NepMed Repository :: Browsing by Author "Tiwari, A"

Browsing by Author "Tiwari, A"

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An unusual presentation of huge cervical fibroid
(Kathmandu Univesiity, 2005) Basnet, N; Banerjee, B; Badani, U ; Tiwari, A; Raina, A; Pokharel, H; Yadav, P; Agrawal, A; Chhetri, S
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Antenatal diagnosis of large sacro-coccygeal teratoma with foetal cardiomegaly and hydrops
(Kathmandu University, 2008) Gupta, N; Shah, D; Singh, U; Tiwari, A
Abstract We report the case of a young primigravida who presented with a 20 weeks pregnancy with a previous diagnosis of uterine broid. However, ultrasound evaluation revealed the presence of a large sacro-coccygeal teratoma in the foetus which was heterogeneous with cystic areas and calci c foci, and showed increased vascularity. There was also evidence of foetal cardiomegaly and hydrops foetalis, indicated by subcutaneous oedema in the foetus, thickened placenta and polyhydramnios. The presence of hydrops with sacro-coccygeal teratoma has a grave prognosis for the mother and child; hence termination of pregnancy was done. A 20 weeks old foetus with a huge sacro-coccygeal mass, which was ruptured at many places and showed areas of active bleed, was expelled.
Clinical and Bacteriological Profiles of Blood Culture Positive Sepsis in Newborns
(Nepal Paediatric Society (JNPS), 2007) Shrestha, P; Das, BK; Bhatta, NK; Jha, DK; Das, B; Setia, A; Tiwari, A
Abstract: Neonatal infections currently cause about 1.6 million deaths annually in developing countries. Sepsis and meningitis is responsible for most of these deaths. This study was undertaken to determine the clinical presentations, bacteriological profiles and antibiotic sensitivity patterns of isolates from blood cultures of neonates admitted in a tertiary care hospital in Eastern Nepal. All blood culture reports (n=103) during January 2006 - February 2007 from newborns admitted in neonatal division at BP Koirala Institute of Health Sciences, Nepal were analyzed and antibiotic sensitivity patterns were studied. The positive blood culture was 20% (103/513). Most (97.1%) of the sepsis was caused by single organism, while polymicrobial aetiology was observed in 2.9% cases. Meningitis was documented in 9(8.7%) cases. Staphylococcus aureus (38.8%) and coagulase negative staphylococcus (CONS) (21.3%) are the commonest isolates in blood culture. Among gram-negative organisms, Klebsiella species (11.6%) and Enterobacter species (9.7%) were the leading cause of neonatal sepsis. Majority of newborns with neonatal sepsis presented with refusal to feeds (42.7%), fever (41.7%) and jaundice (41.7%). Most of the organisms showed sensitivity with amino glycosides (gentamicin and amikacin) and third generation cephalosporins. It is concluded that Staphylococcus aureus, CONS, and Klebsiella species remain the principal organisms causing neonatal sepsis and first line antibiotics like amino glycosides should be first choice of drugs.
Evaluation of Mannheim Peritonitis Index for Predicting Outcome in Emergency Exploratory Laparotomy for acute peritonitis
(Institute of Medicine, 2014) Paudel, P; Tiwari, A; Pradhan, GBN; Shrestha, S; Bhattachan, CL
Abstract Introduction: Exploratory laparotomy is one of the commonest emergency procedure performed by general surgeons in daily practice. Due to heterogenisity of conditions required in exploratory laparotomy, the outcome is to variable. It is often difficult to predict outcome of such patients server scoring system are available to predict outcome to patients undergoing exploratory laparotomy for acute peritonitis. The aim of this study is to evaluate the role of Mannheim Peritonitis Index (MPI) score is predicting the outcome to patience you need exploratory laparotomy for acute peritonitis. Methods: This is our prospective analysis of 86 patients who underwent emergency exploratory laparotomy over past 2 years. The mean age of patient was 41 years and 29 (33.7%) were female. All the patients had presented to the emergency with features of peritonitis. Two patient presented with shock. Hollow viscus perforation was present in 37 patients, intestinal obstruction in 31 patients and 18 patients had various other pathologies. There were total 29 complication including 10 mortalities. The mean MPI score was 21.2 ± 8(4 – 39). There was significant correlation of MPI with mortality (p<0.05). Conclusion: the MPI score can provide simple and objective means to predict the outcome of patients with peritonitis. Keywords: Exploratory Laparotomy, MPI score, Outcome, Peritonitis
Glomerular Diseases in Children - A Review of 27 Cases Recorded at a Single Centre in Eastern Nepal
(Nepal Paediatric Society (JNPS), 2009) Shrestha, P; Bhatta, NK; Tiwari, A; Singh, R; Kalakhetti, BK; Majhi, S; Paudel, P; Sinha, A
Abstract: Glomerular disease remains an important cause of renal disease in children. We retrospectively assessed the clinical features and histopathological diagnoses in kidney biopsy specimens in children (n=27). The medical records and histopathological diagnoses between 2003 and 2006 were reviewed. In each patient, clinical presentation, age at onset of disease, gender, presence of nephrotic range proteinuria, hematuria, hypertension and histopathological diagnoses were evaluated. SLE nephritis (n=8) and membranoproliferative glomerulonephritis (MPGN) (n=8) were the most frequent glomerular diseases and nephrotic syndrome (n=21) was the frequent clinical manifestation.
Utility of Micronucleus Study on Breast Cytology Smears
(Kathmandu University, 2025) Shrestha, O; Baral, R; Tiwari, A
ABSTRACT Background Micronuclei (MN) are extranuclear chromatin bodies that arise due to chromosomal breakage and serve as biomarkers of genomic instability. Their presence has been linked to malignant transformation. Breast cytology offers a minimally invasive method for early detection of breast lesions. Evaluating micronuclei in these smears may enhance diagnostic accuracy by providing an additional objective parameter. Objective To compare the MN score in benign and malignant epithelial neoplasms of the breast as well as compare it within different grades of breast carcinomas. Method A retrospective cross-sectional study was conducted including epithelial breast neoplasms over a period of three years from February, 2021 to February, 2024. May– Grünwald–Giemsa (MGG) and Papanicolaou stained cytology smears of cases whose biopsy sample was also received in department of Pathology were included after ethical approval from institutional review committee. Micronuclei were identified based on established criteria and scored in 1,000 epithelial cells per case. The micronuclei frequency was compared across cytologically diagnosed benign and malignant lesions proven histopathologically. Statistical analysis was performed to evaluate significance. Result The mean micronuclei score was significantly higher in malignant smears compared to benign lesions (p < 0.05). A progressive increase in micronuclei frequency was observed from grade 1 to grade 3 amongst the malignant category. Conclusion Micronuclei scoring on breast cytology smears is a simple, cost-effective and potentially reliable marker of malignancy. It can serve as a useful adjunct in routine cytological evaluation, and also help in predicting the grade of malignancy. KEY WORDS Breast, Chromosomal instability, Neoplasm

Browsing by Author "Tiwari, A"

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