Browsing by Author "Shrestha, Anjan"
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Publication Essential Thrombocythemia among Patients with Myeloproliferative Neoplasms in Haematology Unit of a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2022) Sah, Sanjit Kumar; Shah, Sangam; Tiwari, Sansar Babu; Poudel, Basanta Sharma; Singh, Biranmol; Sharma, Prakash; Acharya, Sunil Sharma; Murarka, Hritik; Thapaliya, Sabin; Shrestha, AnjanAbstract Introduction: Essential thrombocythemia, a myeloproliferative condition with an increased number of circulating platelets, is a rare hematological malignancy. The aim of the study is to find out the prevalence of essential thrombocythemia among patients with myeloproliferative neoplasms presenting in haematology unit of a tertiary care centre. Methods: This was a descriptive cross-sectional study at a tertiary care centre from September, 2020 to September, 2021 (Reference number: 48 (6-11) E2077/076). All the patients with a diagnosis of essential thrombocythemia and willing to give consent were included in the study while the patients with incomplete investigations were excluded. A sample size of 72 patients was taken and convenience sampling was done. Data were entered in Microsoft Excel 2010 and analysis was done by the Statistical Package for the Social Sciences Version 22.0. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data along with mean and standard deviation for continuous data. Results: Among 72 patients with myeloproliferative neoplasms, the prevalence of essential thrombocythemia was found to be 17 (23.61%) (13.80-33.42 at a 95% Confidence Interval). The mean age of patients was 55.41±11.20 years with a male to female ratio of 9:8. The mean hemoglobin level and platelet count in patients were found to be 11.20±2.1 g/dl and 677000±262067.70 cells/mm3. Twelve (70.58%) of total patients were under low risk of essential thrombocythemia while 3 (17.64%) of them were at high risk. Conclusions: The prevalence of essential thrombocythemia was similar to other studies done in similar settings.Publication Morphological and Immunophenotyping Profile of Acute Leukemia: A Study from a Tertiary Level Hospital in Nepal(Rapti Academy of Health Sciences (RAHS), 2024) Bishowkarma, Sabita; Bishowkarma, Sabita; Shrestha, Anjan; Shrivastav, Shreya; Rasaily, SureshAbstract: Introduction: Acute leukemia is a heterogeneous disorder necessitating a multidisciplinary diagnostic approach. Flow cytometry is essential for lineage assignment and maturation stage identification. This study aims to determine the frequency and immunophenotyping of acute leukemia at Tribhuvan University Teaching Hospital (TUTH). Methods: Conducted from January 2020, to December 2021, this cross-sectional study analyzed 504 bone marrow aspiration samples. Among these, 97 (19.2%) cases were identified as acute leukemia. Patient demographics, morphology, and immunophenotyping features were recorded and analyzed. Results: Of the acute leukemia cases, 66% were male and 34% female. The pediatric population comprised 62.9%, while adults made up 37.1%. Cytochemical staining was performed in 92 cases, revealing 67% as acute lymphoblastic leukemia (ALL) and 33% as acute myeloid leukemia (AML). Flow cytometry was conducted on 84 cases, leading to diagnoses of 30 AML, 45 B-ALL, and 9 T-ALL. Conclusion: Acute leukemia can affect all age groups with male preponderance. ALL is more prevalent in children, while AML is more common in adults. Immunophenotyping is critical for the classification and subtyping of acute leukemia, enhancing diagnostic accuracy and guiding treatment strategies.Publication Role of Mentzer Index for Differential Diagnosis of Iron Deficiency Anaemia and Beta Thalassemia Trait(Nepal Health Research Council, 2023) Shah, Tej Prakash; Shrestha, Anjan; Agrawal, Jagdish Prasad; Rimal, Suman; Basnet, AnitaAbstract Background: The most common differential diagnoses of microcytic hypochromic anaemia are iron deficiency anaemia and beta thalassemia. Globally, thalassemia affects approximately 4.4 out of every 10,000 live births whereas iron deficiency anaemia comprises half of all anaemia worldwide as per world health organization. The definitive diagnosis of beta thalassemia trait and iron deficiency anaemia requires haemoglobin analysis and iron studies respectively, which are not possible to perform in all suspected cases especially in resource limited settings. The study aims to evaluate the reliability of mentzer index in differentiating beta thalassemia trait from iron deficiency anaemia. Methods: This was a cross sectional, observational study done on 59 patients each of beta thalassemia trait and iron deficiency anaemia from August 2019 to July 2020. Patients who were found to be having iron deficiency anaemia diagnosed by iron studies and beta thalassemia trait diagnosed by Hb electrophoresis were enrolled in the study using simple random sampling technique. Results: Mentzer index correctly identified 95.76% of overall patients. Area under receiver operating characteristic curve was 0.993 (95% CI, 0.985-1.002, p<0.001). For beta thalassemia trait, mentzer index showed a sensitivity of 93.2%, specificity of 98.3%, positive predictive value of 98.2%, negative predictive value of 93.5%; while for iron deficiency anaemia, sensitivity of 98.3%, specificity of 93.2%, positive predictive value of 93.5% and negative predictive value of 98.2%. Youden’s index was 91.5. Conclusions: The findings of the present study make mentzer index a reliable screening method, especially in a resource poor setting, like Nepal. Further confirmation by gold standard tests is recommended. Keywords: Beta thalassemia trait; iron deficiency anaemia; mentzer index