Browsing by Author "Kayastha, Prakash"
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Publication 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, GovindaAbstract 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.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 Brain MRI Findings in Severe COVID-19: Case Report of Two Cases(Institute of Medicine, 2021) Regmi, Pradeep R; Amatya, Isha; Kayastha, PrakashABSTRACT Most of the imaging spectrums of COVID-19 are evolving day by day. Every other day, we get to know the imaging peculiarities in this novel disease. Apart from the chest involvement, neurological manifestations are well recognized in COVID-19 infection. The neurological manifestations are infarcts (ischemic or hemorrhagic), acute demyelination, acute necrotizing encephalomyelitis, micro-haemorrhages, acute demyelinating encephalomyelitis, leukoencephalopathy, global hypoxic injury, cranial nerve enhancement, cytotoxic lesions of the corpus callosum, olfactory bulb involvement and Guillain Barre Syndrome. Though the imaging findings in COVID-19 are non-specific and may not be diagnostic, proper correlation with the history and clinical spectrums can suggest the changes related to COVID-19. We have reported two severe COVID-19 cases that illustrate various neuroimaging manifestations. Keywords: COVID-19, imaging, neuroimaging manifestationsPublication 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, UshaAbstract: 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.Publication 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 KrishnaAbstract 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 reactionPublication Correlation of Hypoechoic Lesions in Trans-rectal Ultrasound of Prostate with Histopathology in Prostate Cancer(Institute of Medicine, 2020) Chataut, Dinesh; Basnet, Babin; Lohani, Benu; Suwal, Sundar; Paudel, Sharma; Kayastha, PrakashABSTRACT Introduction: Prostate cancer is one of the most common cancer in elderly male. Suspicion of prostate cancer is based on increased Prostate Specific Antigen (PSA) level and abnormal digital rectal examination (DRE) findings. Transrectal ultrasonography (TRUS) can detect and localize hypoechoic lesions in prostate which are considered as suspicious for malignancy. TRUS can also guide for prostate biopsy, which is the gold standard for diagnosis of prostate cancer. The study was aimed to find out TRUS findings in suspected prostate cancer patients and correlate these findings with histopathological findings. Methods: Prospective study was done in 66 males of age >40 years, sent for prostate biopsy in suspicion for prostate cancer (PSA >4 ng/ml, and/or abnormal DRE findings). Prostate was evaluated with TRUS and subsequently underwent TRUS guided six core biopsy of prostate. Total 396 cores of biopsy were taken. Histopathology reports were collected and correlated with the TRUS findings. Results: Twenty three patients were positive for prostate cancer and 14 of them showed hypoechoic lesions in TRUS. Total 81 suspicious hypoechoic lesions were seen in prostate of all the patients and among them 42 lesions matched with histopathology report for cancer. Cancerous focus detection rate of TRUS was 51.85%. Conclusion: TRUS is a supplementary tool in diagnosis of prostate cancer, however when used alone it has less sensitivity for detection of prostate cancer. Keywords: Biopsy, prostate cancer, transrectal ultrasonographyPublication 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, PrakashAbstract: 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.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 Measurement of Optic Nerve and Optic Nerve Sheath Diameter in MRI Brain(Institute of Medicine, 2023) Paudel Sharma; Joshi, Sweta; Pandey, Durga; Kayastha, PrakashABSTRACT 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 sheathPublication Modern Paediatric Radiology: Meeting the Challenges in CT and MRI(Nepal Medical Association, 2022) Regmi, Pradeep Raj; Amatya, Isha; Paudel, Sharma; Kayastha, PrakashAbstract 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.Publication 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, IshaABSTRACT 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-ethmoidPublication 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.Publication Normative Measurement of Orbital Structures in Computed Tomography(Institute of Medicine, 2020) Rokka, Damodar; Poudel, Sharma; Kayastha, Prakash; Suwal, Sundar; Poudyal, Sudil; Chhetry, Saroj; Lohani, Benu; Shrestha, Shantalall; Karn, RakeshABSTRACT Introduction: Normal orbital dimensions are important for diagnosing orbital pathologies. Computed tomography (CT) of the orbit is an important modality offering high accuracy for precise measurements of orbit. The study was disbursed to ascertain criteria for the normative values of the various orbital dimensions using computed tomography in patients visiting Tribhuvan University Teaching Hospital, Kathmandu. Methods: Orbital volume, ocular diameter, length of the interzygomatic line (IZL), the distance of the posterior extent of the globe from the interzygomatic line, globe position, diameters of extraocular muscles (medial, lateral, superior group, and inferior rectus) and lens density were measured in each eye of 172 patients undergoing CT examination of paranasal sinuses. The correlations with age and sex were also analyzed. Results: Mean values (mean±SD) of orbital volume, ocular diameter, IZL, globe position and lens density were 24.54±2.57 cm3, 2.44±0.22 cm, 94.3±6.2 mm, 12.3±2.4 mm and 141.43±16.62 HU respectively. Mean diameters of extraocular muscles were 3.67± 0.52 mm, 3.36± 0.50 mm, 3.74±0.42 mm and 3.87±0.38 mm for medial rectus, lateral rectus, inferior rectus and the superior group respectively. There was no significant age and gender difference in most of the measurements. There was significant positive correlation of age with lens density, orbital volume and ocular diameter (p<0.05). Conclusion: Normative data of different orbital measurements were obtained. The present result may help radiologists and ophthalmologists to accurately assess various orbital parameters, particularly in Nepalese populations. Keywords: CT, measurements, orbitPublication 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, PrakashABSTRACT 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, ultrasoundPublication 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, PrakashAbstract: 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.Publication Right Sided Aortic Arch with Aberrant Left Subclavian Artery from Kommerell’s Diverticulum, a Cause of Persistent Dysphagia in an Adult: A Case Report(Institute of Medicine, 2021) Regmi, Pradeep R; Amatya, Isha; Kafle, Bipula; Kayastha, Prakash; Paudel, SharmaABSTRACT Congenital variations and anomalies of the aortic arch are important entity in vascular imaging. Most of them are asymptomatic. About 30-40% presents with tracheo-oesophageal symptoms like dyspnea and dysphagia. A 27 year-old female presented with persistent dysphagia for 6 months duration and cause of persistent dysphagia was the right sided aortic arch with aberrant left subcalvian artery from Kommerell’s diverticulum. The diagnosis was made through combination of chest X-Ray, echocardiography, non-ionic contrast swallow and Computed Tomography angiography. Non-invasive modalities (CT and MR Angiography) play an important role in diagnosis and pre-operative surgical planning providing relationship with the surrounding structures especially trachea and esophagus. Keywords: Aortic arch, CT angiography, dysphagia, left subcalvian arteryPublication 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 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 RajAbstract 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.Publication 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, ShailendraAbstract 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.