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Long COVID Patient Symptoms and its Evaluation and Management
(Nepal Medical Association, 2021) Shrestha, Deepak Sundar; Love, Richard
Abstract: While the acute case burdens and deaths from the COVID-19 pandemic (in Nepal approaching 700,000 and 10,000 respectively) have been costly, the characteristics and potentially huge dimensions of the chronic disease sequelae of this infectious disease are only slowly becoming apparent. We reviewed Pub Med, major medical meeting and medical journal, and investigative journalist materials seeking to frame and describe COVID-19 chronic disease. The consequences of COVID-19 infections follow major organ damage, and induction of immunological and hormonal systems dysfunction. The first injuries are consequent to direct viral effects on tissues, and vasculitis, endothelialitis, thrombosis and inflammatory events. Pulmonary, cardiac, brain, and kidney tissues incur function-limiting damage, with dyspnea, arrythmias, decreased exercise capacity, cognitive dysfunction, and decreased glomerular filtration rates. The second process is characterized by immune dysregulation and autoimmunity, and dysfunction of hormonal regulation systems, with high, fluctuating levels of physical and mental fatigue, multiple-site pain and ache, and non-restorative sleep, in 10-30% of cases. This communication proposes evaluation and management of chronic COVID-19 patients with efficient assessment of commonest symptoms, targeted physical examination and organ function testing, and interventions based on specific organ functional status, and experience with similar chronic immune syndromes, such as myalgic encephalomyelitis.
Medical Students Volunteering during COVID-19 Pandemic: Synopsis of Some Student-led Initiatives in Nepal
(Nepal Medical Association, 2021) Basnet, Pragyan; Joshi, Anjali
Abstract: The efforts shown by healthcare professionals, security personnel and the general public in fighting Coronavirus Disease 2019 pandemic is highly appreciable. Medical students are future healthcare professionals and have the opportunity to volunteer and help their seniors fight Coronavirus Disease 2019 pandemic. In Nepal, we as medical students are contributing by raising awareness about Coronavirus Disease 2019 along with some innovative initiatives which are Project Personal Protective Equipment, Project Telemedicine and the ″Donate Plasma, Help Defeat COVID-19″ Campaign. Since we were able to support thousands of frontline healthcare workers with personal protective equipment and reduce burden in hospitals by providing telemedicine service, we believe such volunteering and initiations from medical students can be an inspiration for all students for future crises.
Protection of our Future Generation: Use of Face Masks in Children amidst COVID-19 Era Authors
(Nepal Medical Association, 2021) Gyawali, Mallika
Abstract: During the Coronavirus disease-19 (COVID-19) crisis, the universal use of face masks in addition to hand washing and practicing safe distancing is recommended worldwide. Children, like adults, also get infected through direct contact or airborne droplets. Face masks efficiently prevent respiratory droplet transmissions. However, asking children to wear face masks can be challenging and may have potential advantages and disadvantages. In this viewpoint, we discuss the effectiveness of face mask usage in children and its associated challenges, myths, advantages, and disadvantages.
Carcinosarcoma of the Cervix: A Case Report Authors
(Nepal Medical Association, 2021) Bhagat, Birendra; Aacharya, Bijaya Chandra; Gurung, Sarita; Bhatta, Ranjan Raj; Rajbhandari, Aasiya
Abstract: Cervical carcinoma is the most common cause of mortality due to cancer in Nepal. Carcinosarcoma is a very rare subtype of cervical cancer which is characterized by the presence of both epithelial and mesenchymal malignant component. It constitutes less than 1% of cervical carcinoma. Due to the low occurrence of the disease, most of the data on treatment and prognosis are based on case reports and series. Here, we report a case of 69 years, female with cervical cancer (FIGO IIA2). Histopathological and immunohistochemical analysis of cervical biopsy initially showed primary adenosarcoma of the cervix. The tumor was non-responsive to primary treatment with concurrent chemoradiation. Later she was treated with abdominal hysterectomy and bilateral salpingo-oophorectomy. The final histopathology of the resected specimen showed a sarcomatous component along with carcinomatous changes in the endocervical glands favouring the diagnosis of carcinosarcoma of the cervix.
Isolated Medial Dislocation of Elbow: A Case Report
(Nepal Medical Association, 2021) KC, Kapil Mani; Aryal, Ramesh; Acharya, Samir; KC, Amuda
Abstract: Even though posterior or postero-lateral dislocations of elbow are more common, both isolated medial and lateral dislocations of elbow are extremely uncommon. Since there are subtle findings and minimum pain after medial dislocation of elbow, these are sometimes missed by attending physician at first presentation and changes into chronic type with guarded prognosis. We report a case of a 15-year old boy with isolated medial dislocation of elbow which was correctly identified and treated with closed reduction and posterior slab application. Flexion extension as well as supination pronation of elbow 3 months after injury was nearly normal.
Guillain Barre Syndrome associated with COVID-19 Infection: A Case Report
(Nepal Medical Association, 2021) Shrestha, Sujan; KC, Niranjan; Hirachan, Niroj
Abstract: Coronavirus Disease has become a global pandemic after its emergence at the end of 2019 as a cluster of pneumonia. Apart from respiratory symptoms, neurologic complications are also common, mostly in hospitalized patients. More than 80 percent of patients have neurological symptoms during their disease course of which most common is encephalopathy. However, data on neurological complications like Guillain-Barré syndrome associated with coronavirus-2019 are scarce. Here, we report a case of a 64-years-old female patient with typical clinical and electrophysiological manifestations of Acute motor axonal neuropathy variant, who was reported positive with polymerase chain reaction for severe acute respiratory syndrome coronavirus-2, 13 days before the onset of acute bilateral weakness of extremities, areflexia, and normal sensory examination. Cerebrospinal fluid and electrophysiological examination were also suggestive. The neurological symptoms improved during treatment with immunoglobulins. Quick recognition of symptoms and diagnosis is important in the management of Guillain-Barré syndrome associated with coronavirus-2019.
Cardiovascular Complication following Covishield Vaccination in Nepal: A Case Report Authors
(Nepal Medical Association, 2021) Basnet, Angela; Ojha, Shiva Kumar; Jha, Suman Kumar; Paudyal, Anjana; Khadka, Manoj; Khadka, Manita; Shrestha, Dhan Bahadur
Abstract: Nepal started the COVID-19 vaccination on 27 January 2021 with AstraZeneca/Oxford Coronavirus Disease-19 AZD1222 (Covishield) vaccine to control the Coronavirus disease pandemic. The vaccine has a good safety profile, with cardiovascular complications being rare. Herein we report a rare case of cardiovascular complication following Covishield vaccination in a 33 years old female who had dizziness and elevated blood pressure immediately following vaccination and abnormal electrocardiogram showing T wave inversions followed by left bundle branch block. The patient was kept on observation, following which the blood pressure and electrocardiogram changes were normal by seven days. This cardiovascular complication following the vaccination demands further investigation into the adverse event of the vaccine. However, since the benefit of the vaccine outweighs the risk, World Health Organization has recommended the continuity of the vaccine as of now.
Open Pelvic Fracture with Rectal Laceration: A Case Report
(Nepal Medical Association, 2021) Bhattachan, Sijan
Abstract: Open pelvic fractures are rare but represent a serious clinical problem with high mortality rates. Acute mortality is often associated with haemorrhage and delayed mortality is most often associated with sepsis and multiple organ failure. An aggressive multidisciplinary approach is of paramount importance to prevent catastrophe. It involves emergency resuscitation, stabilization of unstable fracture with an external fixator, and faecal diversion for rectal injury. Here, a case of open pelvic fracture with rectal laceration has been presented.
Hoffa’s Osteochondroma - Para-articular Extrasynovial Infrapatellar Fat Pad Osteochondroma: A Case Report
(Nepal Medical Association, 2021) Panta, Sunil; Thapa, Shrawan Kumar; Paudel, Krishna Prasad; Kandel, Manoj; Adhikari, Bishwa Raj
Abstract: Osteochondroma usually arises from the metaphyseal region of growing bones. The occurrence of extraskeletal osteochondroma is rare with very few case reports. Para-articular osteochondroma is a type of extraskeletal osteochondroma. It frequently occurs around the knee, usually at infrapatellar Hoffa’s fat pad. It is usually intracapsular but extrasynovial and arises from the capsule and connective tissues due to osteocartilaginous metaplasia. We present a case of 19-years male with anterior knee pain for 3 years, swelling, and deformity of the knee with flexion limitation for one year. Radiography revealed ovoid, corticated lesion free from adjoining bones. Mass interpreted as benign, so planned for excision. Well circumscribed nodule excised from the medial parapatellar approach. Histology revealed cartilaginous tissues surrounded by fibrous tissues with scattered enchondral ossification. Postoperatively and subsequent follow-up resulted in pain-free joint, complete recovery of range of motion with no clinicoradiological evidence of recurrence.
Broken Instrument Removal from Mandibular First Molar with Conebeam Computed Tomography based Pre-operative Computer-assisted Simulation: A Case Report
(Nepal Medical Association, 2021) Pradhan, Babita; Gao, Yuan; Gao, Yuan; Guo, Tingwei; Cao, Yangpei; He, Jinzhi
Abstract: Intracanal separation of nickel titanium files hinders complete shaping, cleaning, and filling of the root canal system and ultimately influences the endodontic treatment outcome. In this case report, we presented a successful broken instrument retrieval from the middle third of the mesiobuccal root canal of tooth #30 with the assistance of cone-beam computed tomograpgy based preoperative computer-assisted simulation, micro-trepan bur and micro-tube from Micro-Retrieve & Repair system and dental operative microscope. The involved tooth was then successfully cleaned, shaped and obturated followed by coronal restoration. At the three-year follow-up, tooth #30 was asymptomatic and functioned well without radiographic changes. The present case provides an example to show the robustness of computer-assisted technology in dental procedures and to show how the combination of advanced techniques can facilitate root canal therapy.
Remission after Six Months of Induction Immunosuppressive Treatment with Mycofenolate Mofetil and Prednisolone in Patients with Lupus Nephritis: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2021) Shrestha, Shailendra; Yadav, Rahul
Abstract: Introduction: Treatment of lupus nephritis consists of six months of induction immunosuppression followed by years of maintenance immunosuppression. The aim of present study was to find the prevalence of remission after six months of induction immunosuppressive treatment with induction therapy in patients with lupus nephritis. Methods: A descriptive cross-sectional study was conducted in the nephrology unit of department of internal medicine of a tertiary care hospital from September 2018 to September 2020. The study was approved by institutional review committee of same institution (reference number 184/2018). Convenience sampling method was used and Statistical Package for Social Sciences version 26 was used for statistical analysis. Point estimate at 90% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Out of 24 patients, overall remission was seen in 21 patients (87.4%) (90% Confidence Interval= 76.26-98.54). Complete remission and partial remission were seen in 16 (66.6%) and 5 (20.8%) patients respectively resulting in an at the end of six months of induction immunosuppressive treatment. The most common class of lupus nephritis was class IV, 7 patients, followed by class IV+V, and class V, 6 patients in each respectively. The mean 24-hour urinary total protein, serum albumin and serum creatinine were 2492±1051 mg, 2.1±0.4 g/dl, and 0.9±0.1 mg/dl respectively. Adverse events were observed in 6 (25%) patients. Conclusions: Our study shows that good proportions of patients with lupus nephritis achieve clinical remission at the end of six months of induction immunosuppressive treatment with induction therapy, however, at the cost of some tolerable side effects.
Depression in Patients with Alcohol Dependence Syndrome in a Tertiary Care Center: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2021) Acharya, Mukti
Abstract: Introduction: Alcohol dependence syndrome is an important and major public health issue seen in our community and health center. It is mostly associated with different mental health problems and psychiatric co-morbidities. This study aims to find out the prevalence of depression among alcohol dependence syndrome in a tertiary care hospital. Methods: A descriptive cross-sectional study was conducted over one year from April 15, 2020, to February 15, 2021 at a tertiary care hospital. The ethical approval was obtained from the Institutional Review Committee of Nobel Medical College (reference number: 409/2020). Convenience sampling method was used. The patients admitted for alcohol use and related problems in the Psychiatry Department, Nobel Medical College Teaching Hospital, Biratnagar were included. Data entry was done using Microsoft Excel and statistical analysis was done by using Statistical Packages of Social Sciences Version 16.0. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage. Results: The prevalence of depression in patients with Alcohol Dependence Syndrome was 17 (16.3%) (95% Confidence Interval= 9.20-23.39) . The patients suffering from depressive disorder male and female were 16 (94.1%) and 1 (5.8%) respectively. The participants with Alcohol Dependence Syndrome with no other comorbid psychiatric disorders were found to be 60 (57.7%). Conclusions: Psychiatric comorbidity was found to be common in alcohol dependent people among which depression was found to be most common.
Lipid Profile Abnormalities in Newly Diagnosed Primary Hypothyroidism in a Tertiary Care Centre of Western Nepal: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2021) Khatri, Prabin; Neupane, Aryan; Banjade, Ashish; Sapkota, Suman; Kharel, Smile; Chhetri, Ashmita; Sharma, Dipesh; Subedi, Saphal Nath; Chhetri, Pradip
Abstract: Introduction: Thyroid hormones have a major influence on synthesis, mobilization and metabolism of lipids. Hypothyroidism accounts for a notable cause of secondary dyslipidemia. This can increase the risk for cardiovascular morbidity and mortality. This study was performed to find out the prevalence of lipid profile abnormalities in newly diagnosed primary hypothyroid states. Methods: This descriptive cross-sectional study was conducted among 71 patients in the context of newly diagnosed primary hypothyroidism patients visiting outpatient department of internal medicine from 9th December 2018 to 30th June 2020 after taking ethical clearance from Institutional Review Committee. Case screening for lipid profile changes was performed at the time of diagnosis of primary hypothyroidism. A convenience sampling method was used. Data entry and descriptive analysis were done in Statistical Package for the Social Sciences version 16.0. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: In this study including 71 cases of newly diagnosed primary hypothyroidism, 49 (69.0%) (95% Confidence Interval= 58.24-79.76) had abnormal lipid profiles. Among them, 5 (38.5%) out of 13 (18.3%) cases of subclinical hypothyroidism and 44 (75.9%) out of 58 (81.7%) cases of overt hypothyroidism had abnormal lipid profiles. Conclusions: The prevalence of abnormal lipid profile parameters was similar to the study done in various studies in similar settings except for high-density lipid which showed both similarity and dissimilarity with other studies. Our study suggested that all newly diagnosed cases of primary hypothyroidism are to be investigated for dyslipidemia thus ensuring early treatment and prevention of complications.
Alteration of Thyroid Hormone among Patients with Ischemic Stroke visiting a Tertiary Care Hospital: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2021) Bashyal, Saroja; Gorkhaly, Manen Prasad; Devkota, Rameshwor; Devkota, Ramila; Regmi, Pradeep Raj; Amatya, Isha
Abstract: Introduction: Stroke is broadly classified as cerebral infarction, intracerebral hemorrhage and subarachnoid hemorrhage. Neuroendocrine proﬁle is altered in acute ischemic stroke and there is a link between hypothyroidism and atherosclerosis which in turn may lead to stroke. The objective of this study was to find out the prevalence of alteration of thyroid hormones in patients with ischemic stroke in a tertiary care center. Methods: This descriptive cross-sectional study was conducted from June to December 2019 in a tertiary care center. Ethical approval was taken from Institutional review board of National Academy of Medical Sciences (reference number: IM 175). Patients with a diagnosis of stroke, without evidence of cardioembolic source, history of liver disease, renal failure and thyroid disease and who do not use thyroidal supplementation within 180 days prior the event were included. Convenience sampling was done. Data was entered in Microsoft Excel and analyzed using Statistical Package for the Social Sciences version 22. Point estimate at 90% Confidence Interval was calculated along with frequency and percentage for binary data. Results: The prevalence of altered thyroid levels among 73 patients was 13 (17.8%) (90% Confidence Interval= 10.44-25.16). Among them 11 (15.1%) were hypothyroid and 2 (2.7%) were hyperthyroid. Among severity of hypothyroid cases, subclinical hypothyroidism grade IA was seen in 51 (70%), subclinical hypothyroidism grade IB was seen in 22 (30%), Conclusions: The prevalence of altered thyroid levels among patients undergoing ischemic stroke was similar to the findings of other international studies.
Hypertension among Young Adults with Ischemic Stroke of a Tertiary Care Centre in Nepal: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2021) Kafle, Dilli Ram; Jha, Sudhakar
Abstract: Introduction: Ischemic strokes in young patients have been increasing. Younger patients with ischemic stroke tend to have a different long-term prognosis than older patients. Young patients who have residual neurological deficits following ischemic stroke affect their quality of life. This study was carried out to find out the prevalence of hypertension among patients with ischemic stroke in a tertiary care hospital. Methods: This descriptive cross-sectional study was conducted in all the patients who were admitted with young ischemic stroke in the Department of Neurology, Nobel Medical College Biratnagar from December 2019 to December 2020 after taking ethical clearance from the Institutional Review Committee (reference number: 332/2019). Convenience sampling was done and data was collected, entered in Microsoft Excel, and analysis was done using Statistical Package for the Social Science software version 16. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Out of the total patients with ischemic stroke in the young adults 30 (40%) (95% Confidence Interval= 28.91-51.08) had hypertension. During follow-up at 6 months, 20 (66.7%) of the patients with hypertension had favorable outcomes with a Modified Rankin Score of 0 or 1. Death during a hospital stay or during follow-up was observed in 2 (7%) of patients with hypertension. Mean age of the patients was 40±4.87 years. Most patients were in the age range of 36-45, 24 (80%). Conclusions: Prevalence of hypertension among young patients with ischemic stroke was high compared to other studies.
Knowledge of Physiotherapy Practice among Medical Interns in a Tertiary Care Hospital: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2021) Mahto, Prakash; Manandhar, Naresh; Joshi, Sunil Kumar
Abstract: Introduction: Medical doctors have profound influence on other health professions including physiotherapist as they are at the top of the pyramid of healthcare profession. There is a lack of knowledge of physiotherapy among medical doctors. They may not be knowing of all physiotherapy services and practice. The objective of this study was to find adequate knowledge of physiotherapy practice among medical interns in a tertiary care hospital. Methods: A descriptive cross-sectional study was conducted on medical interns of a tertiary hospital of Kathmandu between 21st March - 20th May 2021, after taking ethical approval from the Institutional Review Committee. A convenient sampling method was used and sample size was calculated to be 94. A structured questionnaire was used to collect the demographic details and knowledge of Physiotherapy. Data was analyzed using statistical package for the social sciences version 20. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage for binary data. Results: The knowledge of physiotherapy practice was seen adequate among 16 (17%) (95% Confidence Interval = 9.41-24.59) medical interns. Physiotherapy is effective in reducing pain was acknowledged by 89 (97.4 %), 61 (64.9 %) had knowledge about conditions treated by physiotherapy, 55 (58.5 %) had knowledge that physiotherapy treatment follows definite treatment protocol and 26 (27.7 %) had knowledge that exercise prescription is done in physiotherapy. Conclusions: The prevalence of adequate knowledge is less in our study which is similar to other studies done in similar settings. Therefore, there is a need of educating the future medical doctors about physiotherapy, thereby reaching a better patient care.
Virtual Anatomy Classes among the First and Second Year Medical and Dental Students of a Medical College: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2021) Makaju, Sarbada; Rai, Chandra Kala
Abstract: Introduction: The pandemic of COVID-19 affected every single person in the world. This pandemic also affected the academics of medical and dental colleges of Nepal. In these conditions, the virtual study was used as an emergency measure during the COVID-19 period, with an adaptation to the “new normal” to deliver preclinical medical education. This has brought both challenges and opportunities to medical education. The objective of the study is to find out whether the anatomy virtual classes were helpful among the first and second year medical and dental students of a medical college. Methods: The descriptive cross-sectional study was conducted on 206 first and second-year medical and dental students of a medical college between 1st May 2021-31st May 2021 after getting the ethical clearance from the Institutional Review Committee (reference no. 0504202109). The convenient sampling was done. The data were analyzed with Statistical Package for the Social Sciences 20 version. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage for binary data. Results: Out of the total 206 students, 173 (84%) (78.99-89.01 at 95% Confidence Interval) found that virtual anatomy classes were not helpful for the study of the anatomy classes. Conclusions: From the study, we conclude that more than half of the students found that virtual classes were not helpful for the study of anatomy classes. Students have difficulty in studying dissection, cadaveric, and embryological structures via virtual classes. Physical class is better for studying anatomy than virtual classes for medical and dental students.
Higher Termination of Brachial Artery in Cadavers in the Department of Anatomy of a Medical College: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2021) Khatun, Sanzida; Shah, Diwakar Kumar
Abstract: Introduction: The main blood supply for arm is provided by the brachial artery. It shows variation in branching and termination patterns in some individuals. Variation in brachial artery may cause difficulties during various clinical and surgical procedures. The present study aims to find out the prevalence of higher termination of brachial artery in cadavers in the department of anatomy of a medical college. Methods: A descriptive cross-sectional study was carried out from 10th January 2020 to 20th April 2021 after the ethical approval was taken from the Institutional Review Committee of Nobel Medical College (reference number: IRC-NMCTH 280/2020). The study was done in 58 upper limbs of 29 properly embalmed cadavers. Convenient sampling was done. They were carefully dissected. The level of termination of brachial artery was noted. The length of the brachial artery and the distance between its termination and the intercondylar line of humerus was recorded. Results: Higher termination of brachial artery was observed in 3 (5.17%) extremities; one (1.72%) at middle third of arm and two (3.45%) at lower third of arm. In 52 (89.66%) extremities, the site of termination was at the level of neck of radius. The brachial artery terminated a few centimeters below its usual site at the level of upper part of shaft of the radius in 3 (5.17%) extremities. Conclusions: The prevalence of higher termination of brachial artery in cadavers is slightly lower than the studies performed in similar settings. It is not an uncommon finding. It may have impact on clinical and surgical procedures.
Dysmenorrhea among Nursing Staff in a Tertiary Care Center: A Descriptive Cross-sectional Study Authors
(Nepal Medical Association, 2021) Pokhrel, Manoj; Thapa, Meena
Abstract: Introduction: Menstrual disorders are problems faced by women in their reproductive period, which affects their day-to-day activities and the quality of life and sometimes can be an indicator of serious pathology. There are various types of menstrual disorders with dysmenorrhea being the commonest and most distressing. Health, sense of wellbeing and quality of life can be improved because of early detection and treatment for these disorders. The study aimed to find out the prevalence of dysmenorrhea among the nursing staff of a tertiary care center. Methods: A descriptive cross-sectional study was carried out from September 2020 to November 2020 among the nursing staff of a tertiary care hospital. Ethical approval was taken from the Institutional review committee of Kathmandu Medical College and Teaching Hospital (reference number: 1709202003). A convenient sampling technique was used. A pre-structured questionnaire was used for data collection. The subjects were asked to fill the questionnaire anonymously after taking consent. Statistical analysis was done using the Statistical Package for the Social Sciences. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage for binary data. Results: Out of 212 participants, 165 (77.8%) (95% Confidence Interval = 72.21-83.39) participants reported pain during menstruation. Of which, 61 (36.97%) participants reported abdominal pain. Conclusions: The prevalence of dysmenorrhea was high among the nursing staff of a tertiary care centre which was similar to the findings of other studies done in similar settings.
Mean Evan's Index among Patients with Normal Computed Tomography Scan visiting Radiology Department in a Tertiary Care Centre of Nepal: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2021) Koirala, Sagar; Agrawal, Prity; Bishokarma, Suresh; Shrestha, Pratyush
Abstract: Introduction: Evan's index is useful to objectively see if ventricles size is abnormal especially in borderline cases of hydrocephalus. Studying ventricular size in CT scan is essential in every pathology of the brain. Use of objective parameters to define hydrocephalus helps us not only to diagnose a case but also follow up the case following treatment. The aim of this study was to find out the mean even index among patients visiting the department of radiology of a tertiary care hospital. Methods: A descriptive cross-sectional study was conducted at a tertiary care hospital from 1st january 2020 to 31st December 2020. Ethical clearance was obtained from the Institutional Review Committee of Upendra Devkota Memorial Neurological and Allied Sciences (reference number: 116/2021). Computed tomography scans were done for various reasons in the hospital over a one year period and reported normal by the radiologists were included in the study. Convenient sampling was done. Statistical analysis was done using Statistical Package for the Social Sciences. Point estimate at 95% Confidence Interval was calculated along with mean and standard deviation for continuous data. Results: In this study, among the 216 cases, the mean Evan’s index was found to be 0.20±0.04. Conclusions: The mean evan’s index in our study population was lower than the normal cut-off value.

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