Introduction: Tuberculous lymphadenitis is the most common form of extrapulmonary tuberculosis and one of the main causes of lymphadenopathy. Fine Needle Aspiration Cytology (FNAC) has played a substantial role in diagnosis of tuberculous lymphadenopathy and it has become a first-line diagnostic technique. The aim of this study was to describe and understand the spectrum of cytomorphological changes seen in tuberculous lymphadenitis corresponding to stages of disease and to associate the cytomorphological changes with Acid Fast Bacilli (AFB) positivity.Methods: This is a retrospective cytomorphological study of cytologically diagnosed tuberculous lymphadenitis. The recorded details of clinical presentation and site of the lymph nodes were noted. The slides were stained with Papanicolaou, Giemsa and AFB.Result: There were a total of 203 cases with age ranging from 3-75 years. Four cytomorphological patterns observed were Necrotising Granulomatous Lymphadenitis (NGL; 45.32%), Granulomatous Lymphadenitis (GL, 18.22%), Necrotising Suppurative Lymphadenitis (NSL; 21.18%) and Necrotising Lymphadenitis (NL; 15.27%). Necrotising patterns were observed in immunocompromised individuals like HIV infected patients, in patients with previous history of tuberculosis and in patients with chronic renal disease. Strong AFB positivity was observed in necrotising patterns. Lymph nodes of head and neck region were the most common site of involvement with cervical being the commonest. Conclusion:Necrotizing patterns are observed in the later stages of disease or in the immunocompromised patients. Strong positivity for AFB is observed in the smears with necrotizing patterns and less in the granulomatous pattern.
Background: Neoplastic lesions of female reproductive system (FRS) consist majority of surgical cases. The aim of this study is to find out the frequency distribution of tumors occurring in FRS.Methods: This is a retrospective study carried out in Birat Medical College, situated in eastern Nepal. All formalin fixed surgical specimen of FRS from August 2015 to September 2017 were subjected for histopathology and examined under light microscopy. All neoplastic lesions were included, and non-neoplastic lesions were excluded from the study.Results: A total number of ninety (90) histopathological tissues representating various types of neoplastic lesion of FRS were studied. Out of which 6 (6.6%) tumors were from uterine cervix, (including 1 cervical leiomyoma and 5 squamous cell carcinoma cervix) 45(50%) tumors were from uterine body, (all leiomyoma) 20 (22.2%) tumors were from ovary (including 9 mature teratoma, 1 immature teratoma, 6 mucinous cystadenoma and 4 cases of serous cystadenoma) and 19 (21.2%) tumors were from breast (including 16 fibroadenoma, 1 lactational adenoma, 2 infiltrating ductal carcinoma and 1 comedo carcinoma). Majority 81(90%) were benign and 9 (10%) were malignant. Most common benign tumor was leiomyoma of uterine body and most common malignant tumor was squamous cell carcinoma of uterine cervix both commonly occurring in the age group of 41-50 years.Conclusions: Benign tumor, leiomyoma is the common tumor occurring in FRS. Carcinoma of the cervix is the common malignant tumor.
Background: Human blood till date has no substitute. Transfusion of blood and its components is a lifesaving procedure. Hence, optimum utilization and minimum wastage of blood and its components should be strictly monitored. Materials and Methods: This is a prospective study conducted on data collected from the blood bank of B.P. Koirala Institute of Health Sciences, Dharan, Nepal for a duration of 1 year from year 2015 to 2016. The sample size was calculated by using systematic random sampling with every third sampling interval sample collection method. The study included usage and wastage of packed red blood cells, platelet concentrate, fresh frozen plasma, and cryoprecipitate including data on the supply of blood components to different departments, age distribution, gender distribution, and distribution of blood components based on blood groups. Results: A total of 1641 units of blood component were included in the study. A total of 92.9% (1524 units) were used and 7.13% (117 units) were wasted. The renal disorder was the most common cause of blood component utilization. The medicine department utilized the majority of the blood components. The expiry was the most common cause of wastage. Among the wasted blood components, platelet concentrate was the maximum. Conclusion: Blood components are a life-saving resource. It should be evaluated and analyzed properly for utilization in a justifiable manner. The hospital should act in accordance so that maximum blood components are utilized in a safe manner and waste is minimized to the least.
Acanthamoeba keratitis is a sight-threatening corneal infection and is a growing clinical problem in the world. Though Acanthamoeba keratitis is considered uncommon and rarely reported in Nepal, we encountered six cases in 2019. All patients had redness, photophobia, decreased vision, and pain with ring infiltrate. Ten percent potassium hydroxide mount revealed Acanthamoeba cyst in all cases. Non-nutrient agar overladen with Escherichia coli revealed feeding tracks and Polymerase Chain Reaction revealed T4 genotype Acanthamoeba in four cases. Amoebicidal treatment was started with chlorhexidine 0.02% eye drop half-hourly and supplementary treatment included moxifloxacin eye drop, a combination of polymyxin B sulfate, neomycin sulfate, and bacitracin eye ointment. After treatment, one patient had the best-corrected visual acuity of 6/9 while others had a visual outcome of hand movement. A high level of clinical suspicion and wet mount examination of specimen from infected corneal tissue are essential to aid in rapid diagnosis.
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