Paricha Upadhyaya

Primary laryngeal leishmaniasis: a rare case report.

Laryngeal leishmaniasis is extremely rare. We report a case of primary laryngeal leishmaniasis in a 70-year-old male who was admitted with complaints of gradual progressive hoarseness of the voice, dyspnea, cough for the past 3 months and noisy breathing for the past 5 days. An X-ray of the soft tissue of the neck showed a prevertebral soft tissue mass causing narrowing of the airway at the C6-C7 vertebral level. A computerized tomography (CT) scan showed a soft tissue mass in the subglottic region causing significant narrowing of the airway. A direct laryngoscopy showed a pinkish-white, friable mass involving the subglottic region and the anterior half of the vocal cords. With the clinical suspicion of malignancy, an endoscopic biopsy was done. A histopathological examination showed diffuse mixed inflammatory cell infiltrate in subepithelium with numerous Leishmania donovani bodies in the cytoplasm of histiocytes.

Proposition of Fine Needle Aspiration Cytology as a Diagnostic Tool in Cases of Cysticercosis by

Introduction: Cysticercosis in humans caused by the larval stage of Taenia solium is quite common in developing countries, including South Asia, and poses a serious health challenge in these countries. This study was mainly undertaken to prove the utility of fine needle aspiration cytology (FNAC) in the diagnosis of cysticercosis. Materials and methods: The study included cases diagnosed with cysticercosis by FNAC from January 2008 to December 2015 who were reviewed for clinical data, cytomorphologic findings, and, when available, histopathologic findings. Results: The study included 24 cases, the majority being women (67%) with a median age of 28 years. Most cases presented with head and neck swelling which was firm and nontender. Aspiration yielded a clear fluid aspirate in most cases (33%). Cytology revealed the presence of wall of parasite in all cases, with the presence of hooklets in 3 cases. Conclusions: This study reinforces that in cases where a definite parasitic parenchymal layer can be seen, FNAC eliminates even the need for biopsy for confirmation.

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.