scholarly journals Clinico-Pathological Study of Hysterectomy Specimens in Kathmandu Medical College Teaching Hospital

2018 ◽  
Vol 3 (2) ◽  
pp. 423-426
Author(s):  
Sailesh Bahadur Pradhan ◽  
Mamata Sedhain ◽  
Sneh Acharya ◽  
Sailuja Maharjan ◽  
Samikchhya Regmi

Introduction: Uterus is subjected to many non-neoplastic and neoplastic diseases. Hysterectomy is the commonest gynecological surgery done for the management of the pathologies of the female reproductive system. Histopathological examination of hysterectomy specimens is done routinely which has both diagnostic and therapeutic significance.Objective: To study the common pathologies identified in hysterectomy specimens and to correlate them with the clinical findings.Methodology: A cross sectional study was carried out among all the hysterectomy specimens irrespective of primary lesion sent for histopathological examination from January 2016 to December 2017 in Department of Pathology, Kathmandu Medical College Teaching Hospital (KMCTH). Relevant history was taken from the requisition form. Ethical clearance was obtained from the Institutional Review Committee of KMCTH.Results: A total of 198 cases were studied. The most common pathology encountered was leiomyoma (60.0%) followed by adenomyosis (14.0%). Atrophic endometrium was seen in 24.3% cases. Chronic cervicitis was found in most of the cases (96.5%) along with endocervical polyp in 8.1% cases. Leiomyoma was found to be the most common indication for hysterectomy comprising 48.0% followed by abnormal uterine bleeding (24.75%) and utero-vaginal prolapse (18.25%). Hysterectomy was most commonly performed in the age group of 41 - 50 years and total abdominal hysterectomy with bilateral salpingo-oophorectomy was found to be the commonest procedure done comprising 8 0.0%.Conclusion: Leiomyoma was found to be the most common pathology in myometrium and chronic cervicitis in cervix. Abnormal uterine bleeding and vaginal prolapsed were also found to be common. Lesions which can be managed conservatively do need hysterectomy or not, is a matter of great concern. BJHS 2018;3(2)6:423-426.

2020 ◽  
Vol 5 (2) ◽  
pp. 1035-1039
Author(s):  
Neeta Kafle ◽  
Shilpi Shaukin ◽  
Santosh Upadhaya Kafle ◽  
Mrinalini Singh ◽  
Surya Bahadur Parajuli

Introduction: Abnormal uterine bleeding (AUB) is one of the commonest gynaecological problems. Etiology of AUB may be structural and functional and varies according to age group. Histological pattern of endometrial sampling along with clinical and radiological findings remains the diagnostic standard for clinical diagnosis of endometrial pathology which ultimately helps in deciding the management of the patients. Objectives: To determine histopathological pattern of endometrial biopsies in patients with AUB attending Birat Medical College Teaching Hospital. To determine the pattern of menstrual abnormality in patients with AUB in different age groups. Methodology: We conducted a prospective hospital based cross sectional study for a period of one year (1 April 2019 to March 31 2020). Histopathological findings of all endometrial biopsy samples in patients with AUB were examined. Patients were categorized into different age groups and the patterns of menstrual abnormality were also documented. Results: 166 patients presenting with AUB underwent endometrial biopsy. Most of them were of perimenopausal age group (42.77%). Menorrhagia was the most common presenting menstrual abnormality. Histopathological examination predominantly revealed normal cyclical endometrium. Hyperplasia was seen more frequently in patients > 40 years of age. Malignancy was diagnosed in 2.41%, all were adenocarcinoma and was seen in > 50 years age. Conclusion: AUB is a common gynaeco-pathological problem with varied clinical presentation and multiple causes. Functional endometrial changes account for the highest histological pattern. However hyperplasia and malignancy are important cause of AUB in perimenopausal and post menopausal age group's women.


2018 ◽  
Vol 8 (1) ◽  
pp. 1285-1288
Author(s):  
Sailesh Bahadur Pradhan ◽  
Binita Pradhan ◽  
Sailuja Maharjan ◽  
Prabin Bikram Thapa

Background: Gastrointestinal tract tumour is responsible for more cancers and death than any other cancers.  The tumour in GIT include the tumour of the Oral cavity, Esophagus, Stomach, Colon, Rectum, Liver, Gallbladder, Pancreas and Biliary tree.Materials and methods: A cross sectional study was carried out among all the gastrointestinal tract tumours specimens received for histopathological examination in between January 2016 to June 2017 in Department of Pathology, Kathmandu Medical College Teaching Hospital. All tumors diagnosed either benign or malignant were included in this study. Ethical clearance was obtained from the Institutional Review Committee in KMCTH.Results: Colorectum was found to be the most commonly involved site for malignant lesion comprising 40.2% among all malignant lesions followed by stomach comprising 28.6%. Malignancy was found to be more prevalent among male with M:F ratio of 1.6:1 in colorectal region and 1.4:1 in stomach cancers. Regarding benign lesions (polyps), rectum was found to be the commonest site (57.5%), followed by colon (20.0%) and stomach, the least common site.Malignant lesions were more common among the age group of 51-60 years (37.66%) with 70.13% above 50 years. Benign lesions were also found to be the most common above 50 years comprising 40.0 percent.Conclusion: Rectum & colon was found to be the most commonly involved site for both malignant and benign lesion. Malignancy is more prevalent among male and common above 50 years of age. However, malignant cases noted in the adult age group are a matter of great concern.


2020 ◽  
Vol 27 (03) ◽  
pp. 481-486
Author(s):  
Aisha Rashid ◽  
Haniya Qamar ◽  
Saba Pario

Hysterectomy is one of the most frequently performed gynecological procedure all over the globe undertaken for varying indications, to effectively cure many gynaecological conditions. Histopathological analysis of the hysterectomy specimens should be undertaken for justification of procedure and diagnostic purposes. Objectives: To determine the frequency and morphology of different benign histopathological lesions in total abdominal hysterectomy specimens. Study Design: Descriptive cross-sectional study. Setting: Department of Pathology Fatima Jinnah Medical College. Period: From Jan 2015 to June 2015. Material & Methods:  The gross and histopathological findings of uterus and cervix in one hundred Total Abdominal hysterectomy specimens were studied. Non-probability, purposive sampling was done. Total abdominal hysterectomy specimens with or without salpingoophorectomy of patients aged between 20 to 70 years were included. While Total abdominal hysterectomy done in mentally retarded patients and for malignancies were excluded. Patient’s data, presenting complaints and preoperative diagnosis was recorded on predesigned proforma. SPSS version 17 was used as an analytical tool. Results:  Age of the patients ranged from 30-55 years with 72% between 41-50 years. The microscopic examination of the cervix revealed features of chronic cervicitis in 75% cases. The commonest neoplastic lesion was leiomyoma present in 66% of cases. Myometrium revealed foci of adenomyosis in 21% cases. Endometrial histology showed hyperplasia in 25% of cases(simple hyperplasia 20%, cystic hyperplasia 4% and complex hyperplasia 1%), hormonal imbalance in 21%, pressure atrophy in 11%, atrophic endometrium in  6% , cystic atrophy in 2% while acute and chronic endometritis in 1% and 2% of cases respectively. Conclusion: The commonest cervical lesion was chronic cervicitis (75%). The commonest benign neoplastic lesion was leiomyoma, present in 66% of cases. Other common pathologies on histology were hyperplasia in 25% of cases, adenomyosis and hormonal imbalance in 21 % of cases each, pressure atrophy in 11%, atrophic endometrium in 6% while endometritis  (acute & chronic ) in 3% of cases mainly. Histopathological examination of hysterectomy specimens helps to detect the exact cause and underlined pathology.


2020 ◽  
Vol 5 (2) ◽  
pp. 1104-1109
Author(s):  
Santosh Upadhyaya Kafle ◽  
Mrinalini Singh ◽  
Neeta Kafle ◽  
Amrita Sinha

Introduction: The histopathological examination of appendectomy specimens is the gold standard method for diagnosis. The presence of eosinophil besides other inflammatory cells like neutrophils and mature lymphocytes within different histological layers of appendectomy specimens are common findings for labeling it under various groups. This finding supports the assumption that appendicitis is triggered by Type 1 hypersensitivity reaction.  Objective: To evaluate the eosinophil count variation in appendectomy specimens in patients with the clinical diagnosis of appendicitis.  Methodology: This is a cross sectional hospital based study of 144 appendectomy specimens obtained in Department of Pathology, Birat Medical College Teaching Hospital from January 2019 to December 2019. Socio-demographic data, association of histopathological patterns with age groups, gender and eosinophil count in various histopathological groups was compared and cross-tabulated using SPSS version 16.  Result: Among 144 appendectomy specimens, male gender (50.70%) of 15-24 years age group (36.80%) was predominant. The commonest histopathological diagnosis was acute appendicitis (31.25%) with highest eosinophil count in all of its histological layers. The association of various histopathological patterns with age groups and gender were not statistically significant, whereas it revealed statistically significant correlation between eosinophil counts in all histological layers.  Conclusion: Findings suggest that the eosinophil count variation in the entire histological layers correlate well among different histopathological patterns of appendectomy specimens. This reflects the high diagnostic value of evaluating the eosinophil count in appendectomy specimens. 


Author(s):  
Vibhusha S. Rohidas ◽  
Niranjan N. Chavan

Background: Abnormal uterine bleeding (AUB) is debilitating condition affecting 14-25% of women of reproductive age. It has significant impact on women’s personal, social, physical and quality of life. Present study is planned to study causes, investigation along with management of structural causes of abnormal uterine bleeding in reproductive age group.Methods: Consecutive type of non-probability sampling was used for selection of study subjects. A total of 100 gynaecology OPD women diagnosed with menorrhagia of 15-45 years age group were enrolled in study.Results: Mean age of the study subjects was between 26-35 years (47%). 67% were from low socio-economic class while 33% were from middle class. Maximum number of women (66%) had symptoms for less than 6 months. 47% presented with Menorrhagia. 89% were Multiparous, and 11% were Nulliparous. Most common structural causes of AUB was leiomyoma (41%) followed by polyps (23%), adenomyosis (17%), endometrial hyperplasia (15%) and endometrial carcinoma (4%). Prevalence of anemia was 73% in present study. Maximum leiomyoma were treated medically while higher percentage of polyps and hyperplasia was treated surgically. Most commonly performed surgery was polypectomy (20%) followed by dilatation and curettage (17%) and myomectomy (15%). Total abdominal hysterectomy was done in 8% cases while radical hysterectomy was done in 2% cases.Conclusions: Benign lesions of endometrium account for majority of cases presenting with AUB in reproductive age group. Other premalignant and malignant causes should also be considered. High prevalence of anemia was observed in these cases. A comparative clinicopathological study will help in arriving at the cause and correct diagnosis. Histopathological examination is one of the major tools in evaluation of abnormal uterine bleeding and helps us in proper management and treatment of cases. 


2014 ◽  
Vol 13 (2) ◽  
pp. 135-139 ◽  
Author(s):  
Nazlima Nargis ◽  
Iqbal Karim ◽  
Khondaker Bulbul Sarwar

Background: Abnormal uterine bleeding (AUB) is the most common reason for gynecological visits for perimenopausal bleeding and may account for more than 25% of all hysterectomies. Objective: This study was aimed to review the causes of abnormal uterine bleeding in perimenopausal women establishing the correlation with ultrasonographic and histopathological examinations. Study Method: This descriptive study was conducted in the department of gynecology and obstetrics, Ibn Sina Medical College, Dhaka during January to December 2012. Two hundred and eleven women were selected for this study, who admitted into the hospital with abnormal uterine bleeding in perimenopausal age. The clinical, ultrasonographic and histopathological findings of these women were evaluated in this study. Results: Menorrhagia was the major symptom (52.6%) irrespective of age and parity. All these women underwent D&C followed by either medical management or hysterectomy depending upon the diagnosis. The histopathological findings of endometrium were analyzed and confirmed as fibroid uterus (58.28%) and DUB (17.58%) correlated well with transvaginal sonography (TVS) and histopathological examination. Hysterectomy conferred other uterine lesions as adenomyosis (18.71%), endometrial polyp (4.81%) and malignancy (1.06%). Conclusion: Abnormal uterine bleeding in perimenopausal age group is a common but ill-defined entity which needs proper evaluation. Accurate diagnosis of the causative factors of AUB in this age group is of utmost importance so that appropriate management can be established early that leads the minimization of the patients’ sufferings. DOI: http://dx.doi.org/10.3329/bjms.v13i2.18295 Bangladesh Journal of Medical Science Vol.13(2) 2014 p.135-139


Med Phoenix ◽  
2021 ◽  
Vol 6 (1) ◽  
pp. 14-18
Author(s):  
Smita Singh ◽  
Deependra Prasad Sarraf ◽  
Prabin Singh ◽  
Pragati Poudyel

Introduction: Pharmacovigilance helps in the detection and prevention of adverse effects of drugs. For the effectiveness of this program, health care professionals should report adverse drug reactions (ADRs) considering it as their moral and professional obligation. The objective of the study was to assess the knowledge, attitude, and practices (KAP) of the doctors towards ADRs and pharmacovigilance in  National Medical College Teaching Hospital (NMCTH), a tertiary care teaching hospital situated in the Narayani zone. Materials and Methods: A cross-sectional study was carried out using a self-administered questionnaire consisting of four parts; first part included a demographic profile of participants, the second part consisted of ten questions for the assessment of the knowledge about pharmacovigilance, third part comprised of six questions on attitude and fourth part consisted of five questions on practice. The results were depicted in the form of percentages for each KAPs questionnaire.   Results: The response rate of participants was 85.16%. Pharmacovigilance was correctly defined by 52%. Department of drug administration was responsible for monitoring ADRs in Nepal was correctly given by 80%. Only 8% had reported ADRs, although 62% had encountered an ADR in their clinical practice. Conclusion: The doctors at NMCTH had a poor KAP towards pharmacovigilance and educational intervention is needed for the proper functioning of this program.


Author(s):  
Prachi Singh ◽  
Prashant Dubey ◽  
Shweta Yadav ◽  
Sachin Singh Yadav

Background: Abnormal Uterine Bleeding (AUB) is one of the commonest gynecological complain in reproductive age group. Menstrual abnormalities are commonly seen when there is any alteration in thyroid function. Objective of present study was to investigate the prevalence of AUB and to determine the menstrual pattern in cases with thyroid dysfunction.Methods: The present cross sectional observational study was conducted Teerthankar Mahaveer Medical College and Research Center Moradabad. Total 400 cases presenting with AUB were included in the study. Routine blood test, ultrasonography and thyroid function tests were done in these cases.Results: Among all the cases presenting with menstrual abnormalities 26% had hypothyroidism and 9% have hyperthyroidism and rest had euthyroid status. Menorrhagia (45.2%) and polymenorrhoea (37.5%) were commonest menstrual abnormality seen in cases with hypothyroidism. Most cases with hyperthyroidism presented with hypomenorrhoea (27.8%).Conclusions: Thyroid function abnormality is common in cases presenting with AUB and it gets relieved in correcting hormonal imbalance.


2015 ◽  
Vol 6 (2) ◽  
pp. 76-77
Author(s):  
Shirin Akhter ◽  
Rumana Nazneen

Total abdominal Hysterectomy are gradually rising in our country. This study has been designed to find out the common indications of abdominal hysterectomy in a tertiary care hospital,. to know the clinical characters of the patients and. o elucidate postoperative complication of abdominal hysterectomy.Methodology : Cross- sectional observational study was done during 1st October 2007 to 30th September 2008. Holy Family Red Crescent Medical College Hospital (HFRCMCH). Total 100 patients were selected following enclusion & exclusion criteria hyperposive sampling. Data were recorded before and after operation and analyzed by SPSS version 15.Result : In the present study patients with leiomyoma of uterus was found to be the major indication of hysterectomy followed by dys functional uterine bleeding (DUB) 18.0%, Pelvic inflammatory disease (PID) 14.0%, chronic cervicitis 10.0%, adenomyosis 10.0%, pelvic endometriosis 6.0%, cervical polyp 2.0%, ovarian cysts 1.0% and chriocarcinoma 1.0%. Mean duration of operation (hour) and hospital stay was 1.15 hours and 7.48 days respectively. Most common complication of present series was fever 20.0% followed by 13.0% had wound infection, 6.0% UTI and 2.0% wound dehiscence.Conclusion : Hysterectomy is now the most widely performed major operation in gynaecology. Indication and post operative complications of hysterectomy varies from region to region.Northern International Medical College Journal Vol.6(2) 2015: 76-77


2018 ◽  
Vol 7 (1) ◽  
pp. 45-49
Author(s):  
Manish Pradhan ◽  
Chandra Bhal Jha ◽  
Dipa Rai

Background: Acne is a very common distressing skin condition that affects multiple aspects of quality of life of an individual. It has been illustrated that acne have tremendous effect on an individual’s self-image and impacts his or her quality of life. The extent of burden of the disease experienced by the patients seems to be underestimated by the whole medical fraternity. The aim of the study is to determine the health related quality of life impairment in acne patients using CADI and to identify various variables that increase the patients’ susceptibility for quality of life impairment. Subjects and Methods: This is a hospital based, cross sectional study conducted in the Department of Dermatology, Nobel Medical College Teaching Hospital from Jan 2017 to December 2017.A total of 202 acne patients were evaluated with CADI. Clinical characteristics were recorded after history and clinical examination. Results: Out of total 202 patients enrolled, 56.4% of patient scored a CADI score of (5-9) indicating moderate quality of life impairment and 15.3% of patient scored a CADI score of 10 or more indicating severe quality of life impairment. The mean CADI score was 6.82 ± 2.75. There was positive correlation between the CADI score and impact on quality of life with grade of acne, which was statistically significant (p<0.001). Conclusion: Acne is a common skin disease with tremendous adverse effect on the patient’s health related quality of life. Patients are affected both physically and mentally with this condition. Journal of Nobel Medical College Volume 7, Number 1, Issue 12, January-June 2018, Page: 45-49 


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