Introduction: Pancytopenia is a relatively common hematological entity and is a manifestation of many illnesses which can be life threatening at times. The severity of pancytopenia and the underlying pathology determine the management and prognosis. This study was conducted to evaluate hematological and bone marrow findings in patients presenting with pancytopenia. Methods: It was a prospective study carried out in Department of Pathology, Manipal College of Medical Sciences, Pokhara, Nepal, during the period of January 2011 to December 2016. Clinical and hematological parameters including bone marrow aspiration and biopsy were evaluated in all patients who presented with pancytopenia. Results: Among 138 cases studied, patient’s age ranged from 2 to 82 years with a mean age of 43.95 years, and there was male predominance. Most of the patients presented with generalized weakness, pallor, dypnoea and fever. Hypoplastic marrow was seen in 38(27.5%) cases, followed by megaloblastic anemia 26 (18.8%) cases and acute leukemia 19(13.76%) cases. Other findings included one each case of hemophagocyosis, leishmaniasis, plasmodium vivex malaria and metastatic carcinoma. Conclusions: This study highlights that pancytopenia is a common hematological problem and the study of detailed primary hematological investigations along with bone marrow study in patients with pancytopenia will help to identify the cause for further planning and management. Keywords: hypoplastic marrow; leukemia; megaloblastic anemia; pancytopenia.

Introduction: Radiography of the paranasal sinuses is commonly used diagnostic modality. However,the trustworthiness of plain radiographic findings of paranasal sinuses is debatable. The intentionof this study was to weigh the diagnostic soundness of plain radiograph of the paranasal sinuses tothat of computed tomogram scan. Methods: This is a descriptive cross sectional study carried out in 110 participants in Departmentof Radiology of Gandaki Medical College from November 2017 to April 2018. Ethical approval isobtained from Institution review board (Ref. No.39/074/075). Sample size was calculated takingconfidence level of 95%, expected prevalence of 14% and precision of 6.5% in population of 492098 inProvince 4 of Nepal. Random sampling method was used. Data was enter in Statistical Package forthe Social Sciences version 17 software and analysed. Results: A total of 110 participants are included in this study of which 62 (56.4%) are females and48 (43.6%) are males with an overall mean age of 34.5 years. The commonly involved sinus wasmaxillary 56 (50.9%) followed by ethmoid 33 (30%) sinus. The overall sensitivity and specificity ofdetecting sinusitis by sinus radiography is higher for maxillary sinus (89.7% and 87%) followed byethmoid (69.7% and 96.1%) and frontal (61.5% and 96.9%) sinuses. Conclusions: Sinus radiography is more sensitive for detecting pathologies in maxillary sinuses,while it is moderate for frontal, ethmoid sinuses and least for sphenoid sinuses. Diagnostic accuracyof computed tomogram scan is more, hence should be recommended to characterize the complexpathology and anatomy of the osteomeatal complex.

Introduction: The incidence of skin cancer is increasing exponentially around the world. This study aims to analyze different malignant skin tumors concerning age pattern, gender, and site-wise distribution. Materials and Methods: This is a descriptive cross-sectional hospital-based study carried out in the Department of Pathology, a tertiary care center for over ten years from April 2011 to March 2021. All malignant skin tumors arising from the epidermis along with melanocytic and adnexal tumors were included in the study. Results: A total of 208 cases of skin malignancies among which 117 (56.3%) cases were males and 91 (43.8%) females with a male to female ratio of 1.3:1. Overall, the majority were seen in the sixth decade 49 (23.6%) with head and neck region 113 (54.3%) being the commonest site of involvement. Basal cell carcinoma 79 (38%) was the most frequent non-melanoma skin cancer followed by squamous cell carcinoma 75 (36.1%). A maximum number of basal cell carcinoma were observed in the sixth decade 19 (24.1%) whereas squamous cell carcinoma in the seventh decade 21 (28%) cases. Other skin cancers were malignant melanoma 31 (14.9%), verrucous carcinoma 13 (6.3%), trichilemmal carcinoma five (2.4%), sebaceous carcinoma two (1%), and one case each of eccrine carcinoma, malignant nodular hidradenoma, and malignant proliferating trichilemmal tumor. Conclusions: Skin malignancies were seen in the sixth decade with male preponderance. Overall, the head and neck region was the commonest site of involvement. Basal cell carcinoma was the most frequent non-melanoma skin cancer followed by squamous cell carcinoma.

A 15-year-old boy reported a 2-month history of severe left thigh pain Physical examination revealed left thigh swelling measuring 6x5 cm. X-ray of the region showed mixed lytic and sclerotic lesion involving the femoral head and neck. A Computed Tomography scan showed mixed lytic and sclerotic lesion involving the femoral head and neck with cortical irregularity and mild periosteal reaction with associated soft tissue in the anterior aspect.  Magnetic resonance imaging demonstrated heterogeneous signal intensity lesion with areas of sclerosis involving the femoral head and neck. The large associated soft tissue in the anterior aspect appears predominantly hyperintense on T2W images. On post-contrast axial and sagittal images, heterogeneous enhancement with areas of necrosis involving soft tissue was seen. A presumptive radiological differential diagnosis of Ewing Sarcoma and Osteosarcoma was made. However, on histopathology, it was a case of mesenchymal chondrosarcoma.

Introduction: Gallbladder diseases are prevalent worldwide and present with a diverse histopathological spectrum. Mucosal irritation and chronic inflammation is considered as an important etiological factor for the mechanical or functional dysfunction of emptying of the gallbladder. This study aims to find the prevalence of non-neoplastic lesions of gallbladder among cholecystectomy specimens of a tertiary care center. Methods: A descriptive cross-sectional study was conducted in the Department of Pathology, of a tertiary care center from January 2005 to December 2020. Ethical approval was taken from the Institutional Review Committee. All the patients who had undergone cholecystectomy procedures which showed non-neoplastic lesions were enrolled in the study. Convenient sampling was done. Statistical Package for Social Sciences version 21 and Microsoft Excel were used for data analysis. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion forbinary data. Results: Out of 4914 cholecystectomy specimens, 4852 (98.73%) (95% Confidence Interval= 98.42- 99.04) were non-neoplastic lesions. There were 1252 (25.8%) males and 3600 (74.2%) females with a male to female ratio of 1:2.87. Age ranged from 2 to 89 years with a mean age of 45±14.48 years. Gallbladder lesions were observed maximum in age group 41-50 years with 1200 (24.7%) cases. Among the non-neoplastic lesions, cholecystitis without any specific finding was the most common finding with 3028 (62.4%) cases followed by cholelithiasis with 1478 (30.5%) cases. Conclusions: The prevalence of non-neoplastic lesions of gallbladder is similar to other studies done in similar setings. Female predominance was noted in non-neoplastic lesions.