NepMed Repository :: Browsing by Author "Ansari, MA"

Browsing by Author "Ansari, MA"

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A Retrospective Study of Magnetic Resonance Imaging Findings in Acute Encephalitis Syndrome
(Institute of Medicine, 2015) Songmen, S; Panta, OB; Maharjan, S; Paudel, S; Ansari, MA; Ghimire, RK
Abstract 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, 5(26.31%) had HSV antigen positive serology and in 8(42.10%) no etiology could be found. Posterior fossa and basal ganglia involvement was the most predominant findings in Japanese encephalitis and involvement of medial temporal lobe was seen in all cases of Herpes encephalitis. Fifteen patients had good prognosis: complete recovery or minimal residual deficit, while four patients were either dead or left against medical advice. Conclusion: Medial temporal lobe involvement was seen in all cases of Herpes encephalitis; and thalamus and basal ganglia involvement was predominant pattern in Japanese encephalitis. Posterior fossa involvement was common probably due to a non-conventional etiological agent. Keywords: Acute Encephalitis Syndrome, MRI, Herpes encephalitis
Accuracy of ultrasonography in the diagnosis of acute appendicitis
(Kathmandu University, 2008) Khanal, BR; Ansari, MA; Pradhan, S
Abstract Aims and Objectives: To assess the accuracy of ultrasonography in the diagnosis of acute appendicitis. Methodology: A prospective randomized study was carried in the Dept. of Radiology and Imaging, Tribhuvan University, Teaching Hospital, Maharajgunj, Kathmandu, Nepal. A total of 120 patients, who were clinically diagnosed as acute appendicitis were subjected to ultrasonography of the abdomen. A detailed ultrasonography was performed and the findings were recorded. Twenty one cases had alternate diagnosis. Ninety nine cases ultimately underwent laparotomy and the retrieved appendices were sent for histopathological examination. Intra-operative, histopathological and ultrasonographic diagnoses were then statistically analyzed. Results: Ultrasonographic, intra-operative and histopathological findings were statistically insignificant (P≥0.05). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy percentage of ultrasonography in the diagnosis of acute appendicitis was 85.7%, 100%, 100%, 6.7% and 85.9% respectively. Conclusion: Ultrasonography has a high degree of accuracy in the diagnosis of acute appendicitis. However, the diagnosis should be considered with the diameter of appendix over 6 mm. Therefore acute appendicitis with diameter of appendix having less than 6 mm should be evaluated with other diagnostic parameters. Key words: Acute Appendicitis, Ultrasonography.
Assessment of anatomical variations of nose and paranasal sinuses in multidetector computed tomography
(Institute of Medicine, 2017) Yadav, RR; Ansari, MA; Humagain, M; Mishra, D
Abstract Introduction: Paranasal sinuses are a group of air filled spaces developed as an expansion of the nasal cavities, eroding the adjacent bone structures. Conventional radiology does not permit a detailed study of anatomical variations of nose and paranasal sinuses. Currently, MDCT scanning is the standard imaging modality in the evaluation of the paranasal sinuses and anatomical variations. Methodology: A cross-sectional hospital based study of 128 patients referred for CT scan of PNS was conducted from October 2015 to February 2016. CT scan was done in 128 slice Siemens Somatom Definition AS+ CT scanner machine applying standard protocol set by the department of radiology and imaging, Tribhuvan University Teaching Hospital, Maharajgunj. The images were evaluated for presence of any anatomical variants in paranasal sinuses. Results: The absolute frequency of anatomical variations are Agger Nasi cell (75.8%) and DNS (68%) along with Concha Bullosa (35.9%), Paradoxical middle turbinate (26.6%), Haller’s cell (15.7%) and Onodi cell (18.8%). In this study the most frequent type of olfactory fossa was Keros type 2 (63.3%). The typical orientation of uncinate process was found in both sides 199 (77.73%) whereas medial deviation in left side (20.3%) and right side was (18.8%) along with lateral deviation in left side was (3.9%) and right side was found in (1.6%) only. Conclusion: Anatomical variations of nose and paranasal sinuses are best depicted on MDCT scan of PNS on coronal plane with thin slice (3.0 mm) section along with bone algorithm. Agger nasi cell is the commonest anatomical variation (75.8%) followed by DNS, Concha bullosa, Paradoxical middle turbinate, Onodi cells and Haller’s cells. Keywords: Concha bullosa, Multidetector CT, Osteomeatal complex, Paranasal Sinuses
Correlation between Sonoelastography and Histopathological Findings in Evaluation of Chronic Renal Allograft Disease
(Kathmandu University, 2022) Bhandari, RM; Suwal, S; Chataut, D; Ansari, MA
ABSTRACT Background Non-invasive evaluation tool for allograft kidney is important to predict chronic allograft dysfunction as it can be alternative to the invasive biopsy which is prone to so many complications. Sonoelastography can assess the stiffness of the allograft renal parenchyma, which is prone to undergo interstitial fibrosis. Objective To correlate sonoelastography with histopathology findings in the renal allografts. Method Sonoelastography was done in 60 renal allograft recipients prior to their biopsy for various indications. Estimated glomerular filtration rate (eGFR) of the patient were also obtained. Histopathology reports were collected to determine Banff score of interstitial fibrosis. Descriptive measurements (Mean ± standard deviation, Frequencies, Proportions) were calculated. Correlations among the variables were measured using Pearson’s correlation, independent sample t-test, and ANOVA. Result The mean strain index (SI) was lower in higher grades of fibrosis. There was significant difference in mean SI (F=18.264; df= 2,57; p < 0.001) among the histological grades of fibrosis. Also a significant difference in SI among mild and moderate (S.E. 0.27, p value < 0.001), mild and severe (S.E. 0.213, p value < 0.001) as well as moderate and severe fibrosis (S.E. 0.244, p value < 0.001) was seen. Significant correlation of eGFR with SI (p < 0.001) was also seen. Conclusion Strain index, measured with sonoelastography, significantly correlated with different grades of tissue fibrosis. Thus it can be used as alternative method for evaluation of renal allograft patients to avoid complications of biopsy. KEY WORDS Allograft biopsy, Complications, Interstitial fibrosis, Renal allograft, Strain index
Evaluation of image quality in CT chest by 50% mAs reduction
(Institute of Medicine, 2015) Thapa, N; Humagain, MP; Mishra, D; Shrestha, SI; Ansari, MA
Abstract Introduction: Conventional chest CT is usually performed in the setting between 220-280 mAs. Increase use of CT in recent times has the potential to increase radiation burden to the general population. The purpose of this study was to evaluate the image quality in CT Chest with 50% mAs reduction. Methods: This prospective study was done in 101 patients with age above 18 years and BMI less than 25kg/m2 who were referred for CECT chest examination. A 16 slice multi detector CT scanner was used to acquire non contrast at 120 kVp and 140 mAs, a modified protocol with 50% reduction in mAsand contrast enhanced scan at standard protocol of 120 kVp and 280 mAs. The images of plain and contrast enhanced scans were evaluated by two expert radiologists and given the image quality score in 5 point scale (1-worst, 2-suboptimal, 3- adequate, 4-good, 5-excellent) to each. Im- age noise was measured in images of each patient. Patient weight, height and BMI were recorded and correlated with image quality score. Statistical analysis was done with relevant test. Results: The overall image quality with standard protocol was significantly better (p<0.05) than modified protocol. The modified protocol had acceptable image quality score for patients with weight< 60 kg, BMI<25kg/m2. The CTDIvol was 11.15 with reduced mAs and 22.15 with standard mAs resulting in significant reduction in radiation dose of about 49%. Conclusion: Image quality of modified protocol with 50% mAs reduction i.e.140 mAs is accept- for average built patients and not patients with large anthropometric parameters. Keywords: Computed Tomography, mAs reduction, Image quality, Noise, Radiation dose
Giant cell tumor of patella
(Institute of Medicine, 2012) Paudel, S; Kayastha, P; Pokharel, P; Shah, A; Ghimire, RK; Ansari, MA
Abstract Giant cell tumor of bone also known as osteoclastoma is a distinct clinical, roentgenographic and pathologic entity with specific characteristics. It is a benign but locally aggressive neoplasm of the epiphyseal or metaphyseal-epiphyseal region of long tubular bones extending to the articular surface. It usually occurs after skeletal maturation and is one of the rare bone tumors that more frequently affects women. We report here a case of giant cell tumor originating from the right patella diagnosed on fine needle aspiration cytology.
MRI Pattern of Lumbosacral Degeneration in Tribhuvan University Teaching Hospital, Nepal
(Institute of Medicine, 2015) Ansari, MA; Subedi, K; Panta, OB; Suwal, S
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. Keywords: disc degeneration, lumbosacral spine, MRI
Pulmonary Arteriovenous Malformation: A Rare Cause of Right to Left Shunt
(Institute of Medicine, 2015) Panta, OB; Songmen, S; Ansari, MA; Ghimire, RK
Abstract Pulmonary arteriovenous malformations are rare anomalies where pulmonary arteries and veins communicate by passing the pulmonary capillary bed. They are mostly congenital in origin, however sometimes may be acquired. They may present as a diagnostic dilemma in plain radiography. Computed tomography angiogram has emerged as the diagnostic modality of choice not only for diagnosing the case but also for delineating the angioarchitecture that is useful in treatment planning by surgery or transcatheter embolisation. Here we present a case of a child with large pulmonary arteriovenous malformation being treated as pneumonia and finally diagnosed on computed tomography angiogram. Keywords: Computed tomography, Pulmonary arteriovenous malformation, Right to left shunt
Sonographic Quantification of Ovarian Volume in Adults Attending General Health Checkup and General Out Patient Department in Tribhuvan University Teaching Hospital
(Kathmandu University, 2020) Upadhyaya, RP; Ansari, MA; Jha, A; Kayastha, P; Paudel, S
ABSTRACT Background Ultrasonography is the easily available, cheap and reliable method for evaluation of ovaries. Ovarian volume is the major factor in the diagnosis of various ovarian pathologies and confusing discrepancies are found in the literature. Objective To determine the ovarian volume among individuals attending outpatient department in tertiary level hospital. Method Descriptive cross sectional study design was used; 305 patients of 16-60 years attending general outpatient department in the Tribhuvan University Teaching Hospital, Kathmandu, Nepal were included. Ovarian volume was calculated by using transabdominal ultrasonography. Data was collected in the predesigned proforma and analyzed using statistical package for the social sciences software. Result The study showed mean total ovarian volume 5.95 ± 2.44 cc (centimeter cube) with mean right ovarian volume 5.94 ± 2.70 cc and mean left ovarian volume 6.05 ± 2.79 cc. Significant decrease in ovarian volume with age was observed. Height and weight did not show significant correlation with ovarian volumes and no significant variation seen in the volumes of right and left ovaries. Periovulatory ovaries show significantly higher volumes on right side than luteal phase. Similarly, significantly higher volume of left ovary seen in mixed ethnic group than mongoloid group. Conclusion Measurement of ovarian volume is important for evaluation and management of ovarian disorders. Ultrasonography which is readily available, simple and cost effective is better suited for our environment than other imaging modality. Values of ovarian volume from this study may provide a baseline of normal ovarian volume in our community. KEY WORDS Ovary, Ultrasonography, Volume
Ultrasound elastography of liver: How Radiologist can help
(Institute of Medicine, 2017) Maharjan, S; Panta, OB; Lohani, B; Pathak, YR; Ansari, MA
Abstract Conventional Ultrasonography imaging does not provide information on mechanical properties of body tissues. Advances in ultrasound like contrast enhanced ultrasound, multiplaner 3D ultrasound and elastography have improved the performance of ultrasound in detection and characterization of pathologies and also has added a new dimension to conventional imaging technique. At this time, the use of elastography is not recommended for characterization of focal liver lesions, however in diffuse liver diseases Ultrasound elastography finds a role in identifying, classifying and grading fibrosis. Liver biopsy has been regarded as the gold standard to detect and classify liver fibrosis. However, due to high cost, inherent complications, invasive nature and its observer and sampling inadequacy, alternative methods to biopsy like Ultrasound elastography might have a role to play in detecting and grading liver fibrosis. This review focuses on the type of elastography and its role and applicability in various liver pathologies. Keywords: Elastography, Liver fibrosis, Stiffness, Ultrasonography
Visualization of Normal Appendix in Multidetector Computed Tomography
(Institute of Medicine, 2015) Ansari, MA; Kumar, M; Subedi, K
Abstract Introduction: Acute appendicitis is one of the most common causes of acute abdominal pain. Visualization of normal appendix is important to exclude the possibility of appendicitis. With the widespread use of multidetector computed tomography (MDCT) for evaluation of acute abdomen, the normal appearance and rate of visualization of appendix has to be defined. Methods: This was a prospective cross sectional study involving 250 patients undergoing abdominal CT for various indications in Tribhuvan University Teaching Hospital between October 2012 and September 2013. One hundred twenty seven patients were female and 123 were male. Age ranged from 17 years to 73 years. CT scans of the patients were obtained with a 16 slice CT scanner with IV contrast. In all patients, there was no clinical suspicion of acute appendicitis or history of appendectomy. Appendix was searched in these patients by tracing caecum. Results: Appendix was visualized in 215 patients, 111 females and 104 males. Appendix was not visualized in 35 patients, 16 females and 19 males. In total appendix was visualized in 86% of patients (87.4% females and 84.6% males). Conclusion: MDCT is an accurate imaging modality for detection of appendix, whether normal or pathological. Visualization rate of normal appendix by CT scan is higher ranging up to 96% as shown in various studies. Thin collimation, use of contrast and multiplanar reconstruction may be the reason for increased rate of visualization of normal appendix. Keywords: aapendix, multidetector computed tomography

Browsing by Author "Ansari, MA"

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