Browsing by Author "Khanal, Anupa"
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Publication A Spectrum of Histopathological Findings in Hysterectomy Specimens at a Tertiary Care Center in Western Nepal: A Descriptive Study(Nepal APF Hospital, 2026) Lama, Laxmi; Karki, Asmita; Khanal, Anupa; Shrestha, Dipesh; Vaidya, Sahesh Gopal; Bajracharya, Prasamsha; Khatri, SwostikaAbstract: Introduction: Hysterectomy is a widely performed major surgical procedure in women globally. It is performed as a definitive treatment for several pathologies of female reproductive organs, which include uterine fibroids, uterine prolapse, abnormal uterine bleeding, adenomyosis, endometriosis, and malignancies. The current study aimed to assess the spectrum of histopathological findings in hysterectomy specimens. Methods: A retrospective descriptive study was conducted in the Department of Pathology from November 2022 to July 2025 after ethical approval from the Institutional Review Committee. (Reference number: IRC-LMC-07/2025) A total of 210 women were enrolled who presented with a clinical diagnosis of female genital tract lesions. Clinical details, including age of patients, preoperative diagnosis and type of surgical procedure, were retrieved from medical records of the Department of Obstetrics and Gynaecology. All slides were observed under a light microscope by the consultant pathologist. Descriptive data were analyzed statistically, and SPSS software version 25 was used for the analysis. Results: Among the specimens observed, the most predominant endometrial lesions were proliferative phase endometrium in 103 (49%) cases, followed by atrophic endometrium in 51 (24.28%) cases. Leiomyoma was the most common myometrial lesion in 90 (42.85%) cases, and adenomyosis was seen in 20 (9.52%). The ovaries manifested various lesions; the corpus luteal cyst was the most frequently encountered lesion, seen in 23 (16.31%) cases and two malignant tumors one high-grade serous carcinoma and one transformed teratoma. Conclusions: The current study revealed that a wide spectrum of lesions can be identified on histopathological examination. Therefore, it is essential that all hysterectomy specimens undergo thorough histopathological evaluation even when they appear grossly normal.Publication Correlation of Cervical Pap Smear with Cervical Biopsy in Lesions of Cervix(Institute of Medicine, Tribhuvan University, 2024) Tiwari, Archana; Khanal, Anupa; Sapkota, Pratima; Karki, AsmitaAbstract: Introduction Cervical cancer is the leading cause of mortality for women in underdeveloped nations and the 4th leading cause globally. Pap smears are non-invasive method, but are unable to pinpoint their location. However, cervical biopsies are an invasive but gold standard procedure. Methods An analysis of all pap smears obtained during a one-year period, from April 14, 2022 to April 12, 2023 was carried out in the Department of Pathology, LMC, Palpa. But only the cases that had undergone both pap smear and cervical biopsy were compared. Only 64 of the 337 pap smears that were obtained for cytological analysis also had a biopsy. Results Out of 64 pap smear, 32.81% had normal cytology, 25% had ASC-US, 4.68% had atypical glandular cells, and 9.37% had HSIL. The most pap smears were done on people between the ages of 31 and 40. In 64 biopsies, 23 (35.93%) had HSIL, 20 (31.25%) had LSIL, and 7 (10.93%) had chronic cervicitis, according to the histological diagnosis of biopsies. Four individuals had a cancer diagnosis, including two (3.12%) squamous cell carcinomas and two (3.12%) adenocarcinomas. The Pap smear showed a sensitivity of 25.92%, specificity of 94.59%, PPV of 77.77%, NPV of 63.63%, and a diagnostic accuracy of 65.62%. Conclusion The Pap smear test, had poor sensitivity but good specificity in detecting premalignant and malignant cervical abnormalities. Pap smear is a noninvasive method; however, cervical biopsy is a gold standard but invasive technique.Publication Hemodynamics following Prophylactic Phenylephrine Infusion in patients undergoing Cesarean Section under Spinal Anesthesia(Institute of Medicine, Tribhuvan University, 2024) Gauchan, Sabin; Thapa, Chitra; Acharya, Sulav; Khanal, AnupaAbstract: Introduction Phenylephrine is considered the vasopressor of choice in hypotension associated with obstetric spinal anesthesia. But the dose and mode of administration that is effective yet safe in mother as well as fetus remains controversial. We studied the hemodynamics of parturients who received prophylactic infusion of phenylephrine 50µg/min following spinal anesthesia. Methods Patients posted for elective cesarean section received a prophylactic phenylephrine infusion of 50µg/min immediately after spinal anesthesia for 30 minutes. Parturients were also co-loaded with lactated Ringer’s solution 1 litre. Blood pressure and heart rate was monitored at an interval of 3min initially and after the delivery of baby interval was increased to 5min. Episodes of hypotension, reactive hypertension and bradycardia in mother were recorded. Neonatal APGAR score at 1 and 5min was also recorded. Results One hundred and forty parturients were included in the study. Twenty patients (14.28%) developed hypotension. Out of 20 patients who developed hypotension, 3 patients (15%) had a single episode, 11 patients (55%) had 2 episodes and 6 patients (30%) had 3 episodes of hypotension. Three patients (2.14%) had reactive hypertension. None of the patients had bradycardia. There was no episode of hypotension induced nausea vomiting. Mean APGAR score at 1min and 5min was 8 and 9 respectively. Conclusion The prevalence of hypotension with prophylactic phenylephrine infusion was low. We found minimal episodes of reactive hypertension, no episodes of bradycardia and no adverse effect on fetus. It can be regarded a safe means to minimize hypotension in obstetric spinal anesthesia.