scholarly journals Significance of Reporting Cannon Balls in Diagnosing Bacterial Vaginosis Infection in PAP Smear

2021 ◽  
Vol 23 (2) ◽  
pp. 109-113
Author(s):  
Kricha Pande ◽  
Shraddha Koirala ◽  
Astha Shrestha

Bacterial vaginosis is the most common cause of vaginitis. It is caused by depopulation of lactobacilli from the normal vaginal flora and overgrowth of Gardnerella vaginalis and other anaerobic species. Pap smear being a screening and diagnostic tool for malignancy, is equally important to diagnose infective pathology as well. This study tried to establish the significance of reporting the presence of cannon balls in Pap smears and whether their presence suggested bacterial vaginosis or not. This was a cross sectional study conducted at Nepal Medical College, Teaching Hospital (NMCTH), Kathmandu for duration of one year (January 2020 to December 2020). Pap smears were sent from gynaecology department and standard routine Pap stain was done in Pathology Department. Presence of bacterial vaginosis and cannon balls were noted. Total of 799 Pap smears were received. The mean age of bacterial vaginosis was 38.2 ± 9.6 years. The age group of 31-40 years (n=32, 39%) was most commonly affected. Bacterial vaginosis was seen in 81 pap smears out of 799 pap smears. The prevalence of bacterial vaginosis was 10.1%. Of the total of 799 cases of Pap smears, cannon balls were seen in 9.1% cases and among the bacterial vaginosis, cannon balls were seen in 48% cases. There was significant association between cannonballs and bacterial vaginosis (p < 0.0001). Thus, the present study re-enforces the fact that Pap smear is also very effective tool to diagnose bacterial vaginosis.

2020 ◽  
Vol 18 (2) ◽  
pp. 73-77
Author(s):  
U. Sharma ◽  
S. Lama Moktan ◽  
S.B Shrestha

Background Sciatic nerve block used for various surgeries below knee and for maintenance of analgesia demonstrates wide variability regarding its bifurcation into tibial and common peroneal nerves, frequently accounting for incomplete nerve blocks. Objective To determine the variation of sciatic nerve bifurcation among Nepalese volunteers. Method This cross sectional study was conducted in the Department of Anesthesiology of Kathmandu Medical College Teaching Hospital from March to May 2019, where 110 healthy volunteers underwent ultrasonography of sciatic nerve starting from popliteal fossa to its bifurcation. The distance between the bifurcation of sciatic nerve from popliteal crease and depth of the nerve at that point from the skin were measured. Result The mean distance at which sciatic nerve bifurcated from the popliteal crease was 5.42 ± 1.37 cm. Most commonly, the sciatic nerve bifurcated at a distance of 5-7 cm from the popliteal crease in 110 limbs (50.45%). However, in 80 limbs (36.69%), the bifurcation was found at less than 5 cm from the popliteal crease. The depth of the nerve from the skin at the point of bifurcation was 1.72 ± 0.54 cm, with results showing it was deeper in females compared to males (p value < 0.001). Conclusion This study showed that though the distance of sciatic nerve bifurcation from the popliteal crease in our study group was coherent with the published literature of 5-12 cm; many volunteers also had this bifurcation at distances less than 5 cm. Females showed nerves to be deeper at the point of bifurcation than males.


Author(s):  
Girishma J. ◽  
Rupakala B. M. ◽  
Sunil Chavan

Background: Bacterial vaginosis is the most common cause of vaginal discharge among women in reproductive age group. It is characterized by an increased vaginal pH and loss of normal lactobacilli and overgrowth of anaerobes like Gardnerella vaginalis and other gram-negative rods. Purpose of this study is to compare the characteristics of pap smear and microbiological pattern in patients with abnormal vaginal discharge.Methods: The study was conducted in the Department of Gynecology and Obstetrics of Rajarajeswari Medical College and Hospital (RRMCH) Bangalore, India. All patients with vaginal discharge were included in the study. Vaginal discharge samples were sent to gram staining, culture and pap smear examination.Results: Of the 52 patients, 18 patients (34.6%) showed positive for bacterial vaginosis according to Nugent’s score. Of the 18 patients with positive Gram stains, 8 of them were positive for bacterial vaginosis according to pap’s smear (44%) and 10 had negative pap smears. In our study, of the 18 patients with positive Gram stains, 14 (77%) of them were positive for bacterial vaginosis according to culture.Conclusions: In the present study we found out that correlation of gram stain and pap smear was 44% whereas correlation of gram stain and culture was 77%. Hence, we conclude that gram stain and culture are preferred for the diagnosis of bacterial vaginosis rather than the pap smear evaluation.


2018 ◽  
Vol 8 (2) ◽  
pp. 1389-1392
Author(s):  
Nirajan Mainali ◽  
Neha Homagai ◽  
Niraj Nepal ◽  
Prabesh Choudhary

Background: Carcinoma cervix is among a curable cancer, if identified at an early stage. Pap smear is a simple, safe, noninvasive, outdoor and effective method for detection of lesions of the cervix but it fails to localize the lesion. Cervical biopsy, on the other hand is a gold standard but invasive technique.Materials and Methods: A prospective cross-sectional study was done in Nobel medical college from January 16, 2017 to January 15, 2018 where all pap smears received in a Department of Pathology were included in the study. However, only cases that had undergone both Pap smear and cervical biopsy were compared. Out of the 1492 pap smears, 118 cases underwent biopsy. Correlation was then done regarding cytological and histological diagnosis.Results: Majority of the cytological findings were normal. 7 patients of HSIL revealed moderate dysplasia and higher lesions in biopsy. 2 cases were that of adenocarcinoma which were diagnosed as inflammatory smear in Pap smear.Conclusion: Cervical Pap smear is reliable screening test to identify high grade squamous cell lesions and carcinoma, but it fails to localize the lesion and adenocarcinoma is hard to identify in a pap smear. Hence, cervical biopsy should be carried out to confirm the findings of Pap smear and in case of strong clinical suspicion.


2020 ◽  
Vol 11 (3) ◽  
pp. 58-61
Author(s):  
Subodh Kumar Yadav ◽  
Sanjenbam Arun Chandra Singh ◽  
Renu Yadav

Background: Angle of femoral torsion has an anatomical variation based on sex, geography, ethnicity and occupation and concludes various impact factor on determining the angulation as well as the length of the bone. Aims and Objective: Thus, present study is aimed to determine the angle of femoral torsion in Nepalese population. Materials and Methods: This is a cross-sectional study carried out at the Department of Anatomy, Nobel Medical College and Teaching Hospital, Biratnagar, Nepal. Of the total 60, unpaired and unknown gender, dry femora were collected during one year period and separated as right sided (n=30) and left sided (n=30) according to the standard anatomical landmarks. Measurement of angle was done by Kingsley Olmsted method and the length, mid-circumference by measuring tape. Results: The angle of torsion in dry femora (n=60) for right (16.73± 3.095) and left (16.67± 2.963) side were recorded. The mean shaft length, mid circumference for right sided femora were recorded as 39.367±0.9185 and 7.933 ± 0.6661cm respectively. The mean shaft length and mid circumference were 38.917± 0.8914 and 7.933 ± 0.5833cm respectively for left sided femora. Differences (ATF, p=0.932, LF, P=0.059, MCF, P=1) of variables between right and left femora were analyzed and correlation of angle of femoral torsion with shaft length and midshaft circumference (ATF vs MCF, p= 0.571 and LF, p=0.153) was done. Conclusion: Documenting the femoral angle of torsion with shaft length, midshaft circumference in normal dry femora of cadaver is of great importance for Orthopedic surgeons since it provides a knowledge for planning the hip surgeries.


2020 ◽  
Vol 23 (1) ◽  
pp. 14-18
Author(s):  
Manish Pokhrel

Introduction: Comparison of penile measurements between boys with and without hypospadias is important to determine whether there is any truth in the notion that the hypospadic penis is shorter than its age-matched normal counterpart. This study was designed to check whether there was any difference in penile sizes between Nepalese boys with and without hypospadias. Methods: A cross-sectional study was conducted among 72 Nepalese boys (36 with hypospadias and 36 without hypospadias) attending the paediatric surgical unit of Kathmandu Medical College Teaching Hospital between July 2019 and June 2020. The penile length was measured in both the flaccid state and the stretched state yielding the flaccid penile length (FPL) and the stretched penile length (SPL) for each subject utilizing standardized measuring conditions. The SPL/FPL ratio was calculated for each patient. Results: The mean FPL in the hypospadias group (A) was 3.42±0.80cms while that in the normal group (B) was 3.62±0.61cms. The mean SPL in group A was 4.58±0.94cms compared to 5.52±0.68cms in group B. The SPL/FPL ratio was 1.34±0.14 in group A compared to 1.54±0.17 in group B. The difference in FPL was not significant between groups but the difference in SPL and the SPL/FPL ratio was statistically significant between groups. Conclusion: The flaccid penile length (FPL) does not vary between the two groups. However, the stretched penile length (SPL) and the Stretched penile to Flaccid penile length ratio (SPL/FPL ratio) are significantly different between the two groups of boys.


2020 ◽  
Vol 22 (3) ◽  
pp. 118-122
Author(s):  
Kricha Pande ◽  
S Koirala ◽  
A Giri

Adenomyosis is a common condition, detected in 15-30% of hysterectomy specimens. It is characterized by the presence of endometrial glands and stroma within the myometrium. The data regarding incidence or incidental finding of adenomyosis in hysterectomy specimen is lacking despite this condition being common and bearing serious implications in symptomatology as well as in infertility. Adenomyosis can be incidental finding in hysterectomy done for other gynecologic pathology as well. Hence, this present study has established the prevalence of adenomyosis as well as it’s association with other uterine pathology in routine hysterectomy specimens. This was a cross sectional study conducted at Nepal Medical College and Teaching Hospital (NMCTH), Kathmandu for a duration of one year (March 2019 to February 2020). Total of 154 hysterectomies were included in the study, out of which 37 cases showed adenomyosis. The prevalence of adenomyosis was 24%. The age group for adenomyosis ranged from 36 years to 52 years with the mean age of 44 ± 4.4 years. The most common pathology other than adenomyosis was leiomyoma (19 cases) followed by two cases of endometriotic cyst, two cases of endometrial polyp, one case of high grade squamous intraepithelial lesion (HSIL), one case of hyperplasia of endometrium with atypia, and one case of serous cyst adenoma of ovary. Thus this study showed that the prevalence of adenomyosis was 24% and was seen higher in the age group of 35-50 years. The most frequent co-pathology in these adenomyosis cases was leiomyoma.


2020 ◽  
Vol 22 (3) ◽  
pp. 141-145
Author(s):  
Krishna Chandra Devkota ◽  
S Hamal ◽  
PP Panta

Pleural effusion is present when there is >15ml of fluid is accumulated in the pleural space. It can be divided into two types; exudative and transudative pleural effusion. Tuberculosis and parapneumonic effusion are the common cause of exudative pleural effusion whereas heart failure accounts for most of the cases of transudative pleural effusion. This study was a hospital based cross sectional study performed at Nepal Medical College during the period of January 2016-December 2016. A total of 50 patients who fulfilled the inclusion criteria were enrolled. Pleural effusion was confirmed by clinical examination and radiology. After confirmation of pleural effusion, pleural fluid was aspirated and was analysed for protein, LDH, cholesterol. The Heffner criteria was compared with Light criteria to classify exudative or transudative pleural effusion. Among 50 patients, 30 were male and 20 were female. The mean age of patient was 45.4±21.85 years. The sensitivity and specificity of using Light criteria to detect the two type of pleural effusion was 100% and 90.9%, whereas using Heffner criteria was 94.87%, 100% respectively(P<0.01). There are variety of causes for development of pleural effusion and no one criteria is definite to differentiate between exudative or transudative effusion. In this study Light criteria was more sensitive whereas Heffner criteria was more specific to classify exudative pleural effusion. Hence a combination of criteria might be useful in case where there is difficulty to identify the cause of pleural effusion.


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.


2021 ◽  
Vol 15 (12) ◽  
pp. 3198-3199
Author(s):  
Pervez Muhammad ◽  
Sajjad Muhammad ◽  
Muhammad Tariq ◽  
Amir Khan ◽  
Akhtar Munir ◽  
...  

Aim: Prevalence of colorectal carcinoma with respect to age and gender Study design: Observational / cross sectional study. Place and duration of study: This study was conducted at the Department of Pathology and Surgery, Post Graduate Medical Institute Lahore and Jinnah Medical College Peshawar from July, 2013 to February, 2015 Methodology: Surgical specimens of 60 histopathologically diagnosed cases of colorectal adenocarcinoma were included in this study. Age and sex were evaluated in CRC. Results: The mean±sd of age was 54.4±19.7 yrs. Out of 60 cases, 6 (10%) were between 16-29 yrs, 9 (15%) cases were between 30-49 yrs, 34 cases (56.7%) were of 50-69 yrs and 11 cases (18.33%) were of 70 yrs. Out of sixty cases, males were 33 (55%) and females were 27(45%). Conclusion: There are 34 out of 60(56.7%) patients were 50-69 years and 33 out of 60 (55%) cases were males i.e. males dominance. Keywords: Colorectal adenocarcinoma, immunohistochemistry, gender


2017 ◽  
Vol 9 (2) ◽  
pp. 47-51 ◽  
Author(s):  
Nisha Shrestha ◽  
P Shrestha

Background: Pressure ulcer (PU) development remains a significant complication among at-risk patients. It is considered “never events” because they are preventable and should “never” happen. It has been associated with increased morbidity, mortality, hospital cost and length of stay in the hospital. Prevention of pressure ulcers is considered a nurse-sensitive indicator hence nurses should have adequate knowledge about current evidence-based prevention and management of pressure ulcer. However, non adherence to these guidelines is frequent and lack of knowledge may act as barriers to using guidelines in clinical practice.Objectives: The objectives of the study were to 1. assess the knowledge of pressure ulcer management among nurses 2. determine the level of knowledge of pressure ulcer management among nurses 3. assess the association of knowledge of nurses and baseline variables.Methods: A descriptive cross sectional study was conducted, using pretested self administered questionnaire to assess the knowledge on pressure ulcer management among purposively selected 100 nurses working in Gandaki Medical College Teaching Hospital in 2015. Descriptive statistics as frequency and percentage were used and inferential statistics (Chi-square test) was done to find out association between knowledge and selected baseline variables.Results: The study revealed that 59% of the respondents had adequate knowledge where as 41% of nurse’s knowledge was found to be inadequate. Significant association was not found between age, working ward, experience, education, training, duration and knowledge of pressure ulcer management among Nurses.Conclusion: This result indicates that more than half of the nurses had the adequate knowledge but there is still need of education and training related pressure ulcer management.Journal of Gandaki Medical CollegeVolume, 09, Number 2, July December  2016, Page: 47-51


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