Browsing by Author "Pradhan, Sailesh"
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Publication Benign Histopathologic Findings of Endometrium among Perimenopausal Women presenting with Abnormal Uterine Bleeding: A Descriptive Cross-sectional Study(Nepal Medical Association, 2021) Dhakhwa, Ramesh; Bhattarai, Rashmi; Shah, Jayanti; Shakya, Archana; Pradhan, SaileshAbstract: Introduction: Abnormal uterine bleeding is the most common presenting complaint in the perimenopausal age group. Endometrial biopsy obtained by dilatation and curettage is the preferred modality of investigation to determine the causative pathology of abnormal uterine bleeding. The objective of this study was to find out the prevalence of the benign histopathological findings in perimenopausal women presenting with abnormal uterine bleeding. Methods: This descriptive cross-sectional study was conducted among patients between 1st June 2020 to 30th September 2021. Ethical approval was taken from the Institutional Review Committee of Kathmandu Medical College (reference number: 305202002). Using the convenience sampling method, 96 cases of endometrial biopsies were studied under light microscopy. Data was analyzed using the Statistical Package for the Social Sciences version23.0. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Among the 96 specimens, the prevalence of benign findings was 93 (96.9%) (93-100 at 95% Confidence Interval). Among them, the commonest benign histopathologic spectrum was hormonal imbalance pattern in 40 (41.7%) followed by normal menstrual pattern 35 (36.5%). Five (5.2%) cases showed chronic endometritis. Six (6.2%) cases of endometrial hyperplasia without atypia were identified. Three (3.1%) cases showed endometrial atrophy. Four (4.1%) cases showed endometrial polyp. Conclusions: The prevalence of benign histopathological findings among endometrial biopsies in the study was similar to other studies.Publication Extensive Drug Resistant Acinetobacter Species Isolates in Sputum Sample of Patient Admitted in Intensive Care Unit of a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2021) Prasai, Astha; Pant, Abhishek; Neupane, Asmita; Pant, Subash; Pradhan, SaileshAbstract: Introduction: Increasing antibiotic resistance has created a global public health threat worldwide. Acinetobacter species is one of the important pathogenic organisms in the hospital setting due to its ability to persist in the hospital environment for long. Its resistance to commonly used antibiotics can prolong hospital stay, increase financial burden, and increase morbidity and mortality. This study aims to find the prevalence of extensive drug resistant Acinetobacter species in the sputum sample of Intensive Care Unit patients admitted in a tertiary care center. Methods: A descriptive cross-sectional study was conducted in a tertiary care center among the hospital records from May 2017 to May 2021, after ethical approval (Reference number: 2104202101). All the Intensive Care Unit patients with isolated acinetobacter species in their sputum samples within the past four years were collected and Statistical Package for Social Sciences version 25 was used for analysis. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Of the total 409, 196 (47.9%) (95% Confidence Interval= 43.06-52.74) of Acinetobacter species in the sputum sample had extensive drug resistance. Of these, 193 (98.5%) and 1 (0.5%) of the extensive drug resistant Acinetobacter species were resistant to carbapenem and polymyxin respectively. Conclusions: Prevalence of extensive drug resistant acinetobacter was found higher compared to other studies.Publication Histopathologic Analysis of Gastrointestinal Tract Polypoidal Lesions in a Tertiary Care Centre(Institute of Medicine, Tribhuvan University, 2024) Chalise, Sanat; Hirachan, Suspana; Pradhan, SaileshAbstract: Introduction Gastrointestinal tract polyps lesions are commonly encountered lesions in histopathological examination. It is necessary to examine these polyps and to determine its nature for the management of patient. Methods A descriptive cross-sectional study was done in the Pathology Department of Kathmandu Medical College from January 2023 to July 2023 after obtaining ethical clearance. The study included all gastrointestinal tract polyps or polypoidal lesions identified endoscopically or colonoscopically, biopsied, and received for histopathological analysis. Results Among 96 polyps examined, 58 (60.4%) were seen in males and 38 (39.6%) were seen in female. The age of the patients ranged from 15 to 89 years, with a mean age of 45 years. Most of the polypoidal lesions were less than 1 cm in size (76 cases, 79.1%). Colon (54 cases, 56.2%) was the most common site followed by the stomach (22 cases, 23.0%). Of the polypoidal lesions, 66(68.8%) were non-neoplastic polyps, while 30(31.2%) were neoplastic. Tubular adenoma with low-grade dysplasia was the most common polyp identified in the colon (17 cases, 17.8%). Hyperplastic polyps were the most common type overall (19 cases, 19.8%), stomach being the most frequent site (13 cases, 13.6%). Conclusion A wide range of histological types of polypoidal lesions were found in the gastrointestinal tract. The most frequent occurrence was in the colon, and the majority were non-neoplastic in nature.Publication Histopathological Study of Whipple’s Pancreaticoduodenectomy Specimens at Tertiary Care Center(Institute of Medicine, Tribhuvan University, 2024) Chalise, Sanat; Hirachand, Suspana; Pradhan, SaileshAbstract: Introduction Whipple’s pancreaticoduodenectomy has become a widely used resection procedure for pancreatic head, periampullary, ampullary, and biliary tumors. This study was conducted to analyze the histopathological features of these tumors in pancreaticoduodenectomy specimen. Methods A descriptive study was carried out in the Pathology Department of Kathmandu Medical College Teaching Hospital. Pancreaticoduodenectomy specimens received were assessed for tumor location, histopathologic categorization, grading, lymphovascular and perineural invasion, margin status, and lymph node status. AJCC TNM staging was done. Results Out of 41 Whipple's pancreaticoduodenectomy cases, 35 (85.4%) were malignant and 6 (14.6%) were benign. The patients' ages ranged from 30 to 84 years, with a mean age of 58.3 years and a male to female ratio of 1.2:1. Adenocarcinoma was the most common malignant lesion (73.2%; n=30) frequently found in the intra-ampullary and periampullary regions (31.4%; n=11). The intestinal type of adenocarcinoma was the most common (42.8%; n=15), followed by the pancreaticobiliary type (34.3%; n=12). Most tumors were moderately differentiated (74.3%; n=26). Perineural invasion was frequently seen in intra-ampullary and periampullary carcinoma (81.8%; n=9). Lymphovascular invasion was frequently seen in intra-ampullary and periampullary carcinoma (81.8%; n=9). Most tumors were in the T3 stage (42.9%; n=15), and overall nodal metastasis (N1 and N2) was seen in 57.1% (n=20). Conclusion Adenocarcinoma was the commonest diagsosis in pancreaticoduodenectomy specimens of the intra-ampullary and periampullary region. Malignant lesions were more frequent than benign lesion in our study.Publication Malignant Serous Effusions among Hospital In-patients in a Tertiary Care Hospital: A Descriptive Cross-sectional Study(Nepal Medical Association, 2022) Dhakhwa, Ramesh; Sapkota, Shreya; Maharjan, Anju; Pradhan, SaileshAbstract: Introduction: Cell block technique is an adjunct to conventional smears in the diagnosis of malignancy in effusion fluid. It aims at retrieving cellular material and concentrating cells in a small field, with preservation of cytomorphologic details. The objective of this study was to find the proportion of malignant serous effusions using cell block technique among hospital in-patients in a tertiary care centre. Methods: This was a descriptive cross-sectional study conducted among patients visiting a tertiary care centre between 1st June 2020 to 30th November 2020. Ethical approval was taken from the Institutional Review Committee (Reference number: 305202001). Using a convenience sampling method, 96 hospital in-patients were included in the study. Serous effusions were evaluated by conventional smears and cell block sections. Data was analysed using the Statistical Package for the Social Sciences version 23. Point estimate at 95% Confidence Interval was calculated along with frequency, percentage, mean and standard deviation. Results: Among 96 hospital in-patients, 15 (15.62%) (8.35-22.88 at 95% Confidence Interval) were diagnosed as positive for malignancy by using cell block technique. By conventional smears, 80 (83.33%) cases turned out to be negative for malignancy, 13 (13.54%) were positive for malignancy and three (3.12%) were suspicious for malignancy. Of the three (3.12%) cases suspected for malignancy, two turned out to be positive for malignancy and one was found to be negative for malignancy on cell block technology. Conclusions: The proportion of malignant serous effusions was similar in comparison to other studies. Cell block technique could be routinely incorporated along with conventional smears for a more accurate diagnosis of malignancy on serous effusion.Publication Mean Cholinesterase Level among Organophosphorus Poisoning Patients Visiting the Emergency Department in a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2023) Pradhan, Binita; Pandey, Sujan; Niroula, Aliska; Adhikari, Nishob; Chapagain, Nibedita; Pradhan, SaileshAbstract Introduction: Acute organophosphorus pesticide poisoning is widespread and the most common in many developing countries, including Nepal. Through the inhibition of acetylcholinesterase, organophosphorus poisoning is characterised by the clinical picture of acute cholinergic crisis. Many researchers have shown increased levels of liver enzymes and decreased levels of serum cholinesterase in organophosphorus poisoning, however, very little work has been done in Nepal that studies the correlation between serum cholinesterase and liver enzymes in organophosphorus poisoning. The aim of the study is to find out the mean cholinesterase level among organophosphorus poisoning patients visiting the Emergency Department in a tertiary care centre. Methods: This was a descriptive cross-sectional study done among 94 organophosphate poisoning cases visiting the emergency department of a tertiary care centre from August 2021 to August 2022 after obtaining approval from the Institutional Review Committee (Reference number: 04102021/06). Convenience sampling was done. Blood workups were done for cholinesterase and liver function tests. Point estimate and 90% Confidence Interval were calculated. Results: The mean cholinesterase level among organophosphorus poisoning patients was 1978.82±1878.22 (1660.17-2297.47, 90% Confidence Interval). Conclusions: The mean cholinesterase level among organophosphorus poisoning patients was similar when compared to other studies done in similar settings.Publication Mean Serum Lactate Levels in Patients with Sepsis Presenting to the Department of Emergency Medicine of a Tertiary Care Center: A Descriptive Cross-sectional Study(Nepal Medical Association, 2023) Pradhan, Binita; Ghimire, Urbi; Chapagain, Nibedita; Adhikari, Nishob; Pandey, Sujan; Pradhan, SaileshAbstract Introduction: Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection. Serum lactate is useful in predicting the prognosis of critically ill patients. Elevated blood lactate levels as well as delayed clearance have been linked to higher mortality in sepsis. Shock index is a simple and effective bedside assessment means of gauging the degree of shock and is an important predictor of identifying high-risk patients. Monitoring lactate levels may aid clinicians in understanding tissue perfusion and detecting unrecognized shock and making prompt therapy adjustments. This study aimed to find out the mean serum lactate levels in patients with sepsis presenting to the Department of Emergency Medicine of a tertiary care centre. Methods: A descriptive cross-sectional study was conducted at a tertiary care centre among the patient with sepsis presenting to the emergency department from 1 September 2022 to 30 November 2022. Ethical approval was obtained from the Institutional Review Committee of a tertiary care centre (Reference number: 26082022/02). History taking and detailed examination were done. Blood was sent for serum lactate and other parameters as proforma was sent. The shock index was calculated. Convenience sampling was done. Point estimate and 95% confidence interval were calculated. Results: Among 53 sepsis patients, the mean serum lactate level in sepsis patients was 2.84+2.02 (male: 2.83+1.70 and female: 2.85+2.42). Conclusions: The mean serum lactate level in patients with sepsis is similar as compared the studies done in similar settings.