Background Fine needle aspiration cytology (FNAC) with it’s minimally invasiveness has been a well accepted procedure in the initial diagnosis of various swellings. With time and experience high sensitivity and specificity of FNAC over conventional open biopsy has lead to the wide acceptance of this procedure.Objective To evaluate the utility of aspiration cytology as a first-line diagnostic tool in palpable head and neck masses and correlate with histologic results for evaluating diagnostic accuracy.Methods A hospital based prospective, comparative study was conducted among patients with various swellings at Head and Neck regions in the Department of Pathology, Dhulikhel Hospital between July 2011 to June 2012. FNAC were done from the palpable masses of head and neck regions and were compared with biopsy findings of the same lesions. Data entry and analysis performed using SPSS version 16. The sensitivity, specificity and accuracy rates were calculated.Results A total 64 patients were subjected to both FNAC and histopathological examination (HPE). Total 39 (61 %) were females and 25 (39 %) were males with M: F ratio of 1:1.6. The age group ranged from 9 to 80 years. Twenty five percent of patients were in the age group below 20 years. The highest number of cases included lymph nodes 29 (45%) followed by thyroid 24(37.5 %), salivary glands 10(16%) and 1 case (1.6%) was a soft tissue swelling over the occipital region. Highest sensitivity, specificity and accuracy rate for diagnosis by FNAC were observed in thyroid. The overall sensitivity and specificity of FNAC were 86% and 97% respectively in determining the various pathologies. The overall accuracy of FNAC in present study was 87.4%.Conclusion FNAC is a minimally invasive first line investigation with a high sensitivity and specificity for the diagnosis of various head and neck lesionsKathmandu Univ Med J 2013; 11(4): 296-299
Background Colonoscopy is the method to visualize the mucosa of the entire colon and terminal ileum to detect the intestinal abnormalities and obtain biopsy for definitive diagnosis. For clinical decisions in the diagnosis of various colonic lesions unambiguous interpretation of colorectal biopsies is necessary. Objectives To assess the prevalence pattern of colonic diseases and to correlate the incidence of colorectal carcinoma with age, sex, site and symptoms presented at Dhulikhel Hospital. Methods The materials consisted of 126 biopsies which were submitted to the Department of Pathology, Kathmandu University School of Medical Sciences, Dhulikhel, during the period of July 2011- July 2012 .Data collected and entered in MS-Excel and were analyzed using SPSS-16. Results Out of 126 colonoscopic biopsies 34(27%) showed chronic nonspecific inflammation, followed by carcinoma 25(19.8%), non-neoplastic polyps 21(16.7%), granulomatous inflammation 14(11.1%), neoplastic polyps 8(6.3%), ulcerative colitis 4(3.2%) Miscellaneous lesions; Acute focal colitis, Eosinophilic colitis were also observed in 19 (15.1%). A higher frequency of colonic diseases in males with a male to female ratio of 1.4:1 and age range of two years to 84 years was observed. Out of 25 patients diagnosed with colorectal carcinoma,48% (n=12) were males and 52% (n=13) were females with a mean age of 55.17 years in men and 59.46 years in females. Male and female ratio among cancer groups was 1:1.08. Total 36% (n=9) were diagnosed with cancer before the age of 50. Out of these nine cases, 6( 66.7%) were males and 3(33.3%) were females. The male and female ratio in younger and older age groups were 2:1 and 1:1.7 . 17( 68%) of the lesions were left sided and 8(32%) were right sided. Below age 50 , left to Right sided lesions in males were 2:1 and in females 1:2. However, above 50 years the ratio among proximal and distal lesions were 5:1 in males and 2.3:1 in females. A statistically significant association was seen between the growth (p=0.000) and per rectal bleeding (p= 0.006) with carcinoma. Conclusion The most prevalent lesion in colorectal biopsies was non-specific colitis followed by carcinoma colon. The incidence of colorectal carcinoma is on rise in Nepalese society. Although colorectal carcinoma is more common in older age group the incidence are also increasing among young especially among women. DOI: http://dx.doi.org/10.3126/kumj.v11i3.12503 Kathmandu Univ Med J 2013; 43(3):196-200
Introduction: Arteriovenous fistulas are a preferred choice for hemodialysis access in chronickidney disease patients. There is increased adoption of arteriovenous fistula creation in Nepal.Our objective is to study various arteriovenous fistulas that have been created in our center. Methods: This is a descriptive cross-sectional study conducted in a tertiary care hospital includingall cases of arteriovenous fistula creation from January 2018 to December 2019. We obtained theethical clearance from the institutional review committee of Kathmandu University School ofMedical sciences. Convenient sampling method was used. Detailed vascular mapping and colordoppler ultrasonography was done in the bilateral upper limb as preoperative preparation and tochoose a site for arteriovenous fistula creation. Data were entered into the Statistical Package for theSocial Sciences version 20 for analysis. Results: Among 50 patients, the most common location was brachiobasilic 20 (40%) patients followedby brachiocephalic 18 (36%), radiocephalic 11 (22%), and arteriovenous graft between the brachialartery and axillary vein 1 (2%). The mean duration of hospital stay was 1.44 days. Three (6%) patientsrequired re-intervention, all within 24 hours. Two (4%) patients had a failure of arteriovenous fistularequiring the creation of a new arteriovenous fistula. Conclusions: Brachiobasilic was the most common location for arteriovenous fistula creation.Reintervention was not common.
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