Background: Like in other developing countries, cancer of cervix is one of the most common malignancies in women in Nepal. Most women never undergo a cervical Pap smear screening. The objective of this study is to determine the prevalence of abnormal cervical epithelial lesions. Materials and Methods: This was a retrospective study of 880 conventional cervical Pap smears reported from the Department of Pathology, Chitwan Medical College in Chitwan, Nepal. The time period was from June 2009 to November 2010. Results: In this study, High-grade Squamous Intraepithelial Lesion was the most common with 6 cases (40%), followed by Low-grade Squamous Intraepithelial Lesion with 3 cases (20%), then Atypical Squamous Epithelial Cells of Undetermined Significance, and atypical Glandular Cells and Squamous cell carcinoma with 2 cases each (13.3%). Eighty per cent of all the abnormal epithelial lesions were found in women above the age of 40 years. Conclusion: At least one Pap screening test of the cervix of all women between the ages of 40-50 years is recommended. Keywords: Pap smear; Cervical Intraepithelial Lesion; Squamous cell carcinoma. DOI: 10.3126/jpn.v1i1.4447Journal of Pathology of Nepal (2011) Vol.1, 30-33

Background: Acute appendicitis is one of the common conditions requiring emergency surgery. A retrospective study was performed to determine various histopathological diagnoses, their demographics and the rates of perforated appendicitis, negative appendectomy and incidental appendectomy. Materials and Methods: Histopathological records of resected appendices submitted to histopathology department Chitwan medical college teaching hospital over the period of 2 yrs from May, 2009 to April 2011 were reviewed retrospectively. Results: Out of 930 specimens of appendix, appendicitis accounted for 88.8% with peak age incidence in the age group of 11 to 30 yrs in both sexes. Histopathologic diagnoses included acute appendicitis (45.6%), acute suppurative (20.8%), gangrenous (16.3%), perforated (1.7%), resolving /recurrent/non specific chronic appendicitis (2.5%), acute eosinophilic appendicitis (1.2%), periappendicitis (0.2%), and carcinoid tumour (0.1%). Other important coexisting pathologies were parasitic infestation (0.2%) and Meckel’s diverticulum (0.2%). Negative appendectomy rate was 10.8% and three times more common in females with peak occurrence in the age group of 21-30 yrs. There were 10 cases of acute appendicitis in incidental appendectomies (2.5%, 24 cases) with 7 times more common in females of age group of 31- 60 yrs. Conclusion: There is a high incidence of appendicitis in adolescents and young adults in central south region of Nepal. Negative appendectomy is also very common in females. Incidental appendectomy in elderly females may have preventive value. DOI: http://dx.doi.org/10.3126/jpn.v2i3.6025 JPN 2012; 2(3): 215-219

Fine needle aspirates (FNA) were obtained from lymph node and other sites in 250 suspected cases of tuberculosis. Twenty-four cases proved to be non-tubercular on FNA smears and served as negative controls. Of the smears obtained from the remaining 226 cases, 233 were classified into five groups based on cytomorphological features, i.e. presence of necrosis and granulomas, necrosis alone or acute inflammatory exudate (AIE) with or without granuloma. Cases with AIE alone formed the largest group (n = 123). Staining for AFB was done by Ziehl-Neelsen (ZN) and fluorescent methods in all 250 cases. A correlation of AFB positivity and its semiquantitative scoring (1+ to 3+) with the cytomorphological spectrum was done. Overall AFB positivity by ZN staining was 33.5% and by fluorescent staining 45.4%. When the two methods were combined, AFB positivity was 58.7%. Fluorescent staining was superior to the ZN stain in the presence of a low bacterial load as seen in smears with diagnostic cytomorphological features of tuberculosis. In problem areas like AIE alone or with occasional granulomas, AFB positivity by ZN staining is nearly as good as the fluorescent method, because the bacterial load is high.

To determine the frequencies of various benign breast diseases (BBD) in female patients in Rural India. METHODOLOGY: This is a prospective cohort study of all female patients visiting the surgical clinic with breast problems. This study was conducted at SGT Medical College, Budhera (Gurgaon) India, over a period of about three years starting from March 2010 to February 2013. All female patients visiting the surgical department with breast problems were included in the study. Patients with obvious clinical features of malignancy or those who on work up were diagnosed as carcinoma were excluded from the study. RESULTS: A total of 225 patients were included in the study. About 50.22% (113/225) patients belonged to 3rd decade of life (age between: 21-30 years) followed by 25.77% from 4th decade (age between: 31-40 years). Fibroadenoma was the most common benign breast disease, seen in 29.77% (67/225) of patients, followed by fibrocystic disease seen in about 25.77% (58/225) patients. CONCLUSION: Benign Breast Diseases (BBD) are common problems in females of reproductive age. Fibroadenoma is the commonest of all benign breast disease in our set up mostly seen in 2nd and 3rd decade of life. Fibrocystic disease of the breast is the next common BBD whose incidence increases with increasing age.

Background: Cervical cancer prevention, the most common cancer in women in Nepal, is almost nonexistent because of very low pap smear coverage. Material and methods: This study was done to find out pap smear coverage, to assess women’s knowledge about cervical cancer and cervical pap smear, to assess women’s attitude towards cervical pap smear, and to find out association of demographic variables, attitude of women towards pap smear test, and knowledge of cervical cancer and cervical pap smear test with its practice. It was a cross sectional analytical observational study which was carried out in a one-day free health camp organized in Udayapur district of Nepal jointly by Chitwan Medical College and Satya Sai Organization on January 5 of 2013. Participants were interviewed with the help of structured questionnaire. Fisher’s exact test was done to detect association of the variables with pap smear practice. Results: Fisher’s exact test showed that knowledge about pap smear test and attitude towards the test were the only variables which significantly influenced pap smear utilization (p= 0.04). Pap smear utilization was not associated with age-at-marriage, age-at-menarche, parity and age-at-first-childbirth. Conclusion: Pap smear coverage was found to be 7.8% (at 95% CI was 0.02-0.13) which is lower than the average for developing countries. This study has shown that knowledge about pap smear test and attitude towards the test significantly influence pap smear utilization. Therefore, work should be done towards that end to increase pap smear coverage. DOI: http://dx.doi.org/10.3126/jcmc.v4i4.11969

These results suggest that BST2 plays an important role in the progression of RCC. Because BST2 is expressed on the cell membrane, BST2 is a good therapeutic target for RCC.

Background: Cytological study of body fluids a non-invasive, simple procedure, relatively inexpensive, and helps in faster reporting that has high population acceptance. The present study aims to determine the proportion of malignant and non malignant lesions. Methods: A total of 1129 specimens of exfoliative cytology were examined during the period over five years from year January 2011 to December 2016 at Department of Pathology at Chitwan Medical College Teaching Hospital, Nepal. The fluid received was centrifuged at 3000 revolutions per minute for five minutes. Smears were made from the sediment. Two to three slides were air dried and stained with Giemsa stain. One slide was immediately fixed in 95% alcohol and stained with Papanicolaou (Pap) stain for cytological evaluation. Results: Pleural fluid was most common specimen (49.3%) with peritoneal fluid (32%), pericardial fluid (1%), BAL (7.8%), CSF (4%), sputum (3.4%), synovial fluid (2%) and urine (0.5%) specimens. Male to female ratio was 1.33:1. Maximum cases belonged to age group of 50-69 years. Only (5.8%) 67 cases were neoplastic. The maximum cases of malignant neoplasm were detected in pericardial fluid and pleural fluid, each 21 (1.8%) cases, and 20 (1.7%) cases BAL. Malignant effusions were detected in 46 (4%) cases. Maximum malignant cases were adenocarcinoma (71.6%), followed by squamous cell carcinoma (20.8%). Conclusion: Exfoliative cytology should be suggested in all cases of effusion and suspected malignancies which helps in reaching at a particular diagnosis and aids in further management.

Background: Peripheral blood smear examination and other routine laboratory assays are not always sufficient to diagnose various diseases which affect the blood and bone marrow. A bone marrow aspirate examination is essential in most of the cases.Methods: This work was a hospital-based cross sectional analytical observational study carried out in the department of pathology at the Chitwan Medical College, Teaching Hospital, Nepal, over a period of 3 years from January, 2013 to December 2015. Bone marrow was aspirated from posterior superior iliac crest under local anesthesia; sternum was the alternative site in obese patients. Univariate analysis was performed for each variable using frequency distribution and means with the help of Statistical Package for Social Sciences 20.0 (SPSS 20.0) software.Results: One hundred and fifty-nine patients were included in the study. Eight cases of 'dry tap' were excluded, for whom bone marrow biopsy was advised. Anemia was the largest group followed by malignancy, infection and miscellaneous diseases. Among anemia, megaloblastic anemia was the most common, followed by aplastic anemia, dyserythropoietic anemia and myelopthisic anemia. The category 'malignancy' consisted of leukemia, multiple myeloma and myelodysplastic syndrome. Regarding individual diseases, megaloblastic anemia was the most common haematological disorder followed by immune thrombocytopenic purpura, leukemia and aplastic anemia.Conclusions: Bone marrow aspiration cytology is a mildly invasive technique which can diagnose many haematological and non-hematologic diseases that can be confirmed by more advanced investigations, if needed: serological, biochemical or molecular. However, bone marrow sample cannot be obtained (dry tap) in a proportion of cases. In such cases, a bone marrow biopsy needs to be performed.