Browsing by Author "Thapa, Subash"
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Publication Prevalence and Patterns of Circle of Willis Variants in Civil Service Hospital: A Retrospective Cross-Sectional Study Using 3 Tesla Magnetic Resonance Angiography(Nepal Medical Association, 2025) Thapa, Subash; Desar, Rabindra; Basnet, Jorina; Thapa, SushmitaAbstract Introduction: The Circle of Willis (CoW) is a crucial cerebral arterial network, and its anatomical variations may influence cerebrovascular health. This study aimed to determine the prevalence and patterns of CoW variants using 3 Tesla magnetic resonance angiography. Methods: This retrospective cross-sectional study was conducted at the Department of Radiology, of a tertiary care center, Nepal, from October 2022 to September 2024 following ethical approval (IRC- 16/2024). Inclusion required adequate 3T MRI imaging using a TOF MRA protocol. (TR 20 ms, TE 3.5 ms, flip angle 15°, slice thickness 0.5 mm). Patients with cerebrovascular disease, prior interventions, or contraindications were excluded. Circle of Willis morphology was analyzed for prevalence, variants, and age/gender correlations using SPSS and Excel. Results: The study included 384 participants of which 206 (53.65%) were male. The mean age was 59.20±16.30 years. A complete Circle of Willis (COW) was observed in 139 (36.19%), while 220 (57.39%) were incomplete. Anterior anomalies 126 (32.81%) primarily consisted of hypoplasia 95 (75.40%), right A1 dominance) and absence 24 (19.05%). Posterior variants 345 (89.84%) frequently involved hypoplasia 155 (44.93%) or absence 189 (54.78%) of the posterior communicating artery, with fetal PCA origin in 121 (31.51%). Conclusions: This study found common Circle of Willis variations, especially in older adults. Hypoplasia of the posterior communicating artery was the most frequent variation, with differences observed by gender.Publication Suspicious Case of a Body packer “Mule” in a Low Resource Country: A Case Report(Nepal Medical Association, 2021) Rajbhandari, Bibek; Shilpakar, Olita; Thapa, Subash; Singh, SumiAbstract: Body packing is the process of smuggling illicit drugs in the form of packages concealed within the gastrointestinal tract via ingestion or inserting into body orifices. These individuals are described as “body packers”, “stuffers”, “mules” or “swallowers” and resort to carrying drugs like heroin, cocaine and cannabis. They present to the hospital following the development of complications or brought dead due to the rupture of packets or directly from detention for further investigations. This case illustrates a suspected case detained from the airport who was found to be carrying 93 pellets of an illicit drug, heroin, weighing 900 grams, one of the highest quantity carried by any body packer in the country till date. This case further sheds light on the fact that a meticulous history, detailed clinical examination and radiographic investigations like abdominal radiograph and imaging are the keys to diagnose body packers in a resource limited setting.