Browsing by Author "Panthi, Bishal"
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Publication Breast Cancer among Cancer Patients Visiting the Department of Internal Medicine of a Tertiary Centre(Nepal Medical Association, 2024) Shrestha, Rakshya; Paudel, Bishal; Panthi, Bishal; Gyawali, Bindu; Pandey, Anup; Khanal, Surendra; Gyawali, SiddinathAbstract Introduction: Breast cancer is one of the most common cancers worldwide both in terms of incidence and mortality. Its incidence has been on an increasing trend in developing nations including Nepal, however, there is very limited evidence of its demographic profile in our setting. This study aimed to find out the prevalence of breast cancer among cancer patients visiting the Department of Internal Medicine of a tertiary centre. Methods: A descriptive cross-sectional study was conducted among cancer patients visiting the Department of Internal Medicine of a tertiary care centre using retrospectively collected data from 1 August 2022 to 30 July 2023 after obtaining ethical approval from the Institutional Review Committee. Histopathologically confirmed cancer patients were included and those with incomplete and duplicated data were excluded. A convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Among 2067 cancer patients, the prevalence of breast cancer was 102 (4.93%) (4.00-5.87, 95% Confidence Interval). The mean age was 50.51±2.08 years. The most commonly affected age group was 40 to 60 years constituting 61 (59.80%) patients. Histologically, invasive breast cancer of no special type was the most common and was found in 91 (89.22%) patients. Conclusions: The prevalence of breast cancer was similar to other studies done in similar settings.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 Histopathological Profile of Lung Cancer: A Single-Center Study from Nepal(Institute of Medicine, Tribhuvan University, 2025) Paudel, Bishal; Dhungana, Reechashree; Shrestha, Rakshya; Panthi, Bishal; Kharel, SanjeevAbstract: Introduction Lung cancer remains the leading cause of cancer-related mortality globally, accounting for approximately 18% of all cancer death. Despite the global prevalence of lung cancer, epidemiological data from Nepal remain limited. The study aims to bridge these gaps by investigating the histopathological characteristics of lung cancer in a cohort of patients from a tertiary care center in Nepal. Methods This is an observational cross-sectional study conducted at Tribhuvan University Teaching Hospital (TUTH) among lung cancer patients aged greater than 18 years of age from September 2024 to February, 2025. Descriptive statistics was used to summarize demographic and histopathological characteristics. Results A total of 107 lung cancer patients were included in our study. The male:female ratio was 1.3 in our study, while the mean age of the patients was 67 years and standard deviation is 11 years. Squamous cell carcinoma (48%) and Adenocarcinoma (46%) were the major histological subtypes while only 6% cases were Small-cell carcinomas. Conclusion This study analyzes the histopathological and the demographic profile of lung cancer diagnosed at a single tertiary center of Nepal. Non-small cell lung cancer is the most common histological diagnosis in this study. Broader study is needed to explore the clinical and molecular associations.Publication Impact of Incentive Spirometry in COPD Exacerbations: A Comparative Study(Institute of Medicine, Tribhuvan University, 2024) Paudel, Bishal; Panthi, Bishal; Shrestha, Rakshya; Karki, Onika; Dhungana, Reechashree; Yadav, Alisha; GC, Saroj; Neopane,ArpanaAbstract: Introduction: Chronic Obstructive Pulmonary Disease (COPD) is a major cause of morbidity and mortality in Nepal, with acute exacerbations (AECOPD) leading to severe complications. This study explores the impact of incentive spirometry (IS) on clinical outcomes, arterial blood gases and hospital stay in AECOPD patients. Methodology: This comparative study was conducted at a tertiary care center in Kathmandu, Nepal and involved 60 AECOPD patients, split into two groups: 30 receiving standard medical treatment (control) without IS and 30 using IS. Demographic and clinical information were recorded and key outcomes— arterial blood gases (ABGs), MMRC score, respiratory rate, oxygen saturation, and hospital stay—were measured after stabilization and at discharge. Statistical analysis used SPSS 22, with significance set at p<0.05. Results: Both groups showed significant improvement in MMRC and oxygen saturation(p<0.001). However, the IS group also demonstrated a significant reduction in respiratory rate (26.73±2.52 to 21.07±2.11, p<0.001), unlike the control group (27.3±2.3 to 26.80±2.37, p=0.12) and had a shorter hospital stay (5.87±1.36 days vs. 8.56±1.99 days, p<0.001). The IS group also demonstrated significant improvements in ABG parameters from admission to discharge: pH (7.35±0.087 to 7.42±0.054, p<0.001), pCO2 (62.76±9.55 to 43.88±6.62, p<0.001), and pO2 (62.76±9.55 to 78.88±6.97, p<0.001), while the control group did not. Conclusion: Incentive spirometry proved superior to medical treatment alone by significantly improving ABGs, respiratory rate and reducing hospital stay in AECOPD patients. These findings support IS as a cost-effective tool in AECOPD management, particularly in resource-limited settings like Nepal. Further research is recommended to validate these results.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.