Study of Thyroid Lesions by Fine Needle Aspiration Cytology and its Correlation with Thyroid Function Test

  Introduction: Fine needle aspiration cytology (FNAC) of the thyroid gland has been widely and successfully utilized for diagnosis. Assessment of thyroid pathology is even more informative if correlated with thyroid function tests (TFT). This study aims to compare the efficacy of fine needle aspiration cytology with thyroid function tests in different thyroid lesions.   Methods: A descriptive study was carried out among the patients who presented with thyroid swellingvisiting Department of Ear Nose Throat (ENT) of Lumbini Medical College and Teaching Hospital (LMCTH) fromJune 2012 to February 2013. The study population were selected on random basis. A total of fifty patients involved in the study and were sent to Department of Pathology for FNAC and TFT.   Results: Most of the cases (44%) of thyroid swelling were from 21 to 40 years of age. Among them, 86% were females. Out of total respondents, 48% were found to be colloid goiter. 70% findings of FNAC and TFT were in accordance.   Conclusions: The findings of FNAC and TFT were found to be significantly associated (P value <0.05)

Present potential of exfoliative cytology in detection of cervix cancer

  Introduction: Conventional Pap smear is the mainstay for cervical cancer screening in developing countries and women should be motivated for cervical screening program to detect early dysplastic cells. This study was carried out to find out the prevalence of abnormalities in Pap smears, particularly pattern of epithelial cell abnormality in women attending Lumbini Medical College in western Nepal.   Methods: A cross-sectional study was carried out and 1066 Pap smears were studied to look for epithelial cell abnormality according to revised Bethesda system 2001.   Results: Out of 1066 patients who underwent Pap smear examination, 71 (6.6%) revealed epithelial cell abnormality; most were low grade squamous intra-epithelial lesions (LSIL) occupying 4.59% at the age between 23 to 29 years. Squamous cell carcinoma was found in 0.37 % of patients at the age 40 years and above. In our scenario, per vaginal discharge was the major finding of the patients who showed premalignant features.   Conclusions: Women above 40 years are at a risk of premalignant as well as malignant lesions and these women should undergo screening for abnormal cells at the age of 18 or when sexual activity starts and as per recommendations to look for early dysplastic cells. Cervical screening program should be motivated by the national policy makers and also by health professionals

Clinico-Pathological Study of ovarian tumors: A two years study at LMC & Teaching Hospital, Tansen – 11, Parvas, Palpa.

Ovarian neoplasm is the commonest condition observed in gynecology practice. Both non-neoplastic as well neoplastic ovarian tumors are common. In the present study neoplastic ovarian tumors were analyzed for their age of occurrence, site of ovary involved and histological typing. Oophrectomy/Hysterectomy and Oophrectomy was performed on patient suffering from ovarian tumors and the specimens were sent to Pathology department LMC & Teaching Hospital for their histological study. The present study of 40 cases of ovarian neoplasm is from 2068/05/05 B.S. to 2070/05/30 B.S. The mean age of patient was 39 years with S.D of 1.25 years. The size of the tumor varies from 5 cm to 32.9 cm and weight varies from 41 gms to 350 gms. Commonest tumor was mature cystic teratoma (52.5 %) followed by serous cyst adenoma (30%). Not much difference was found for ovarian tumor regarding its site right and left ovary. Only two cases of malignant ovarian neoplasm were found in this study, one case (2.5 %) was of immature cystic teratoma and another (2.5 %) was of serous cyst adenocarcinoma

Upper Gastrointestinal Endoscopy in Lumbini Medical College and Teaching Hospital

  Introduction: Upper gastrointestinal (UGI) endoscopy includes visualization of the oropharynx, esophagus, stomach, and proximal duodenum, with real time assessment and interpretation of the findings encountered. An upper endoscopy is indicated in the diagnostic evaluation of signs and symptoms of a wide variety of gastrointestinal disorders. Besides there are some therapeutic implication of the endoscopy. This study was conducted to study the spectrum of diseases found during the upper gastrointestinal endoscopy in patient presenting in Lumbini Medical College and Teaching Hospital (LMCTH).   Methods: This was a retrospective observational study carried out in LMCTH. The endoscopic record book of the patients who underwent UGI endoscopy for various reasons from February 2011 to 2013 was analysed. The risk factor of smoking and alcohol was also included and analysed in the study.   Results: All together 550 upper GI endoscopy was performed in the two years. There were 290 males (52.72%) and females were 260 (47.38%). The mean age was 45.7 years (SD=17.9). Most of the patient belonged to the age group 41 to 80 years (71%). Among total patients, 209 (38%) of them were found to be macroscopically normal. Of those who had positive endoscopic findings; 165 (48.4%) had gastritis and 36 (10.6%) had duodenal ulcer, esophageal varices was in 30 (8.8%), gastric carcinoma in nine (2.6%) of cases. Cigarette smoking was significantly associated with the presence of peptic ulcer disease (p=0.01) and malignancy of gastrointestinal tract (p=0.03). Alcohol intake was non-significantly related to peptic ulceration (p=0.07) and malignancy of gastrointestinal tract (p=0.09).   Conclusion: Upper gastrointestinal endoscopy is a safe and useful procedure for investigating patients with gastrointestinal complains. Gastritis was the most common finding among the patients who had abnormal endoscopy followed by duodenal ulcer and esophageal varices

Extrapulmonary Tuberculosis: A retrospective Study at a tertiary care hospital in Palpa, Nepal

Background: Extra-pulmonary tuberculosis (EPTB) is a significant global health problem. Related studies to it in different places and diff erent durations are indicated by many previous research findings. Findings of this study could be beneficial for its preventive and control strategies. Methodology: Retrospective analysis of clinical specimens submitted to Central laboratory of Lumbini Medical College and Teaching Hospital (LMCTH) for extrapulmonary tuberculosis was performed. Total 261 samples submitted from April 2011 to February 2013 were included for analysis in this study. Results: Total 20.7% (54/261) prevalence of EPTB was reported. Based on sites involved; lymph node 87.03%, pleural effusion7.40%, peritoneal5.55% were found. Genderwise equal prevalence was seen among male and females. Age-wise prevalence among patients between 21-40 years was reported. Conclusion: Our finding indicates great necessity for further large scale study on prevalence of EPTB in this location for its prevention and control

Characteristics of Patients with Tuberculous Pleural Effusion in Rural Nepal

  Introduction: Tuberculosis (TB) is a major cause of mortality and morbidity in developing countries. TubercularPleural effusion is the second most common form of extra pulmonary tuberculosis (EPTB), superseded in Prevalence only by lymph node tuberculosis. Pleural effusion occurs in approximately 5% of patients with TB. The purpose of this study was to assess the demographic characteristics of patients presenting with pleural effusion in rural Nepal.   Methods: A retrospective study was conducted with all the cases diagnosed and admitted with pleural effusion at Lumbini Medical College And Teaching Hospital from April 2011 to March 2013 of all the cases diagnosed andadmitted with pleural effusion were included in the study. Hundred cases diagnosed with pleural effusion by clinical Examination or chest X-ray or ultrasonography’s (USG) of the chest were included in the studied. The following parameters patients demographic profile, causes of pleural effusion, location (unilateral/bilateral), hemoglobin and complete blood count, sputum stain and culture sensitivity, Monteux test, chest X-ray and USG findings and Pleural fluid analysis (biochemical, hematological, microbiological and cytological) were analyzed by using SPSS 21.   Results: Out of 100 cases, the cause of pleural effusion in 59 patients was tuberculosis, 14 by malignancy, next 14 by Para pneumonic Effusion, 12 by congestive cardiac failure and three cases by alcoholic liver disease. Patients with tuberculous pleural effusion were younger, predominantly males, had unilateral effusion, lower blood hemoglobin, lower Pleural fluid neutrophils, higher pleural fluid Adenosine Deaminase (ADA) levels and higher level of pleural fluid to serum protein ratio as compared to the patients with non-tuberculous effusion.   Conclusion: Tuberculosis is the most common cause of pleural effusion in patients of rural Nepal

Galactic Core-Collapse Supernovae at IceCube: “Fire Drill” Data Challenges and follow-up

The next Galactic core-collapse supernova (CCSN) presents a once-in-a-lifetime opportunity to make astrophysical measurements using neutrinos, gravitational waves, and electromagnetic radiation. CCSNe local to the Milky Way are extremely rare, so it is paramount that detectors are prepared to observe the signal when it arrives. The IceCube Neutrino Observatory, a gigaton water Cherenkov detector below the South Pole, is sensitive to the burst of neutrinos released by a Galactic CCSN at a level >10σ. This burst of neutrinos precedes optical emission by hours to days, enabling neutrinos to serve as an early warning for follow-up observation. IceCube\u27s detection capabilities make it a cornerstone of the global network of neutrino detectors monitoring for Galactic CCSNe, the SuperNova Early Warning System (SNEWS 2.0). In this contribution, we describe IceCube\u27s sensitivity to Galactic CCSNe and strategies for operational readiness, including "fire drill" data challenges. We also discuss coordination with SNEWS 2.0

All-Energy Search for Solar Atmospheric Neutrinos with IceCube

The interaction of cosmic rays with the solar atmosphere generates a secondary flux of mesons that decay into photons and neutrinos – the so-called solar atmospheric flux. Although the gamma-ray component of this flux has been observed in Fermi-LAT and HAWC Observatory data, the neutrino component remains undetected. The energy distribution of those neutrinos follows a soft spectrum that extends from the GeV to the multi-TeV range, making large Cherenkov neutrino telescopes a suitable for probing this flux. In this contribution, we will discuss current progress of a search for the solar neutrino flux by the IceCube Neutrino Observatory using all available data since 2011. Compared to the previous analysis which considered only high-energy muon neutrino tracks, we will additionally consider events produced by all flavors of neutrinos down to GeV-scale energies. These new events should improve our analysis sensitivity since the flux falls quickly with energy. Determining the magnitude of the neutrino flux is essential, since it is an irreducible background to indirect solar dark matter searches

TXS 0506+056 with Updated IceCube Data

Past results from the IceCube Collaboration have suggested that the blazar TXS 0506+056 is a potential source of astrophysical neutrinos. However, in the years since there have been numerous updates to event processing and reconstruction, as well as improvements to the statistical methods used to search for astrophysical neutrino sources. These improvements in combination with additional years of data have resulted in the identification of NGC 1068 as a second neutrino source candidate. This talk will re-examine time-dependent neutrino emission from TXS 0506+056 using the most recent northern-sky data sample that was used in the analysis of NGC 1068. The results of using this updated data sample to obtain a significance and flux fit for the 2014 TXS 0506+056 "untriggered" neutrino flare are reported