Background: Fine needle aspiration cytology has become an indispensable tool for diagnosis of intrathoracic lesions. The purpose of this study was to evaluate the spectrum of intrathoracic lesions by image guided fine needle aspiration cytology. Materials and Methods: This was a prospective study of 100 patients, who underwent image guided fine needle aspiration cytology of intrathoracic lesions from December 2015 to November 2016 in the Department of Pathology, Institute of Medicine, Tribhuwan University Teaching Hospital. Results: Of the 100 cases, diagnostic material was obtained in 86 cases, which included 69 cases (80.23%) from lung, 7 cases (8.13%) from pleura and 10 cases (11.62%) from mediastinum. Lung lesions constituted of 61 neoplastic lesions (88.40%), 3 cases (4.34%) suspicious of malignancy, 3 cases (4.34%) negative for malignancy and 2 non- neoplastic lesions (2.89%). Squamous cell carcinoma was the most common lesion of the lung. Pleural lesions consisted of 5 neoplastic cases (71.42%), 1 non- neoplastic case (14.28%) and 1 negative for malignancy (14.28%). Mediastinal lesions consisted of 7 neoplastic lesions (70.00%) and 3 non- neoplastic lesions (30.00%). Biopsy for histopathological examination was available in 30 cases. The concordance of diagnosis of lung lesions by fine needle aspiration cytology and histopathology was 90.90%. Image guided FNAC had sensitivity of 95.83% and specificity of 50.33% in diagnosing intrathoracic lesions. The positive predictive value of image guided FNAC in diagnosis of intrathoracic lesions was 92.00% and negative predictive value of 66.67 percent. Conclusions: Image guided fine needle aspiration cytology of intrathoracic lesions permits categorization and distinction between non- neoplastic and neoplastic lesions.

Foreign body aspiration is common in children and adolescents. Foreign body aspiration is often unnoticed and diagnosis may be delayed in children, as many fail to provide a history. Although rigid bronchoscopy is preferred modality, flexible bronchoscopy is also a useful tool for foreign body extraction from the distal airways in selected cases. An eleven-year-old boy presented with a history of fever and dry cough of one month's duration. A chest x-ray showed a linear radiopaque foreign body along the course of the right bronchus. Flexible bronchoscopy revealed a metallic nail-like structure in right lower lobe bronchus which was successfully grasped with the flexible forceps and extracted via the oral route with the bronchoscope. Upon extraction aspirated foreign body was found to be a push-pin.

Systemic inflammatory response syndrome (SIRS) is a frequent and serious problem faced by clinicians in day to day practice and is a major factor of intensive care morbidity and mortality. The American College of Chest Physicians and the American Society of Critical Care Medicine in 1991 published definitions and criteria for systemic inflammatory response syndrome.  Since then many researches have been undertaken  to better understand the pathophysiology of systemic inflammatory response syndrome and to determine the accuracy of its diagnostic criteria. The criteria set by the 1991 consensus  is still popularly  used  today. However,  with  the current  knowledge   on this matter many researchers have put forward the need of refinement in the criteria of systemic inflammatory response syndrome defined by 1991 consensus. This article aims to review  the epidemiology, etiology, pathophysiology, laboratory diagnosis,  treatment and the current views regarding SIRS.Journal of Universal College of Medical SciencesVol. 6, No. 1, 2018, Page: 56-61

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: Novel Coronavirus disease has caused a substantial halt to the ongoing world in every aspect. There are medical and social implications of the disease. Cutaneous manifestations have been reported to be a part of the disease as well. Dermatologists globally are in dilemma with the clinical practice because of the fear of acquiring the disease. Objectives: This article aims to recommend best practice measures that can be followed in local scenario for re-opening up of dermatological services in the context of Nepal. Materials and Methods: A preliminary draft for guidance on Dermatological services based on recommendations of American Academy of Dermatology, International league of Dermatological societies, National recommendations from Ministry of Health, Nepal was sent to a panel of national experts to determine the level of consensus in first week of April, 2020.  A preliminary survey was sent to all the members of Society of Dermatologists, Venereologists, and leprologists of Nepal on first week of June and a second draft was subsequently formed which was sent again to experts and revised based on the opinions of national experts. Results: A total of 19 experts participated in the preparation of draft and reached a national consensus after a series of revisions in preliminary draft. Conclusion: Agreements regarding the opening of practice in dermatology discipline have been summarized. Recommendations have been made for opening of dermatological services – opening of outpatient department, performing dermatosurgical and cosmetic procedures as well as strategies on triage of patients and use of masks.

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Introduction: The association between thyroid disorders and breast cancer is debated. A possible relationship between breast carcinoma and thyroid disorders have been suggested considering the fact that the breast malignancy may alter endocrine homeostasis. A prospective cross sectional study in breast cancer patients was performed to evaluate the association of breast cancer with thyroid disorders. Ultrasonography and cytological changes in thyroid gland were evaluated.  Materials and methods: The study included 30 consecutive newly diagnosed breast cancer patients between the age group of 30 to 60 years. The study had a control group of 20 age matched patients from the same geographical area with no breast or thyroid disease and no malignancy. The presence of thyroid disease was examined by using well defined diagnostic criteria of ultrasonography. The observations on ultrasound were correlated with cytological assessment in breast cancer patients only.  Results: Results were analyzed statistically by Fischer's exact probability test, Pearson correlation coefficient and unpaired student 'T' test. Sonographically nodular thyroid was observed in 50% of breast cancer patients as compared to 10% in control group (p<0.002).  Majority of patients had solitary and solid echo texture thyroid nodules. There was a direct correlation between the stage of breast cancer and total thyroid volume. All thyroid nodules were cytologically benign (adenomatous/ colloid nodular goiter) on cytological evaluation.  Conclusion:  It is concluded that an increased preponderance of thyroid disorders exist in patients with breast cancer.