Browsing by Author "Gurung, Ghanshyam"
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Publication Mean Carotid Intima-Media Thickness in Patients with Type 2 Diabetes Mellitus Attending Tertiary Care Center: A Descriptive Cross-sectional Study(Nepal Medical Association, 2021) Kayastha, Prakash; Paudel, Sharma; Gurung, Ghanshyam; Kumar, Pradeep; Upadhyaya, Rudra Prasad; Tuladhar, Sasmita; Adhikari, Govinda; Maharjan, SantoshAbstract: Introduction: Sonographic carotid intima media thickness measurement in diabetic patients is an important tool for estimating the risk of cardiovascular and cerebrovascular events. It is a simple, noninvasive and widely available tool which can give idea of further treatment needed. The objective of this study was to determine the mean intima media complex thickness in patients with type II diabetes mellitus attending a tertiary care center. Methods: This was a descriptive cross-sectional study done in 64 patients with the type II diabetes mellitus patients visiting diabetic clinic of Tribhuvan University Teaching Hospital, sent for carotid Doppler examination in the department of radiology and imaging. Ethical approval was taken from the Instituitonal Review Board. Convenient sampling method was used. Carotid intima media thickness was measured on both sides and mean intima media thickness was calculated. Mean intima media thickness for male and female diabetic patients was also calculated separately. Statistical Package for Social Sciences version 25 was used for data analysis. Results: The mean carotid intima media thickness was 0.86±0.13mm with range from 0.7mm to 1.3mm. Mean intima media thickness in male was 0.832±0.094mm and in female it was 0.904±0.144mm. Among 64 patients, 30 (46.8%) were female and 34 (53.3%) were male. Age of the patients ranged from 35 years to 68 years with mean age of 52.4±6.54 years. Conclusions: Carotid intima media thickness in patients with type II diabetes mellitus showed higher values than that of mean value from study done in similar study. Female had higher mean intima media thickness than male.Publication 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(Nepal Medical Association, 2021) Adhikari, Govinda; Kayastha, Prakash; Suwal, Sundar; Paudel, Sharma; Chataut, Dinesh; Maharjan, Santosh; Gurung, GhanshyamAbstract: 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.Publication Variations in Pancreatic Duct Course, Configuration and Pancreaticobiliary Junction on MRCP in 3-T MRI: A Descriptive Cross Sectional Study(Institute of Medicine, 2022) Jha, Anamika; Tuladhar, Sasmita; Jha, Sujit K; Gurung, Ghanshyam; Karki, Dan BABSTRACT Introduction: Anomalies and anatomic variations of the pancreatic duct must be identified because they can predispose to conditions like pancreatitis, choledochal cysts, and cholangiocarcinoma, as well as increase surgical complications. In this study, we describe the course and configuration of pancreatic ducts and pancreaticobiliary confluence in cholangiopancreaticography on 3-Tesla magnetic resonance (3-T MR) scanner. Methods: This cross-sectional descriptive study was done after obtaining ethical clearance, and included 128 magnetic resonance cholangiopancreatography (MRCP). The MRCP image records from December 2015 to 2018 were retrospectively analyzed for pancreatic duct course, configuration, angle of pancreaticobiliary confluence and common channel. Obtained data was entered in previously prepared proforma. Statistical analysis was performed using SPSS v 16. Results: There were 56 (43.8%) males and 72 (56.2 %) females with mean age 48.72±18.05 years, ranging from 3 - 84 years. The most common pancreatic duct course was descending in 45 (36.3%) followed by sigmoid in 42 (33.9%) and vertical in remaining 37 (29.8%) patients. The most common ductal configuration was rudimentary non-dominant duct of Santorini in 88 (71%) patients followed by bifid configuration with dominant duct of Wirsung in 27 patients (21.8%). Pancreatico-biliary junction was more often acute angled than right or obtuse. The common indications for undergoing MRCP were pain abdomen (102, 82.8%), vomiting (53, 43%) and jaundice (36, 28.9%). Conclusion: In symptomatic patients undergoing MRCP, the common anomalies of the pancreatic duct observed were descending course, rudimentary non-dominant duct of Santorini configuration and acute pancreatico-biliary angle. Keywords: Duct of Santorini; duct of Wirsung; magnetic resonance imaging; pancreatic ducts