Background/Aim:Alcohol is the most common substance abused in Nepal. Liver disease caused by alcohol abuse, including its end stage, cirrhosis, is a major health care problem, which is difficult to treat.Objectives:To study the demographic profile, laboratory parameters, complications and their prognostic implications among patients of alcoholic liver disease (ALD).Materials and Methods:Records of all patients of ALD admitted from January 1' 2005 to December 31' 2006 were studied and followed up to December 31, 2007. A total of 181 patients were analyzed. Their clinical profile and laboratory parameters were noted and analyzed using SPSS-10.0 software.Results:Among the 181 patients, 80.7% were male, 30.9% were army/ex-army and 65.2% were documented smokers. The mean age of presentation was 52.08 years. Jaundice (57.5%) was the most common presentation followed by hepatomegaly (51.4%). Hypoalbuminemia (50.3) followed by ascites (48.1) were common complications. Death occurred in 19.1% of the patients, the most common cause being hepatic encephalopathy (72.2%) followed by variceal bleeding and hepatorenal syndrome. Jaundice, ascites and hepatic encephalopathy at presentation and female sex were significantly associated with increased mortality along with discriminant score >32, aspartate aminotransferase (AST): Alanine aminotranferase (ALT) ≥ 2, ultrasonography (USG)-proven cirrhosis, rise in prothrombin time ≥5 s, total bilirubin ≥ 4mg/dL and ESR ≥34.Conclusion:ALD was predominantly seen among the productive age group with a high morbidity and mortality. Jaundice, ascites, hepatic encephalopathy at presentation and female sex are poor prognostic indicators along with discriminant score > 32, AST:ALT ≥ 2, USG-proven cirrhosis, coagulopathy, hyperbilirubenemia and high ESR.

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Introduction: Acute appendicitis is common surgical emergency which can lead to high morbidity and mortality in absence of timely treatment. Ultrasonography (USG) is commonly used to diagnose appendicitis and exclude other intraabdominal pathology leading to right iliac fossa pain in emergency setting. We aimed to Þ nd out the diagnostic value of graded compression USG in suspected appendicitis cases. Methods:Altogether 107 patients with clinical impression of acute appendicitis were followed. Four cases were excluded because of other diagnosis established in USG. Appendicitis was diagnosed by standard criterias of inß ammed appendix by graded compression technique. Informations of 103 cases were recorded in proforma which was later entered in SPSS and statistical calculations done.Results: Out of 103 cases followed, 93 had appendicitis. Of those, 46 cases only showed inß ammed and distended appendix, others showed ancillary features only. Males were more affected 61(65.6%) than females. Sensitivity, speciÞ city, positive predictive value, negative predictive value and accuracy of ultrasound in detecting appendicitis were 98.9%,90%,98.9%,90% and 97.1% respectively. Conclusions:Graded compression ultrasonography is good investigation modality in assessement of suspected acute appendicitis.

Background: Focal lung masses are common radiological fi ndings which need to be characterized to plan management. Suspicious lesions require invasive investigations and aggressive treatment. However, likely benign lesions require no invasive investigations. Objectives: We aimed to correlate the computerized tomography fi ndings of focal lung lesions with pathological diagnoses. Methods: A total of 56 patients were enrolled in the study. Plain and contrast enhanced computerized tomography scan of chest was done in spiral computerized tomography. Radiologist's computerized tomography reports were obtained. Pathological diagnosis were followed in all cases and recorded. computerized tomography reports were compared with pathological reports and validity of computerized tomography in predicting the nature of lung lesion was assessed. Results: Overall, squamous cell carcinoma was the most common histological cell type (46.34%) followed by adenocarcinoma (41.46%). In 95.12% of total cases, size of the malignant lesion was more than 3cm. Squamous cell carcinoma was the most common tumor located centrally (71.42%) and adenocarcinoma peripherally (55.55%). Spiculated margin was most commonly associated in malignant lesions. Among morphological characters, chest wall invasion and mediastinal invasion were statistically signifi cant for malignancy. Contrast enhancement more than 20 hounsfi eld unit had more than 80% sensitivity and specifi city for malignant lesions. Sensitivity of computerized tomography combining all morphological characteristics for depicting malignancy was 97.6% and specifi city was 46.7%. Conclusion:The present study showed that contrast enhanced computerized tomography provides more precise tumor localization, characterization and intrathoracic extension to differentiate benign from malignant lung lesion. Enhancement of the lesion is more specifi c for malignancy than other morphological characteristics.

Neurocysticercosis is one of the common space occupying lesion of brain in Asian countries. Cysticercosis of brain can present in variable forms with or without classic scolex in cyst. As they are so common and treatable cause of new onset seizure, identification of such pathology is crucial in imaging. We are presenting a cystic lesion of brain of middle aged patient with spontaneous onset of seizure and headache. On CT scan there was large cystic lesion of white matter of right cerebral hemishere with no perilesional edema and contrast uptake. On further imaging with MRI, there were other small lesions in left cerebrum apart from large lesion detected on CT. None of the lesions showed scolex and contrast uptake. Excisional biopsy showed the lesion to be taeniasis of brain. The albendazole and steroid therapy cured the symptom of the patient. It is one of the rare pattern of common disease.