Among the ovarian cystic lesions the incidence of mature cystic teratoma was the highest (30%). The most common non-neoplastic cyst was endometriotic cyst (39%), while the most common benign tumor was mature cystic teratoma (58%). The malignant tumor encountered in the study was serous cystadenocarcinoma. Two cases of borderline epithelial tumors (1.5%) were also observed in the study. Conclusion: The most common cystic lesion that were encountered in the study was benign tumor followed by benign cyst. Of the benign tumors, mature cystic teratoma was the most frequently observed lesion. Among the non-neoplastic cysts, endometriotic cyst was the most frequently observed lesion. Keywords: borderline tumors, endometriosis cyst, mature cystic teratoma, Ovarian cyst, serous cystadenocarcinoma
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, M
Abstract 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

Browsing by Author "Gurung, P"

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