Browsing by Author "Pradhan, SB"
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Publication Correlation of PAP smear findings with clinical findings and cervical biopsy(Kathmandu University, 2007) Pradhan, B; Pradhan, SB; Mital, VPAbstract Objectives: Carcinoma of the cervix is the most common cause of the death in Nepal. Cervical carcinoma does not develop suddenly from normal epithelium but is presented by a spectrum of intraepithelial neoplastic changes that are precancerous lesion and were termed as cervical intraepithelial neoplasia (CIN). Cervical cytological screening is designed to detect over 90% of cytological abnormalities. It has also been established that most cervical cancers can be diagnosed at the preinvasive stage with adequate and repetitive cytological screening. Keeping in view of the importance of carcinoma and the precancerous lesion (CIN) of cervix, study of different methods for the early detection of abnormalities in cervix, correlation with the clinical findings and comparison between the techniques was carried out. Material and methods: Patients with suspicious cervix attending Gynaecology OPD of TUTH and Western regional hospital (Pokhara) who have undergone for pap smear cytology test along with biopsy were selected. Detail history with clinical examination was performed and the findings were correlated. Results and conclusion: Unhealthy cervix with discharge was found to be common even in chronic cervicitis however bleeding and tenderness were associated with more advanced lesions. Pap smear test was found to be equally sensitive to histopathological examination for the early detection of different cervical lesions. However, it is advised to perform biopsy if any abnormalities are detected in pap smear for correlation and confirmation. Key words: Pap smear, CINPublication Malignant teratoid medulloepithelioma in eye(2003) Pradhan, SB; Adhikari, RC; Shrestha, B; Sayami, G; Dali, S; Shrestha, HGNA.Publication Prevalence of different types of gallstone in the patients with cholelithiasis at Kathmandu Medical College, Nepal(Kathmandu University, 2009) Pradhan, SB; Joshi, MR; Vaidya, AAbstract Background: Gallstone disease known as cholelithiasis is the most common digestive surgical disorder and account for an important part of health care expenditure. Attempt was made to analyse the gallstone for typing depending upon the composition. Aims & objectives: The main objective of this study was to see the prevalence of different types of gallstone in Nepal and to correlate them with the clinical findings. Materials & methods: Gallstones of 80 different patients who underwent cholecystectomy for cholelithiasis were collected from 20th January 2005 to 16th May 2006 in Department of Pathology, Kathmandu Medical College Teaching Hospital. Detailed history was taken. Stones were analyzed with chemical and enzymatic methods using clinical spectrophotometer. Results & conclusion: The most commonly involved age group for cholelithiasis (32.5%) is found to be 30-39 years with a female predominance (M: F=1:3.2). Cholelithiasis was found more commonly among non-vegetarian with the vegetarian: non-vegetarian ratio 1:9. Mixed type stone was found to be the most common type of stone comprising 78.75%, followed by cholesterol stone 12.5%, Brown pigment stone 7.5% and Black pigment stone 1.25%. Key words: Gallbladder, cholelithiasis, GallstonePublication Relation between gallbladder neoplasm and helicobacter hepaticus infection(Kathmandu University, 2004) Pradhan, SB; Dali, SObjective: The main objective of this study was to see the various histopathological changes in the gallbladder with cholelithiasis and to correlate them with Helicobacter hepaticus infection. Methods: A total of 380 cholecystectomy specimens were received during a study period from 2058/11/29 to 2059/11/4 at Department of Pathology, TU Teaching Hospital, Institute of Medicine. Results: Among 380 cases, 249 (65.53%) were found to have chronic cholecystitis, 52 (13.68%) cholesterolosis, 29 (7.63%) adenomyosis, 20 (5.26%) metaplasia, 15 (3.95%) low-grade dysplasia, 10(2.63%) malignancy, 4(1.05%) xanthogranulomatous change and 1(0.26%) carcinoma in situ. Out of these, 100 cases that were willing to provide gallbladder for study were taken as a study group. Sections were stained with Haematoxylin & Eosin for microscopic features and with Warthin Starry Silver stain for Helicobacter hepaticus. Among the study group, 43% cases were found to have chronic cholecystitis, 17% adenomyosis, 13% cholesterolosis, 9% low-grade dysplasia, 9% metaplasia, 7% malignancy, 1% carcinoma in situ and 1% xanthogranulomatous change. All the malignant cases were found to be Adenocarcinoma. Out of total 100 cases, 82% cases were found to have Helicobacter hepaticus infection. Only one out of 7 malignant cases (14.29%) was found to be negative for Helicobacter Hepaticus infection. Gallbladder neoplasm was found to be common in Nepal comprising 2.63%. Helicobacter hepaticus infection was found in 82% of gallbladders and it was found in 87.5% of malignant cases. Whether Helicobacter hepaticus that might be the number one cause for the gallstone formation that ultimately leads to malignancy or itself acts as a risk factor for the pathogenesis of carcinoma gallbladder is yet to be determined. Key words: Helicobacter hepaticus, Helicobacter pylori, Warthin Starry Silver stainPublication Study of effusion cytology in patients with simultaneous malignancy and ascites(Kathmandu University, 2006) Jha, R; Shrestha, HG; Sayami, G; Pradhan, SBObjective: To evaluate sensitivity of effusion cytology in detecting malignancy Materials and methods: Effusion cytology was studied from 37 malignancy associated and 28 non malignancy associated ascitic fluid samples. Results: Out of 65 cases, 44 (67.7%) effusions were reported negative, 15 (23.1%) were positive and 6 (9.2%) were suspicious for malignancy. Thus total 21 effusions (32.3%) were tumour cell positive. All 21 (100%) were true positive, none (0%) was false positive, 28 (63.6%) were true negative and 16 (36.4%) were false negative. Thus ascitic fluid cytology had sensitivity of 56.7% and specificity of 100%. Predictive value of positive test and negative test was 100% and 63.6% respectively. Stomach was the most common primary site of malignancy associated with ascites (11 /37 i.e. 29.7%) where as adenocarcinoma was the most common type of malignancy (11/15 i.e.73.3%) in ascitic fluid cytology. Conclusion: Ascitic fluid cytology is a simple and useful procedure with sensitivity of 56.7% and should be routinely requested. Key words: Ascitic fluid, Effusion cytologyPublication Study of Helicobacter hepaticus in gallbladders with cholelithiasis and its sensitivity pattern(Kathmandu University, 2009) Pradhan, SBAbstract Background: Cholelithiasis is one of the most common digestive surgical disorders. The natural history of gallstone development is unknown. Bacteria are found in high concentration in bile and stone. It is diffcult to ascertain whether bacterial infection of the bile arose before stone formation or vice versa. Materials & methods: Prospective study was carried out in 30 cholecystectomy specimens of patients with cholelithiasis collected from 15th January 2005 to 24th July 2005 in Department of Pathology, Kathmandu Medical College Teaching Hospital. The samples were collected in a sterile vial containing 0.5% saline. A small piece of gallbladder was taken in Blood agar and Chocolate agar media for micro anaerobic culture at 370 C. The growth of the organism was observed after 48 hours of incubation. Gram stain and various biochemical tests were performed for the confirmation of Helicobacter hepaticus and its sensitivity pattern was studied. Histologically Helicobacter hepaticus was demonstrated in formalin fixed tissue sections using Warthin Starry Silver stain. Results: A total of 76.66% cases showed growth positivity. Nitrofurantoin was found to be the most sensitive drug (95.7%) for Helicobacter hepaticus followed by Ciprofloxacin (91.3%), Cephalaxin (91.3%), Certriaxone (91.3%), Ofloxacin (82.6%), Amikacin (65.2%) and Norfloxacin (60.9%). Helicobacter hepaticus was least sensitive to Amoxycillin (57%). Conclusion: From this study, it is quite apparent that Helicobacter hepaticus infection is commonly associated (76.66%) with cholelithiasis. If the patients are treated with the sensitive antibiotics regularly and the infection, that is the number one cause for the precipitation of bile leading to the formation of gallstones, can be controlled, the incidence of cholelithiasis can be reduced so that the health care expenditure related to gallbladder disease can be reduced markedly. Key words: Cholelithiasis Helicobacter hepaticus, WSS stain