NepMed Repository :: Browsing by Author "Kayastha, Prakash"

Browsing by Author "Kayastha, Prakash"

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Abnormal Anatomic Variation of Pancreaticobiliary Union in Magnetic Resonance Cholangiopancreatography Department of Radiology and Imaging in a Tertiary Care Centre: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2023) Paudel, Sharma; Chaudhary, Bidyanand; Regmi, Pradeep Raj; Kayastha, Prakash; Maharjan, Santosh; Adhikari, Govinda
Abstract Introduction: The knowledge of the variations of the abnormal anatomy of pancreaticobiliary union is of great importance for understanding various pathologies of the biliary tract, gall bladder, and pancreas as well as to avoid surgical complications and morbidity which may arise from pancreaticobiliary maljunction. Moreover, it helps in the early diagnosis and preventive treatment of pancreaticobiliary disease. The objective of this study was to find out the prevalence of abnormal anatomic variations of the pancreaticobiliary union in magnetic resonance cholangiopancreatography examinations. Methods: This descriptive cross-sectional study was done in patients referred for Magnetic resonance cholangiopancreatography examinations for various clinical indications from 1 February 2021 to 30 May 2021. Ethical approval was obtained from the Institutional Review Committee [Reference number: 306 (6-11)E 2 077/078]. The variations in the pancreaticobiliary union, length of the common channel, and angle between the common bile duct and major pancreatic duct were obtained from the 1.5T magnetic resonance scanner in 90 patients. The three‑dimensional magnetic resonance cholangiopancreaticography images were visually analyzed and classified into four categories. Convenience sampling method was used. Point estimate and 90% Confidence Interval were calculated. Results: Out of 90 patients, 73 (81.11%) (74.34-87.88, 90% Confidence Interval) patients had abnormal pancreaticobiliary union with pancreaticobiliary type as the most common occurrence seen in 33 (36.67%) patients. Conclusions: The prevalence of abnormal anatomic variation of pancreaticobiliary union was found to be higher than other studies done in similar settings.
Compliance with Social Distancing, Facial Mask, Sanitizer/Hand Washing against COVID-19
(Institute of Medicine, Tribhuvan University, 2024) Kayastha, Jyoti; Kayastha, Prakash; Nepali, Rabin; Kayastha, Usha
Abstract: Introduction: At the end of 2019, a novel coronavirus spread rapidly, resulting in a global pandemic. Many countries have employed various nonpharmaceutical interventions, including social distancing, mask use, and sanitizer/hand hygiene measures (SMS). Previous studies have reported that compliance with these preventive measures varied widely. So, this study was conducted to assess the compliance with social distancing, mask use, and sanitizer/soap use measures in Biratnagar. Methods : This was a descriptive cross-sectional study conducted from September to November 2021 among 310 individuals at a hospital, supermarket, and vegetable market in Biratnagar. Using convenience sampling, mask use, social distancing, and hand hygiene was observed. Individuals not following SMS measures were asked about their reasons for non-compliance. Results : Among 310 individuals, 84.19% used masks, but only 86.97% of them wore them correctly. Surgical masks were used by 93.1%, while 6.9% used cloth masks. Social distancing was followed by 20.96%, and 31.29% used hand sanitizer. Common reasons for noncompliance included discomfort with masks, cost of sanitizer, lack of handwashing facilities, absence of social distancing markings, and poor adherence by others. Conclusion : Compliance of face mask was relatively high, while compliance with social distancing and sanitizer use was low highlighting the need for improved public awareness, better infrastructure, and stricter enforcement. In low-resource settings like Nepal, the continued promotion of SMS measures is essential for managing current health threats and preventing future outbreaks of respiratory illnesses.
Computed Tomography Chest Findings in COVID-19 Patients
(Nepal Health Research Council, 2022) Tamang, Ongden Yonjen; Paudel, Sharma; Kayastha, Prakash; Maharjan, Santosh; Adhikari, Govinda; Upadhyaya, Rudra Prasad; Dawadi, Kapil; Pradhan, Prajina; Rehman, Tanveer; Malla, Saurav Krishna
Abstract Background:COVID-19 which has caused significant morbidity and mortality around the world has been declared by the World Health Organization to be a global health emergency. Our objective was to find out the lung parenchymal patterns commonly evident in high resolution Computed Tomography in patients with COVID-19 pneumonia. Methods: A retrospective cross-sectional study was conducted at a tertiary multi-specialty hospital in Kathmandu, Nepal. With ethical clearance from the institutional review board, a total of 235 patients with positive reverse transcriptase polymerase chain reaction for COVID-19 and having respiratory symptoms were included in the study. High Resolution Computed Tomography images of chest were retrieved from picture archiving and communication systems retrospectively and studied for the findings commonly attributed to COVID-19 pneumonia. The data was then analyzed using Stata version 14 (Stata Corp, College Station, TX, USA). Descriptive statistics were presented as mean and median while chi-square test was used to assess the association between socio-demographic characteristics and CT severity indices. Results: Out of 235 patients, 174 (74.0%) were males and 61(26%) were females with a mean age of 54.8±14.5 years. The most commonly encountered pattern of pulmonary changes was bilateral involvement in 222 (94.5%) patients followed by ground-glass opacities in 218 (92.8%) patients and peripheral predominance of ground-glass opacities in 211 (89.8%) patients. Conclusions: Chest Computed Tomography abnormalities are common in COVID-19 positive patients with respiratory symptoms. These findings can guide in the assessment of the severity of the disease as well as patient management. Keywords: Computed Tomography; COVID-19; ground-glass opacities; reverse transcriptase polymerase chain reaction
Epidemiological and Clinical Pattern of Pediatric Supracondylar Fracture of Humerus in A Provincial Hospital: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2021) Joshi, Pramod; Dawadi, Pravakar; Rana, Krishna; Bista, Navindra Raj; Bisht, Rishi; Kayastha, Prakash
Abstract: Introduction: Supracondylar fractures of humerus are the most common elbow fractures in children consisting of about 15% of all pediatric fractures and more than half of all elbow fractures. A high incidence of nerve injures, and vascular injuries make this fracture a serious injury. Our study aims to study on the clinical and demographic pattern of pediatric supracondylar fracture cases presenting in the hospital retrospectively. Methods: We conducted a descriptive cross-sectional study in Seti Provincial Hospital in the month of December. The data from the medical record section was retrospectively collected. A whole sampling technique was used. The descriptive statistical analysis was done. Results: Seven hundred cases were studied, among which the most common age group was found to be 5-10 410 (58.57%). Most of the cases presented in the emergency department 513 (73.28%), and the most common time of presentation was from 3 AM to 6 AM 170 (24.28%). Conclusions: Supracondylar fracture cases presented as a common injury among pediatric population. It was presented as an emergency more than general cases.
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, Santosh
Abstract: 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.
Measurement of Optic Nerve and Optic Nerve Sheath Diameter in MRI Brain
(Institute of Medicine, 2023) Paudel Sharma; Joshi, Sweta; Pandey, Durga; Kayastha, Prakash
ABSTRACT Introduction: Many diseases affect the size of the optic nerve and optic nerve sheath, measurement of which is important for the diagnosis and treatment of different pathologies of the brain and orbit. This study aimed to measure the diameter of the optic nerve and optic nerve sheath in MRI brain examinations. We also studied their variation according to age, gender, and laterality. Methods: This cross-sectional, quantitative study was performed in the Radiology Department of Tribhuvan University Teaching Hospital (TUTH). The diameter of the optic nerve and optic nerve sheath were measured in the T2 weighted Dixon Turbo Spin Echo axial images. The diameter was measured at the level of 3mm and 8mm behind the eye globe. The study was completed over a period of 3 months (August 2023 to October 2023). Results: The mean diameters of the optic nerve were 2.187±0.35 mm/2.14 ± 0.35 mm at 3 mm behind the eye globe and 2.056 ± 0.334 mm/2.11 ± 0.35 mm at 8 mm behind the globe for the right/left sides respectively. The optic nerve sheath of the right/left sides measured 4.50 ± 0.60 mm/4.46 ± 0.56 mm at 3 mm behind the eye globe and 4.16 ± 0.50 mm/ 4.14 ± 0.47 mm at 8mm behind the eyeball. Conclusion: The measurements for the diameter of the optic nerve and optic nerve sheath complex were similar in both the right and left eyes. There was no significant difference in optic nerve and optic nerve sheath diameters with the age and gender of the participants. Keywords: MRI, optic nerve, optic nerve sheath
Modern Paediatric Radiology: Meeting the Challenges in CT and MRI
(Nepal Medical Association, 2022) Regmi, Pradeep Raj; Amatya, Isha; Paudel, Sharma; Kayastha, Prakash
Abstract Radiology plays a very important part in the diagnosis, treatment, and follow-up of children. Computed tomography and magnetic resonance imaging are the two most crucial developments in the modern era. However, the two modalities have their challenges to overcome. Radiation dose is the most unwanted side effect of computed tomography scans while longer scan time along with sedation is a major disadvantage in children during magnetic resonance imaging. Paediatric-specific protocol selection and limiting the exposure to the area of interest aid in reducing the dose during computed tomography scans. Faster scan protocols and sequences can result in imaging without sedation in magnetic resonance imaging. Considering the radiation exposure, "as low as reasonably achievable" principle should be followed strictly in the paediatric population. In this article, possible ways for minimising the radiation dose in computed tomography, as well as effective, short, and sedation-free magnetic resonance imaging, are discussed.
Naso-Orbito-Ethmoid Fibrous Dysplasia, a Rare Case in a Rare Location for Radiologists: A Case Report
(Institute of Medicine, 2022) Regmi, Pradeep R; Kayastha, Prakash; Amatya, Isha
ABSTRACT Fibrous dysplasia is a non-inherited but congenital disorder which is characterised by the replacement of normal bone by an excessively proliferative cellular fibrous connective tissue intermixed with irregular bony trabeculae. Fibrous dysplasia may be localised to the single bone (monostotic form) or multiple bones (polyostotic form). About 25-30% of the facial dysplasia is associated with cranial or facial involvement. Imaging plays an important role in diagnosis and follow-up in the cases of cranio-facial fibrous dysplasia because of the anatomical complexity of the region. We have described herein a rare case of fibrous dyplasia involving naso-orbito-ethmoid region in radiological perspective. Keywords: Computed tomography, fibrous dysplasia, naso-orbito-ethmoid
Papillary Carcinoma of Thyroid in a Child, Rare but Aggressive: A Case Report
(Institute of Medicine, 2021) Regmi, Pradeep R; Amatya, Isha; Paudel, Sharma; Kayastha, Prakash
ABSTRACT Thyroid nodules are uncommon in childhood than adult population. Thyroid malignancies are more common in the detected nodules comprising 22-26% in paediatric age groups in comparison to 5-15% of the adult population. In addition, thyroid malignancies are more aggressive in children than in adults with nodal and pulmonary metastasis. Despite having more recurrent rate than in the adults, survival seems to be better. We are presenting a case of an 11-year-old child presented to our clinic with swelling of neck for 3 months duration. Diagnosis was made through ultrasound, computed tomography and histopathological analysis. Therefore, diagnosing a case with papillary carcinoma of thyroid in children is very challenging and demanding the expertise. Paediatric radiologist could play a vital role in diagnosis which leads to proper management. Keywords: Children, computed tomography, papillary carcinoma, ultrasound
Pediatric Radiology in Era of COVID-19, International Consensus and What Lies Beyond Pneumonia: A Review
(Nepal Medical Association, 2021) Regmi, Pradeep Raj; Amatya, Isha; Paudel, Sharma; Kayastha, Prakash
Abstract: Diagnostic radiology plays a crucial role in children. The pediatric population has been less studied than the adult population since the initial period of the COVID-19 pandemic to date. Realizing the potential utility of structured reporting, different guidelines and international consensus statements regarding COVID-19 in the pediatric population have been released in recent times. Different clinical and radiological manifestations in children have been evolving in this period of uncertainty and are different from the adult population in certain aspects. Apart from the involvement of lungs, a multisystemic inflammatory syndrome in children or pediatric multi systemic inflammatory syndrome is unique in children. Therefore, awareness of the recent consensus, structural uniform reporting and multi-organ involving patterns in COVID-19 can guide radiologists for a better understanding of this complex novel disease leading to early diagnosis and timely treatment of affected children.
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, Ghanshyam
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 6.84Â±1.09 mm2 using direct method and 7.09Â±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.
Ultrasound Guided Biopsy among Patients with Lung Lesions Undergoing Procedures in Interventional Radiology of a Tertiary Care Centre
(Nepal Medical Association, 2024) Kayastha, Prakash; Adhikari, Binaya; Paudel, Sharma; Suwal, Sundar; Shingh, Shashi Shekhar; Chapagain, Pradip; Regmi, Pradeep Raj
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.
Variation in the Branches of Arch of Aorta in Patients Undergoing Contrast Enhanced Multidetector Computed Tomography in a Tertiary Centre, Nepal
(Nepal Medical Association, 2024) Kayastha, Prakash; Paudel, Sharma; Bista, Nikesh; Adhikari, Binaya; Katwal, Shailendra
Abstract Introduction: Variations in the branching pattern of the Arch of Aorta (AoA) are common in patients undergoing contrast-enhanced Multidetector Computed Tomography, the identification of which is crucial in managing patients undergoing cardiovascular/neck surgeries and interventions. Methods: This prospective cross-sectional study involved 513 patients who were sent to the Department of Radiology for evaluation of various pathologies of chest and neck between August 2018 and July 2019. After approval from the Institutional Review Committee {Reference No: 11(6-11) E2/075/076}, contrast-enhanced computed tomography images were evaluated with variations in branches of the left-sided arch of the aorta and symptoms associated. Results: Variations in branches of the arch of aorta were seen in 69 (13.45%; 95% CI: 10.60%-16.71%) of cases, left common carotid artery and brachiocephalic trunk having common origin or common trunk was 51(9.94%). The mean age was 52.4±20 years (Range 3 months to 92 years) with male to female ratio of 1.3:1. Conclusions: Contrast-enhanced computed tomography is the modality of choice for the detection of the variations in branches of AoA, recognition of which is crucial in vascular intervention and surgical procedures to reduce the postoperative morbidity and mortality of the patients.

Browsing by Author "Kayastha, Prakash"

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