82 results on '"Suwal S"'
Search Results
2. Correlation between Sonoelastography and Histopathological Findings in Evaluation of Chronic Renal Allograft Disease
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Bhandari, R. M., primary, Suwal, S., additional, Chataut, D., additional, and Ansari, M. A., additional
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- 2022
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3. Comparative Study of Common Bile Duct Diameter between Normal and Post Cholecystectomy Cases Using Trans-abdominal Ultrasonography
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Paudel, R. C., primary, Karki, S., additional, Suwal, S., additional, Palikhe, A., additional, Mandal, D., additional, and Manandhar, M., additional
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- 2022
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4. Real Time Trans-Rectal Elastography of Prostate Correlation with Histopathology in a Suspected Case of Prostate Cancer
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Basnet, B., primary, Suwal, S., additional, Chataut, D., additional, Lohani, B., additional, and Paudel, S., additional
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- 2021
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5. Role of social media in the development of land use and building projects
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Porkka, J, primary, Jung, N, additional, Päivänen, J, additional, Jäväjä, P, additional, and Suwal, S, additional
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- 2012
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6. Site characterisation for the Ballina field testing facility
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Kelly, R. B., primary, Pineda, J. A., additional, Bates, L., additional, Suwal, S. P., additional, Fitzallen, A., additional, Mesri, G., additional, and Kane, T., additional
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- 2018
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7. DIGITAL RECORDING AND NON-DESTRUCTIVE TECHNIQUES FOR THE UNDERSTANDING OF STRUCTURAL PERFORMANCE FOR REHABILITATING HISTORIC STRUCTURES AT THE KATHMANDU VALLEY AFTER GORKHA EARTHQUAKE 2015
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Shrestha, S., primary, Reina Ortiz, M., additional, Gutland, M., additional, Napolitano, R., additional, Morris, I. M., additional, Santana Quintero, M., additional, Erochko, J., additional, Kawan, S., additional, Shrestha, R. G., additional, Awal, P., additional, Suwal, S., additional, Duwal, S., additional, and Maharjan, D. K., additional
- Published
- 2017
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8. Role of social media in the development of land use and building projects
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Porkka, J., Nusrat Jung, Päivänen, J., Jäväjä, P., and Suwal, S.
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SDG 11 - Sustainable Cities and Communities ,SDG 15 - Life on Land - Abstract
A new social applications era is reforming the way people communicate nowadays. These technologies generate a network effect in turning passive content consumers into active content producers. Land use planning and building projects commonly operate between public and private domains, but the urban data is currently fragmented over multiple industry systems, such as BIM and GIS based technologies. This paper draws from a literature survey and adopts new ways of collaboration into the case study context of "Finnoo-Kaitaa" in Espoo, Finland. The municipality decided to work collaboratively while engaging citizens in developing the city district vision. Through this case study we consider qualitatively social media in enabling increased citizen participation. Conclusively, implications of social relevance in every-day work life are demonstrated through a future knowledge worker scenario. The forthcoming years will reveal whether the industry is ready for a strategic change towards transparent larger audiences with new business communication landscape
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- 2012
9. Social interaction in urban planning projects
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Jäväjä, P., Suwal, S., Porkka, Janne, Savisalo, A., and Kokko, P.
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social media ,Web-based game environment ,virtual reality ,BIM ,urban planning - Abstract
Construction industry and the stakeholders are rapidly inclining towards the use of model-based applications such as building information modelling (BIM), also referred to as "sociotechnical system". End user perspective and feedback are an integral part of urban planning projects. Developments of ICT and advancement in the use of social media tools have provided new dimensions to web 2.0 applications enabling utilization of 3D virtual world for larger audience. Virtual environments thus act as a scene of participation and social interaction for citizens and end users enabling new methods of participative design process. This paper introduces participatory approach in urban planning through implementation of freely available social media tools and applications with underlying concept of "Social BIM 2.0". The end users can monitor the built environment and verify the needs, requirements and usability of the current and future environment. The empirical part of paper consists of two case studies, which present the results of social application testing in urban planning projects. It presents approaches and results of testing social media applications, experimental visualization methods and technologies like web-based gaming environment in urban planning projects.
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- 2012
10. Multi-Detector Computed Tomography Evaluation of Normal Appendix.
- Author
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Suwal, S., Karki, S., Mandai, D., and Poudel, R. C.
- Published
- 2016
11. Prevalence of Anatomical Variations of the Sinonasal Region and their Relationship with Chronic Rhinosinusitis.
- Author
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Karki, S., Pokharel, M., Suwal, S., and Poudel, R.
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- 2016
12. Imaging in Infertile Female Patients Who Underwent Hysterosalpingography Investigation at Dhulikhel Hospital.
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Karki, S., Suwal, S., Tamrakar, S. R., and Poudel, R.
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- 2016
13. Assessment of normal splenic volume by Computed Tomography in Nepalese population.
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Suwal, S, Subedi, K., and Gurung, G.
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SPLENIC artery , *COMPUTED tomography - Abstract
Introduction: The purpose of this study was to assess the normal splenic volume in Nepalese population by Computed Tomography and its variability with age, sex and body habitus. Methods: This was a cross sectional observational study involving 264 patients undergoing CT abdomen examination for pathologies not pertaining to spleen, in Department of Radiology, Tribhuvan University Teaching Hospital.The spleen volume was obtained by adding cross-sectional area of spleen from 10 mm contiguous CT slices in axial CT images and multiplying them with the slice thickness. The relationships between spleen volume and age, sex and body habitus were also derived. Results: The mean splenic volume was 151.20 cm3 ± 59.62 cm3, ranging from 25.95 cm3 to 331.66 cm3. Weak negative correlation of spleen volume with age (r = -0.173, p <0.01) and body habitus (r = -0.132, p <0.05) were also noted. No significant correlation of spleen volume with gender was noted. Conclusion: The finding provided defining the criteria for splenomegaly. The mean splenic size in Nepalese population is similar and/or larger compared to Asian population, and smaller compared to western population. However a larger sample size is required for corroboration of our findings. [ABSTRACT FROM AUTHOR]
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- 2015
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14. Hand-touch Method for Detection of Neonatal Hypothermia in Nepal
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Tuitui, R. L., primary, Suwal, S. N., additional, and Shrestha, S., additional
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- 2010
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15. MRI Pattern of Lumbosacral Degeneration in Tribhuvan University Teaching Hospital, Nepal.
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Ansari, M. A., Subedi, K., Panta, O. B., and Suwal, S.
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MAGNETIC resonance imaging ,LUMBOSACRAL region ,COLLEGE teaching ,TEACHING hospitals ,PUBLIC health - Abstract
Introduction: The economical and social burden of degenerative disc disease remains unclear in Nepal due to lack of systematic data. However, considering the large volumes of spinal magnetic resonance imaging (MRI) performed for low back pain and/or radiculopathy, this has become the prime problems in all spinal care facilities in Nepal. Spinal MRIs constitute approximately sixty percent of the MRI performed in the Tribhuvan University Teaching Hospital (TUTH). This study is being conducted to review the pattern of degeneration of lumbosacral spine in patients referred for MRI at TUTH. Methods: A retrospective study was conducted at TUTH. Patients with low back pain and or radiculopathy undergoing MRI in the previous 5 months were included in the study. Patients with trauma and or conditions other than degenerative processes were excluded in the study. The findings were recorded and analyzed using SPSS. Results: A total of 301 patients were included in the study. Age ranged from 16 to 83 years, mean age being 42 years. Highest number of patients were in the 30-40 years age group (26.2%). Male to female ratio was 1.22. Disc bulge was the most common finding, seen in 77.7% followed by protrusion (58.5%), extrusion (3.9%) and sequestration (0.3%). Foraminal stenosis (68.4%) was the most common complication followed by central canal stenosis (51.8%) and nerve root compression (37.8%). Disc protrusion was the most significant (p<0.05) predictor of complications (nerve root compression, foraminal stenosis and central canal stenosis). Conclusion: The study shows that degenerative disc diseases remain the cause of morbidity in the most productive years of life (30-40 years of age). Large volumes of MRIs performed for this condition represent significant economic and healthcare burden in a developing country like Nepal as well. [ABSTRACT FROM AUTHOR]
- Published
- 2015
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16. Radiation Hazards and Protection: Are Nepalese Radiologists Up to Date?
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Subedi, K., Suwal, S., and Pant, O. B.
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MEDICAL education , *MEDICAL radiology , *EDUCATIONAL programs , *IONIZING radiation measurement - Abstract
Introduction: Radiation safety is a major concern in this modern era of diagnostic and therapeutic radiology. Institutions in Nepal still lack the adequate standards to maintain radiation safety. This study was conducted to assess the status of update on radiation hazards and methods of protection among radiologists in Kathmandu. Methods: A questionnaire survey was performed during continuing medical education program at Tribhuvan University Teaching Hospital, Kathmandu before and after a lecture session on radiation hazards and protection. Results: A total of 28 participants volunteered to answer the questionnaire. The mean pretest score was 57.8±29.7, which increased to 83.5± 16.8 after the lecture session. Twelve (42.86%) participants scored less than 50%, which increased significantly comparable to the rest (scoring more than 50%) in posttest score. Mean score was least in ionizing radiation questions. Conclusion: The update on radiation hazards and methods of protection is inadequate among radiologists in Kathmandu. Continuing medical education programs pertinent to the topic must be regularly conducted to keep the radiologists up to date. [ABSTRACT FROM AUTHOR]
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- 2014
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17. Falcine Meningioma with Massive Calvarial Hyperostosis.
- Author
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Subedi, K., Suwal, S., Chataut, D., and Paudel, S.
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MENINGIOMA , *EXOSTOSIS , *SKULL base , *COMPUTED tomography , *MAGNETIC resonance imaging , *TUMORS - Abstract
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. [ABSTRACT FROM AUTHOR]
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- 2014
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18. Bilateral Ovarian Teratoma: One Parasitic Twisted In-situ and Another Parasitic at the Hepato Renal Space.
- Author
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Chitrakar, N. S., Suwal, S., and Neupane, S.
- Published
- 2015
19. Hand—touch method for detection of neonatal hypothermia in Nepal.
- Author
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Tuitui, R. L., Suwal, S. N., and Shrestha, S.
- Published
- 2012
20. Comparative evaluation of knee osteoarthritis: radiography vs. ultrasonography in Nepalese population: a cross-sectional study.
- Author
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Suwal S, K C B, Katwal S, Chataut D, and Lohani B
- Abstract
Background and Objectives: Osteoarthritis (OA) is a degenerative and long-term debilitating disease with rising prevalence, predominantly involving larger joints including the knee joint. While radiography has traditionally been the primary modality for joint evaluation, there is a growing trend towards using ultrasonography (USG) for musculoskeletal disorders, including joint assessment. This study aimed to find the role of USG in the evaluation of OA of knee joints with comparison to the radiographs., Methods: This was a cross-sectional study done on patients with signs and symptoms of OA of the knee who visited the radiology department for knee radiographs. Kellgren and Lawrence system was used for grading OA in radiographs. USG of knee joints was done with high-frequency probes and searched for joint space width, articular cartilage thickness, marginal osteophytes, meniscal extrusion, and other articular/ extra-articular abnormalities. The USG findings were correlated with findings in anteroposterior and lateral radiographs., Results: The mean number of osteophytes was higher in USG compared to the radiographs ( P <0.001). Mean joint spaces were comparable in both modalities. Meniscal extrusion was seen with USG, which significantly correlated with joint space width and cartilage thickness ( P <0.005). USG also detected synovial changes, effusion, and Baker's cyst., Conclusion: Although radiography is the standard first-line radiological investigation for the diagnosis of OA of the knee joint, USG can be an adjunct as it well correlates with the radiograph findings and can provide more useful information., Competing Interests: The authors declare that there is no conflict of interest regarding the publication of this article.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)
- Published
- 2024
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21. Pericardial hydatid cyst: A comprehensive case report on diagnosis and multidisciplinary intervention in a young patient.
- Author
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Suwal S, Katwal S, Lamichhane S, Chataut D, Bhusal A, and Sharma A
- Abstract
Pericardial hydatid cysts, although rare, present unique diagnostic challenges and require a multidisciplinary approach for effective management. This parasitic infection, caused by Echinococcus granulosus larvae, typically affects the liver and lungs but can manifest in the pericardium, leading to potentially life-threatening complications if untreated. The 22-year-old female's escalating dyspnea posed diagnostic challenges despite inconclusive echocardiography. Employing a multidisciplinary strategy, including preoperative albendazole therapy and surgical excision, effectively managed the condition. This case highlights the intricate diagnostic nature of pericardial hydatid cysts, emphasizing the importance of heightened clinical awareness, especially in endemic regions. The detailed clinical trajectory, imaging methodologies, and therapeutic interventions contribute significant insights to the medical community. The study aims to deepen comprehension and guide clinicians in refined diagnostic and treatment approaches for pericardial hydatid cysts, ultimately improving patient outcomes. It underscores the imperative for continued research in this niche to enhance medical understanding and optimize clinical practices., (© 2024 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)
- Published
- 2024
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22. Rare encounter: Adult-onset temporal lobe schizencephaly with septo-optic dysplasia - a case report on comprehensive diagnosis and management.
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Suwal S, Katwal S, Chataut D, Lamichhane S, Adhikari A, Baral P, and Bhusal A
- Abstract
This case report presents a 21-year-old male with recurrent seizures attributed to isolated temporal lobe closed-lip schizencephaly coexisting with septo-optic dysplasia. Despite adult-onset seizures, the patient lacked motor deficits, maintaining normal developmental milestones. Comprehensive diagnostic modalities, including MRI revealing temporal lobe atrophy and associated abnormalities, contributed to the unique identification of schizencephaly. The classic triad of septo-optic dysplasia further complicated the clinical spectrum. Financial limitations influenced the predominantly conservative management, highlighting healthcare challenges. This case enhances our understanding of the rare congenital disorder, emphasizing the importance of tailored diagnostics and management strategies for diverse presentations of schizencephaly, particularly in the context of associated congenital anomalies., (© 2024 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)
- Published
- 2024
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23. Angiodysplasia simulating variceal bleeding: a challenging case report of diagnosis and intervention.
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Chataut D, Katwal S, Suwal S, Thapa A, and Bhattarai B
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Introduction and Importance: Angiodysplasia, a prevalent vascular anomaly in the gastrointestinal tract, often presents with upper gastrointestinal bleeding, sharing symptoms with gastric varices. The diagnostic challenge arises due to overlapping clinical features. This case report highlights the importance of considering angiodysplasia in the differential diagnosis, especially when variceal bleeding is less likely, and emphasizes the role of various diagnostic modalities in accurate identification., Case Presentation: A 52-year-old male presented with severe hematemesis and melena, mimicking variceal bleeding. Despite initial management, bleeding persisted. Contrast-enhanced computed tomography revealed dilated vascular channels, raising suspicion for both gastric varices and angiodysplasia. Endoscopy confirmed an angiomatous lesion, inadvertently disrupted during the procedure, necessitating angiography. The angiographic findings supported the diagnosis of angiodysplasia, and successful interventions included temporary glue embolization and argon laser coagulation during endoscopy. The patient was discharged with stable hemoglobin; a 2-year follow-up showed no recurrence., Clinical Discussion: The case discusses the challenges in differentiating angiodysplasia from varices, emphasizing the role of imaging and endoscopic modalities. It highlights the need for a tailored approach to treatment, including argon plasma coagulation, and underscores the significance of meticulous follow-up for recurrence., Conclusion: This case report elucidates the diagnostic and therapeutic journey in managing a patient with angiodysplasia masquerading as variceal bleeding. It emphasizes the importance of considering vascular anomalies without typical signs and the significance of individualized interventions for optimal patient outcomes. The 2-year follow-up without recurrence signifies the successful management of the case., Competing Interests: All the authors declare that they have no conflicts of interest.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)
- Published
- 2024
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24. Endovascular embolization for massive hemoptysis in intralobar pulmonary sequestration with celiac artery supply: A comprehensive case report.
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Chataut D, Katwal S, Suwal S, Thapa A, and Bhusal A
- Abstract
Pulmonary sequestration (PS) is a rare congenital anomaly characterized by noncommunicative lung tissue supplied by an abnormal systemic vessel. We present a case of a 30-year-old male with intralobar PS, receiving arterial supply from the celiac artery, manifesting as massive hemoptysis. After urgent stabilization, endovascular embolization using polyvinyl alcohol particles was successfully employed. The patient's symptoms resolved, and follow-up confirmed satisfactory recovery. Our case underscores the diverse arterial origins of PS and the efficacy of endovascular embolization as a minimally invasive treatment. The complexity of PS, its diagnostic imaging, and alternative therapeutic options are discussed, emphasizing tailored approaches for optimal outcomes in managing this uncommon congenital anomaly., (© 2024 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)
- Published
- 2024
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25. Lipoma arborescens in the dorsum of the hand: a case report and a comprehensive review.
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Suwal S, Katwal S, Chataut D, Lamichhane S, Bhusal A, and Bhandari S
- Abstract
Introduction and Importance: Lipoma arborescens is a rare synovial disorder, typically affecting the knee joint, with limited reports of atypical presentations. The study emphasizes the need for a multidisciplinary diagnostic approach and discusses the genetic and signalling factors associated with its pathogenesis., Case Presentation: A 50-year-old male presented with a painless swelling in the dorsum of the right hand, a rare extra-articular manifestation of Lipoma arborescens. Comprehensive clinical, imaging, and histopathological evaluations confirmed the diagnosis, revealing unique features on MRI and frond-like fatty tissue infiltration on excisional biopsy., Clinical Discussion: The case underscores the distinct clinical characteristics, diagnostic challenges, and differential considerations associated with atypical Lipoma arborescens presentations. Extra-articular manifestation of Lipoma arborescens involving the dorsum (extensor aspect) of the hand is rare. Imaging techniques, including MRI and ultrasound, play a crucial role in accurate diagnosis, differentiating it from other joint pathologies. The MRI findings include intra-articular fat deposits and villous proliferation of the synovial membrane. At the same time, the histopathological analysis includes frond-like infiltration of sub-synovial tissue with mature adipocytes which helps in confirming the diagnosis., Conclusion: Successful surgical excision of the extra-articular lesion highlights the importance of a comprehensive diagnostic strategy for managing this uncommon condition. The study contributes valuable insights into understanding, diagnosing, and treating atypical presentations of lipoma arborescens., Competing Interests: All the authors declare that they have no competing interest.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)
- Published
- 2024
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26. Post-traumatic jejunal branch of superior mesenteric artery pseudoaneurysm in paediatrics: a compelling case report highlighting early diagnosis and successful endovascular embolization.
- Author
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Katwal S, Chataut D, Suwal S, Thapa A, Paudel P, and Bhandari S
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Introduction and Importance: This manuscript underscores the critical significance of prompt diagnosis and intervention in cases of post-traumatic gastroduodenal artery pseudoaneurysms. Such occurrences, particularly in the paediatric population, are rare but potentially life-threatening complications following abdominal trauma, necessitating heightened clinical awareness. Despite their rarity, the devastating consequences of delayed recognition and management emphasize the necessity for advanced imaging modalities and individualized treatment strategies., Case Presentation: A 17-year-old male presented with severe epigastric pain following a football fall. Despite initial stability, persistent symptoms prompted further investigation. Conventional screening methods proved inconclusive, leading to a contrast-enhanced computed tomography (CT) scan that revealed a jejunal branch of superior mesenteric artery (SMA) pseudoaneurysm. The subsequent fluoroscopy-guided angiography and successful embolization using glue exemplify the importance of timely intervention in such cases., Conclusion: This case highlights the importance of early recognition and appropriate intervention in post-traumatic jejunal branch of SMA pseudoaneurysms. The successful outcome achieved through endovascular embolization underscores the necessity for vigilant monitoring and tailored management strategies in similar clinical scenarios., Competing Interests: All the authors declare that they have no competing interest.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)
- Published
- 2024
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27. Ultrasound Guided Biopsy among Patients with Lung Lesions Undergoing Procedures in Interventional Radiology of a Tertiary Care Centre.
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Kayastha P, Adhikari B, Paudel S, Suwal S, Shingh SS, Chapagain P, and Regmi PR
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- Humans, Tertiary Care Centers, Cross-Sectional Studies, Image-Guided Biopsy methods, Ultrasonography, Interventional methods, Lung diagnostic imaging, Retrospective Studies, Radiology, Interventional, Lung Neoplasms pathology
- Abstract
Introduction: Minimally invasive image-guided percutaneous core needle biopsy can obtain tissue samples for diagnosis of subpleural lung cancer, which is crucial for the correct management of lung lesions. Common complications of lung biopsy include pneumothorax, parenchymal haemorrhage and haemoptysis. The study aimed to determine the prevalence of ultrasound-guided biopsy among patients with lung lesions undergoing procedures in interventional radiology of a tertiary care centre., Methods: A descriptive cross-sectional study was performed in the Department of Radiology and Imaging from 1 August 2018 to 30 September 2019 after obtaining ethical approval from the Institutional Review Committee. USG-guided biopsy of peripheral lung lesions was performed with an 18 gauge semiautomatic biopsy instrument and a 17 gauge coaxial needle. A convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval., Results: Among 188 biopsy of lung lesions, ultrasound-guided biopsies were performed in 28 (14.89%) (9.80-19.98, 95% Confidence Interval)., Conclusions: The prevalence of ultrasound guided biopsy among lung lesions is lower than other studies done in similar settings., Keywords: biopsy; interventional radiology; lung neoplasms; prevalence.
- Published
- 2024
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28. Imaging and Histopathological Features Of Primary Thymic Neuroendocrine Tumor.
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Suwal S, Chen YY, Huang SD, Li WF, and Chen H
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- Humans, Positron Emission Tomography Computed Tomography, Retrospective Studies, Tomography, X-Ray Computed methods, Neuroendocrine Tumors diagnostic imaging, Thymus Neoplasms diagnostic imaging, Thymoma
- Abstract
Objectives: To investigate CT, MRI, and PET/CT features with histopathological findings of primary thymic neuroendocrine tumor., Materials and Methods: All 9 cases with pathologically proven primary thymic neuroendocrine tumors were reviewed retrospectively. Among them, 7 underwent enhanced CT, 1 with MRI (enhanced) and another with PET/CT scan. Multiple characters were examined, including tumor location, contour, CT attenuation, enhancement pattern, involvement of surrounding structure and lymphadenopathy., Results: Among 9 patients studied, 7 (77%) masses were located in the anterior superior mediastinum, 1 in the anterior superior-middle mediastinum, and 1 in the anterior and middle mediastinum. The maximum diameter (longitudinal) ranged from 4.2 to 23 cm (mean ± standard deviation, 9.5 cm ± 2.8). Four masses had irregular, 3 had lobulated, and 2 had smooth contours, while 8 masses had clear margins and 1 had an ill-defined margin. Six masses showed heterogeneous attenuation with necrotic/cystic component (n=5), calcification (n=2) and hemorrhage(n=1), and 3 showed homogeneous attenuation on the non-enhanced image. After contrast administration, 8 masses showed heterogeneous attenuation, and 1 showed homogeneous attenuation with tumor vessels visible in 4 masses. Among all, 8 masses showed strong enhancement, and 1 showed moderate enhancement in comparison to muscles in the anterior thoracic wall on enhanced images. Involvement of adjacent mediastinal structures was observed in 5 cases. Immunohistochemical analysis showed that the tumor cells were positive for CgA, Syn, CK, CD56 and EMA., Conclusion: Primary NETs are large masses located anterior superior mediastinum, irregular in contour, showing heterogeneous attenuation with necrotic/cystic component and strong heterogeneous enhancement with tumor vessels, compressing local mediastinal structures. In addition, immunohistochemical examination is required in such a diagnosis., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)
- Published
- 2024
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29. Internal auditory canal duplication with facial and cochlear nerve dysfunction: A case report.
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Ghising R, Dongol K, and Suwal S
- Abstract
Internal auditory canal duplication is a rare anomaly of the temporal bone. The condition is diagnosed on performing High-Resolution Computed Tomography of the temporal bone and magnetic resonance imaging for sensorineural hearing loss. A bony septum divides the internal auditory canal into dual compartments. Duplication may be either unilateral or bilateral and vestibulocochlear nerve may be aplastic or hypoplastic. Rarely, patient may present with facial nerve palsy. A 26-year-old female presented with right grade IV lower motor neuron facial nerve palsy for 12 years and right-sided hearing loss for 9 years. Pure tone audiogram revealed 45 dB of moderate degree sensorineural hearing loss on the right ear. On High-Resolution Computed Tomography of the temporal bone, an incomplete bony septum was visualized in the right internal auditory canal, dividing it into two compartments. Internal auditory canal on the left side was normal. Other inner and middle ear structures were normal. On magnetic resonance imaging, both the vestibulocochlear and facial nerves were well visualized with normal calibers., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2023.)
- Published
- 2023
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30. Comparative analysis of automated breast volume scanner (ABVS) combined with conventional hand-held ultrasound and mammography in female breast cancer detection.
- Author
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Sherchan A, Liang JT, Sherchan B, Suwal S, and Katwal S
- Abstract
Objective and Background: This study aimed to compare the diagnostic value of an automated breast volume scanner (ABVS) combined with conventional hand-held ultrasound and mammography in detecting female breast cancer. Early detection is vital in improving patient outcomes for this prevalent disease., Methods: Seventy-eight suspicious breast lesions from 60 patients were examined between August 2019 and July 2020. Each patient underwent ABVS, conventional hand-held ultrasound, and mammography. Diagnostic values, including coincidence rate, sensitivity, specificity, positive predictive value, and negative predictive value, were calculated using histopathology results as the "gold standard.", Results: Histopathology confirmed 55 malignant (70.51%) and 23 benign lesions (29.48%). ABVS combined with conventional hand-held ultrasound identified 56 malignant (52 confirmed, 4 benign) and 22 benign nodules (3 confirmed, 19 benign). Mammography detected 48 malignant (45 confirmed, 3 benign) and 30 benign nodules (10 confirmed, 20 benign). ABVS combined with conventional hand-held ultrasound had a sensitivity of 94.5%, specificity of 82.6%, positive predictive value of 92.9%, and negative predictive value of 86.4%. Mammography showed a sensitivity of 81.8%, specificity of 87.0%, positive predictive value of 93.8%, and negative predictive value of 66.7%., Conclusion: ABVS combined with conventional hand-held ultrasound showed high diagnostic value in detecting female breast cancer. The "convergence sign" in the coronal section played a significant role. It slightly outperformed mammography and offered advantages in terms of cost, convenience, comfort, and absence of radiation. Further promotion and implementation are supported., Competing Interests: The authors declare that there is no conflicts of interest regarding the publication of this article.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)
- Published
- 2023
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31. Measurement of portal vein indices and splenic index by ultrasound and their association with gastroesophageal varices in cirrhosis of liver.
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Katwal S, Ansari MA, Suwal S, Rayamajhi S, Ghimire P, and Ghimire A
- Abstract
Background and Objectives: Esophageal and gastric fundic varices are common in liver cirrhosis patients. Ultrasound with the Doppler study assesses liver cirrhosis severity, measuring portal vein and splenic indices' association with gastroesophageal varices., Methodology: This study was conducted on 64 subjects with sonographic features of chronic liver disease who were referred for routine follow-up scans. Portal vein diameter, average velocity, splenic index, congestion index (CI), and portal vein area and velocity were measured., Result: Subjects with gastroesophageal varices had significantly larger portal vein diameters (14.7±1.64 mm) compared to those without varices (12.05±1.26 mm) ( P <0.05). Conversely, subjects without varices exhibited a higher portal vein velocity of (17.9±0.6 cm/s) than with varices (13.91±2.01 cm/s) ( P =0.0005). The splenic index was higher in subjects with varices (1120±494 cm
3 ) than those without varices (419 cm3 ) ( P <0.05). The CI was also higher in subjects with varices. Portal vein velocity showed the highest sensitivity (94%) with a cutoff of 19 cm/s, while the CI had the highest diagnostic accuracy (93.75%) with a cutoff of 0.10 cm xsec. The splenic index demonstrated a sensitivity of 92.85% and diagnostic accuracy of 92.18% with a cutoff of 480 cm3 . The splenic index followed by the CI is found to be a better predictor of esophageal varices (area under the curve of 96.8 and 96%, respectively)., Conclusion: Ultrasonographic assessment of the portal vein and spleen is a reliable, noninvasive method for predicting gastroesophageal varices in liver cirrhosis. The splenic index and CI have high diagnostic accuracy., Competing Interests: All the authors declare that they have no competing interest.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)- Published
- 2023
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32. Cerebral venous sinus thrombosis with hemorrhagic infarct: A rare presentation in a risk-defying male patient.
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Katwal S, Suwal S, Lamichhane S, Bhusal A, and Yogi TN
- Abstract
Cerebral venous sinus thrombosis (CVST) is a rare but critical cerebrovascular condition characterized by clot formation in cerebral veins or sinuses. We present a case of a 30-year-old male with CVST, an atypical presentation of right-sided weakness and sudden loss of consciousness. While CVST typically manifests as severe headaches and neurological deficits, our patient's unique symptoms pose diagnostic challenges. Advanced imaging techniques, including MRI with venography, played a pivotal role in confirming the diagnosis. Treatment involved anticoagulation therapy and resulted in a favorable outcome. This case highlights the importance of considering CVST in patients with unusual neurological symptoms and the crucial role of early diagnosis and intervention. Advances in diagnostic modalities and treatment options have significantly improved outcomes in CVST patients, emphasizing the need for timely recognition and management., (© 2023 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)
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- 2023
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33. Computed tomographic assessment of risk of anterior skull base injury of adult patients in tertiary care centre: a cross-sectional study.
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Katwal S, Kumar RR, Ansari MA, Suwal S, and Ghimire P
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Background and Objectives: Functional endoscopic sinus surgery (FESS) carries the risk of anterior skull base injury. Understanding computed tomography of the paranasal sinuses (CT PNS) and anatomical variations is crucial before surgery. Several classifications, including Kero's, Gera's, and Thailand-Malaysia-Singapore (TMS), assess the risk of skull base injury. The objective was to determine the risk of anterior skull base injury using CT PNS in adult patients., Methods: A study of 188 patients with head and paranasal sinus pathologies used CT scans to measure olfactory fossa depth, the angle between lamina papyracea and horizontal plane, and the distance from the orbital rim to the cribriform plate. Variations were classified using Kero's, Gera's, and TMS classifications., Results: The study involved 188 individuals aged 18-85, with OF depths ranging from 0.1 to 0.52 cm. Kero's Class I was observed in 82.44% and 81.38% of individuals, while distances from orbital floor to cribriform plate and ethmoidal roof ranged from 1.37 to 2.93 cm. TMS Type I was observed in all individuals, and the angle between lateral lamella of the cribriform plate and cribriform plate ranged from 34° to 85°. Gera's Class II was observed in 77.12% and 84.57% of individuals., Conclusion: CT PNS provides important anatomical information for assessing the risk of skull base injury during FESS. Kero's, Gera's, and TMS classifications can be utilized to evaluate this risk. The study findings provide insights into the variations in olfactory fossa depth, distance measurements, and angle, which can aid in preoperative planning and reducing complications during FESS in Nepalese populations., Competing Interests: The authors declare that they have no financial conflict of interest with regard to the content of this report.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)
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- 2023
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34. Correlation between Femoral Intercondylar Notch Width and Anterior Cruciate and Posterior Cruciate Ligament Widths on MRI of Knee Joint.
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Ghimire P, Kayastha P, Suwal S, Katwal S, Dhakal P, Lamichhane S, and Lohani B
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- Humans, Male, Female, Adult, Middle Aged, Adolescent, Young Adult, Anterior Cruciate Ligament Injuries diagnostic imaging, Posterior Cruciate Ligament anatomy & histology, Posterior Cruciate Ligament diagnostic imaging, Magnetic Resonance Imaging methods, Femur diagnostic imaging, Femur anatomy & histology, Knee Joint diagnostic imaging, Knee Joint anatomy & histology, Anterior Cruciate Ligament diagnostic imaging, Anterior Cruciate Ligament anatomy & histology
- Abstract
Background Anatomic variations have been implicated as one of the intrinsic causes of injuries to the cruciate ligaments which can induce a functional deficiency to the knee. Narrow cruciate ligament widths as well as narrow femoral intercondylar notch widths can increase the risk of these ligaments rupturing. Objective To correlate the width of the femoral intercondylar notch (ICN) with anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) widths on MRI of the knee joint. Method A total of 46 patients who met the inclusion criteria were evaluated. Intercondylar notch was identified on coronal T1W images while anterior cruciate ligament and posterior cruciate ligament were identified on proton density coronal images. All the widths were measured in the same plane at a mid-coronal level where anterior cruciate ligament and posterior cruciate ligament cross each other. Result Our result showed a significant correlation between the widths of intercondylar notch and anterior cruciate ligament (r = 0.68, p < 0.001) and between intercondylar notch width (INW) and posterior cruciate ligament width (r = 0.65, p < 0.001). Overall, the mean intercondylar notch width measured was 17.5 ±2.5 mm (range 11.8 to 21.8 mm), the mean anterior cruciate ligament width was 5.9 ±1.3 mm (range 3.3 to 8.6 mm), and the mean posterior cruciate ligament width was 8.9 ±1.5 mm (range 5.9 to 11.8 mm). A statistically significant difference was observed between males and females for mean widths of intercondylar notch (p < 0.001) and posterior cruciate ligament (p=0.01). However, no statistically significant difference was seen for anterior cruciate ligament width (p=0.07) between the two genders. Conclusion Measurement of the femoral intercondylar notch width can be used as an indicator of anterior cruciate ligament and posterior cruciate ligament widths which can further assist to identify the individuals who are more susceptible to cruciate ligament injuries.
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- 2023
35. Insight into adult-onset metachromatic leukodystrophy with optic atrophy: A comprehensive case report.
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Katwal S, Suwal S, Lamichhane S, Bhusal A, and Ghimire A
- Abstract
This abstract provides an overview of metachromatic leukodystrophy (MLD), an autosomal recessive disorder stemming from arylsulfatase A deficiency. MLD leads to cerebroside sulfate accumulation, causing central and peripheral demyelination. Clinical manifestations vary by age group: late-infantile (rapid progression), juvenile (slower progression), and adult-onset (psychiatric symptoms). A case study details a 23-year-old with progressive vision impairment, motor weakness, and cognitive changes. Examination and MRI findings led to suspicion of MLD, later confirmed by enzyme testing. Optic nerve involvement is emphasized, along with diagnostic criteria involving enzyme assays, imaging, and urinary sulfatide excretion tests. While no cure exists, symptomatic and supportive care, including hematopoietic stem cell transplantation, remains key in MLD management ., (© 2023 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)
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- 2023
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36. Prospective quantitative study: Doppler ultrasound in the evaluation of chronic renal allograft disease and correlation with histopathological finding.
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Katwal S, Suwal S, Bhandari RM, Chataut D, Ansari MA, and Lamichhane S
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Background and Objectives: Renal allograft biopsy is the gold standard for diagnosing chronic allograft nephropathy, but noninvasive methods are needed to avoid unnecessary biopsies. Doppler ultrasonography, particularly the resistive index (RI), correlates with renal allograft dysfunction. This study aims to assess the relationship between renal sonographic parameters and biochemical parameters in diagnosing graft interstitial fibrosis., Methods: The study evaluated 60 renal allograft recipients for sonographic renal morphological features and Doppler indices. The estimated glomerular filtration rate (eGFR) was calculated, and cortical fibrosis after the biopsy was determined using the Banff score. Continuous variables like mean and SD were calculated, and categorical variables were reported using frequencies and proportions. Associations were examined using independent sample t -tests, χ
2 tests, and multivariate regression analysis., Results: The mean eGFR was 75.23±25.45 ml/min/1.73 m2 . A significant correlation of eGFR with RI ( r =0.341, P =0.008) was seen. A significant difference in mean RI (F=10.167; df=2,57; P <0.001) was seen among the histological grades of fibrosis. Among the histological grades of fibrosis, significant differences in RI among mild and moderate (S.E. 0.033, P =0.043), mild and severe (S.E. 0.026, P =0.001) as well as moderate and severe (S.E. 0.036, P =0.029) was seen., Conclusion: Doppler was able to noninvasively predict allograft fibrosis and could be used as a complementary imaging tool during the follow-up of renal allograft patients. Future research is needed to improve evidence, diagnostic criteria, guidelines, and long-term impact., Competing Interests: Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)- Published
- 2023
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37. Pancreas divisum in a young patient with chronic abdominal pain as per radiological findings: A case report.
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Kayastha P, Pokhrel B, Bhatta U, Pathak R, Jha G, Paudel S, Suwal S, and Regmi D
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Key Clinical Message: Pancreas divisum (PD) can be one of the causes of unexplained chronic abdominal pain. In PD, the dominant duct drains the majority of the pancreas via the minor papilla, which can be conveyed in the imaging as crossing duct sign., Abstract: We report a case a of 16-year-old man who presented with unexplained chronic abdominal pain. Contrast-enhanced computed tomography and magnetic resonance cholangiopancreatography showed a bulky pancreas, but his pancreatic enzymes were normal. The crossing duct sign was prominent in imaging, which confirmed the diagnosis of PD., Competing Interests: The authors declare that there is no conflict of interest regarding the publication of this paper., (© 2023 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd.)
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- 2023
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38. Phospholipid Encapsulation of an Anti-Fibrotic Endopeptide to Enhance Cellular Uptake and Myocardial Retention.
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Sonkawade SD, Xu S, Kim M, Nepali S, Karambizi VG, Sexton S, Turowski SG, Li K, Spernyak JA, Lovell JF, George A, Suwal S, Sharma UC, and Pokharel S
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- Humans, Mice, Animals, Liposomes metabolism, Tissue Distribution, Collagen metabolism, Myocardium metabolism, Fibrosis, Mammals metabolism, Phospholipids metabolism, Myocardial Infarction metabolism
- Abstract
Background: Cardioprotective effects of N -acetyl-ser-asp-lys-pro (Ac-SDKP) have been reported in preclinical models of myocardial remodeling. However, the rapid degradation of this endogenous peptide in vivo limits its clinical use., Method: To prolong its bioavailability, Ac-SDKP was encapsulated by phosphocholine lipid bilayers (liposomes) similar to mammalian cell membranes. The physical properties of the liposome structures were assessed by dynamic light scattering and scanning electron microscopy. The uptake of Ac-SDKP by RAW 264.7 macrophages and human and murine primary cardiac fibroblasts was confirmed by fluorescence microscopy and flow cytometry. Spectrum computerized tomography and competitive enzyme-linked immunoassays were performed to measure the ex vivo cardiac biodistribution of Ac-SDKP. The biological effects of this novel synthetic compound were examined in cultured macrophages and cardiac fibroblasts and in a murine model of acute myocardial infarction induced by permanent coronary artery ligation., Results: A liposome formulation resulted in the greater uptake of Ac-SDKP than the naked peptide by cultured RAW 264.7 macrophages and cardiac fibroblasts. Liposome-delivered Ac-SDKP decreased fibroinflammatory genes in cultured cardiac fibroblasts co-treated with TGF-β1 and macrophages stimulated with LPS. Serial tissue and serum immunoassays showed the high bioavailability of Ac-SDKP in mouse myocardium and in circulation. Liposome-delivered Ac-SDKP improved cardiac function and reduced myocardial fibroinflammatory responses in mice with acute myocardial infarction., Conclusion: Encapsulation of Ac-SDKP in a cell membrane-like phospholipid bilayer enhances its plasma and tissue bioavailability and offers cardioprotection against ischemic myocardial injury. Future clinical trials can use this novel approach to test small protective endogenous peptides in myocardial remodeling.
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- 2023
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39. Interstitial brachytherapy for internal mammary node in breast cancer: A case report.
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Pandit S, Sapkota S, Suwal S, Adhikari A, Karki P, and Jha AK
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This case study reports the feasibility, safety, and efficacy of interstitial brachytherapy for internal mammary nodal recurrence in a 68-year-old woman with triple-negative breast cancer. The patient had previously undergone mastectomy followed by chemotherapy and radiotherapy. However, an internal mammary node was discovered during a routine follow-up a year later, which was confirmed as metastatic carcinoma by fine needle aspiration, with no other metastatic lesions. The patient underwent interstitial brachytherapy under ultrasound and computed tomography (CT) guidance, with a prescribed dose of 20 Gray in one fraction. Follow-up CT scan imaging over a 2-year period of treatment showed a complete resolution of internal mammary node. Therefore, brachytherapy may be considered a potential treatment option for cases of isolated internal mammary node recurrence in breast cancer., Competing Interests: The authors report no conflict of interest., (Copyright © 2023 Termedia.)
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- 2023
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40. Metastatic Supraclavicular Lymph Nodes among Patients with Lung Carcinoma in a Tertiary Care Centre: A Descriptive Cross-sectional Study.
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Lamichhane S, Thapa A, Chataut D, Suwal S, Ansari MA, and Yadav BK
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- Humans, Tertiary Care Centers, Cross-Sectional Studies, Lymph Nodes diagnostic imaging, Lymph Nodes pathology, Lung, Lung Neoplasms diagnostic imaging, Lung Neoplasms pathology, Carcinoma pathology
- Abstract
Introduction: Metastatic spread of lung cancer to supraclavicular lymph nodes is considered distant metastasis for treatment purposes. Detection of supraclavicular lymph node metastasis in patients with lung cancer serves for tissue diagnosis by itself and also helps avoid more invasive biopsy from the primary lung mass itself. Ultrasonography of the lower neck can detect supraclavicular lymph nodes before they are palpable and can also be used for safe sampling of these lymph nodes. The aim of this study was to find out the prevalence of metastatic supraclavicular lymph nodes among patients with lung carcinoma in a tertiary care centre., Methods: A descriptive cross-sectional study done in a tertiary care center, carried out from 15 September 2019 to 14 September 2020. Ethical approval was obtained from the Institutional Review Committee (Reference number: 84(611)E2/076/077). The study was done among 92 patients with biopsy-proven lung cancer (lung mass or supraclavicular lymph node biopsy) who were referred for evaluation, and/or percutaneous transthoracic biopsy. Convenience sampling method was used. Point estimate and 90% Confidence Interval were calculated., Results: Among 92 patients with proven lung cancer, metastatic supraclavicular lymph nodes were seen in 13 patients (14.10%) (8.17- 19.73, 90% Confidence Interval). Among 13 patients with metastatic lymph nodes, 9 (69.23%) had palpable supraclavicular lymph nodes. The majority 11 (84.61%) had round-shaped lymph nodes. All metastatic lymph nodes showed loss of echogenic fatty hilum. A total of 12 (92.30%) metastatic lymph nodes showed a peripheral disorganized pattern of vascularity., Conclusions: The prevalence of metastatic supraclavicular lymph nodes was lower than in similar studies done in international settings., Keywords: lung cancer; malignancy; ultrasonography.
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- 2023
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41. Development of a human milk protein concentrate from donor milk: Impact of the pasteurization method on static in vitro digestion in a preterm newborn model.
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Sergius-Ronot M, Suwal S, Pitino MA, Shama S, Unger S, O'Connor DL, Pouliot Y, and Doyen A
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- Infant, Newborn, Humans, Milk, Human chemistry, Milk Proteins chemistry, Digestion, Pasteurization methods, Lactoferrin chemistry
- Abstract
The impact of high temperature short time (HTST, 72 °C, 15 s), Holder pasteurization- (63 °C, 30 min) and high hydrostatic pressure (HHP, 600 MPa-10 min) was evaluated on the digestibility of human milk protein concentrate (HMPC) by using a static in vitro gastrointestinal digestion system. The results showed that the processing steps used to produce the HMPC induced a decrease in readily available nitrogen (non-protein nitrogen and peptides). Overall, digestibility was similar between pasteurized and raw HMPC (degree of hydrolysis ranged from 26 to 34 %). Lactoferrin was more susceptible to gastric and intestinal digestion after thermal pasteurization. Additionally, the resistance of β-casein to digestion increased after HHP and Holder pasteurization due to aggregation and changes in protein structure. During intestinal digestion, Holder pasteurization induced a higher release of arginine, phenylalanine and tyrosine from HMPC compared to raw and HHP-treated HMPC. Overall, protein structural changes induced by human milk (HM) processing (freeze-thawing and filtration) and pasteurization treatments affected HMPC proteolysis during in vitro digestion. However, protein digestion behaviors were quite similar for raw and HHP-treated HMPC compared to the thermal-treated HMPC, with no effect on lactoferrin digestion. Consequently, pasteurization of HMPC by HHP represents an interesting non-thermal process that preserves the HM bioactive proteins during digestion., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Ltd. All rights reserved.)
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- 2023
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42. Impact of holder, high temperature short time and high hydrostatic pressure pasteurization methods on protein structure and aggregation in a human milk protein concentrate.
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Sergius-Ronot M, Pitino MA, Suwal S, Shama S, Unger S, O'Connor DL, Pouliot Y, and Doyen A
- Subjects
- Hot Temperature, Humans, Hydrostatic Pressure, Milk, Human chemistry, Temperature, Milk Proteins analysis, Pasteurization
- Abstract
This work evaluated the impact of high temperature short time (HTST, 72 °C, 15 s), high hydrostatic pressure (HHP, 400-600 MPa at 5 and 10 min) and Holder pasteurization (HoP, 62.5 °C, 30 min) on protein profile and aggregation in a human milk protein concentrate (HMPC). The structural changes induced in milk proteins were investigated in HMPC as well as in sedimentable and non-sedimentable fractions recovered after ultracentrifugation. The results showed that heat treatments induced more protein denaturation and aggregation than did HHP treatments. Indeed, heat-induced protein aggregates observed in HMPC and the sedimentable fraction were mainly composed of lactoferrin and α-lactalbumin. More specifically, the concentration of lactoferrin in HMPC decreased by 86% after HTST and HoP whereas no effect was observed after HHP treatment. These results show the potential of HHP processing as a pasteurization method for HMPC since it minimizes the impact on protein structure, which generally correlates to protein quality and bioactivity., (Copyright © 2021 Elsevier Ltd. All rights reserved.)
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- 2022
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43. Use quantitative parameters in spectral computed tomography for the differential diagnosis of metastatic mediastinal lymph nodes in lung cancer patients.
- Author
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Huang S, Meng H, Cen R, Ni Z, Li X, Suwal S, and Chen H
- Abstract
Background: Accurate diagnosis of mediastinal lymph node (LN) metastases is very important for the treatment and prognosis in lung cancer patients. Spectral computed tomography (CT), as a non-invasive approach, has good prospects for detecting mediastinal nodal metastasis. However, the diagnostic criteria of differentiating metastatic and nonmetastatic LNs have not been determined., Methods: Clinical and imaging data of 64 lung cancer patients (mean age 61.3±10.3 years, 41 men) from April to December 2019 were retrospectively analyzed. The unenhanced scan and contrast enhanced arterial phase (AP) and venous phase (VP) spectral CT scans were performed. The 70 keV monochromatic image and iodine-based image in all phases were analyzed to measure the parameters of LNs. LNs were divided into the metastatic and non-metastatic groups based on confirmative pathological results, and their differences were statistically analyzed. The receiver operating characteristics curve (ROC) was used to evaluate the efficacy of the differential diagnosis., Results: Seventy-four metastatic LNs and 152 non-metastatic LNs were obtained. Compared with non-metastatic LNs, metastatic LNs often had a larger size (P<0.001). In the unenhanced scans, the density of metastatic LNs was lower than that of non-metastatic LNs (P<0.001); however, there was no difference in CT value in AP and VP between metastatic and non-metastatic LNs (P=0.07, P=0.08, respectively). A statistically significant difference was found in iodine concentration (IC), normalized iodine concentration (NIC) and slope of the spectral curve (λHU) in unenhanced scan, IC and λHU in AP, as well as IC, NIC and λHU in VP between metastatic and non-metastatic LNs. There was no difference in NIC in AP between them., Conclusions: Combined with morphology, spectral CT quantitative parameters demonstrate certain diagnostic efficiency for differential diagnosis between metastatic and non-metastatic LNs in lung cancer patients., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://dx.doi.org/10.21037/jtd-21-385). The work of HC was supported by the Natural Science Foundation of Guangdong Province, China (2019A1515011382) and the Science and Technology Planning Project of Guangzhou, Guangdong Province, China (201904010130). The work of Suidan Huang was supported by 2019 Achievement Transformation and Cultivation Project of the First Affiliated Hospital of Guangzhou Medical University (ZH201906). The other authors have no conflicts of interest to declare., (2021 Journal of Thoracic Disease. All rights reserved.)
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- 2021
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44. A Human Milk-Based Protein Concentrate Developed for Preterm Infants Retains Bioactive Proteins and Supports Growth of Weanling Rats.
- Author
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Shama S, Unger S, Pouliot Y, Doyen A, Suwal S, Pencharz P, Pitino MA, Sergius M, Aufreiter S, Stone D, and O'Connor DL
- Subjects
- Amino Acids blood, Animal Nutritional Physiological Phenomena, Animals, Caseins administration & dosage, Cattle, Enteral Nutrition, Humans, Infant Formula microbiology, Infant, Newborn, Infant, Premature, Infant, Very Low Birth Weight, Male, Milk, Human microbiology, Models, Animal, Organ Size, Rats, Rats, Sprague-Dawley, Weight Gain, Infant Formula chemistry, Milk Proteins administration & dosage, Milk Proteins chemistry, Milk, Human chemistry
- Abstract
Background: Bovine milk-based protein modulars are currently available to nutrient-enrich enteral feedings; however, they have limitations for use in very-low-birth-weight infants., Objectives: Our objectives were to develop a human milk-based protein (HMP) concentrate and to conduct a preclinical assessment of the HMP concentrate in weanling rats., Methods: An HMP concentrate was produced from donor milk using pressure-driven membrane filtration processes and high hydrostatic pressure processing. Protein and lactoferrin concentrations and lysozyme activity were determined by Kjeldahl, HPLC, and turbidimetric assay, respectively. Male Sprague Dawley rats 24 d old (n = 30) were randomly assigned to 1 of 3 isocaloric AIN-93G diets for 4 wk containing 100% casein (control) or with 50% of the casein replaced with the HMP concentrate (treatment) or a bovine whey protein isolate (treatment). Body weight, food intake, fat mass, plasma amino acid profiles, and organ weights were measured. Data were analyzed using linear regression models., Results: Raw donor milk contained (mean ± SD) 101 ± 6 g protein/kg and 5 ± 1 g lactoferrin/kg of milk solids. Postprocessing, protein and lactoferrin concentrations were 589 ± 3 g/kg and 29 ± 10 g/kg, respectively. Lysozyme activity was initially 209 ± 4 U/kg and increased to 959 ± 39 U/kg in the HMP concentrate. There were no statistically significant differences in body weight, food intake, fat mass, or plasma amino acid profiles between rats fed diets containing the HMP concentrate and the control diet. Full cecum weights were higher in rats fed the HMP concentrate than in those fed control diets (mean difference: 5.59 g; 95% CI: 4.50, 6.68 g; P < 0.0001), likely reflecting the concentration of human milk oligosaccharides. No differences were found for other organ weights., Conclusions: The HMP concentrate retained important bioactive proteins and supported normal rat growth in the preclinical assessment., (© The Author(s) 2021. Published by Oxford University Press on behalf of the American Society for Nutrition.)
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- 2021
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45. The ultrafiltration molecular weight cut-off has a limited effect on the concentration and protein profile during preparation of human milk protein concentrates.
- Author
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Sergius-Ronot M, Suwal S, Shama S, Chamberland J, Unger S, O'Connor DL, Pouliot Y, and Doyen A
- Subjects
- Animals, Cattle, Humans, Milk, Human, Molecular Weight, Muramidase, Milk Proteins, Ultrafiltration veterinary
- Abstract
Optimizing protein intake for very low birth weight (<1,500 g) infants is fundamental to prevent faltering postnatal growth with the potential association of impaired neurodevelopment. The protein content of human milk is not sufficient to support the growth of very low birth weight infants. To meet their elevated protein requirements, human milk is currently fortified using typically bovine milk-based protein isolates (>85% on a dry basis). However, these products have several limitations for use in this vulnerable population. To overcome the shortcomings of bovine milk-based protein supplement, a human milk protein concentrate (HMPC) was developed. In preliminary attempts using 10 kDa ultrafiltration (UF) membranes, it was not possible to reach the protein content of commercial protein isolates, presumably due to the retention of human milk oligosaccharides (HMO). Consequently, it was hypothesized that the use of a UF membrane with a higher molecular weight cut-off (50 kDa rather than 10 kDa) could improve the transmission of carbohydrates, including HMO, in the permeate, thus increasing the protein purity of the subsequent HMPC. The results showed that permeate fluxes during the concentration step were similar to either UF molecular weight cut-off, but the 50-kDa membrane had a higher permeate flux during the diafiltration sequence. However, it was not sufficient to increase the protein purity of the human milk retentate, as both membranes generated HMPC with similar protein contents of 48.8% (10 kDa) and 50% (50 kDa) on a dry basis. This result was related to the high retention of HMO, mainly during the concentration step, although the diafiltration step was efficient to decrease their content in the HMPC. As the major bioactive proteins (lactoferrin, lysozyme, bile salt stimulated lipase, and α1-antitrypsin) in human milk were detected in both HMPC, the 50-kDa membrane seems the most appropriate to the preparation of HMPC in terms of permeation flux values. However, improving the separation of HMO from proteins is essential to increase the protein purity of HMPC., (Copyright © 2021 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.)
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- 2021
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46. Occurrence of Peptide-Peptide Interactions during the Purification of Self-Assembling Peptide f1-8 from a β-Lactoglobulin Tryptic Hydrolysate.
- Author
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Pimont-Farge M, Bérubé A, Perreault V, Brisson G, Suwal S, Pouliot Y, and Doyen A
- Subjects
- Hydrogen-Ion Concentration, Hydrolysis, Hydrophobic and Hydrophilic Interactions, Protein Multimerization, Hydrogels chemistry, Lactoglobulins chemistry, Lactoglobulins metabolism, Peptide Fragments isolation & purification, Peptide Fragments metabolism
- Abstract
Self-assembling peptides have gained attention because of their nanotechnological applications. Previous work demonstrated that the self-assembling peptide f1-8 (Pf1-8) that is generated from the tryptic hydrolysis of β-lactoglobulin can form a hydrogel after several purification steps, including membrane filtration and consecutive washes. This study evaluates the impact of each processing step on peptide profile, purity, and gelation capacity of each fraction to understand the purification process of Pf1-8 and the peptide-peptide interactions involved. We showed that peptide-peptide interactions mainly occurred through electrostatic and hydrophobic interactions, influencing the fraction compositions. Indeed, the purity of Pf1-8 did not correlate with the number of wash steps. In addition to Pf1-8, two other hydrophobic peptides were identified, peptide f15-20, and peptide f41-60. The gelation observed could be induced either through peptide-peptide interactions or through self-assembling, both being driven by non-covalent bond and more specifically hydrophobic interactions.
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- 2021
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47. Ultrasonographic Measurement of Mean Cross-sectional Area of the Median Nerve in Pregnant Women in a Tertiary Level Hospital of Nepal: A Descriptive Cross-sectional Study.
- Author
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Adhikari G, Kayastha P, Suwal S, Paudel S, Chataut D, Maharjan S, and Gurung G
- Subjects
- Cross-Sectional Studies, Female, Humans, Nepal, Pregnancy, Tertiary Care Centers, United States, Median Nerve diagnostic imaging, Pregnant Women
- Abstract
Introduction: Pregnancy is one of the predisposing factors for carpal tunnel syndrome, which may manifest as swelling of the median nerve. The purpose of this study was to obtain the mean cross-sectional area of median nerve using ultrasound in pregnant females at carpal tunnel inlet and its variations with different trimesters., Methods: A total of 102 pregnant females at first, second and third trimesters were evaluated for median nerve with ultrasonography. Mean cross sectional area of median nerve was calculated in both hands by using two methods- direct and indirect. The study was conducted after obtaining ethical clearance from Institutional Review Board of Institute of Medicine, and after obtaining the written informed consent from the subjects. Convenience sampling technique was used. Data obtained were compiled and analyzed using Statistical Package for the Social Sciences version 20., Results: The overall mean cross-sectional area was 6.84±1.09 mm2 using direct method and 7.09±1.19 mm2 using indirect method. The values obtained with indirect method were greater than that obtained with direct method. Mean cross-sectional area of the median nerve were higher at third trimester in both hands and by both direct and indirect methods., Conclusions: From the study conducted, the normal value of mean cross-sectional area of median nerve in pregnant females was established.
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- 2021
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48. Estimation of Hepatic Elasticity by Shear Wave Sonoelastography among Asymptomatic Individuals in a Tertiary Level Hospital.
- Author
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Maharjan S, Lohani B, Kayastha P, Suwal S, and Paudel S
- Subjects
- Humans, Nepal, Prospective Studies, Reproducibility of Results, Elasticity Imaging Techniques, Liver diagnostic imaging
- Abstract
Background: Shear wave elastography is currently most widely used method for determining the elasticity of liver. Liver fibrosis, final common pathway of chronic liver disease, is associated with increased liver stiffness. This study aimed to obtain normal liver elasticity in Nepalese population, as it can be used as reference in future for determination of elasticity in abnormal liver., Methods: Quantitative prospective study was done in 132 individuals with normal liver function tests. Shear wave elastography was done to measure elasticity of both lobes of liver and thus obtained values were also correlated with age, gender and fatty changes in liver., Results: Forty seven out of 132 individuals had fatty liver. Mean elasticity of liver was 4.40±0.60 kPa with range of 3.12-6.62 kPa. There was no significant difference between mean elasticity of right and left lobe of liver. No significant correlation was found between mean liver elasticity with age and gender. There was statistically significant difference in the mean elasticity between non-fatty and fatty liver (p=0.041)., Conclusions: The study established normal elasticity of liver in Nepalese population and this reference can be used to obtain abnormal liver elasticities.
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- 2021
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49. Anatomical Variations in Circle of Willis in Patients Undergoing CT Cerebral Angiography in a Tertiary Hospital in Nepal: A Descriptive Cross-sectional Study.
- Author
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Dhakal P, Kayastha P, Paudel S, Suwal S, Sharma MR, and Ghimire RK
- Subjects
- Cerebral Angiography, Cross-Sectional Studies, Humans, Nepal, Tertiary Care Centers, Tomography, X-Ray Computed, Circle of Willis diagnostic imaging, Computed Tomography Angiography
- Abstract
Introduction: Variation in Circle of Willis is a commonly encountered entity in patients undergoing computed tomography angiography, identification of which is crucial in the management of patients with vascular pathologies. The aim of the study was to find out the anatomical variations in the 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 the presence of variations in Circle of Willis, aneurysms, and other vascular pathologies. Data were analyzed using SPSS., Results: Among 95 subjects included in the study, the anatomical variations in the arteries of Circle of Willis was seen in 52 (54.7%) patients, hypoplastic posterior communicating artery being the most common variation 33 (34.7%). The aneurysm was seen in 22 (23.2%) of cases., Conclusions: CT Angiography is a commonly performed imaging modality for suspected cases of cerebral aneurysms and various other vascular pathologies. Multidetector computed tomography can effectively detect variations in arteries of Circle of Willis, recognition of which is crucial in operative management of vascular pathologies.
- Published
- 2020
- Full Text
- View/download PDF
50. Normal Anatomy and Variants of Renal Vasculature with Multidetector Computed Tomography in a Tertiary Care Hospital: A Descriptive Cross-sectional Study.
- Author
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Regmi PR, Amatya I, Kayastha P, Paudel S, Suwal S, and Ghimire RK
- Subjects
- Cross-Sectional Studies, Humans, Renal Veins diagnostic imaging, Tertiary Care Centers, Kidney diagnostic imaging, Multidetector Computed Tomography
- Abstract
Introduction: Preoperative multisection computed tomography evaluation can provide necessary anatomic information in minimally invasive surgeries. This study was done to estimate the preva-lence and pattern of variations of renal vasculature through contrast-enhanced computed tomogra-phy in patients referred to the radiology department of a tertiary care hospital., Methods: A descriptive cross-sectional study was conducted from 6th April 2016 to 6th April 2017. Ethical approval was taken. The triple-phase contrast-enhanced computed tomography was per-formed on 188 patients enrolled through convenient sampling. The images were evaluated in un-enhanced, arterial, and venous phases for the vascular variants. Data were analyzed based on the anatomical types of variations and descriptive statistics such as frequency and percentage using the Statistical Package for the Social Sciences., Results: Out of the 188 patients, 60 (31.9%) had accessory renal arteries. The most common variant was hilar arteries which comprised 38 cases (20.2%) whereas polar arteries were present in 21 (11.1%)cases and the capsular artery was present in one (0.5%) case. Early bifurcation of the renal artery was noted in 15 (8%) cases with 10 (5.3%) on the right and 5 (2.7%) on the left side. Twelve (6.3%) cases of the double right renal vein were noted whereas retroaortic left renal vein was noted in only 4(2.1%) cases., Conclusions: Based on our study, almost one in three patients had accessory renal arteries and eighty-five out of a thousand patients had variants of renal veins.
- Published
- 2020
- Full Text
- View/download PDF
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