Introducti on: Lung cancer is one of the leading cause of death in western countries and is the second most common malignancy in Nepal. Fiberopti c bronchoscopy has an excellent result in diagnosis of lung cancer when combined with brushing cytology & biopsy. This prospecti ve study was conducted at Tribhuvan University Teaching Hospital over the period of one year with the aim to correlate brushing cytology with biopsy in diagnosis of bronchoscopically visible lung cancer.Method: A total of 62 cases were included in this study on whom bronchoscopy was performed in endoscopy unit. Bronchial brushing, biopsy specimens were collected & processed accordingly. Results:Out of 62 cases, 53 were found to be malignant and 9 were infl ammatory lesions. Thus, cytohistological correlati on was done in 53 malignant cases. There were 38 male and 15 were female with a mean age of 54 years. The male:female rati o was 2.5:1.The most common type of carcinoma was squamous cell carcinoma (64.2%), followed by adenocarcinoma (18.8%), small cell carcinoma(13.2%), large cell carcinoma (1.9%), carcinoid tumor(1.9%). Sensiti vity of the bronchial brushing was 94.6% while that of biopsy was 91.3%. Conclusion:Bronchial brushing cytology has bett er detecti on rate than biopsy in this study. However combinati on of these modaliti es gives higher detecti on rate for bronchoscopically visible tumor. Therefore, bronchial brush cytology should be performed whenever possible in all suspected cases of lung cancer.

Introduction: Klebsiella pneumoniae is one of the most common Gram negative bacteria encountered byclinicians worldwide as a cause of infections in human. Most of the infections are acquired in hospital settingtherefore, it is reported to be the amongst the 10 most common nosocomial pathogen in various studies. Nowadays,Klebsiella pneumoniae infections are complicated by increase in Extended Spectrum Beta Lactamase (ESBL)producing isolates. Therefore, this study is being conducted with the objective to fi nd out the prevalence ofESBL producing Klebsiella pneumoniaein various clinical samples and to fi nd out there sensitivity pattern.Methods: A total of 100 Klebsiella pneumoniae were isolated from various samples during the period of April2013 to November 2013 in Microbiology Unit of Shree Birendra Hospital. All the isolates were identifi ed withtheir sensitivity pattern according to standard methodology. Combination disc diffusion method was followedfor identifi cation of ESBL.Results: Out of total 100 isolates of Klebsiella pneumoniae21% were ESBL producer.ESBL producer isolatesshowed 100% sensitivity to Imepenem followed by Amikacin 57.1% and Chloramphenicol 47.6%. All theESBL isolates were resistant to both Cefotaxime and Ceftazidime.Conclusions: ESBL producer Klebsiella pneumoniae isolates were multidrug resistant. Continuous surveillanceand timely intervention with discouraging the use of cephalosporin group of antibiotics is mandatory.doi:  http://dx.doi.org/10.3126/mjsbh.v13i1.12996

Nepalese Journal of ENT Head and Neck Surgery, Vol. 3 Issue 1 (Jan-June 2012) Page 9-10 DOI: http://dx.doi.org/10.3126/njenthns.v3i1.8180

Introduction: This is a retrospective study on fine need aspiration cytology (FNCA) of superficially palpable lesions done in Shree Birendra Hospital, Chhauni, over a period of one year from 14th April 2008 to 13th April 2009. Aim: The aim of this study was to review cytological diagnosis on superficially palpable lesions in various sites. Methods: A total of 323 cytological diagnoses of palpable lumps performed in one year by pathologists were retrieved. Sites of FNA and diagnoses were analyzed and correlated with age and sex of the patients. Results:This study has included 323 FNACs. Lymph node was the most common site for FNAC (32%), followed by breast (29%), thyroid (22%), and salivary gland (2%). Other site comprised 15% of cases. In lymph node, reactive lymphadenitis was the most common benign lesion (42.7%) and metastatic squamous cell carcinoma was the commonest malignant lesion(12.62%). In breast, benign proliferative breast disease was the most common(84.1%) and ductal carcinoma was commonest among malignant lesions(8.5%). Among thyroid lesions, benign proliferative thyroid disease was the commonest one (47.9%)followed by papillary carcinoma among malignant lesions(11.3%).Among salivary gland lesions, Chronic sialadenitis was common inflammatory lesion (37.5%) followed by pleomorphic adenoma among benign lesions(25%) and carcinoma comprised 25%. Lipoma was the commonest lesion ( 63%) from other sites. Conclusion: Wide range of lesions, both benign and malignant, can be diagnosed by FNAC thus restricting surgery to cases only requiring further histopathological evaluation. DOI: http://dx.doi.org/10.3126/mjsbh.v9i2.5022 Medical Journal of Shree Birendra Hospital Vol.9(2) 2010: 25-29