Introduction: Magnetic resonance imaging (MRI) plays an important role in distinguishing malignant from benign adnexal mass which are indistinguishable from ultrasonography. This can help in early diagnosis and treatment of indeterminate adnexal lesions. This study aims to evaluate the features suggestive of malignant features and accuracy of ovarian adnexal reporting and data system (O-RADS) MRI score in distinguishing benign from malignant lesions when compared with histopathology which is gold standard. Method: This was a retrospective study of MRI pelvis carried out in patients with indeterminate adnexal lesions who had MRI pelvis done from 2018 to 2022 at Patan Hospital, Lalitpur, Nepal. Ethical approval was obtained from the institutional review committee of Patan Academy of Health Sciences. MRI diagnosis based on O-RADS MRI score was compared with histopathology diagnosis and sensitivity, specificity was calculated. Chi square test was computed and p-value less than 0.05 was considered statistically significant. Result: Among 175 patients, 135 had benign and 40 had malignant lesions. Malignancy was common in middle aged patients (41-60years).MRI features of malignancy were multilocular, solid cystic lesion with contrast enhancement, septations and diffusion restriction. Significant statistical association of O-RADS MRI score was found with histopathology diagnosed malignancy. 92.5% of malignancy had O-RADS MRI score of 4 and 5.The sensitivity and specificity of MRI diagnosing indeterminate lesion was 92.5% and 91.85% respectively. Conclusion: O-RADS MRI scoring is significantly associated with histopathology proven adnexal malignancy hence helps in accurately diagnosing indeterminate adnexal lesions and stratisfying the risk of malignancy.
Introduction: Hyperlipidemia is emerging as a major risk factor for developing cardiovascular diseases like atherosclerosis and coronary heart disease. Hyperlipidemia in turn results in platelet activation and thrombotic events. Platelets have been shown to have a role in the thrombus consequences of atheromatous damage in hyperlipidemic individuals by initiating and propagating atherosclerotic plaques. Platelet activity can be evaluated with platelet indices, including platelet distribution width and plateletcrit.Materials and Methods: This was a prospective study carried out over a period of one month in the Department of Pathology, Patan hospital. A total of 223 subjects with hyperlipidemia and 35 controls with normal lipid profiles and PDW were included. Statistical analysis was done using Pearson’s correlation test and data were expressed as mean ±SD for each parameter. A p-value of < 0.05 was considered to be significant.Results: Maximum number of patients was in 41-60 years of age (42.6%). The male-to-female ratio was 1: 1.1 with 47% males and 53% females. The mean total cholesterol, mean LDL-C, and mean HDL-C of the study group were 230.4±26.7, 150.3±28.4, and 40.9±15.2 respectively. The mean platelet count and PDW were 288.9±230.5 and 14.1±3.3 respectively. There was a significant correlation between PDW with total cholesterol and LDL-C in a study group with a p-value of <0.001.Conclusions: The present study indicates that PDWs are significantly higher in patients with hyperlipidemia. These indices are available without any additional cost to clinicians, pathologists, and patients and can be used to assess the risk associated with hyperlipidemia.
Background: Infertility is defined as the failure of a couple to conceive after one year of regular sexual intercourse. The malefactor is responsible for at least 50% of cases of failure to conceive. Semen analysis remains the cornerstone in the preliminary investigation of male factor infertility. This study aimed to evaluate seminal fluid parameters in the male partners of infertile couples. Materials and Methods: This retrospective study was conducted in the Department of Pathology, Patan Academy of Health Sciences, Patan hospital, Nepal between December 2019 and January 2020. All the 243 specimens were processed and analyzed according to WHO guidelines on semen analysis. Results: Present study included a total of 243 semen samples, aged between 20-63 years with a mean age of 32.0 years. Normozoospermia was observed in (26.3%). The most common abnormalities found in this study were asthenozoospermia (25.5%), oligospermia (19.3%), azoospermia (6.5%), and teratozoospermia. Conclusions: Semen analysis remains a keystone in assessing male factor infertility in developing countries like Nepal. However, needs further evaluation to establish possible etiologies of male infertility.
Introduction: The 2019 novel coronavirus global pandemic compelled nationwide lockdown in Nepal with attendance of only urgent consultations and surgeries. This study aims to assess the volume, diagnostic categories, and age distribution of cases received in a histo-cytopathology laboratory so that laboratories can be prepared accordingly, to cope with a probable surge of COVID-19 or similar incidence in Nepal. Materials and Methods: A retrospective descriptive study was performed in the Pathology Department, Patan Academy of Health Sciences during first four weeks of nationwide lockdown from March 24 to April 24, 2020. The current data was compared with that of March 24 to April 24, 2019. Results: The volume of histopathology specimens was reduced by one-fifth and cytological samples by one-seventh. In histopathology, non-neoplastic lesions were 269 and 65, benign lesions 48 and 1, and malignancy 27 and 6 cases in the corresponding period of the previous year and COVID-19 lockdown period respectively. Appendix, product of conception, placenta, and tubal ectopic pregnancy constituted a major bulk of histopathology cases. The percentage of malignant cases reported in histopathology, as well as cytology, increased during the COVID-19 pandemic. The mean age of patients was 37 years during the COVID-19 lockdown and 41 years in the previous year. Conclusions: Despite the reduction in the overall volume of histo-cytopathology samples, a higher rate of malignancy was recorded. This emphasizes the necessity of continuing histo-cytopathology services and delivering timely diagnosis even during such a contagion crisis so that oncological patients are not deprived of appropriate management.
Introduction: The characteristics of salivary gland lesions identified by fine-needle aspiration cytology are varied and may overlap, which makes diagnosis difficult for cytopathologists. To provide consistency in the reporting of salivary gland cytology and to enhance clinic-pathologic communication, the "Milan system for reporting salivary gland cytopathology" has been introduced, which offers guidelines for diagnosis and treatment based on various categories of malignancy risk. Material and Methods: In this retrospective study, Fine needle aspiration cytology was done for all salivary gland lesions for three years and were retrieved from the Department of pathology, Patan hospital. All the cases were recategorized according to the Milan system for reporting salivary gland cytology with histopathology follow-up wherever available. Consistency of the two different types of assessment techniques (Milan category and primary cytology diagnosis) were assessed and the k score was calculated Results: A total of 58 cases were included in the study of which histological follow-up was available in 27 cases. Out of 58 cases, maximum cases 32 (55.1%) were classified under IVA followed by 15.5% cases classified under II, 8.6% of cases under Category IVB), 6.8% under category Vand 5.1% cases under category VI. Kappa's score was 0.58 which represents a moderate agreement. Conclusions: Milan system for reporting salivary gland cytopathology is a recently proposed six-category scheme, which places salivary gland fine needle aspiration cytology into well-defined categories that limit the possibilities of false negative and false positive cases.
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