Browsing by Author "Regmi, PR"
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Publication Comparison of the Mean Cross-sectional Area of the Median Nerve between Pregnant and Non-Pregnant Women Using Ultrasonography in a Tertiary Level Hospital, Nepal(Kathmandu University, 2023) Adhikari, G; Regmi, PR; Paudel, S; Lamichhane, B; Kayastha, P; Maharjan, S; Amatya, IABSTRACT Background The median nerve is subjected to compression in the carpal tunnel giving rise to a constellation of symptoms known as carpal tunnel syndrome. It is the most frequent form of peripheral entrapment neuropathies and is most prevalent in the middle age females. The most common cause of this syndrome is idiopathic. One of the known secondary causes is pregnancy. Objective To compare the mean cross sectional area of median nerve using ultrasound in pregnant and non-pregnant females at carpal tunnel inlet and its variations with different trimesters. Method The study was conducted during a period of one year (October 2014 to September 2015). A total of 204 participants were evaluated among which 102 were nonpregnant and 102 were pregnant. Among the 102 pregnant participants, 34 females each were in the first, second, and third trimesters. A convenience sampling technique was used for the selection of the participants. The mean cross-sectional area of the median nerve was calculated in both of these groups in both hands by using the direct method. The mean cross-sectional area of non-pregnant female was used as the reference value to which that of pregnant female were compared. Data obtained were compiled and analyzed using Statistical Package for Social Sciences Version 16. Result The overall mean cross-sectional area of the median nerve in non-pregnant females was 6.76 ± 1.05 mm2 and in pregnant females was 6.84 ± 1.09 mm. No statistically significant difference was noted in the mean cross-sectional area of the median nerve in either hand in both pregnant and non-pregnant females. No statistically significant difference was noted in the overall mean cross-sectional area between the non-pregnant and pregnant females. There was no significant difference in the mean cross-sectional area within the different trimesters in both hands on intergroup comparisons. Conclusion Ultrasound examination of the median nerve and measurement of its cross- sectional area is a useful diagnostic tool in the evaluation of carpal tunnel syndrome. Ultrasound has the advantage of easy availability, low cost, quick scan time, able to scan a long segment of nerve and examine the structures in both static and dynamic states. Besides, it also helps in the identification of various anatomic variants and pathologies within or adjacent to carpal tunnel. KEY WORDS Carpal tunnel, Mean cross sectional area, Median nerve, UltrasonographyPublication Comparison of Ultrasonography with Computed Tomography in Diagnosis and Staging of Lung Cancer(Kathmandu University, 2024) Paudel, S; Kayastha, P; Suwal, S; Nepal, B; Bhusal, KR; Bhusal, KR; Katwal, S; Regmi, PRABSTRACT Background Ultrasound (US) can aid in lung cancer diagnosis and staging in peripheral-based lesions by demonstrating chest wall invasion, aiding as a guide to biopsy, and detecting supraclavicular lymph nodes which are often missed by computed tomography (CT). Objective This study is to compare the ultrasound with computed tomography in the diagnosis and staging of lung cancer. Method This was an observational prospective study conducted from October 2020 to April 2023 in patients with or suspected lung cancer sent for imaging assessment to the Department of Radiology and Imaging. Out of 306 patients who underwent computed tomography scan, a total of 234 patients with proven lung cancer were subjected to ultrasound of the chest, liver, bilateral adrenal, and supraclavicular regions for the evaluation of lung mass, pleural effusion, and metastasis in lung, adrenal, and supraclavicular lymph nodes. Diagnostic values of ultrasound to detect peripheral lung lesions, chest wall invasion, pleural effusion, liver and adrenal metastasis, and supraclavicular lymph nodes were compared with contrast-enhanced computed tomography scans. Ultrasound’s performance was evaluated against computed tomography scans as the gold standard, using the chi-square test, z-test, and area under the curve for comparison (p < 0.05 for significance). Result The majority of patients (53.8%, n=126) were aged 61-75, with 53% being male and 89% smokers. Ultrasound was superior in detecting pleural effusion (sensitivity 80.3%, NPV 92.2%, AUC 0.860) and supraclavicular lymph nodes (sensitivity 72.2%, NPV 91.6%, AUC 0.817). Conclusion In resource-constrained settings like Nepal, where advanced imaging may be limited, integrating ultrasound with contrast-enhanced computed tomography significantly improves lung cancer diagnosis. This non-radiation approach is particularly beneficial for peripheral lesions, patients with renal function impairment and aiding effective staging of lung cancer. KEY WORDS Computed tomography, Lung cancer, Role, Ultrasound