NepMed Repository :: Browsing by Author "Rajbhandari, M"

Browsing by Author "Rajbhandari, M"

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Histomorphological Profile of Colonoscopic Biopsies and Pattern of Colorectal Carcinoma in Kavre District
(Kathmandu University, 2013) Rajbhandari, M; Karmacharya, A; Khanal, K; Dhakal, P; Shrestha, R
ABSTRACT Background Colonoscopy is the method to visualize the mucosa of the entire colon and terminal ileum to detect the intestinal abnormalities and obtain biopsy for definitive diagnosis. For clinical decisions in the diagnosis of various colonic lesions unambiguous interpretation of colorectal biopsies is necessary. Objectives To assess the prevalence pattern of colonic diseases and to correlate the incidence of colorectal carcinoma with age, sex, site and symptoms presented at Dhulikhel Hospital. Methods The materials consisted of 126 biopsies which were submitted to the Department of Pathology, Kathmandu University School of Medical Sciences, Dhulikhel, during the period of July 2011- July 2012 .Data collected and entered in MS-Excel and were analyzed using SPSS-16. Results Out of 126 colonoscopic biopsies 34(27%) showed chronic nonspecific inflammation, followed by carcinoma 25(19.8%), non-neoplastic polyps 21(16.7%), granulomatous inflammation 14(11.1%), neoplastic polyps 8(6.3%), ulcerative colitis 4(3.2%) Miscellaneous lesions; Acute focal colitis, Eosinophilic colitis were also observed in 19 (15.1%). A higher frequency of colonic diseases in males with a male to female ratio of 1.4:1 and age range of two years to 84 years was observed. Out of 25 patients diagnosed with colorectal carcinoma,48% (n=12) were males and 52% (n=13) were females with a mean age of 55.17 years in men and 59.46 years in females. Male and female ratio among cancer groups was 1:1.08. Total 36% (n=9) were diagnosed with cancer before the age of 50. Out of these nine cases, 6( 66.7%) were males and 3(33.3%) were females. The male and female ratio in younger and older age groups were 2:1 and 1:1.7 . 17( 68%) of the lesions were left sided and 8(32%) were right sided. Below age 50 , left to Right sided lesions in males were 2:1 and in females 1:2. However, above 50 years the ratio among proximal and distal lesions were 5:1 in males and 2.3:1 in females. A statistically significant association was seen between the growth (p=0.000) and per rectal bleeding (p= 0.006) with carcinoma. Conclusion The most prevalent lesion in colorectal biopsies was non-specific colitis followed by carcinoma colon. The incidence of colorectal carcinoma is on rise in Nepalese society. Although colorectal carcinoma is more common in older age group the incidence are also increasing among young especially among women. KEY WORDS Colonoscopy, colorectal carcinoma
Lansoprazole – Induce Black Hairy Tongue- A Case Report
(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2017) Aryal, Eliz; Rajbhandari, M; Bhattarai, Sabina
Abstract: Lansoprazole induced black hairy tongue has been rarely reported. The purpose of this paper is to report a case of lansoprazole induce black hairy tongue and review the literature. A 75 year man from eastern part of Kathmandu presented with black hairy fine growth from tongue along with discomfort, burning and halitosis from oral cavity after taking lansoprazole for acute peptic disease(APD) from over the counter and after discontinuation of lansoprazole, black hairy tongue was resolving. Clinically and histopathologically: lansoprazole induced black hairy tongue was confirmed. Black hairy tongue is characterized by abnormal hypertrophy and elongation of filliform papillae. Lansoprazole is a proton-pump inhibitor (PPI) with a racemic 1:1 mixture of the enantiomers dexlansoprazole which inhibits the stomach’s production of gastric acids. Keywords: lansoprazole, induce black hairy tongue
The Correlation Between Fine Needle Aspiration Cytology and Histopathology of Head and Neck Lesions in Kathmandu University Hospital
(Kathmandu University, 2013) Rajbhandari, M; Dhakal, P; Shrestha, S; Sharma, S; Shrestha, S; Pokharel, M; Shrestha, I; Shrestha, B; Makaju, R
ABSTRACT Background Fine needle aspiration cytology (FNAC) with it’s minimally invasiveness has been a well accepted procedure in the initial diagnosis of various swellings. With time and experience high sensitivity and specificity of FNAC over conventional open biopsy has lead to the wide acceptance of this procedure. Objective To evaluate the utility of aspiration cytology as a first-line diagnostic tool in palpable head and neck masses and correlate with histologic results for evaluating diagnostic accuracy. Methods A hospital based prospective, comparative study was conducted among patients with various swellings at Head and Neck regions in the Department of Pathology, Dhulikhel Hospital between July 2011 to June 2012. FNAC were done from the palpable masses of head and neck regions and were compared with biopsy findings of the same lesions. Data entry and analysis performed using SPSS version 16. The sensitivity, specificity and accuracy rates were calculated. Results A total 64 patients were subjected to both FNAC and histopathological examination (HPE). Total 39 (61 %) were females and 25 (39 %) were males with M: F ratio of 1:1.6. The age group ranged from 9 to 80 years. Twenty five percent of patients were in the age group below 20 years. The highest number of cases included lymph nodes 29 (45%) followed by thyroid 24(37.5 %), salivary glands 10(16%) and 1 case (1.6%) was a soft tissue swelling over the occipital region. Highest sensitivity, specificity and accuracy rate for diagnosis by FNAC were observed in thyroid. The overall sensitivity and specificity of FNAC were 86% and 97% respectively in determining the various pathologies. The overall accuracy of FNAC in present study was 87.4%. Conclusion FNAC is a minimally invasive first line investigation with a high sensitivity and specificity for the diagnosis of various head and neck lesions KEY WORDS FNAC, lymph nodes, salivary Glands, thyroid
The Predictive Value of Pre-Operative Symptoms Including Upper Gastrointestinal Endoscopy Before Laparoscopic Cholecystectomy for Elective Symptomatic Cholecystolithiasis
(Kathmandu University, 2013) Karmacharya, A; Malla, BR; Joshi, HN; Gurung, RB; Rajbhandari, M
ABSTRACT Background It has always been a challenge to distinguish between upper gastrointestinal symptoms due to gall stones or any other causes. The persistence of abdominal symptoms even after cholecystectomy is highly discouraging for surgeons. Objective To evaluate the value of preoperative (UGE) as a routine investigative tool in patients with gall stone disease and to assess the outcome of cholecystectomy in patients with gallstones on preoperative abdominal symptoms. Methods This is a prospective study conducted on 96 cases at the Department of Surgery, Dhulikhel Hospital among ultrasonographically proven gall bladder stones irrespective of age and sex. After the examination, all the patients were subjected to UGE, and biopsy were obtained for histopathology if required. The statistical analysis were performed using spss version 16. Results Out of total patients, 84(87.5%) were females and 12(12.5%) were males with a M: F ratio of 1:7. Both the sexes were comparable in age groups. Out of total 96 patients, 53(55.2%) presented with typical pain and 43(44.8%) presented with atypical pain. All the patients were subjected to upper gastrointestinal endoscopy (UGE) and 53(55.2%) had normal findings and 43(44.8%) had various lesions. Patients with typical pattern of pain had normal endoscopic findings and those with atypical pain had pathology in upper gastroendoscopy (p<0.001). Serious pathology resulting to change of the planned treatment was found in three cases (3.12%). Among them two had gastric carcinoma and one had active peptic ulcer disease. The relief rate after the cholecystectomy was significant in patients with typical pain than among those with atypical pain (p<0.001). The commenest post cholecystectomy symptoms were heart burn (10%), abdominal discomfort (9%) and dyspepsia (7%). Conclusion Presence of atypical pain in patients with gall stones is highly likely to have other coexisting upper gastrointestinal pathologies. Hence, upper gastrointestinal endoscopy prior to elective cholecystectomy in patients with gall stones can be clinically helpful. KEY WORDS Biliary colic, cholelithiasis, upper gastrointestinal endoscopy

Browsing by Author "Rajbhandari, M"

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