Browsing by Author "Tiwari, Archana"
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Publication Correlation of Cervical Pap Smear with Cervical Biopsy in Lesions of Cervix(Institute of Medicine, Tribhuvan University, 2024) Tiwari, Archana; Khanal, Anupa; Sapkota, Pratima; Karki, AsmitaAbstract: Introduction Cervical cancer is the leading cause of mortality for women in underdeveloped nations and the 4th leading cause globally. Pap smears are non-invasive method, but are unable to pinpoint their location. However, cervical biopsies are an invasive but gold standard procedure. Methods An analysis of all pap smears obtained during a one-year period, from April 14, 2022 to April 12, 2023 was carried out in the Department of Pathology, LMC, Palpa. But only the cases that had undergone both pap smear and cervical biopsy were compared. Only 64 of the 337 pap smears that were obtained for cytological analysis also had a biopsy. Results Out of 64 pap smear, 32.81% had normal cytology, 25% had ASC-US, 4.68% had atypical glandular cells, and 9.37% had HSIL. The most pap smears were done on people between the ages of 31 and 40. In 64 biopsies, 23 (35.93%) had HSIL, 20 (31.25%) had LSIL, and 7 (10.93%) had chronic cervicitis, according to the histological diagnosis of biopsies. Four individuals had a cancer diagnosis, including two (3.12%) squamous cell carcinomas and two (3.12%) adenocarcinomas. The Pap smear showed a sensitivity of 25.92%, specificity of 94.59%, PPV of 77.77%, NPV of 63.63%, and a diagnostic accuracy of 65.62%. Conclusion The Pap smear test, had poor sensitivity but good specificity in detecting premalignant and malignant cervical abnormalities. Pap smear is a noninvasive method; however, cervical biopsy is a gold standard but invasive technique.Publication Incidental Neoplasm and Histopathological Spectrum of Suspected Acute Appendicitis in Appendectomy Specimen: An Observational Study(Nepal Medical Association, 2025) Tiwari, Archana; Sapkota, Pratima; Shrestha, DipeshAbstract Introduction: Acute appendicitis is the most common surgical emergency and histopathological studies are the gold standard for confirmation of clinical diagnosis and key methods of discovering appendiceal neoplasm. Appendiceal neoplasms are uncommon and are mostly identified by pathologic examination after appendectomy for presumed appendicitis as an incidental finding. Methods: An observational cross-section study was conducted at a Medical College from 1st August 2022 to 31st July 2024. Appendectomy specimens were included in the study after obtaining consent. Ethical approval was taken from the Institutional Review Committee (Reference number: IRC-LMC 05/S-22). Descriptive analysis was done, frequency and proportion were calculated. Results: Among 350 appendectomy cases, 30 (8.57%) cases had negative appendectomies. Out of total 320 patients, 183 (57.19%) were male and 137 (42.81%) were female. Histopathological findings suggestive of acute appendicitis were observed in 164 (51.25%) specimens and there were 6 (1.87%) specimens suggestive of neoplasms. Amongst the neoplasm of appendix 3 (0.94%) were carcinoid tumours. Conclusions: Appendiceal neoplasms are uncommon which was comparable to previous studies. Carcinoid tumour was the most common incidental neoplasm.Publication Study of Histomorphological Patterns of Uterine Leiomyomas: An Observational Study(Nepal Medical Association, 2025) Tiwari, Archana; Sapkota, PratimaAbstract Introduction: Uterine leiomyoma, also known as a fibroid, is a benign mesenchymal tumor derived from the smooth muscle of the uterus. It is the most common tumor in women with an estimated incidence of 20%-40% in women during their reproductive years. Leiomyoma can occur in any organ, but the most common forms appear in the uterus. This study is conducted to analyze histomorphological patterns of uterine leiomyomas. Methods: An observational cross-section was conducted between 1st June 2021 and 31st May 2023 in the Department of Pathology of a Medical College and Teaching Hospital. Patients with leiomyoma were included in the study. Clinical, sonographic, gross, and histopathology findings were analyzed. Ethical approval for the study was obtained from Institutional Review Committee (Reference Number: LMC10/B-021). Results: There were 100 patients with leiomyoma during the study period, among whom 55 (55%) were 40-49 years old. There were 65 (65%) patients in the group with a parity of two to three. Abnormal uterine bleeding was observed in 60 (60%) of the cases. Histologically 84 (84%) of the cases were simple conventional leiomyoma. The co-existing conditions found were cystic ovarian disease 37 (37%), adenomyosis 19 (19%), and cervical intraepithelial neoplasia 12 (12%). Conclusions: Conventional leiomyoma is the commonest histological subtype and and the most common clinical presentation is abnormal uterine bleeding.