Browsing by Author "Songmen, S"
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Publication A Retrospective Study of Magnetic Resonance Imaging Findings in Acute Encephalitis Syndrome(Institute of Medicine, 2015) Songmen, S; Panta, OB; Maharjan, S; Paudel, S; Ansari, MA; Ghimire, RKAbstract Introduction: MRI is the imaging modality of choice to investigate acute encephalitis and is recommended in all patients as soon as possible in whom diagnosis is uncertain. This study aimed to study the pattern of brain involvement in MRI in patients with acute encephalitis syndrome and to correlate the findings with clinical and laboratory data. Methods: The study was a retrospective hospital record based review conducted at Tribhuvan University Teaching Hospital. MRI and records of patients undergoing MRI for acute encephalitis syndrome during two years duration was studied. Data analysis was done using IBM SPSS 20.0. Results: A total of 47 MRI were studied among which 11(23.40%) were pediatric and 36(76.59%) were adult population. Edema was the commonest manifestation. Cerebral hemisphere (temporal lobe) was the commonest location involved 34(72.3%). Basal ganglia and thalamus involvement was also fairly common. Five (26.31%) out of 19 patients had positive Japanese encephalitis, 5(26.31%) had HSV antigen positive serology and in 8(42.10%) no etiology could be found. Posterior fossa and basal ganglia involvement was the most predominant findings in Japanese encephalitis and involvement of medial temporal lobe was seen in all cases of Herpes encephalitis. Fifteen patients had good prognosis: complete recovery or minimal residual deficit, while four patients were either dead or left against medical advice. Conclusion: Medial temporal lobe involvement was seen in all cases of Herpes encephalitis; and thalamus and basal ganglia involvement was predominant pattern in Japanese encephalitis. Posterior fossa involvement was common probably due to a non-conventional etiological agent. Keywords: Acute Encephalitis Syndrome, MRI, Herpes encephalitisPublication Measurement of Portal Vein Diameter, Peak Systolic Velocity and Pulsatility Index by Ultrasound Doppler Evaluation in Asymptomatic Nepalese Population(Institute of Medicine, 2017) Songmen, S; Panta, Om B; Neupane, NP; Ghimire, RKAbstract Introduction: Portal vein diameter and Doppler studies give hemodynamic information that can correlate with disease status. Their normal values are not established in Nepalese population. This study aims to establish the normal values of portal vein diameter, PSV and PI in Nepalese population and study their variability with age, gender and ethnicity. Methods: Cross-sectional hospital based study. All adults more than 20 years of age attending ultrasound OPD of Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu for general health checkup were included. Patients with liver disease, cardiac disease and ascites were excluded. A single observer took all measurements. Data were entered in a predesigned proforma and analysis was performed with SPSS 21.0. Results: Two hundred patients were included in the study. The mean age was 44.34+12.9 years. The mean portal vein diameter was 10.41+1.18mm. The mean portal vein PSV was 33.35+9.3cm/s and PI was 0.76+0.07. There was a positive correlation of portal vein diameter with age (r=0.345; p<0.001). Also, mean portal vein diameter was significantly higher in males (10.9+0.99mm) than in females (9.9+1.1mm). PSV and PI did not differ with age, gender or ethnicity. Conclusions: Mean portal vein diameter in this study is comparable with previous standards. Keywords: Peak systolic velocity, portal vein diameter, pulsatility indexPublication Pulmonary Arteriovenous Malformation: A Rare Cause of Right to Left Shunt(Institute of Medicine, 2015) Panta, OB; Songmen, S; Ansari, MA; Ghimire, RKAbstract Pulmonary arteriovenous malformations are rare anomalies where pulmonary arteries and veins communicate by passing the pulmonary capillary bed. They are mostly congenital in origin, however sometimes may be acquired. They may present as a diagnostic dilemma in plain radiography. Computed tomography angiogram has emerged as the diagnostic modality of choice not only for diagnosing the case but also for delineating the angioarchitecture that is useful in treatment planning by surgery or transcatheter embolisation. Here we present a case of a child with large pulmonary arteriovenous malformation being treated as pneumonia and finally diagnosed on computed tomography angiogram. Keywords: Computed tomography, Pulmonary arteriovenous malformation, Right to left shunt