Browsing by Author "Pradhan, Sailesh"
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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 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.