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1.
Kathmandu Univ Med J (KUMJ) ; 18(71): 316-319, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-34158444

RESUMEN

Adrenal ganglioneuromas are rare sympathetic differentiated tumors which originate from neural crest cells. These lesions are usually discovered incidentally on imaging and tend to be hormonally silent. Preoperative diagnosis of adrenal ganglioneuroma remains extremely challenging and the gold standard treatment is adrenalectomy. There is good prognosis after surgery without recurrence. We herein report a case of adrenal ganglioneuroma in a 15 year old female who presented with complaint of abdominal discomfort. Contrast Enhanced Computed Tomography abdomen showed a large septated hypodense right suprarenal mass which was echogenic on Ultrasonography. It showed T1 hypointense and T2 hyperintense signal on Magnetic Resonance Imaging of abdomen and pelvis. Excisional biopsy and histological examination of the mass was suggestive of adrenal ganglioneuroma. This report presents the clinical and radiological data for the rare tumor which would share some experience to facililate the diagnosis of adrenal ganglioneuroma.


Asunto(s)
Neoplasias de las Glándulas Suprarrenales , Ganglioneuroma , Adolescente , Neoplasias de las Glándulas Suprarrenales/diagnóstico por imagen , Neoplasias de las Glándulas Suprarrenales/cirugía , Femenino , Ganglioneuroma/diagnóstico por imagen , Ganglioneuroma/cirugía , Humanos , Imagen por Resonancia Magnética , Recurrencia Local de Neoplasia , Tomografía Computarizada por Rayos X
2.
Nepal Med Coll J ; 16(2-4): 152-5, 2014 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-26930735

RESUMEN

The fetal nasal bone length (FNBL) is a recent sonographic marker included in second trimester genetic sonography which varies with race and ethnicity. The importance of measuring FNBL is in the prenatal diagnosis of Down's syndrome (DS), the most common chromosomal abnormality. Nasal bone hypoplasia or absence is one of the frequent features of DS. Different studies conducted in different parts of the world have established FNBL in different races. But, reference values for normal fetal nasal bone length are yet to be established for Nepalese population. So, the aim of this study was to determine normal FNBL in second trimester. Objective was to create normal reference values for fetal nasal bone in Nepalese population. A cross sectional study was carried out on 150 second trimester pregnancy cases referred for antenatal ultrasound to Department of Radiology at Nepal Medical College and Teaching Hospital between May 2014 and July 2014. Cases included all the clinically normal second trimester pregnancy in which fetal nasal bone could be visualized in midsagittal plane. Table demonstrating normal FNBL corresponding to weeks of gestation was generated using IBM SPSS Statistics Version 20. There was linear increase in mean FNBL with gestational age. Minimum mean FNBL was 2.93 mm at 14 weeks and maximum was 7.89 mm at 27 weeks. Age of patients ranged from 17 to 35 years. Normal FNBL values in Nepalese population corroborates with those published in Western literature but with variation. Hence, reference values for local population become more relevant for antenatal ultrasound practices in Nepal.


Asunto(s)
Feto/anatomía & histología , Edad Gestacional , Hueso Nasal/anatomía & histología , Hueso Nasal/diagnóstico por imagen , Adolescente , Adulto , Estudios Transversales , Femenino , Humanos , Embarazo , Ultrasonografía Prenatal , Adulto Joven
3.
Nepal Med Coll J ; 16(1): 26-9, 2014 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-25799806

RESUMEN

A prospective study was carried out from 2009 to 2013 in the Department of Radiology and Imaging of Nepal Medical College and Teaching Hospital, Attarkhel, Jorpati, Kathmandu, Nepal, in which a total of 75 patients underwent percutaneous renal biopsy with a 16 or 18 gauge needles. This was done blindly by marking a site on the skin, or, whenever there was difficulty with the blind procedure, by direct real time USG guidance. In all cases, the marking in the skin was done by the radiologist and the biopsy was performed by the Nephrologist, with the aid of the radiologist in cases of real-time USG guided renal biopsy. This study was carried out to assess the safety and efficacy of the USG aided, and USG guided renal biopsy, to see for the types and severity of complications arising from renal biopsies to determine the optimal period of observation required after the procedure. All renal biopsies were performed after the patients were admitted to the hospital at least 1 day prior to the procedure. Coagulation profile was done in all patients prior to the procedure. All patients were kept under strict complete bed rest for 24 hours post procedure. The ages of the patients ranged between 14 years to 71 years, with 42 female and 33 male patients. A mean of 21.8 glomeruli was obtained in each specimen, with absent glomerular yield seen in only 3 patients. Minimal change disease was seen in 19 patients, being the most common histopathological diagnosis followed by a spectrum of others. The overall complication rate was 4% and all of these were self-limiting needing no other intervention, or management except for observation and bed rest. Late complications were not seen. Percutaneous renal biopsy with the help of USG is a safe and efficacious procedure with less chance of minor complications.


Asunto(s)
Riñón/diagnóstico por imagen , Riñón/patología , Ultrasonografía Intervencional , Adolescente , Adulto , Anciano , Biopsia con Aguja Fina/métodos , Femenino , Hospitales de Enseñanza , Humanos , Enfermedades Renales/diagnóstico , Masculino , Persona de Mediana Edad , Nepal , Estudios Prospectivos , Adulto Joven
4.
Nepal Med Coll J ; 15(2): 87-90, 2013 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-24696922

RESUMEN

Advanced maternal age defined as age 35 years or more at estimated date of delivery is considered to have higher incidence of obstetric complications and adverse pregnancy outcome than younger women. The objective of this study was to compare the obstetric and perinatal outcome of pregnancies in women with advanced maternal age > or = 35 years with that of younger women < 35 years. A prospective comparative study was carried out in department of obstetrics and gynecology at Nepal Medical College and Teaching Hospital over the period of one year from October 2012 to September 2013. The obstetric and perinatal outcome of 90 women with advanced maternal age (study group) were compared with those of 90 younger women aged 20-34 years (control group). Among antenatal complications, women of advanced maternal age had increased incidence of hypertensive disorder of pregnancy (26.6% vs 4.4%; p = 0.00009) and breech presentation (8.8% vs 1.1%; p = 0.04). There were no significant difference between two groups in incidence of antepartum hemorrhage, gestational diabetes mellitus, prelabor rupture of membrane and preterm delivery. The rate of caesarean delivery was significantly higher in advanced maternal age (28.8% vs 17.7%; p = 0.05). In perinatal outcome, older women had significantly higher incidence of perinatal death (7.7% vs 0%; p = 0.01). There were no significant differences in low birth weight rate and apgar score less than 7 at five minutes of life in two groups. Thus from this study, it can be concluded that advanced age women had higher incidence of hypertensive disorder of pregnancies and malpresentation, were more likely to deliver by caesarean section and had increased incidence of perinatal death.


Asunto(s)
Parto Obstétrico/métodos , Edad Materna , Resultado del Embarazo , Adulto , Distribución de Chi-Cuadrado , Femenino , Humanos , Nepal , Embarazo , Estudios Prospectivos , Adulto Joven
5.
Nepal Med Coll J ; 15(2): 98-101, 2013 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-24696925

RESUMEN

A prospective study was carried out during 2010 - 2011 in the Department of Radiology & Imaging of Nepal Medical College and Teaching Hospital, Jorpati, Kathmandu and Om Hospital and Research Centre, Chabahil, Kathmandu in which a total of 45 patients with clinically and CT scan diagnosed ischaemic cerebrovascular accident (CVA) underwent carotid Doppler study. During the hospital stay these patients also underwent lipid profile estimation to see for presence or absence of hyperlipidemia. Of these 45 patients, CT scan showed left middle cerebral artery (MCA) infarctions in 12, right MCA infarction in 12, lacunar infarctions in 10, watershed territory infarction in 4, posterior circulation infarction in 1 and venous infarction in 1 patient. Carotid Doppler study showed more than 50% stenosis in 31 patients. Among these 31 patients, 28 had hyperlipidemia where as blood cholesterol and triglyceride values in 3 patients were normal. The present study like several other studies done in the past showed association between carotid stenosis and hyperlipidemia, leading to CVA.


Asunto(s)
Estenosis Carotídea/sangre , Estenosis Carotídea/diagnóstico por imagen , Accidente Cerebrovascular/sangre , Accidente Cerebrovascular/diagnóstico por imagen , Adulto , Anciano , Anciano de 80 o más Años , Arterias Carótidas/diagnóstico por imagen , Distribución de Chi-Cuadrado , Femenino , Humanos , Hiperlipidemias/sangre , Hiperlipidemias/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Nepal , Estudios Prospectivos , Ultrasonografía
6.
Nepal Med Coll J ; 14(4): 271-4, 2012 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-24579532

RESUMEN

A prospective study was carried out during 2010 - 2012 in which a total of 194 patients underwent USG guided FNAC from lesions in deep seated thoracic and abdominal organs. These included liver, lungs, intra-abdominal lymphnodes, gall bladder, ovary and adnexa, pancreas, stomach, omentum, other mass of unknown origin in peritoneal cavity, mediastinum, kidney, colon, small intestine, pleura, appendix and adrenal gland. Of these, FNAC was diagnostic in 168 (86.7%) cases, in 15 (7.7%) cases it was not conclusive. In next 6 (3.1%) it was suspicious of malignancy and the smears were acellular and /or contained blood only in 5 (2.6%) cases. Of all diagnosed cases, 153 (78.9%) cases were malignant, 28 (14.4%) were non-noplastic which included inflammatory, infective and granulomatous lesions and 13 (6.7 %) were benign neoplastic lesions. In liver, metastatic adenocarcinoma was the most common FNAC diagnosis, in lungs non-small cell carcinoma. The aim of this study was to evaluate the overall role of USG guided FNAC in diagnosis of abdominal and thoracic lesions.


Asunto(s)
Biopsia con Aguja Fina , Ultrasonografía Intervencional , Abdomen , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Tórax
7.
Nepal Med Coll J ; 13(3): 213-5, 2011 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-22808819

RESUMEN

A combination of antiprogesterone mifepristone and prostaglandin analogue misoprostol provides an effective non surgical method for termination of pregnancy up to gestational age of 63 days. The objective of this study was to assess the efficacy of this medical regimen for termination of pregnancy up to 63 days of pregnancy. A hospital based prospective study was carried out in department of obstetrics and gynecology at Nepal Medical College Teaching Hospital (NMCTH) for a period of one year where 100 women requesting for medical abortion were enrolled. The medical regimen used was mifepristone 200 mg orally followed 24 hours later by misoprostol 800 micrograms administered buccally. Most of the women were in age group 20-29 years (50%), were nulliparous (81%) and were within 42 days of pregnancy (47%). The overall success rate of this regimen was 93.6%. Where success was defined as achieving complete abortion without needing surgical evacuation. Surgical evacuation was needed in 6 (6.4%) patients i.e. 5 for incomplete abortion and one for continued viable pregnancy. The combination of oral mifepristone 200mg followed 24 hours later by buccal misoprostol 800mcg is effective method of medical termination of pregnancy.


Asunto(s)
Abortivos , Aborto Inducido , Hospitales de Enseñanza , Mifepristona , Misoprostol , Adulto , Femenino , Edad Gestacional , Humanos , Mifepristona/administración & dosificación , Misoprostol/administración & dosificación , Nepal , Embarazo , Estudios Prospectivos , Factores de Tiempo , Adulto Joven
8.
Nepal Med Coll J ; 11(2): 127-9, 2009 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-19968155

RESUMEN

A prospective study was carried out from November 2006 - December 2008 in which a total of 304 patients with early pregnancy were examined by ultrasound (US). Of these, 203 (66.8%) cases were normal pregnancies (including 8 cases of twin pregnancy), 32 (10.5%) missed abortions, 19 (6.3%) incomplete abortions, 14 (4.6%) complete abortions, 12 (4.0%) blighted ovums, 11 (3.6%) without sonographic evidence of pregnancy, 7 (2.3%) ectopic pregnancies and 6 (1.9%) molar pregnancies. US in early pregnancy gave a reliable and accurate differentiation between a viable normal pregnancy and an abnormal/pathological pregnancy.


Asunto(s)
Complicaciones del Embarazo/diagnóstico por imagen , Ultrasonografía Prenatal , Adolescente , Adulto , Diagnóstico Diferencial , Femenino , Humanos , Embarazo , Estudios Prospectivos
9.
Nepal Med Coll J ; 11(1): 42-5, 2009 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-19769237

RESUMEN

Fallopian tube defects are responsible for subfertility in 12.0-33.0% of subfertile couple. Hysterosalpingography (HSG) is a safe and less invasive method of detecting both the tubal and uterine defects. The objective of this study was to find out the incidence of tubal blockage including its site and side diagnosed by HSG in subfertile Nepalese women and to find out the incidence of uterine and other abnormalities detected by this test. This was a prospective study of 1000 cases of subfertility, conducted in Om Hospital, Kathmandu. A short history and HSG report of these cases were obtained from the Radiology department of the hospital. Size and shape of the uterine cavity, evidence of cervical incompetence, tubal visualization, spillage of dye, tubal block with its side and site, evidence of peritoneal adhesion and intravasation of dye in vessels were noted. Quick spillage of the dye in the peritoneal cavity or spillage only after pushing the dye with pressure was also noted. Results were entered in simple tabulations and analyzed. Among 1000 cases, 65.8% had primary and 34.2% had secondary subfertility. 29.0% of the total 1000 cases had abnormal HSG findings. 19.0% of total 1000 cases had tubal blockage. Incidence of tubal blockage in both primary (19.1%) and secondary subfertilty (18.7%) was almost same, in contrary to previous belief. Mullerian defect was present in 3.2% of primary subfertility and 2.0% of secondary subfertility cases. Cervical incompetence was not detected in any case. Evidence of uterine infection was present in 0.7% of primary subfertility and 0.2% of secondary subfertility cases. Abnormal size of uterine cavity was present in 1.2% of primary subfertility and 0.5% of secondary subfertility. Features of phimosis of fimbrial opening, localized spill and intravasation of dye were present respectively in 5.6%, 1.5%, 1.2% in primary subfertility and 4.9%, 1.7% and 1.7% in secondary subfertility.In conclusion; the incidence of tubal blockage detectable by HSG in this study was 19.0%.


Asunto(s)
Enfermedades de las Trompas Uterinas/diagnóstico , Histerosalpingografía , Adulto , Enfermedades de las Trompas Uterinas/complicaciones , Femenino , Humanos , Infertilidad Femenina/etiología , Nepal , Estudios Prospectivos , Adulto Joven
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