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

Introduction: Dry eye is a common disorder affecting a significant percentage of the population. Materials and methods: This study is a prospective, hospital-based, case-controlled study conducted between January 2009 and May 2010. Seventy-six pterygium cases and 152 age-and-sex matched controls presenting to the OPD of Manipal Teaching Hospital were included. The TBUT Schirmer's test and basal tear secretion were estimated in all patients. A TBUT of less than 10 seconds and a Schirmer's test of less than 10 mm were considered abnormal. Results: Pterygium was bilateral in 15 (19.7 % ) and unilateral in 61 (80.3 %) patients. Ninety-two (92.1 %) pterygium patients reported either one or more of the six dry eye symptoms. Redness was the most common (67 %) symptom reported. The mean Schirmer's test I, mean basal secretion and mean TBUT values were 16.19 mm, 10.01 mm and 10.56 seconds in pterygium cases and 20.22 mm,13.25 mm and 26.25 seconds in the control group respectively. There was a statistically significant difference in the dry eye results between the pterygium cases and the control group (p value < 0.05). The odds ratio between pterygium and dry eye was 3.28. Dry eye was present in 26 % of the normal patients and in 54 % of the pterygium cases. Conclusion: There is a strong relationship between dry eye and pterygium.

This study aimed to find bacterial profile of urinary tract infection (UTI) in children between 2 months to 15 years of age. This is a hospital based retrospective study conducted at Gandaki medical college and teaching hospital, Pokhara over a period of 18 months. Among the total 575 children enrolled for the study, 110 children (19.1%) were found to be culture positive. Most common age group having culture positivity is 1-5 years (40%). Present study showed that UTI is more common in girls (69.1%) than in boys (30.9%). E. coli was still the most commonly isolated bacteria (70.9%) followed by Proteus (20%), Klebsiella (5.4%) and Pseudomonas sp. in (1.8%). E. coli was sensitive to Nitrofurantoin (84.6 %), Amikacin (80.7%), Gentamicin (73%) and Ofloxacin in (53.8%). Most commonly used drugs for the treatment of UTI like Cefixime and Ceftriaxone was sensitive only in 15% and 10% respectively. Similarly, Klebsiella was sensitive to Amikacin and Gentamicin (100%) but sensitive to Nitrofurantoin in only 66% of cases. Proteus was sensitive to Nitrofurantoin (95.4%), Amikacin (86%) and to Gentamicin (59%). High resistance rate was observed to Cefixime and Ceftriaxone, the commonly used drugs for its treatment in OPD basis. DOI: http://dx.doi.org/10.3126/jcmc.v3i3.8633 Journal of Chitwan Medical College 2013; 3(3): 22-25

In Nepal, three most common causes of newborn (NB) admission in the neonatal intensive care unit (NICU) are birth asphyxia, neonatal sepsis and prematurity and they are the leading causes of death too. A study previously done in Nepal shows asphyxia as a leading cause of hospital admission accounting 22% followed by prematurity 20% and neonatal sepsis 17% with mortality due to these three causes being 7%, 3% and 5% respectively. Reasons of NICU admission in Chitwan Medical College (CMC) are clinical sepsis in 50% of cases followed by birth asphyxia 17.6%, and prematurity in 6.7% cases. Respiratory distress syndromes (RDS), neonatal jaundice, congenital hydrocephalus, meningitis are other reasons of NICU admission. Most of the babies were delivered by normal vaginal delivery at health facility 53%, and 47% of NB was delivered through lower section Caesarean section (LSCS). Only 6% of NB was having birth weight of less than 1.5 kg and majority of them were above that. There were 65% NB who was born at term and remaining 35% were preterm. Majority of NB were admitted within 72 hours of birth with 79% of the total admission. Hypoglycemia was observed in 83 out of 202 newborns accounting 41% neonatal hypoglycemia at birth. Journal of Chitwan Medical College 2013; 3(4); 13-16 DOI: http://dx.doi.org/10.3126/jcmc.v3i4.9547