Browsing by Author "Mandal, D"
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Publication Comparative Study of Common Bile Duct Diameter between Normal and Post Cholecystectomy Cases Using Trans-abdominal Ultrasonography(Kathmandu University, 2022) Paudel, RC; Karki, S; Suwal, S; Palikhe, A; Mandal, D; Manandhar, MABSTRACT Background Increase in common bile duct diameter can occur because of different causes. Post cholecystectomy status is one of the potential causes. Many studies done in the past show different results and are hence inconclusive. Objective To see if the post cholecystectomy cases would have a statistically significant change in common bile duct diameter. Method We carried out a study in 100 cases (46 post cholecystectomy cases and 54 cases with intact gall bladder, measuring their common bile duct diameters and performing an unpaired t test to see if the mean in common bile duct among these two groups of cases was statistically significant. Result One hundred cases, 46 post cholecystectomy cases and 54 cases with intact gall bladder were included in our study. An unpaired t-test was used to compare the common bile duct diameters in these two groups. Our findings showed that the difference in common bile duct diameter between the cases with intact gall bladder and those who underwent cholecystectomy was significant for both one tailed and two tailed studies (p < 0.001). Hence, it can be stated that post cholecystectomy status increases the common bile duct diameter. Conclusion An increased Common bile duct diameter in post cholecystectomy case could be because of the post cholecystectomy status itself and not due to some other obstructive cause. So careful decision is necessary before subjecting the patient to further invasive/non-invasive investigations and treatments. KEY WORDS Cholecystectomy, Common bile duct, Diameter, Dilatation, UltrasonographyPublication Computed Tomographic Evaluation of Craniocerebral Trauma in Dhulikhel Hospital(Kathmandu University, 2017) Suwal, S; Karki, S; Mandal, D; Poudel, RCABSTRACT Background Craniocerebral trauma is common health problem in emergency department of any hospital. CT is commonly indicated to to rule out any significant intracranial abnormalities in these patients, so that timely intervention of the significant intracranial pathologies can be done. Objective The study is done to evaluate CT findings of head injury patients in Dhulikhel Hospital. Method This prospective hospital based study was done in Department of Radiology of Dhulikhel Hospital in the period of January 2015 to December 2015. CT findings of the head trauma patients undergoing CT in the Department of Radiology were reviewed and analysed. Result The study was done in 484 patients, 165 female and 319 male patients. Mean age of the patients was 30.87 ± 19.25 years. Among them 205 patients showed abnormal CT findings, scalp injury being the commonest one, followed by skull fracture. 60 patients showed abnormal intracranial findings. There was significant correlation of skull fracture and abnormal intracranial findings in this study. Conclusion This study provided the normal and abnormal CT findings in head of the craniocerebral trauma patients in Dhulikhel Hospital. Abnormal CT findings were predominantly extra-cranial and were overlapping with intracranial abnormal findings. KEY WORDS CT, Craniocerebral trauma, skull fracturePublication Multi-Detector Computed Tomography Evaluation of Normal Appendix(Kathmandu University, 2016) Suwal, S; Karki, S; Mandal, D; Poudel, RCABSTRACT Background Appendix is a blind-ended tubular structure arising from caecum, with variable intraluminal contents and position. Acute appendicitis is one of the common indications for emergency radiological investigation. Objective To assess visualization rate, size and position of normal appendix by Computed Tomography (CT). Method This cross-sectional observational study was done in 198 individuals undergoing abdominal CT without suspicion of acute appendicitis and without any pathology localized within right iliac fossa. Axial and coronal reformatted images of non- enhanced and contrast enhanced CT of abdomen were evaluated for visualization of appendix. Visualized appendices arising from caecum were traced and tip localized. Contents within the appendicular lumen were also evaluated and maximum transverse diameter of appendix measured. The relationship between appendicular diameter, intraluminal content and position with different age groups & gender were also derived. Result Visualization rates of appendix were 90% (93% male and 87% female) in non- enhanced CT and 97% (99.8% male and 95.4% female) in enhanced CT. The mean diameter of the appendix was 6.2 ± 1.16 mm. Most common location of the tip of appendix was pelvic position, followed by retrocaecal position. Most of the appendices showed intraluminal air. Conclusion Multi-Detector Computed Tomography is superior over ultrasonography (USG) in detection of appendix. Modifications of CT protocol reduce limitations of CT over ultrasound in evaluation of appendix. Ultrasound size criteria for appendicitis (>6 mm) is not applicable in CT as normal appendix can measure >6 mm in CT. KEY WORDS Diameter, location, normal appendix, multi-detector computed tomography