Sharma Paudel - Academia.edu (original) (raw)

Papers by Sharma Paudel

Research paper thumbnail of Von Hippel Lindau Disease with central nervous system and multiple visceral manifestations: A case report

Research paper thumbnail of Chondrodysplasia Punctata: A Case Report of Fetal Warfarin Syndrome

DOAJ (DOAJ: Directory of Open Access Journals), Jun 1, 2017

Chondrodysplasia punctata is abnormal calcification in the cartilage of developing bones and has ... more Chondrodysplasia punctata is abnormal calcification in the cartilage of developing bones and has been seen in association with deranged vitamin K metabolism. Warfarin, an oral anticoagulant acting on vitamin K dependent clotting factors is known to cause chondrodysplasia punctata. Despite the knowledge of the condition the management of patients with prosthetic heart valves might require use of the drug for anticoagulation. Here, we present a case of a fetal warfarin syndrome in a second born child of a 27 year lady under warfarin for prosthetic heart valve. The pregnancy was complicated by polyhydramnios in third trimester and terminated at term by normal vaginal delivery. The baby was well, except for facial dysmorphism in the form of depressed nasal bridge, narrow nares and suspected left choanal atresia. Radiograph revealed stippled ephiphysis of vertebra, femora and humera supporting diagnosis of fetal warfarin syndrome. The baby did not develop any perinatal complication and was discharged home.

Research paper thumbnail of Measurement of Foramen Magnum Dimensions in Computed Tomography of Head

Nepal Journal of Medical Sciences

Introduction: Dimensions of the foramen magnum are clinically important because of the vital stru... more Introduction: Dimensions of the foramen magnum are clinically important because of the vital structures passing through it and for sex determination of the skull. The objective of this study was to measure various dimensions of the foramen magnum in Computed Tomography (CT) and correlate them with sex. Methods: Descriptive cross-sectional study was done on 120 CT head images in the Department of Radiology and Imaging, from July to October 2019. The shape of the foramen magnum (FM), anteroposterior diameter (APD), transverse diameter (TD), FM area and FM index were calculated. Statistical analysis was done with SPSS 25 and Excel 2016. Discriminant function analysis and binary logistic regression analysis were used for gender verification. RESULTS: The mean values of the APD, TD, area and FM index in males and females were 33.56 ± 4.30 mm, 29.76 ± 4.10 mm, 792.94 ± 191.60 mm2, 85.01 ± 8.67 and 30.01 ± 2.04 mm, 25.33 ± 4.6 mm, 599.63± 128.13 mm2, 83.17 ± 7.78 respectively. All dimens...

Research paper thumbnail of Abnormal Anatomic Variation of Pancreaticobiliary Union in Magnetic Resonance Cholangiopancreatography Department of Radiology and Imaging in a Tertiary Care Centre: A Descriptive Cross-sectional Study

Journal of Nepal Medical Association

Introduction: The knowledge of the variations of the abnormal anatomy of pancreaticobiliary union... more Introduction: The knowledge of the variations of the abnormal anatomy of pancreaticobiliary union is of great importance for understanding various pathologies of the biliary tract, gall bladder, and pancreas as well as to avoid surgical complications and morbidity which may arise from pancreaticobiliary maljunction. Moreover, it helps in the early diagnosis and preventive treatment of pancreaticobiliary disease. The objective of this study was to find out the prevalence of abnormal anatomic variations of the pancreaticobiliary union in magnetic resonance cholangiopancreatography examinations. Methods: This descriptive cross-sectional study was done in patients referred for Magnetic resonance cholangiopancreatography examinations for various clinical indications from 1 February 2021 to 30 May 2021. Ethical approval was obtained from the Institutional Review Committee [Reference number: 306 (6-11)E 2 077/078]. The variations in the pancreaticobiliary union, length of the common channe...

Research paper thumbnail of Inferior Vena Cava Thrombosis attributable to Hyperhomocysteinemia: A Case Report from Nepal

Inferior vena cava thrombosis (IVCT) is a rare occurrence and is a result of leg deep vein thromb... more Inferior vena cava thrombosis (IVCT) is a rare occurrence and is a result of leg deep vein thrombosis (DVT). The etiology of IVC thrombosis can be divided into congenital versus acquired etiological factors found in Virchow’s triad of stasis, injury, and hypercoagulability. Hyperhomocysteinemia is a rare risk factor for thromboembolism.

Research paper thumbnail of Falcine Meningioma with Massive Calvarial Hyperostosis

Journal of Institute of Medicine, 2014

Meningiomas are neoplasms of meningeal origin. Hyperostosis is a peculiar but common sign of meni... more Meningiomas are neoplasms of meningeal origin. Hyperostosis is a peculiar but common sign of meningioma. Though common in skull base meningiomas, massive calvarial hyperostosis is rare in the vertex, with only few reported cases.We report a rare case of massive calvarial hyperostosis due to falcine meningioma, illustrated with multimodality imaging.

Research paper thumbnail of Point-of-care ultrasonography: training, applications and barriers. A survey study

Journal of Advances in Internal Medicine, 2019

Background and Aims: Use of point-of-care ultrasound (POCUS) in acute care setting has rapidly in... more Background and Aims: Use of point-of-care ultrasound (POCUS) in acute care setting has rapidly increased and has potentials to guide patient management. This survey study aims to explore the usefulness of a one-day workshop and to elicit the perceived barriers for effective use of POCUS. Methods: A total of 169 doctors who had attended one day Acute Care Ultrasound workshop were approached through email. Online link to access the survey created using Google forms was sent. The survey contained questions related to the details about the participants, feedback about the workshop, whether the workshop has helped to change the practice of the participants, availability of ultrasound machine during the daily practice and the perceived barriers for use of POCUS. Results: A total of 41 responses were obtained. Majority of the participants had anaesthesiology as the base specialty followed by general practice. Most of them had ICU as their predominant working place, followed by emergency ro...

Research paper thumbnail of Retroperitoneal Seminoma in Undescended Testis: A Case Report

Nepalese Journal of Radiology

Testicular seminoma needs to be considered as a differential diagnosis for intra-abdominal mass i... more Testicular seminoma needs to be considered as a differential diagnosis for intra-abdominal mass in the male patient if there is a history of undescended testis. The risk of developing seminoma in an undescended testis is about 4-7.5 times greater than in a normally located testis.The risk of seminoma in undescended testis is increased even after orchidopexy.The identification of the draining gonadal vein can play a key role in the diagnosis of the testicular tumor in undescended intra-abdominally located testis. We report a case of seminoma in the retroperitoneal undescended testis in 50 years old male admitted for abdominal pain and distension

Research paper thumbnail of Traumatic Brachial Plexus Root Avulsion with Pseudomeningocele

Journal of KIST Medical College, Jan 31, 2021

Research paper thumbnail of Functional and radiological outcome after closed reduction and percutaneous pinning versus open reduction and internal fixation in displaced supracondylar fractures in children

Journal of Society of Surgeons of Nepal, 2016

Introduction: Supracondylar fracture of humerus is very common fracture in pediatric age group. T... more Introduction: Supracondylar fracture of humerus is very common fracture in pediatric age group. The current trends of management in displaced type are close reduction and per cutaneous pinning (CRPP), if reduction is not satisfactory then open reduction and internal fixation (ORIF) is done. Our study aims to compare the cosmetic, functional and radiological outcome between these two methods. Methodology: Children with displaced extension type supracondylar fracture of distal humerus presenting to emergency room and orthopedics OPD who could meet the inclusion criteria were taken up for study. Sixty-three such patients (37 CRPP and 26 ORIF) were included in the study. Radiological and functional outcomes were followed up at 8 weeks post-operatively. Results: Of the 63 patients enrolled, 26 (41.3%) patients had undergone open reduction and internal fixation and 37 (58/7%) had undergone close reduction and percutaneous pinning. The mean age of patients in CRPP and ORIF groups was 7.29...

Research paper thumbnail of Molecular dynamics approach to the I431V mutational impact on thyroid hormone receptor-beta

Research paper thumbnail of Age- and Gender-Specific Changes in Thyroid Size and Thyroid Function Test Values of Euthyroid Subjects

Journal of Biosciences and Medicines, 2018

Background: The thyroid status is evaluated by two clinical diagnostic tests which are thyroid ul... more Background: The thyroid status is evaluated by two clinical diagnostic tests which are thyroid ultrasonography and thyroid function tests. The objective of this research is to critically analyze the age and gender based variations of thyroid volume and thyroid hormone levels in the hospital based euthyroid subjects. Methodology: A total of 221 euthyroid subjects aged 1-86 years were selected to observe the normal thyroid size by ultrasonography at Department of Radiology and the thyroid function test values (FT3, FT4 and TSH) of 2413 euthyroid subjects aged (<1)-93 years were observed at Department of Biochemistry, Tribhuvan University Teaching Hospital, Kathmandu, Nepal during January 2017 to February 2018. The observed data were analyzed graphically and statistically to check the cross-correlations among the variables. Results: The best fitted equations with significant correlation coefficients and p < 0.05 provide the empirical relations between any two of the observed variables: age, thyroid lobe volumes, FT3, FT4 and TSH. The mean ± SD (p < 0.0001) of thyroid volume, FT3, FT4 and TSH are 4.74 ± 2.30 mL, 5.46 ± 0.82 pmol/L, 14.09 ± 2.71 pmol/L and 2.30 ± 0.98 mIU/L, respectively. Conclusion: The thyroid size first increases and then decreases whereas the thyroxin level first decreases and then increases with aging. Left lobe volume is almost same for both genders and right lobe volume is higher in males. The thyroid size in menarche and menopause periods of females is larger than that of males. Such age-and gender-specific changes recommend the new reference ranges for the normal thyroid functions.

Research paper thumbnail of Mean Carotid Intima-Media Thickness in Patients with Type 2 Diabetes Mellitus Attending Tertiary Care Center: A Descriptive Cross-sectional Study

Journal of Nepal Medical Association

Introduction: Sonographic carotid intima media thickness measurement in diabetic patients is an i... more Introduction: Sonographic carotid intima media thickness measurement in diabetic patients is an important tool for estimating the risk of cardiovascular and cerebrovascular events. It is a simple, noninvasive and widely available tool which can give idea of further treatment needed. The objective of this study was to determine the mean intima media complex thickness in patients with type II diabetes mellitus attending a tertiary care center. Methods: This was a descriptive cross-sectional study done in 64 patients with the type II diabetes mellitus patients visiting diabetic clinic of Tribhuvan University Teaching Hospital, sent for carotid Doppler examination in the department of radiology and imaging. Ethical approval was taken from the Instituitonal Review Board. Convenient sampling method was used. Carotid intima media thickness was measured on both sides and mean intima media thickness was calculated. Mean intima media thickness for male and female diabetic patients was also ca...

Research paper thumbnail of Right Sided Aortic Arch with Aberrant Left Subclavian Artery from Kommerell’s Diverticulum, a Cause of Persistent Dysphagia in an Adult: A Case Report

Journal of Institute of Medicine Nepal

Congenital variations and anomalies of the aortic arch are important entity in vascular imaging. ... more Congenital variations and anomalies of the aortic arch are important entity in vascular imaging. Most of them are asymptomatic. About 30-40% presents with tracheo-oesophageal symptoms like dyspnea and dysphagia. A 27 year-old female presented with persistent dysphagia for 6 months duration and cause of persistent dysphagia was the right sided aortic arch with aberrant left subcalvian artery from Kommerell’s diverticulum. The diagnosis was made through combination of chest X-Ray, echocardiography, non-ionic contrast swallow and Computed Tomography angiography. Non-invasive modalities (CT and MR Angiography) play an important role in diagnosis and pre-operative surgical planning providing relationship with the surrounding structures especially trachea and esophagus.

Research paper thumbnail of The Incidence of Adverse Reaction to Contrast Media in Computed Tomography Scan

Journal of Institute of Medicine, 2014

Research paper thumbnail of Correlation of Hypoechoic Lesions in Trans-rectal Ultrasound of Prostate with Histopathology in Prostate Cancer

Journal of Institute of Medicine, 2020

Introduction Prostate cancer is one of the most common cancer in elderly male. Suspicion of prost... more Introduction Prostate cancer is one of the most common cancer in elderly male. Suspicion of prostate cancer is based on increased Prostate Specific Antigen (PSA) level and abnormal digital rectal examination (DRE) findings. Transrectal ultrasonography (TRUS) can detect and localize hypoechoic lesions in prostate which are considered as suspicious for malignancy. TRUS can also guide for prostate biopsy, which is the gold standard for diagnosis of prostate cancer. The study was aimed to find out TRUS findings in suspected prostate cancer patients and correlate these findings with histopathological findings. Methods Prospective study was done in 66 males of age >40 years, sent for prostate biopsy in suspicion for prostate cancer (PSA >4 ng/ml, and/or abnormal DRE findings). Prostate was evaluated with TRUS and subsequently underwent TRUS guided six core biopsy of prostate. Total 396 cores of biopsy were taken. Histopathology reports were collected and correlated with the TRUS fin...

Research paper thumbnail of Measurement of Subpubic Angle in Radiograph

Introduction: Subpubic angle, an important parameter used for sex determination in the pelvis, is... more Introduction: Subpubic angle, an important parameter used for sex determination in the pelvis, is the angle between two inferior pubic rami below the symphysis pubis. This study was carried out to determine the subpubic angle among the individuals referred for pelvic and KUB radiographs in the department of Radiology and Imaging, Tribhuvan University, Teaching Hospital. Methods: Prospective cross-sectional study was done on 120 individuals. The subpubic angle was measured by drawing two tangent lines on the inferior border of the pubic rami. The subpubic angle of both sexes was measured. An independent sample t-test for equality of means was used to determine the difference between the two sexes regarding the subpubic angle. The correlation between the subpubic angle and the age of subjects was obtained using Pearson Correlation Coefficients in males and females. Results: The range of the subpubic angle in male was 82o to 122° and the mean was 104.72°±10.47°. In females, the range w...

Research paper thumbnail of A Retrospective Study of Magnetic Resonance Imaging Findings in Acute Encephalitis Syndrome

Journal of Institute of Medicine, 2015

Introduction: MRI is the imaging modality of choice to investigate acute encephalitis and is reco... more Introduction: MRI is the imaging modality of choice to investigate acute encephalitis and is recommended in all patients as soon as possible in whom diagnosis is uncertain. This study aimed to study the pattern of brain involvement in MRI in patients with acute encephalitis syndrome and to correlate the findings with clinical and laboratory data. Methods: The study was a retrospective hospital record based review conducted at Tribhuvan University Teaching Hospital. MRI and records of patients undergoing MRI for acute encephalitis syndrome during two years duration was studied. Data analysis was done using IBM SPSS 20.0. Results: A total of 47 MRI were studied among which 11(23.40%) were pediatric and 36(76.59%) were adult population. Edema was the commonest manifestation. Cerebral hemisphere (temporal lobe) was the commonest location involved 34(72.3%). Basal ganglia and thalamus involvement was also fairly common. Five (26.31%) out of 19 patients had positive Japanese encephalitis,...

Research paper thumbnail of Age and Gender Related Variations of Pituitary Gland Size of Healthy Nepalese People Using Magnetic Resonance Imaging

American Journal of Biomedical Engineering, 2015

The pituitary gland is the master endocrine gland of the human body. Its size varies with age and... more The pituitary gland is the master endocrine gland of the human body. Its size varies with age and in various pathological conditions including pituitary adenomas. Magnetic Resonance Imaging (MRI) is the standard tool for the imaging of pituitary gland without using any harmful ionizing radiations. The aim of the study was to obtain standard reference values for the anterior-posterior (AP), height, transverse dimensions and volume of pituitary gland of healthy population and to analyze the potential diagnostic values of dimensions of pituitary gland. These dimensions were measured using standard spin echo sequences with 6 mm thickness in 0.3T permanent magnet MRI. A group of 170 subjects were recruited at Institute of Medicine, Radiology and Imaging Department, Tribhuvan University Teaching Hospital (TUTH) during April 23, 2014 to June 20, 2014. These individuals demonstrated no evidence of abnormalities to the central nervous or endocrine systems prior to the study. The size and sha...

Research paper thumbnail of Anatomical Variations in Circle of Willis in Patients Undergoing CT Cerebral Angiography in a Tertiary Hospital in Nepal: A Descriptive Cross-sectional Study

JNMA: Journal of the Nepal Medical Association, 2020

Introduction: Variation in Circle of Willis is a commonly encountered entity in patients undergoi... more Introduction: Variation in Circle of Willis is a commonly encountered entity in patients undergoing Computed Tomography angiography, identification of which is crucial in management of patients with vascular pathologies. The aim of the study was to find out the anatomical variations in Circle of Willis in patients undergoing Computed Tomography cerebral angiography in a tertiary hospital in Nepal. Methods: This is a descriptive cross-sectional study involving 95 patients using convenient sampling techniques who were sent to the Department of Radiology and Imaging, Tribhuvan University Teaching hospital, for further evaluation of suspected vascular pathologies in the brain from April 2017 to September 2017. Ethical approval was taken from the Institutional Review Committee of the Institute of Medicine with reference number 326 (6-11-E). CT angiographic images of these patients were evaluated for presence of variations in Circle of Willis, aneurysms and other vascular pathologies. Dat...

Research paper thumbnail of Von Hippel Lindau Disease with central nervous system and multiple visceral manifestations: A case report

Research paper thumbnail of Chondrodysplasia Punctata: A Case Report of Fetal Warfarin Syndrome

DOAJ (DOAJ: Directory of Open Access Journals), Jun 1, 2017

Chondrodysplasia punctata is abnormal calcification in the cartilage of developing bones and has ... more Chondrodysplasia punctata is abnormal calcification in the cartilage of developing bones and has been seen in association with deranged vitamin K metabolism. Warfarin, an oral anticoagulant acting on vitamin K dependent clotting factors is known to cause chondrodysplasia punctata. Despite the knowledge of the condition the management of patients with prosthetic heart valves might require use of the drug for anticoagulation. Here, we present a case of a fetal warfarin syndrome in a second born child of a 27 year lady under warfarin for prosthetic heart valve. The pregnancy was complicated by polyhydramnios in third trimester and terminated at term by normal vaginal delivery. The baby was well, except for facial dysmorphism in the form of depressed nasal bridge, narrow nares and suspected left choanal atresia. Radiograph revealed stippled ephiphysis of vertebra, femora and humera supporting diagnosis of fetal warfarin syndrome. The baby did not develop any perinatal complication and was discharged home.

Research paper thumbnail of Measurement of Foramen Magnum Dimensions in Computed Tomography of Head

Nepal Journal of Medical Sciences

Introduction: Dimensions of the foramen magnum are clinically important because of the vital stru... more Introduction: Dimensions of the foramen magnum are clinically important because of the vital structures passing through it and for sex determination of the skull. The objective of this study was to measure various dimensions of the foramen magnum in Computed Tomography (CT) and correlate them with sex. Methods: Descriptive cross-sectional study was done on 120 CT head images in the Department of Radiology and Imaging, from July to October 2019. The shape of the foramen magnum (FM), anteroposterior diameter (APD), transverse diameter (TD), FM area and FM index were calculated. Statistical analysis was done with SPSS 25 and Excel 2016. Discriminant function analysis and binary logistic regression analysis were used for gender verification. RESULTS: The mean values of the APD, TD, area and FM index in males and females were 33.56 ± 4.30 mm, 29.76 ± 4.10 mm, 792.94 ± 191.60 mm2, 85.01 ± 8.67 and 30.01 ± 2.04 mm, 25.33 ± 4.6 mm, 599.63± 128.13 mm2, 83.17 ± 7.78 respectively. All dimens...

Research paper thumbnail of Abnormal Anatomic Variation of Pancreaticobiliary Union in Magnetic Resonance Cholangiopancreatography Department of Radiology and Imaging in a Tertiary Care Centre: A Descriptive Cross-sectional Study

Journal of Nepal Medical Association

Introduction: The knowledge of the variations of the abnormal anatomy of pancreaticobiliary union... more Introduction: The knowledge of the variations of the abnormal anatomy of pancreaticobiliary union is of great importance for understanding various pathologies of the biliary tract, gall bladder, and pancreas as well as to avoid surgical complications and morbidity which may arise from pancreaticobiliary maljunction. Moreover, it helps in the early diagnosis and preventive treatment of pancreaticobiliary disease. The objective of this study was to find out the prevalence of abnormal anatomic variations of the pancreaticobiliary union in magnetic resonance cholangiopancreatography examinations. Methods: This descriptive cross-sectional study was done in patients referred for Magnetic resonance cholangiopancreatography examinations for various clinical indications from 1 February 2021 to 30 May 2021. Ethical approval was obtained from the Institutional Review Committee [Reference number: 306 (6-11)E 2 077/078]. The variations in the pancreaticobiliary union, length of the common channe...

Research paper thumbnail of Inferior Vena Cava Thrombosis attributable to Hyperhomocysteinemia: A Case Report from Nepal

Inferior vena cava thrombosis (IVCT) is a rare occurrence and is a result of leg deep vein thromb... more Inferior vena cava thrombosis (IVCT) is a rare occurrence and is a result of leg deep vein thrombosis (DVT). The etiology of IVC thrombosis can be divided into congenital versus acquired etiological factors found in Virchow’s triad of stasis, injury, and hypercoagulability. Hyperhomocysteinemia is a rare risk factor for thromboembolism.

Research paper thumbnail of Falcine Meningioma with Massive Calvarial Hyperostosis

Journal of Institute of Medicine, 2014

Meningiomas are neoplasms of meningeal origin. Hyperostosis is a peculiar but common sign of meni... more Meningiomas are neoplasms of meningeal origin. Hyperostosis is a peculiar but common sign of meningioma. Though common in skull base meningiomas, massive calvarial hyperostosis is rare in the vertex, with only few reported cases.We report a rare case of massive calvarial hyperostosis due to falcine meningioma, illustrated with multimodality imaging.

Research paper thumbnail of Point-of-care ultrasonography: training, applications and barriers. A survey study

Journal of Advances in Internal Medicine, 2019

Background and Aims: Use of point-of-care ultrasound (POCUS) in acute care setting has rapidly in... more Background and Aims: Use of point-of-care ultrasound (POCUS) in acute care setting has rapidly increased and has potentials to guide patient management. This survey study aims to explore the usefulness of a one-day workshop and to elicit the perceived barriers for effective use of POCUS. Methods: A total of 169 doctors who had attended one day Acute Care Ultrasound workshop were approached through email. Online link to access the survey created using Google forms was sent. The survey contained questions related to the details about the participants, feedback about the workshop, whether the workshop has helped to change the practice of the participants, availability of ultrasound machine during the daily practice and the perceived barriers for use of POCUS. Results: A total of 41 responses were obtained. Majority of the participants had anaesthesiology as the base specialty followed by general practice. Most of them had ICU as their predominant working place, followed by emergency ro...

Research paper thumbnail of Retroperitoneal Seminoma in Undescended Testis: A Case Report

Nepalese Journal of Radiology

Testicular seminoma needs to be considered as a differential diagnosis for intra-abdominal mass i... more Testicular seminoma needs to be considered as a differential diagnosis for intra-abdominal mass in the male patient if there is a history of undescended testis. The risk of developing seminoma in an undescended testis is about 4-7.5 times greater than in a normally located testis.The risk of seminoma in undescended testis is increased even after orchidopexy.The identification of the draining gonadal vein can play a key role in the diagnosis of the testicular tumor in undescended intra-abdominally located testis. We report a case of seminoma in the retroperitoneal undescended testis in 50 years old male admitted for abdominal pain and distension

Research paper thumbnail of Traumatic Brachial Plexus Root Avulsion with Pseudomeningocele

Journal of KIST Medical College, Jan 31, 2021

Research paper thumbnail of Functional and radiological outcome after closed reduction and percutaneous pinning versus open reduction and internal fixation in displaced supracondylar fractures in children

Journal of Society of Surgeons of Nepal, 2016

Introduction: Supracondylar fracture of humerus is very common fracture in pediatric age group. T... more Introduction: Supracondylar fracture of humerus is very common fracture in pediatric age group. The current trends of management in displaced type are close reduction and per cutaneous pinning (CRPP), if reduction is not satisfactory then open reduction and internal fixation (ORIF) is done. Our study aims to compare the cosmetic, functional and radiological outcome between these two methods. Methodology: Children with displaced extension type supracondylar fracture of distal humerus presenting to emergency room and orthopedics OPD who could meet the inclusion criteria were taken up for study. Sixty-three such patients (37 CRPP and 26 ORIF) were included in the study. Radiological and functional outcomes were followed up at 8 weeks post-operatively. Results: Of the 63 patients enrolled, 26 (41.3%) patients had undergone open reduction and internal fixation and 37 (58/7%) had undergone close reduction and percutaneous pinning. The mean age of patients in CRPP and ORIF groups was 7.29...

Research paper thumbnail of Molecular dynamics approach to the I431V mutational impact on thyroid hormone receptor-beta

Research paper thumbnail of Age- and Gender-Specific Changes in Thyroid Size and Thyroid Function Test Values of Euthyroid Subjects

Journal of Biosciences and Medicines, 2018

Background: The thyroid status is evaluated by two clinical diagnostic tests which are thyroid ul... more Background: The thyroid status is evaluated by two clinical diagnostic tests which are thyroid ultrasonography and thyroid function tests. The objective of this research is to critically analyze the age and gender based variations of thyroid volume and thyroid hormone levels in the hospital based euthyroid subjects. Methodology: A total of 221 euthyroid subjects aged 1-86 years were selected to observe the normal thyroid size by ultrasonography at Department of Radiology and the thyroid function test values (FT3, FT4 and TSH) of 2413 euthyroid subjects aged (<1)-93 years were observed at Department of Biochemistry, Tribhuvan University Teaching Hospital, Kathmandu, Nepal during January 2017 to February 2018. The observed data were analyzed graphically and statistically to check the cross-correlations among the variables. Results: The best fitted equations with significant correlation coefficients and p < 0.05 provide the empirical relations between any two of the observed variables: age, thyroid lobe volumes, FT3, FT4 and TSH. The mean ± SD (p < 0.0001) of thyroid volume, FT3, FT4 and TSH are 4.74 ± 2.30 mL, 5.46 ± 0.82 pmol/L, 14.09 ± 2.71 pmol/L and 2.30 ± 0.98 mIU/L, respectively. Conclusion: The thyroid size first increases and then decreases whereas the thyroxin level first decreases and then increases with aging. Left lobe volume is almost same for both genders and right lobe volume is higher in males. The thyroid size in menarche and menopause periods of females is larger than that of males. Such age-and gender-specific changes recommend the new reference ranges for the normal thyroid functions.

Research paper thumbnail of Mean Carotid Intima-Media Thickness in Patients with Type 2 Diabetes Mellitus Attending Tertiary Care Center: A Descriptive Cross-sectional Study

Journal of Nepal Medical Association

Introduction: Sonographic carotid intima media thickness measurement in diabetic patients is an i... more Introduction: Sonographic carotid intima media thickness measurement in diabetic patients is an important tool for estimating the risk of cardiovascular and cerebrovascular events. It is a simple, noninvasive and widely available tool which can give idea of further treatment needed. The objective of this study was to determine the mean intima media complex thickness in patients with type II diabetes mellitus attending a tertiary care center. Methods: This was a descriptive cross-sectional study done in 64 patients with the type II diabetes mellitus patients visiting diabetic clinic of Tribhuvan University Teaching Hospital, sent for carotid Doppler examination in the department of radiology and imaging. Ethical approval was taken from the Instituitonal Review Board. Convenient sampling method was used. Carotid intima media thickness was measured on both sides and mean intima media thickness was calculated. Mean intima media thickness for male and female diabetic patients was also ca...

Research paper thumbnail of Right Sided Aortic Arch with Aberrant Left Subclavian Artery from Kommerell’s Diverticulum, a Cause of Persistent Dysphagia in an Adult: A Case Report

Journal of Institute of Medicine Nepal

Congenital variations and anomalies of the aortic arch are important entity in vascular imaging. ... more Congenital variations and anomalies of the aortic arch are important entity in vascular imaging. Most of them are asymptomatic. About 30-40% presents with tracheo-oesophageal symptoms like dyspnea and dysphagia. A 27 year-old female presented with persistent dysphagia for 6 months duration and cause of persistent dysphagia was the right sided aortic arch with aberrant left subcalvian artery from Kommerell’s diverticulum. The diagnosis was made through combination of chest X-Ray, echocardiography, non-ionic contrast swallow and Computed Tomography angiography. Non-invasive modalities (CT and MR Angiography) play an important role in diagnosis and pre-operative surgical planning providing relationship with the surrounding structures especially trachea and esophagus.

Research paper thumbnail of The Incidence of Adverse Reaction to Contrast Media in Computed Tomography Scan

Journal of Institute of Medicine, 2014

Research paper thumbnail of Correlation of Hypoechoic Lesions in Trans-rectal Ultrasound of Prostate with Histopathology in Prostate Cancer

Journal of Institute of Medicine, 2020

Introduction Prostate cancer is one of the most common cancer in elderly male. Suspicion of prost... more Introduction Prostate cancer is one of the most common cancer in elderly male. Suspicion of prostate cancer is based on increased Prostate Specific Antigen (PSA) level and abnormal digital rectal examination (DRE) findings. Transrectal ultrasonography (TRUS) can detect and localize hypoechoic lesions in prostate which are considered as suspicious for malignancy. TRUS can also guide for prostate biopsy, which is the gold standard for diagnosis of prostate cancer. The study was aimed to find out TRUS findings in suspected prostate cancer patients and correlate these findings with histopathological findings. Methods Prospective study was done in 66 males of age >40 years, sent for prostate biopsy in suspicion for prostate cancer (PSA >4 ng/ml, and/or abnormal DRE findings). Prostate was evaluated with TRUS and subsequently underwent TRUS guided six core biopsy of prostate. Total 396 cores of biopsy were taken. Histopathology reports were collected and correlated with the TRUS fin...

Research paper thumbnail of Measurement of Subpubic Angle in Radiograph

Introduction: Subpubic angle, an important parameter used for sex determination in the pelvis, is... more Introduction: Subpubic angle, an important parameter used for sex determination in the pelvis, is the angle between two inferior pubic rami below the symphysis pubis. This study was carried out to determine the subpubic angle among the individuals referred for pelvic and KUB radiographs in the department of Radiology and Imaging, Tribhuvan University, Teaching Hospital. Methods: Prospective cross-sectional study was done on 120 individuals. The subpubic angle was measured by drawing two tangent lines on the inferior border of the pubic rami. The subpubic angle of both sexes was measured. An independent sample t-test for equality of means was used to determine the difference between the two sexes regarding the subpubic angle. The correlation between the subpubic angle and the age of subjects was obtained using Pearson Correlation Coefficients in males and females. Results: The range of the subpubic angle in male was 82o to 122° and the mean was 104.72°±10.47°. In females, the range w...

Research paper thumbnail of A Retrospective Study of Magnetic Resonance Imaging Findings in Acute Encephalitis Syndrome

Journal of Institute of Medicine, 2015

Introduction: MRI is the imaging modality of choice to investigate acute encephalitis and is reco... more Introduction: MRI is the imaging modality of choice to investigate acute encephalitis and is recommended in all patients as soon as possible in whom diagnosis is uncertain. This study aimed to study the pattern of brain involvement in MRI in patients with acute encephalitis syndrome and to correlate the findings with clinical and laboratory data. Methods: The study was a retrospective hospital record based review conducted at Tribhuvan University Teaching Hospital. MRI and records of patients undergoing MRI for acute encephalitis syndrome during two years duration was studied. Data analysis was done using IBM SPSS 20.0. Results: A total of 47 MRI were studied among which 11(23.40%) were pediatric and 36(76.59%) were adult population. Edema was the commonest manifestation. Cerebral hemisphere (temporal lobe) was the commonest location involved 34(72.3%). Basal ganglia and thalamus involvement was also fairly common. Five (26.31%) out of 19 patients had positive Japanese encephalitis,...

Research paper thumbnail of Age and Gender Related Variations of Pituitary Gland Size of Healthy Nepalese People Using Magnetic Resonance Imaging

American Journal of Biomedical Engineering, 2015

The pituitary gland is the master endocrine gland of the human body. Its size varies with age and... more The pituitary gland is the master endocrine gland of the human body. Its size varies with age and in various pathological conditions including pituitary adenomas. Magnetic Resonance Imaging (MRI) is the standard tool for the imaging of pituitary gland without using any harmful ionizing radiations. The aim of the study was to obtain standard reference values for the anterior-posterior (AP), height, transverse dimensions and volume of pituitary gland of healthy population and to analyze the potential diagnostic values of dimensions of pituitary gland. These dimensions were measured using standard spin echo sequences with 6 mm thickness in 0.3T permanent magnet MRI. A group of 170 subjects were recruited at Institute of Medicine, Radiology and Imaging Department, Tribhuvan University Teaching Hospital (TUTH) during April 23, 2014 to June 20, 2014. These individuals demonstrated no evidence of abnormalities to the central nervous or endocrine systems prior to the study. The size and sha...

Research paper thumbnail of Anatomical Variations in Circle of Willis in Patients Undergoing CT Cerebral Angiography in a Tertiary Hospital in Nepal: A Descriptive Cross-sectional Study

JNMA: Journal of the Nepal Medical Association, 2020

Introduction: Variation in Circle of Willis is a commonly encountered entity in patients undergoi... more Introduction: Variation in Circle of Willis is a commonly encountered entity in patients undergoing Computed Tomography angiography, identification of which is crucial in management of patients with vascular pathologies. The aim of the study was to find out the anatomical variations in Circle of Willis in patients undergoing Computed Tomography cerebral angiography in a tertiary hospital in Nepal. Methods: This is a descriptive cross-sectional study involving 95 patients using convenient sampling techniques who were sent to the Department of Radiology and Imaging, Tribhuvan University Teaching hospital, for further evaluation of suspected vascular pathologies in the brain from April 2017 to September 2017. Ethical approval was taken from the Institutional Review Committee of the Institute of Medicine with reference number 326 (6-11-E). CT angiographic images of these patients were evaluated for presence of variations in Circle of Willis, aneurysms and other vascular pathologies. Dat...