Histopathological Spectrum of Central Nervous System Tumors: an Experience at a Hospital in Nepal.

BACKGROUND: More than half of Central Nervous System tumors are benign; however, they can cause substantial morbidity. The classification of central nervous system is vital for their varied outcomes and management. The objective of this study is to provide the histopathological spectrum of central nervous system tumors in a central hospital in Nepal. METHODS: The present study is a retrospective cross-sectional study conducted at Department of Pathology, Kathmandu Model Hospital, Kathmandu, Nepal from January 2010 to December 2017 of 162 cases of clinically diagnosed cases of central nervous system tumors. All patients were classified according to the World Health Organization classification of central nervous system tumors. RESULTS: Nine of these162 patients did not have any tumor. The most common categories of tumors were astrocytic and oligodendroglial tumors (39.2%), meningiomas (21.5%), cranial and para spinal tumors (15%), tumors of sellar region including pituitary adenoma (4.5%), and metastatic tumors (3.2%). Glioblastoma(51.6%) and diffuse astrocytoma (21.6%) were the most common astrocytic and oligodendroglial tumors. The most common site of tumors in the brain was frontal (14.37%) followed by temporal (10.45%) region in the brain and dorsal region in spine. CONCLUSIONS: This study gives the current scenario of the epidemiology and clinicohistopathological aspects of different brain tumors as encountered in a tertiary level hospital in Kathmandu.

Evaluation of Abnormal Cervix with Visual Inspection under Acetic Acid and Colposcopy.

BACKGROUND: Cervical cancer is a major public health problem especially in developing countries. It can be prevented through implementation of routine screening program. There are different screening methods but their efficacy are still questionable. So the purpose of this study is to evaluate the efficacy of visual inspection of cervix with acetic acid and colposcopy to detect precancerous lesion in women with clinically unhealthy or abnormal cervix. METHODS: Forty patients with abnormal cervix (35) and abnormal pap smear results (5) were enrolled for the study in outpatient department of Kathmandu Model Hospital. Patients were evaluated with visual inspection of cervix with acetic acid and colposcopy in the same sitting. Cervical punch biopsy were taken from suspected lesion or from four quadrant if colposcopy findings were normal and sent for histopathological examination. The finding of visual inspection of cervix with acetic acid and colposcopy were correlated with histopathological finding and compared with each other. RESULTS: The age of participants ranged from 24 to 68 years with mean age of 38.17 years and mean parity of 2.25. visual inspection of cervix with acetic acid and colposcopy were positive in eight (20%) and ten (25%) respectively. There were five (12.5%) cases of histopathologically proven lesion. The sensitivity of visual inspection of cervix with acetic acid and colposcopy were 80% and 100 % respectively and that of specificity were 88.5% and 85.5%. CONCLUSIONS: visual inspection of cervix with acetic acid is an effective screening tool with comparable sensitivity and specificity. It can be used as alternative screening methods especially in low income resource countries where the burden of disease is high.