Spectrum of ocular malignant tumors in a tertiary care teaching hospital

Introductions: The pattern of ocular malignant tumors in institutes of Eastern Nepal was analyzed by a retrospective study. Ocular malignant tumors are relatively rare compared to other eye lesions, and require immediate diagnosis and management. Ignorance or unawareness can result into debility, loss of vision, and death. This study provides spectrum of ocular malignant tumor correlating its pathological and clinical findings. Methods: This cross sectional study includes ninety-six cases of ocular malignant tumors diagnosed in the Department of Pathology from January 2005 to December 2009. Relevant history, clinical findings and light microscopic findings were reviewed. Descriptive analysis was done. Results: A total of 96 patient’s records were studied. Age ranged between 1-90 years. Male to female ratio was 1.4:1. Retinoblastoma was found in 34.5%, basal cell carcinoma (18%), squamous cell carcinoma in 14.5% and malignant melanoma in 10.5%. Conclusions: Early diagnosis and management help to reduce debility and loss of vision of the patients as well as help ophthalmologist in shaping the strategy for diagnosis and management of malignant neoplasm. This help in decrease morbidity and mortality of the patient. Keywords: malignant melanoma, ocular malignant tumor, retinoblastoma, squamous cell carcinoma Â

Accuracy of Frozen Section with Histopathological Report in an Institute

Introduction: Frozen section helps in rapid intra-operative diagnosis. It is commonly used during surgical procedures to detect malignancy so that modifications of surgery can be decided at the time of surgery on the table. Frozen section is also performed for evaluation of surgical margins and detection of lymph node metastasis. In addition it is applied for detection of unknown pathological processes.The objective of this study was to assess the accuracy of frozen section diagnosis in comparison to gold standard histopathological diagnosis and to find concordance and discordance rate of frozen section with histopathological report. Methods: This was a cross sectional study of 41 frozen section samples done in the department of pathology of BP Koirala Institute of Health Sciences from September 2014 to August 2015. All frozen section samples with their permanent tissue samples sent for final histopathological evaluation were included in the study. Results: The overall accuracy of frozen section diagnosis was 97%. The sensitivity was 94%, specificity was 87%, positive predictive value was 90% and negative predictive value was 93%. The concordance rate was 90.2% and the discordance rate was 9.8%. Conclusions: The results of frozen section varied in different organ systems and the common cause of discrepancy in our study were the gross sampling error and the interpretational error

Muscular Hamartoma of Intestine Causing Intestinal Obstruction

Hamartomatous causes of small bowel obstructionare uncommon and of them, most are attributed to inflammatory bowel diseases and also certain medications such as NSAIDs. We describe a case of muscular hamartoma in a patient without prior chronic medical condition with brief review of literature.  Keywords: Bowel; Hamartoma; Muscle; Obstruction. | PubMe

Blood Component Separation Service: A New Experience in an Institution

Introduction: Blood component separation facility began dispatching its blood component units from 21st April 2013 at the new blood component separation service complex at B.P. Koirala Institute of Health Sciences. With the supply of blood components being finite and with the added recognition of a high rate of inappropriate use of blood component services around the world, there is a need to monitor these services. Our study was conducted to identify blood component utilization pattern in institute and to know about different blood components demand for future preparedness. Methods: This retrospective study was conducted at B.P. Koirala Institue of Helath Sciences, Dharan, Nepal for blood component dispatched from 21st April, 2013- 12th February, 2014. Blood components requisitions from all clinical department were reviewed regarding the specific component requested, blood group and socio-demographic profile. Results: Among 3054 transfusion units dispatched, 1552 were males, 1498 females and 4 unspecified. Likewise, 1722 were pack cell volume, 808 platelet rich plasma, 523 fresh frozen plasma and 1 cryoprecipitate disptached respectively with majority of A positive blood group demanded from Neonatal and Paediatric Intensive Care Unit ward for Packed Cell Volume was 201 and Fresh Frozen Plasma was 300 followed by emergency ward for Platelet Rich Plasma. About 197 (6.45%) requistions forms lacked the details of requesting department, while some even reveal multiple demands. Conclusions: Packed Cell Volume of A positive blood group being the predominant blood component requested from Neonatal Intensive Care Unit/Pediatrics Intensive Care Unit ward at the institute making most requests.

Prevalence of Different Types of Apical Root Canal Morphology and their Treatment Recommendations in an Institute

  Introduction: Canals can be of different shapes in cross section including round canals, oval canals, long oval canals or ribbon shaped canals. Recesses of nonround canals may not be included in the round preparation created by rotary instruments and thus they remain unprepared. The aim of this study included determination of shape and taper of the apical root canal based on diameter at different levels. Methods: This was a cross sectional study which used convenient sampling technique to determine the sample size. Seventy extracted teeth were sectioned horizontally at one, two and three millimeter from the apex using the diamond disc which was observed under trinocular research microscope for the determination of diameter of root canal under 10x magnification. Results: The most common canal configuration was oval. The taper of the canals was 25% in mesial root and 20% in distal in bucco-lingual orientation and 14% in mesial root and 15% in distal in mesio-distal orientation. Conclusions: The most prevalent canal configuration in this study was non round, however, most of the rotary instruments tend to prepare root canals into round shape making their use questionable. The taper of the root canals was found to be higher in our study than what most of the shaping instruments have to offer. So it would be advisable to consider this fact while selecting instruments and preparing these non-round canals as far as the Nepalese subpopulation is considered

Crohn disease in Nepal: true rarity or gross underdiagnosis?

Gross and histopathological examination of a resected segment of ileum in a 72-year-old man with the preoperative diagnosis of small intestinal perforation peritonitis revealed the first-ever diagnosed case of Crohn Disease (CD) at the B P Koirala Institute of Health Sciences, Dharan, Nepal. In view of the recent reports on rising incidence of CD in neighbouring Asian countries, it was decided to perform an exhaustive literature search to find out the documented prevalence of CD in Nepal. It was surprising to find only a single case of CD from Nepal, occurring in the year 1980, to be documented in English literature. Further, the index case of CD presenting with acute abdomen is of interest since only about 100 cases of CD with small intestinal perforation have been so far reported worldwide

A review on analytical performance of micro- and nanoplastics analysis methods

Micro- and nanoplastics have been detected in diverse matrices. Recent studies have suggested their health impact on humans, animals, plants, and environment which depends on the size, concentration, chemical nature, and the mode of interaction of the plastic particles. Detection and quantification of these particles are often challenging due to their small size and complexity of the matrix in which they exist. The concentration and size of the particles combined with the nature of the matrix determines an analytical method to be followed. In recent years, many review articles focusing on origin, fate, and health effects of micro- and nanoplastics are already published. A systemic review focusing on analytical performance of currently available micro- and nanoplastics analysis methods would be useful for the scientific community. In this article, we reviewed papers and reports published in recent decades focusing on the sampling, concentration, detection, and chemical identification methods. We also reviewed the emerging new methods for microplastic analysis. Finally, we provide advantages and limitations of the methods and future perspectives on microplastic analysis