Browsing by Author "Regmi, Pradeep Raj"
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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 Attenuation Measurements of the Kidney on Unenhanced CT in Ureterolithiasis(Institute of Medicine, Tribhuvan University, 2024) Gupta, Avinash; Regmi, Pradeep Raj; Shrestha, Suraj; Adhikati, Aayush; Yadav, Sushil Kumar; Katwal, Shailendra; Khadayat, RameshAbstract Introduction: Urolithiasis is a common disease worldwide that affects a wide range of patients. This study evaluated the diagnostic utility of attenuation values of bilateral kidneys on unenhanced helical Computed Tomography (CT) in ureterolithiasis patients. Methods: This cross-sectional study was performed in patients with ureteric calculus referred for unenhanced helical CT of the kidney, ureter, and bladder (CT-KUB). The attenuation of the renal parenchyma in Hounsfield units (HU) was measured, and a mean attenuation value was determined for obstructed and contralateral kidneys of each patient and compared. Results: Among the 95 patients, 40 had ureteric stones on the left kidney and 55 on the right kidney. Lower average attenuation value in obstructed kidneys (on the side of the ureteric stone) was seen in 75 (78.9%) patients. 79% (N=69) of patients and 3.15% (N=3) of patients showed zero average attenuation difference. Mean attenuation values in the upper pole, middle portion, and lower pole were 28.60 HU, 30.23 HU, and 30.59 HU for obstructed kidneys and 32.74 HU, 33.41 HU, and 31.93 HU for contralateral kidneys. Mean of mean attenuation values in the three regions were 29.81 HU for obstructed kidneys and 32.69 HU for contralateral kidneys. A significant difference of 2.88 HU was found in mean attenuation values between the obstructed kidneys and the contralateral kidneys. Conclusion: Attenuation values between the kidneys can serve as a means of differentiating between obstructed and non-obstructed kidneys in unenhanced CT KUB.Publication Hematocolpos: Rare but Commonly Missed Cause of Recurrent Pain Abdomen in Children – A Case Report and Review of Literature(Institute of Medicine, Tribhuvan University, 2025) Bhattarai, Desh Bhakta; Yadav, Bharat; Gautam, Suprima; Regmi, Pradeep RajAbstract: Hematocolpos, a rare condition, occurs when menstrual blood or secretory fluid accumulates in the vagina due to vaginal obstruction. It is often caused by various congenital urogenital anomalies. Early diagnosis is crucial to prevent complications such as tubal adhesion, pelvic endometriosis, and infertility. Hematocolpos can present with recurrent abdominal pain in children, which is occasionally missed in the early period of hospital visits. A proper approach to a hematocolpos includes physical examination and imaging findings. Magnetic Resonance Imaging plays a crucial role in diagnosis and guidance for surgical interventions.Publication Late Presentation of Hypoxic Injury of Brain in an Infant(Nepal Health Research Council, 2023) Regmi, Pradeep Raj; Yadav, Aalok Kumar; Koirala, Bibek; Yadav, Shreelal; Amatya, IshaAbstract Perinatal asphyxia is one of the leading causes of hypoxic-ischemic encephalopathy. In a developing country like Nepal, home delivery is the leading cause of perinatal asphyxia. Neuroimaging remains the diagnostic modality of choice. We present a case report of a 10-month-old infant who presented to the pediatric Out-patient-department with complaints of being unable to hold his head and unable to sit without support. Detailed history, physical examination, and developmental assessment along with lab investigation flash visual evoked potentials and Magnetic Resonance Imaging of the brain was performed. Hypoxic ischemic injury has common five types of imaging patterns in neonates. There are a few imaging differentials to be considered while evaluating the case for hypoxic injury. Clinicians and radiologists must go hand in hand to narrow down the possibilities which can fasten the treatment thereby decreasing morbidity and mortality. Keywords: Hypoxic ischemic encephalopathy, Infant, Magnetic Resonance ImagingPublication Pleomorphic Adenoma of Hard Palate: A Case Report(Institute of Medicine, Tribhuvan University, 2024) Dhakal, Prajwal; Regmi, Pradeep Raj; Bhattachan, Sushma; Paneru, ManishaAbstract: Pleomorphic adenoma is a benign and most common tumor of both major and minor salivary glands. Majority of the minor salivary glands’ tumor are malignant. However, pleomorphic adenoma is the most common neoplasm of palate. Large pleomorphic adenoma in palate may cause pressure erosion of palate mimicking malignant pathology. Imaging with Computed tomography or Magnetic Resonance Imaging is important for surgical planning of the tumors in the uncommon location like palate. Here, we present a case of histopathologically proven pleomorphic adenoma of palate which was evaluated with CT scan prior to wide local excision.Publication Sonography as an Adjunct to Digital Mammography in Patients with Dense Breasts(Nepal Health Research Council, 2024) Jha, Anamika; Regmi, Pradeep Raj; Pradhan, Huney; Thakur, Minaxi; Joshi, Birendra RajBackground: Dense breasts are associated with an increased risk of cancer and also mask lesions on mammograms. In our study, we evaluated the role of sonography as an adjunct to digital mammography in patients with dense breasts. Methods: Sonography of 676 female patients with American College of Radiology category C or D mammographic density was done in this prospective cross-sectional analytical study in the Department of Radiology, Tribhuvan University Teaching Hospital. The final imaging diagnosis was classified as per the American College of Radiology Breast Imaging Reporting and Data System categories. Tissue diagnosis was obtained in patients with sonographic category 3 solid lesions larger than 3 cm, category 4 and 5 lesions. The data were tabulated and analyzed using Statistical Package for Social Service (SPSS) for Windows version 22. Results: Additional sonography confirmed all BIRADS 1 mammograms as normal or benign, 95.7 % (112) of inconclusive, and 82.8% (n=135) of BIRADS 3 ones as benign. It had higher sensitivity and negative predictive value (100%) than mammography with similar accuracy. Most patients (479, 70.9%) had diagnostic indications. There were 540 (79.9%) cases in ACR BIRADS category c. A final diagnosis of benign (316, 46.7%) was most common, followed by normal (293, 43.4%) and malignant (67, 9.9%). The majority of the malignant lesions were Invasive Ductal Carcinoma (59, 88%). Conclusions: Additional sonography confirmed mammography findings as normal, benign, or suspicious for malignancy, definitely described morphology and extent of mass, and also guided biopsy. It had higher sensitivity than mammography in dense breasts. Keywords: Breast density; mammography; ultrasonography mammary.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.