Browsing by Author "Panthi, Bishal"
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Publication Comparative Outcomes of Doxorubicin and Cyclophosphamide with Sequential versus Concurrent Paclitaxel in the Adjuvant Treatment of Non-Metastatic Breast Cancer: A Cross-Sectional Analytical Study(Nepal Medical Association, 2025) Paudel, Bishal; Paudel, Bishnudutta; Shrestha, Rakshya; Panthi, Bishal; Shilpakar, Ramila; Dulal, Soniya; Kharel, Sanjeev; Dhunagana, Reechashree; Singh, Yogendra Prasad; Shrestha, BipsanaAbstract Introduction: Studies have compared the efficacy and toxicities of doxorubicin and cyclophosphamide every three weeks for four cycles followed by four cycles of paclitaxel every three weeks (AC/T); with paclitaxel, doxorubicin, and cyclophosphamide (TAC) every three weeks for six cycles for adjuvant treatment of breast cancer in western countries. Genetic and environmental disparities in Nepalese population warrant the need for similar studies in Nepal. This study compares the toxicity patterns and compliance of AC/T versus TAC in the adjuvant treatment of non-metastatic breast cancer in Nepalese women. Methods: A hospital-based cross-sectional analytic study was conducted at Bir Hospital, Kathmand after obtaining the ethical approval (Reference number: 931/076/077). Sixty women who completed either AC/T or TAC regimens were evaluated. Confounding was minimized by strict inclusion/ exclusion criteria (restriction), group matching, and random sampling. Primary outcome was grade 3–4 hematological toxicity; secondary outcomes included other adverse effects and compliance. Results: Although hematological toxicities were higher in the TAC group, differences were not statistically significant. Non-hematological toxicities (fatigue, nausea, vomiting, pain, nail changes) were significantly higher in the TAC group. Edema was more prevalent in the AC/T group (p=0.04). Compliance without modification favored AC/T (64.5% vs. 34.5%; p=0.038). Conclusions: Sequential AC/T demonstrated superior tolerability and compliance. Confounder control through study design and statistical methods strengthens the validity of these findings, though larger studies are warranted.Publication Uncommon Presentation of Osteochondroma in a Flat Bone of Left Iliac Blade Lesion: A Case Report(Nepal Medical Association, 2025) Sah, Sushant; Sharma, Sujan; Panthi, Bishal; Bhandari, Govinda; Shrestha, Aron; Chhetri, Lalita Poudel; Thakur, Abhishek KumarAbstract Osteochondromas are the most common benign bone tumors, frequently affecting the metaphysis of long bones. Their occurrence in flat bones is rare, accounting for only 5% of cases. This report presents a solitary osteochondroma of the iliac blade, a rare anatomical location. A 17-year-old male presented with a progressively enlarging, painless bony mass on the hip, associated with lower back pain. Imaging studies, including ultrasound and MRI, revealed a bony outgrowth with medullary and cortical continuity and a benign cartilage cap. The patient underwent en bloc excision biopsy under spinal anesthesia, removing the lesion along with a portion of the iliac crest. Osteochondromas in flat bones are rare, posing diagnostic challenges. While imaging provides critical diagnostic clues, histopathology remains essential for confirmation. Surgical excision is the treatment of choice for symptomatic cases. This case highlights the importance of recognizing osteochondromas in unusual locations and employing multidisciplinary approach for optimal diagnosis and management.