Background: Diseases primarily inflicting prostate gland are inflammation, benign prostatic hyperplasia and cancer. Prostate specific antigen is a protein produced by the cells of prostate gland. It has been widely used in the diagnosis and management of patients with prostatic cancer. The aim this study was to determine the correlation between serum prostate specific antigen level and histological findings in biopsy specimens of men with prostatic disease. Materials and Methods: This study was carried out at Kathmandu Medical College and TeachingHospital, department of Pathology over a period of 2 years. One hundred and twenty eight cases with prostatic lesions were included in this study. Prostate specific antigen values of these cases were recorded before the surgical process. Histology of the tissue samples collected after transurethral resection of prostate was studied and relationship with prostate specific antigen level were analyzed.Results: Benign prostatic hyperplasia was the most common histological lesion encountered (n=95; 74.22%). Prostatic adenocarcinomas were seen a decade older than those with benign lesions. Maximum number of the benign cases had the Prostate specific antigen range of 0-7ng/ml. Most of the prostatic intraepithelial neoplasia lesions were seen within the PSA range of 0-7ng/ml and adenocarcinoma in the range of >20ng/ml. Conclusion:Prostate specific antigen is specific for the prostate but not for prostate cancer. Both benign and malignant lesions in prostate can cause increase in serum prostate specific antigen levels, but the chances of malignancy it rising level.
Introduction: Anemia is the most common finding in chronic kidney disease patients. Iron supplements are commonly prescribed for these patients with or without erythropoietin therapy by means of oral and intravenous iron. Both oral and intravenous irons have their own advantage and disadvantage, and the efficacy is also different. The objective of the study is to analyze the efficacy of oral and intravenous iron in chronic kidney disease patients on erythropoietin therapy, an erythropoiesis stimulating agents for increment of haemoglobin. Methods: This is a prospective study comparing intravenous iron to oral iron in chronic kidney disease patients who underwent maintenance hemodialysis at different centers and visited Kathmandu Medical College Teaching Hospital from April 2010 to April 2011. Patients having a haemoglobin level of < 11 g/dl, transferrin saturation (TSAT) < 25%, ferritin < 300ng/ml and who were on erythropoietin therapy were allocated alternately into two groups to receive oral iron (iron fumarate) or IV iron (iv sucrose). Haemoglobin was measured after 30 days of therapy. Results: A significant increase in haemoglobin levels was observed in both groups. But the mean haemoglobin increment was more in the IV iron group than in the oral iron group. Sixty percent 60% of patients in the IV iron group had an increase in the haemoglobin level of more than 1gm/dl while only 20% of the oral iron group had this increase. Conclusions: Intravenous iron therapy is more effective in raising the hemoglobin level in hemodialysis dependent chronic kidney disease patients. Keywords: anemia; chronic kidney disease; iron.
Introduction: Uterus is subjected to many non-neoplastic and neoplastic diseases. Hysterectomy is the commonest gynecological surgery done for the management of the pathologies of the female reproductive system. Histopathological examination of hysterectomy specimens is done routinely which has both diagnostic and therapeutic significance.Objective: To study the common pathologies identified in hysterectomy specimens and to correlate them with the clinical findings.Methodology: A cross sectional study was carried out among all the hysterectomy specimens irrespective of primary lesion sent for histopathological examination from January 2016 to December 2017 in Department of Pathology, Kathmandu Medical College Teaching Hospital (KMCTH). Relevant history was taken from the requisition form. Ethical clearance was obtained from the Institutional Review Committee of KMCTH.Results: A total of 198 cases were studied. The most common pathology encountered was leiomyoma (60.0%) followed by adenomyosis (14.0%). Atrophic endometrium was seen in 24.3% cases. Chronic cervicitis was found in most of the cases (96.5%) along with endocervical polyp in 8.1% cases. Leiomyoma was found to be the most common indication for hysterectomy comprising 48.0% followed by abnormal uterine bleeding (24.75%) and utero-vaginal prolapse (18.25%). Hysterectomy was most commonly performed in the age group of 41 - 50 years and total abdominal hysterectomy with bilateral salpingo-oophorectomy was found to be the commonest procedure done comprising 8 0.0%.Conclusion: Leiomyoma was found to be the most common pathology in myometrium and chronic cervicitis in cervix. Abnormal uterine bleeding and vaginal prolapsed were also found to be common. Lesions which can be managed conservatively do need hysterectomy or not, is a matter of great concern. BJHS 2018;3(2)6:423-426.
Introduction:Histopathologic diagnosis of leprosy is difficult when Bacillary Index (BI) is zero and neural involvement are not easily identifiable on routine Hematoxylin and Eosin stain. This study was undertaken to study the role of S-100 immunostaining in demonstrating different patterns of nerve involvement in various types of leprosy.Methods: Thirty one skin biopsies with clinico-histopathologic diagnoses of leprosy over a period of two years were included in the study. Ten cases of non-lepromatous granulomatous dermatoses (including eight cases of lupus vulgaris and two cases of erythema nodosum) were used as controls. Tissue sections from all cases and controls were stained with Hematoxylin and Eosin (H&E) stain, Fite stain and S-100 immunostain. The H&E stained slides were used to study the histopathological features, Fite stained slides for Bacillary Index and S-100 for nerve changes. Results:Neural changes could be demonstrated in the entire spectrum of leprosy using S-100 immunostaining. The most common pattern of nerve destruction in the tuberculoid spectrum was fragmented and infiltrated whereas lepromatous spectrum showed mostly fragmented nerve twigs. Intact nerves were not detected in any of the leprosy cases.Conclusions: S-100 immunostain is a useful auxiliary aid to the routine H&E stain in the diagnosis of leprosy especially tuberculoid spectrum and intermediate leprosy.
Introduction: Dysfunction of the autonomic nervous system is common in diabetic patients. Presence of autonomic dysfunction should alert the physicians of its serious consequences that require timely preventive measures. Objectives: This study was done to fi nd out the autonomic nervous system involvement in Type 2 diabetic patients and to see its relation with the duration of diabetes. Methods: This was a hospital based cross-sectional study. All consecutive diabetic patients of both genders attending Kathmandu Medical College and a private clinic, Temple of Healing were included. A battery of six well validated and accepted autonomic nervous system evaluation tests were done to evaluate the autonomic function in 245 Type 2 diabetic patients. Results: Prevalence of autonomic dysfunction was found to be 71.02% with 58.78% patients having mild autonomic dysfunction and 12.24% having moderate dysfunction. Severe autonomic dysfunction was detected in none of the patients. Parasympathetic dysfunction was much more common than sympathetic dysfunction (68.16% vs. 17.96%). No association was found between autonomic dysfunction and duration of diabetes. Conclusions: Autonomic dysfunction is very common in diabetics and can be detected by simple tests. Timely detection of autonomic dysfunction in diabetic patients is advised so that its preventive measures can be effective.
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