Cancer patients are at high risk of antibiotic resistant bacterial urinary tract infections (UTIs). In this study, we assessed the bacterial profile and antibiotic resistance among cancer patients suspected of UTI in B.P. Koirala Memorial Cancer Hospital in Nepal through a cross-sectional study with routinely collected data. All cancer patients who had a recorded urine culture between July 2018–June 2019 were included in the study. Out of 308 patients who had undergone culture, 73 (24%) of samples had bacterial growth. The most common organisms isolated were E. coli (58%), Staphylococcus (11%) and Klebsiella (10%). These bacteria had undergone susceptibility testing to 27 different antibiotics in various proportions. Of the limited antibiotic testing levels, nitrofurantoin (54/66, 82%) and amikacin (30/51, 59%) were the most common. Among those tested, there were high levels of resistance to antibiotics in the “Access” and “Watch” groups of antibiotics (2019 WHO classification). In the “Reserve” group, both antibiotics showed resistance (polymyxin 15%, tigecycline 8%). Multidrug resistance was seen among 89% of the positive culture samples. This calls for urgent measures to optimize the use of antibiotics in UTI care at policy and health facility levels through stewardship to prevent further augmentation of antibiotic resistance among cancer patients.
Adrenal leiomyoma is a rare neoplasm and usually associated with adrenal vein or its tributaries. These are benign in nature and are composed of smooth muscle cells. A sixty years Normotensive, non-HIV lady presented with right adnexal mass diagnosed as Mature Cystic Teratoma along with adrenal incidentalomas for which laparoscopic adrenalectomy was done and histopathology diagnosis was Leiomyoma. These are more common in immunocompromised patients especially HIV and or EBV infection. Adrenal incidentalomas can have a hormone secreting functions or they can be malignant tumors hence a proper evaluation and treatment should be performed.
Background: Renal tumours are 16th most common malignancies in the world accounting for 2.2% of all new malignancies and 1.8% of all cancer deaths. Histopathological classification of renal tumours along with tumour grade and stage is proven to have prognostic value.
Material and Methods: This was a retrospective study conducted in Department of Pathology at B.P. Koirala Memorial Cancer Hospital Bharatpur from January 2017 to December 2019 including cases of partial and radical nephrectomies of patients more than sixteen years of age.
Results: Total 78 nephrectomy specimens were received out of which 70 (89.7% consisted of malignant tumour and 8 (10.3%) were benign lesions. Clear cell type renal cell carcinoma was the most common malignant tumour consisting of 57 (81.4%) cases of renal cell carcinoma, followed by papillary type 9(12.9%), Cchromophobe (4.3%) and one case (1.3%) of multiloculated cystic renal neoplasm was noted. Renal cell carcinoma was seen in age range of 26 to 80 years with majority of patients more than 50 years of age, while a small peak (14.3%) was noted in female patients of 31 to 40 years of age.
Conclusions: This study found increased incidence of renal cell carcinoma among female patients of 31 to 40 years of age in contrast to studies done in the Western population.
Background and Objective: Liquid based cytology was introduced at B P Koirala Memorial Cancer Hospital in Bharatpur, Chitwan, Nepal, on 29th November 2017. The objective of this study was to compare the results of conventional pap smears over six (6) months periods from 29th May 2017 to 28th November 2017 with the results of liquid based cytology smears over six (6) months periods from 29th November 2017 to 28th May 2018.
Methods: This is retrospective study. The results of conventional pap smears over 6 months and the results of liquid based cytology smears over 6 months periods were retrieved and analysed to give overall reporting profiles and compared between the two methods.
Results: The percentage of unsatisfactory smears fell 3.9% by conventional pap smears methods where as the percentage of unsatisfactory smears fell 1.2% by liquid based cytology smears. There was an increase in the number of smears reported as dyskaryosis of any grade by liquid based cytology methods.
Conclusion: The introduction of liquid based cytology led to improvements in unsatisfactory smear rates and also with significant pick up rates of dyskaryosis were maintained and improved.
Benign Lymphoepithelial cyst (BLEC) of parotid gland are more common in HIV positive patients and is rare in HIV negative individuals. We present a 16-year-old HIV negative female who presented with a painless, gradually increasing swelling in the left parotid region. Excisional biopsy was done and HPE showed benign lymphoepithelial cysts. The rarity of this lesion in a HIV negative patient is the main reason for reporting this case.
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