Introduction: The COVID-19 is caused by a coronavirus. COVID-19 patients present with lymphopenia, thrombocytopenia, and elevated inflammatory markers. This study aims to find out the prevalence of ...COVID-19 infection among patients attending the fever clinic of a tertiary care centre.
Methods: This was a descriptive cross-sectional study conducted from 15th July, 2020 to 15th January, 2021 in the Department of Pathology at a tertiary care centre. The ethical clearance was obtained from the Institutional Review Committee of a tertiary care centre (Reference number: 2007021388). The patients who attended the fever clinic during the study period were subjected to the COVID-19 reverse transcriptase polymerase chain reaction test. A total of 1431 samples were taken using the convenience sampling method. All data were filled into a predesigned proforma and entered into Microsoft Excel. The data were analyzed using Statistical Package for the Social Sciences version 24.0. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data and mean and standard deviation for continuous data.
Results: Among 1431 patients attending the fever clinic, the prevalence of COVID-19 was found in 277 (19.31%) (17.26-21.36 at 95% Confidence Interval). Most patients belonged to the age group of 20-29 years. There were 113 (40.79%) females and 164 (59.21%) males.
Conclusions: The prevalence of COVID-19 infection in this study was higher than similar studies done in similar settings. Most cases had a low hematocrit with anemia. The total count, absolute neutrophil count, and absolute leukocyte count showed a wide range of variation.
Leprosy is a disease that was declared eliminated in 2010 from Nepal; however, new cases are diagnosed every year. The difficulty arises when the presentation of the patient is unusual.
In this case ...report we present a case of a 22-year-old Tamang man, from the Terai region of Nepal, with a clinical presentation of fever, malaise, and arthralgia for the past 2 weeks with hepatosplenomegaly and bilateral cervical, axillary, and inguinal lymphadenopathy. Features of chronic inflammation with elevated erythrocyte sedimentation rate of 90 mm/hour and liver enzymes were noted. With no specific investigative findings, a diagnosis of Still's disease was made and he was given prednisolone. On tapering the medication, after 2 weeks, the lymphadenopathy and fever reappeared. On biopsy of a lymph node, diagnosis of possible tuberculosis was made. On that basis anti-tuberculosis treatment category I was started. During his hospital stay, our patient developed nodular skin rashes on his shoulder, back, and face. The biopsy of a skin lesion showed erythema nodosum leprosum and he was diagnosed as having lepromatous leprosy with erythema nodosum leprosum; he was treated with anti-leprosy medication.
An unusual presentations of leprosy may delay its prompt diagnosis and treatment; thus, increasing morbidity and mortality. Although leprosy has been declared eliminated, it should not be forgotten and physicians should have it in mind to make it a differential diagnosis whenever relevant.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Retrieval and examination of an adequate number of lymph nodes is an essential part of the correct staging of colorectal adenocarcinoma. The surgeon, pathologist, and factors inherent to patient and ...tumor affect lymph node yield. This study aims to evaluate the influence of patient and tumor characteristics upon lymph node retrieval by analyzing the mean number of lymph nodes and to assess whether these variables are specifically associated with adequate lymph node sampling.
A retrospective study on colectomy specimens of colorectal adenocarcinoma was performed in the Department of Pathology, Patan Academy of Health Sciences, Nepal from April 2011 to October 2019. Variables including age, gender, anatomical location, tumor size, grade, lymphovascular invasion, perineural invasion, length of the surgical specimen, T stage, N stage, and AJCC stage were analyzed to determine their impact on the number of lymph nodes retrieved. The variables were also analyzed to determine their influence on adequate lymph node retrieval.
Gender, age, maximum tumor size, grade, lymphovascular invasion, perineural invasion, T stage, N stage, and AJCC stage showed no statistically significant association. Right-sided adenocarcinoma yielded a notably greater number of lymph nodes with a higher probability of adequate lymph node sampling. Significantly more lymph nodes were retrieved in longer surgical specimens.
Right-sided location and longer surgical specimens were associated with higher lymph node retrieval in colorectal adenocarcinoma.
Diabetes mellitus is a global health problem in 21st century. The incidence of diabetes mellitus is in rise and is estimated to be more prevalent in coming years. It is becoming one of the most ...common non-infectious and non-neoplastic causes of morbidity and mortality. Various complications are associated with diabetes mellitus. With control of blood glucose level, complications of diabetes mellitus can be minimized. In different time frame, different parameters and level have been used to diagnose diabetes. Glycosylated hemoglobin A1c is one of the reliable indicator of chronic hyperglycemia. In 2011, World Health Organization has included HbA1c in the diagnostic criteria. Various methods are used to detect the level of HbA1c. Glycosylated hemoglobin is being used in the management of diabetes mellitus. Various studies have shown its prognostic implication in micro and macrovascular complications. Here we discuss various methods of estimation of HbA1c, various role of HbA1c in the management of Diabetes Mellitus and limitation of the test.
Chromoblastomycosis in Nepal: A study of 13 cases Pradhan, SeemaV; Talwar, OP; Ghosh, Arnab ...
Indian journal of dermatology, venereology, and leprology,
05/2007, Volume:
73, Issue:
3
Journal Article
Peer reviewed
Open access
Background: Chromoblastomycosis is a chronic fungal infection caused
by several pigmented fungi commonly seen in tropical and subtropical
climates. Aim: To evaluate the epidemiologic, clinical and
...pathological characteristics of chromoblastomycosis in our patients.
Methods: This retrospective and prospective study was conducted at the
Manipal Teaching Hospital, Pokhara, Nepal. Clinical features and
histopathology of all the cases diagnosed as chromoblastomycosis during
the last eight years were studied. Results: A total of 13 cases of
chromoblastomycosis were diagnosed during the period of 1999 - 2006.
The disease was seen predominantly in middle-aged male farmers and
those from rural areas. The lesions commonly involved the lower
extremity and were single or multiple in number. They clinically
presented as verrucous or nodular growths. Out of these 13 cases, three
were diagnosed clinically as squamous cell carcinoma and one as
psoriasis. The histopathological features included sclerotic bodies in
12 cases (92%), microabscess formation in 10 cases (76.9%),
pseudoepitheliomatous hyperplasia in nine cases (69.2%) and granuloma
in eight cases (61.5%). Conclusion: Farming is the commonest
occupation in patients with chromoblastomycosis. Early histological
diagnosis helps in effective management of the condition.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Systemic lupus erythematosus (SLE) is known to present with a wide variety of clinical manifestations. Lymphadenopathy is frequently observed in children with SLE and may occasionally be the ...presenting feature. SLE presenting with granulomatous changes in lymph node biopsy is rare. These features may also cause diagnostic confusion with other causes of granulomatous lymphadenopathy.
We report 12 year-old female who presented with generalized lymphadenopathy associated with intermittent fever as well as weight loss for three years. She also had developed anasarca two years prior to presentation. On presentation, she had growth failure and delayed puberty. Lymph node biopsy revealed granulomatous features. She developed a malar rash, arthritis and positive ANA antibodies over the course of next two months and showed WHO class II lupus nephritis on renal biopsy, which confirmed the final diagnosis of SLE. She was started on oral prednisolone and hydroxychloroquine with which her clinical condition improved, and she is currently much better under regular follow up.
Generalized lymphadenopathy may be the presenting feature of SLE and it may preceed the other symptoms of SLE by many years as illustrated by this patient. Granulomatous changes may rarely be seen in lupus lymphadenitis. Although uncommon, in children who present with generalized lymphadenopathy along with prolonged fever and constitutional symptoms, non-infectious causes like SLE should also be considered as a diagnostic possibility.
Introduction: Skin tumor incidence has increased over the last several decades. A wide range of tumors are encountered in clinical practice. Accurate identification of skin lesions is vital in ...ensuring malignancies are not missed and that they are treated early to avoid morbidity and mortality.Materials and Methods: A retrospective cross sectional hospital based study on a series of cases was performed in the Department of Pathology, Patan Academy of Health Sciences, Patan Hospital, Lalitpur, Nepal from April 2011 to March 2016. Data from the histopathology database were analyzed using SPSS version 16.0.Results: During the study period, 410 skin biopsies were received, of which 214 (52.2%) were skin neoplasms. Among them, 175 (81.8%) were benign and 39 (18.2%) were malignant neoplasms. Incidence of keratinocytic tumors was highest followed by soft tissue tumors and melanocytic tumors. Intradermal nevus was the most common benign neoplasm. Among the malignant neoplasms, squamous cell carcinoma was most prevalent (46.1%) followed by basal cell carcinoma (15.3%). Skin neoplasms were present in all age groups with maximum number of benign neoplasms prevalent in 21-30 years and malignant in 51-60 years age group. Mean age was 38 years and 58 years for benign and malignant neoplasms respectively.Conclusions: Histopathological evaluation of skin biopsy is an important tool in diagnosis of skin neoplasms. Intradermal nevus and squamous cell carcinoma was the most common benign and malignant neoplasm respectively. Malignant neoplasms were more common in older patients.
Background: The outcome of Chronic Obstructive Pulmonary Disease depends upon the partial pressure of oxygen and carbon dioxide This study was aimed to find the role of arterial blood gas parameters ...during the length of hospital stay among patients admitted for Chronic Obstructive Pulmonary Diseasewith acute exacerbation.
Materials and Methods: This was an observational study conducted in KIST Medical College Teaching Hospital from February 2017 to August 2019. Patients admitted with the chronic obstructive pulmonary disease were evaluated. Demographic data as well as oxygen saturation (SPO2), pulmonary function test, and arterial blood gas analysis were recorded and analyzed.
Results: Among 112 patients, the female to male ratio was 1.38: 1 with 84.8% over 60 years of age. One-third of patients (n=38) had exposure to both tobacco smoking and biomass and of them, 86.8% were females. Mean SpO2 was 75.9% and mean FEV1 was 0.92 L (SD=0.295) and significant association was found (p<0.001) between them. Furthermore, 70 (62.5%) patients had type I respiratory failure and 42 patients (37.5%) had type II respiratory failure. Patients with type II respiratory failure and hypercapnic patients had prolonged hospital stay with significant p-value (p<0.001). Similarly, significance was observed in the p-value for acidic blood pH, which was <0.05.
Conclusions: Increased length of hospital stay is seen in patients with acute exacerbation of Chronic Obstructive Pulmonary Disease with type II respiratory failure. Hence, aggressive early management to correct hypercapnia may lead to decreased hospital stay along with a better outcome. Thus hypercapnia should be considered as one of the important criteria to flag the patient and manage accordingly.
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