Browsing by Author "Ghimire, Ram Kumar"
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Publication Anatomical Variations in Circle of Willis in Patients Undergoing CT Cerebral Angiography in a Tertiary Hospital in Nepal: A Descriptive Cross-sectional Study(Nepal Medical Association, 2020) Dhakal, Prajwal; Kayastha, Prakash; Paudel, Sharma; Suwal, Sundar; Sharma, Mohan Raj; Ghimire, Ram KumarAbstract: 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.Publication Correlation of Imaging Findings with Molecular Subtypes of Breast Cancer(Nepal Health Research Council, 2023) Panta, Om Biju; Dhakal, Vivek; Gurung, Bibek; Ghimire, Ram KumarAbstract Background: Ultrasound and Mammography are first-line imaging in breast cancer. The management of malignant breast lesions depends on molecular biomarkers in the tumor cells. This study aims to correlate different imaging findings in breast carcinoma with immune-histology subtypes. Methods: The study was a retrospective study conducted between 2018 January to 2021 December. Patients with malignant breast lesions who underwent USG-guided biopsy of breast lesions were included in the study. Ultrasound and mammographic findings of these patients were retrieved in PACS and analyzed. Malignant breast lesions were classified according to molecular markers into Luminal A, Luminal B, Her- 2 enriched, and triple-negative breast cancers. The correlation between imaging findings and molecular subtypes of breast cancer was analyzed. Results: A total of 42 patients were included in the study. The mean age of the patients in our study was 52.24+/-13.54 years with median of 51 years (IQ range-19.5 years). The most common IHC subtype was Luminal type B (22, 52.4%), followed by triple negative (15, 35.7%), luminal type A (4, 9.5%) and least common was Her-2 enriched (1, 2.4%). Mammogram was non-diagnostic in 9.5% of case. Oval shape and well marginated margin in ultrasound were more frequently associated with triple negative breast cancer than other subtypes (P<0.05). Rest of the characteristics of triple negative and other malignancies were not significantly difference in our study. No significant difference is noted between mammographic findings between various subtypes. Conclusions: Triple negative breast cancer was more common in our population than in the west. Triple-negative breast cancers are more frequently well-defined and oval in shape mimicking benign lesions. Keywords: Breast cancer; mammography; molecular subtypes; ultrasoundPublication Mean Intracranial Volume of Brain among Patients with Normal Magnetic Resonance Imaging Referred to the Department of Radiology and Imaging of a Tertiary Care Centre(Nepal Medical Association, 2023) Panta, Om Biju; Gurung, Bibek; Giri, Shahjan Raj; Adhikari,Abhishek; Ghimire, Ram KumarAbstract Introduction: The measurement of brain volume is an important aspect of the assessment of brain structure and function. However, limited data is available on brain volumetry in the Nepalese population. The study aimed to find the mean intracranial volume of the brain among patients with normal magnetic resonance imaging referred to the Department of Radiology and Imaging of a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among patients with normal magnetic resonance imaging referred to the Department of Radiology and Imaging in a tertiary care centre. All magnetic resonance imaging of the brain during the study period was reviewed by a radiologist. Magnetic resonance imaging with abnormal findings, clinical signs of neurological deficit, dementia and psychiatric symptoms were excluded from the study. A convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Among 285 Magnetic Resonance Imaging datasets, the mean intracranial volume was 1286.30±129.88 cc (1271.22-1301.38, 95% of Confidence Interval). The mean cerebral volume was 985.06±106.4 cc, cerebellar volume was 126.99±13.05 cc and brain stem volume was 19.97±2.54 cc. Conclusions: The mean intracranial volume of the brain among patients with normal magnetic resonance imaging was found to be lower than other studies done in similar settings.Publication Normal Anatomy and Variants of Renal Vasculature with Multidetector Computed Tomography in a Tertiary Care Hospital: A Descriptive Cross-sectional Study(Nepal Medical Association, 2020) Regmi, Pradeep Raj; Amatya, Isha; Kayastha, Prakash; Paudel, Sharma; Suwal, Sundar; Ghimire, Ram KumarAbstract: Introduction: Variation in renal vasculature is quite common and has important implication in surgical planning. Computed tomography has high accuracy in evaluation of renal vasculature. The study was done to estimate the prevalence and pattern of variations of renal vasculature through contrast-enhanced computed tomography in a tertiary care hospital. Methods: A descriptive cross-sectional study was conducted from 6th April 2016 to 6th April 2017. Ethical approval was taken from Institutional Review Board, Institute of Medicine (reference number 325). Contrast-enhanced computed tomography was performed on 188 patients enrolled through convenient sampling and variations of renal vasculature were evaluated. Data were analyzed based on the types of variations and descriptive statistics such as frequency and percentage using Statistical Package for the Social Sciences, version 16. Results: Out of the 188 patients, 60 (31.9%) had accessory renal arteries. The most common variant was hilar artery comprising 38 (20.2%) cases whereas polar artery was present in 21(11.1%) cases and the capsular artery was present in one (0.5%) case. Eleven (5.8%) cases had single and five (2.6%) had multiple accessory polar arteries. Single and unilateral hilar artery was present in 28 (14.8%) whereas multiple accessory hilar arteries were present in two (1.1%) cases. Early bifurcation of the renal artery was noted in 15 (7.9%) cases. Double right renal vein was the most common venous variant seen in 12 (6.3%) cases. Retroaortic left renal vein was noted in four (2.1%) cases. Conclusions: Significant patients undergoing computed tomography examination had renal vascular variations. Therefore, Computed Tomography plays key role as a noninvasive method for anatomic evaluation of renal vascular variants.