Browsing by Author "Jha, Anamika"
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Publication Comparison of Sonographic Findings with Diagnostic Mammography(Nepal Health Research Council, 2024) Joshi, Birendra Raj; Paudel, Bishnu; Jha, AnamikaBackground: Breast cancer is the leading female cancer worldwide with a high mortality rate. Early detection of the suspicious lesion is crucial for better prognosis. Higher breast density decreases the sensitivity of mammogram. Ultrasound can differentiate between cystic and solid masses and further characterize these as benign or possibly malignant. Our objective was to compare the findings of sonography with diagnostic mammography. Methods: This was a cross sectional study including 125 females who underwent diagnostic mammogram in a tertiary care center. The mammograms were evaluated and the patients were scanned by ultrasound and categorized as per ACR- BIRADS category. The findings of diagnostic mammography were compared with that of ultrasonography using SPSS version 25. Results: The heterogeneously dense breast in diagnostic mammography corresponded to the heterogenous- fibroglandular breast in ultrasonography. In majority, ultrasound increased the BIRADS category for the lesion than designated by the diagnostic mammography. It was particularly useful for category 0 and 3 lesions which were indeterminate and required further imaging. Conclusions: Ultrasound was useful in evaluation of dense breasts with ACR-BIRADS 0 and 3 in diagnostic mammogram. For category 3 and 4 in diagnostic mammogram, ultrasound showed category 1 or 2 lesions which aided to alleviate patient anxiety and avoid unnecessary biopsies. With emerging technological advances in ultrasound, it can used as a powerful tool for breast lesion detection and patient management. Keywords: Breast density; diagnostic mammogram; ultrasonography.Publication Prevalence and Risk factors of Lower Urinary Tract Symptoms in Menopausal Women(Rapti Academy of Health Sciences (RAHS), 2024) Jha, Anamika; Dangal, Ganesh; Poudel, SandeshAbstract: Introduction: Lower urinary tract symptoms is existing everywhere in the world and depending on the age, geographical location, and culture it is having great impact. They encompass different disease features which include-storage, voiding and post micturition. Numerous risk factors have been identified, and there are few published articles concerning the frequency of LUTS in menopausal women as well as their associated risk factors. Thus, this study was formulated with the intention of ascertaining the incidence and the risk indicators of LUTS in menopausal women. Methods: This was a cross-sectional study of the observational type which was carried out in the Paropakar Maternity & Women’s Hospital Thapathali, Kathmandu. Approval to carry out the study was sought and granted from the IRC. It was a hospital-based descriptive cross-sectional study conducted in gynecological outdoor patient department involving all menopausal women who presented themselves to the clinic between February 1st to April 30th 2024 using convenience sampling technique. Among the study population having LUTS, their details and possible risk factors were incorporated in this study. Results: Three hundred menopausal women were recruited in the study during the considered period of time. Mean age of menopause was 48. 3 years. Concerning LUTS, the current study established a prevalence rate of 71.7% among the respondents. The most frequently reported complaint was urgency reported by 39 % of the patients ,seconded by incontinence reported by 35. 7% of the patients and thirdly nocturia was reported by 23% of patients. In menopausal women, the factors that may increase the risk to develop LUTS were BMI, having a history of childbirth and recurrent UTI. Conclusion: LUTS was significantly high among menopausal women in Paropakar Maternity and Women’s Hospital, the most dominating symptom was urgency and the second one was incontinence. Several factors were established to be predictive of LUTS namely; BMI, giving birth and a history of recurrent UTI but there was no statistical evidence related to the type of delivery. Keywords: Lower urinary tract symptoms, menopause, womenPublication Sonography as an Adjunct to Digital Mammography in Patients with Dense Breasts(Nepal Health Research Council, 2024) Jha, Anamika; Regmi, Pradeep Raj; Pradhan, Huney; Thakur, Minaxi; Joshi, Birendra RajBackground: Dense breasts are associated with an increased risk of cancer and also mask lesions on mammograms. In our study, we evaluated the role of sonography as an adjunct to digital mammography in patients with dense breasts. Methods: Sonography of 676 female patients with American College of Radiology category C or D mammographic density was done in this prospective cross-sectional analytical study in the Department of Radiology, Tribhuvan University Teaching Hospital. The final imaging diagnosis was classified as per the American College of Radiology Breast Imaging Reporting and Data System categories. Tissue diagnosis was obtained in patients with sonographic category 3 solid lesions larger than 3 cm, category 4 and 5 lesions. The data were tabulated and analyzed using Statistical Package for Social Service (SPSS) for Windows version 22. Results: Additional sonography confirmed all BIRADS 1 mammograms as normal or benign, 95.7 % (112) of inconclusive, and 82.8% (n=135) of BIRADS 3 ones as benign. It had higher sensitivity and negative predictive value (100%) than mammography with similar accuracy. Most patients (479, 70.9%) had diagnostic indications. There were 540 (79.9%) cases in ACR BIRADS category c. A final diagnosis of benign (316, 46.7%) was most common, followed by normal (293, 43.4%) and malignant (67, 9.9%). The majority of the malignant lesions were Invasive Ductal Carcinoma (59, 88%). Conclusions: Additional sonography confirmed mammography findings as normal, benign, or suspicious for malignancy, definitely described morphology and extent of mass, and also guided biopsy. It had higher sensitivity than mammography in dense breasts. Keywords: Breast density; mammography; ultrasonography mammary.