Browsing by Author "Paudel, Sharma"
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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 Dural Venous Sinus Variations Observed in Magnetic Resonance Venography at a Tertiary Care Hospital: An Observational Study(Nepal Medical Association, 2024) Paudel, Sharma; Sah, Ramswarth; Singh, Rakesh Kumar; Kayastha, Prakash; Katwal, ShailendraAbstract Introduction: The dural venous system, composed of various sinuses, plays a crucial role in draining deoxygenated blood from the central nervous system. Understanding its anatomical variations is essential to differentiate it from pathological conditions like cerebral venous sinus thrombosis. This study aims to evaluate the anatomical variations of the dural venous sinuses using Magnetic Resonance Venography. Methods: An observational, cross-section study was performed in the Department of Radiology from September 2023 to March 2024 after the approval by the Institutional Review Committee (Reference number: 149/080/081(6-11)E2). Magnetic Resonance Venography of 109 adult patients was performed using a 1.5 Tesla MRI scanner. Diameters of the superior sagittal sinus, straight sinus, and transverse sinuses were measured. Variations in transverse sinuses, straight sinus, and confluence were categorized and analyzed. Results: The study included 52 (47.70%) male and 57 (52.30%) female, with median age of 42 (IQR: 30.5 - 56) years. The superior sagittal sinus had the diameter of 6.4±1 mm. Symmetric transverse sinus variant seen was in 80 (73.39%) patients, and left transverse sinus hypoplasia was seen in 20 (18.35%) patients. Variations in the straight sinus and confluence were also documented with a true confluence (type III) was seen in 71 (65.10%) patients. Conclusions: Anatomical variations of the dural venous sinuses as observed in 1.5 Tesla MRI was quite common.Publication Evaluation of Olfactory Fossa Depth Using Computed Tomography(Nepal Health Research Council, 2024) Paudel, Sharma; Sah, Ramswarth; Budhathoki, Tekendra; Pandey, GhanshyamBackground: Olfactory fossa is a depression in anterior cranial cavity whose floor is formed by cribriform plate of ethmoid bone and is susceptible to injury during functional endoscopic sinus surgery (FESS), especially when fossa is deep. Understanding of patient’s ethmoid roof anatomy and its possible variations is crucial for countering possible complications during functional endoscopic sinus surgery. So, objective of this study was to evaluate olfactory fossa depth. Methods: In this descriptive cross sectional study, olfactory fossa depth was measured on Computed Tomographic images of 280 patients in the Department of Radiology, Tribhuvan University Teaching Hospital. The data were grouped according to Keros classification and their distributions were analyzed according to side and gender. Association between olfactory fossa depth with different parameters were evaluated with descriptive statistics, independent t-test, ANOVA and Chi-square test. Results: Among 280 participants, 144 were male and 136 female. The mean depth of right and left olfactory fossa was found 5.10 ± 1.58 mm and 5.28 ± 1.62 mm respectively. Keros type II was the most common, found in 209 cases (74.60%) on left side and 194 (69.30%) on right side while type III was the least common. The difference between left and right olfactory fossa depth was significant though it was insignificant between male and female. No significant association was found between Keros type with sides and with gender. Conclusions: Variation in olfactory fossa depth was common. Thus, preoperative assessment of ethmoid roof and Keros type is cruicial for warning the surgeon to minimize the critical complications. Key words: Computed Tomography; olfactory fossa depth; para nasal sinus.Publication Prediction of Hamstring Autograft sizes for Anterior Cruciate Ligament Reconstruction using Preoperative Magnetic Resonance Imaging(Nepal Health Research Council, 2023) Shrestha, Prakash; Thapa, Sunil Singh; Mahara, Deepak Prakash; Paudel, Sharma; Lamichhane, Arjun; Saud, TejendraAbstract Background: The purpose of this study is to determine whether preoperative magnetic resonance image measurements can predict the hamstring tendon autograft diameter during anterior cruciate ligament reconstruction. Methods: We prospectively evaluated Forty-two patients with anterior cruciate ligament injury who underwent reconstruction using hamstring tendon autograft. Preoperative diameters and cross-sectional areas of the hamstring tendons were estimated using magnetic resonance imaging of the knee. Intraoperative diameters of the hamstring tendon graft were measured using a cylindrical graft sizer. We used Pearson's correlation test to compare the Preoperative and intraoperative graft size measurements. A possible cutoff value for the hamstring graft size was determined using Receiver operating characteristic analysis. Results: The mean age of the patient in the study was 27.5 ± 8.5 years. There were statistically significant correlations between preoperative and intraoperative hamstring tendon graft measurements (P < 0.001). Our study found 13.3 mm² cross-sectional area as the cutoff for predicting 7mm of quadrupled hamstring graft size with both sensitivity and specificity of 85.7 %, respectively. Conclusions: We can conclude that preoperative magnetic resonance imaging measurements can predict the intraoperative graft size. This study can help in preoperatively planning for the graft choice. Keywords: Anterior cruciate ligament (ACL), Hamstring graft, Magnetic resonance imaging (MRI), PredictionPublication Relationship between Facet Joint Tropism with Lumbar Disc Herniation at A Particular Motion Segment(Nepal Health Research Council, 2023) Shrestha, Sandesh; Lakhey, Rajesh Bahadur; Paudel, Sharma; Paudel, SushilAbstract Background: Lumbar disc herniation is one of the important and common causes of low back pain. There are various modifiable and non-modifiable risk factors for the development of lumbar disc herniation. Any change in the orientation or asymmetry of the facet joint i.e. facet tropism may lead to abnormal shearing stress on the intervertebral disc and may lead to development of disc herniation. Methods: This is a cross-sectional observational study of 46 patients aged 18-40 years with clinical features of Prolapsed Intervertebral Disc and Magnetic Resonance Imaging evidence of single level prolapsed disc who presented to Tribhuvan University Teaching Hospital from December 2019 to June 2021. MRI measurement of facet tropism of normal level (L4-L5 or L5-S1) adjacent to herniated level was used for comparison. The p - value ? 0.05 was considered statistically significant. Overall association of tropism with lumbar disc herniation in affected and normal level combined and at each individual level was studied using McNemar Test. Results: We found a highly significant association of facet tropism with lumbar disc herniation (p-value <0.001). Considering the individual levels, at L4-L5 level, the association between facet tropism and lumbar disc herniation was highly significant (p-value <0.001). However, at L5-S1 level the association was not significant (p-value <0.388). Conclusions: The results of our study show strong association between FT and lumbar disc herniation at a particular motion segment. Keywords: Facet tropism; inter-vertebral disc prolapse; lumbar disc herniation; magnetic resonance imagingPublication Relationship between Facet Joint Tropism with Lumbar Disc Herniation at A Particular Motion Segment(Nepal Health Research Council, 2023) Shrestha, Sandesh; Lakhey, Rajesh Bahadur; Paudel, Sharma; Paudel, SushilAbstract Background: Lumbar disc herniation is one of the important and common causes of low back pain. There are various modifiable and non-modifiable risk factors for the development of lumbar disc herniation. Any change in the orientation or asymmetry of the facet joint i.e. facet tropism may lead to abnormal shearing stress on the intervertebral disc and may lead to development of disc herniation. Methods: This is a cross-sectional observational study of 46 patients aged 18-40 years with clinical features of Prolapsed Intervertebral Disc and Magnetic Resonance Imaging evidence of single level prolapsed disc who presented to Tribhuvan University Teaching Hospital from December 2019 to June 2021. MRI measurement of facet tropism of normal level (L4-L5 or L5-S1) adjacent to herniated level was used for comparison. The p - value ? 0.05 was considered statistically significant. Overall association of tropism with lumbar disc herniation in affected and normal level combined and at each individual level was studied using McNemar Test. Results: We found a highly significant association of facet tropism with lumbar disc herniation (p-value <0.001). Considering the individual levels, at L4-L5 level, the association between facet tropism and lumbar disc herniation was highly significant (p-value <0.001). However, at L5-S1 level the association was not significant (p-value <0.388). Conclusions: The results of our study show strong association between FT and lumbar disc herniation at a particular motion segment. Keywords: Facet tropism; inter-vertebral disc prolapse; lumbar disc herniation; magnetic resonance imaging