Abstract:Dyke- Davidoff-Masson Syndrome (DDMS)

Introduction: Ultrasonography plays a pivotal role in present day obstetrics. It has been well recognized that the fetuses of extremes of the normal birth weight range are associated with increased perinatal morbidity, mortality and adverse development outcomes. Categorization of fetal weight into either the small or large for gestational age may lead to timed obstetric interventions that collectively represent significant departure from routine antenatal care. Objective: To compare the accuracy of Hadlock's 1, 2, 3, 4 and Shepard model in estimating expected fetal weight and its comparison with actual birth weight in our population at eastern region of Nepal. Methodology A prospective observational study was performed in the Department of Radiodiagnosis, Nobel Medical college and teaching hospital, Biratnagar, over a period of 6 months dated Jan 2018 to June 2018 using systematic random sampling with sample size estimated as 160, with 5% level of significance, 80% power of test and a maximum of 200 grams differences by our predicting model from actual mean weight. Singleton, term pregnancy (37- 42 weeks gestational age) verified with antenatal USG performed prior to 20 weeks' gestation. Pregnancies complicated by congenital anomalies and deliveries after 2 days of USG examination were excluded. Results: 159 pregnant ladies were enrolled in our study with mean age of 27.60 ± 5.633 years (range 18-43 years). The average (actual) birth weight recorded was 3450.79±438.73gms. The different formulae for estimating birth weight gave us similar results. Estimation of fetal weight by Shepard gave us a mean of 3340.80 ± 463.72. Hadlock1, Hadlock2, Hadlock3 and Hadlock4were 3546.55±429.92grams, 3491.18±439.49 grams, 3445.23 ±422.79grams, and 3446.12±418.43grams respectively. Conclusion: All four Hadlock formulae gave comparable results for fetal weight estimation including the Shepard formula; however, Shepard formula tends to underestimate fetal weight as compared to rest of the formulae. Among the Hadlock's, Hadlock 2 seems to show betier accuracy in fetal weight prediction in our population of study. The mean birth weight recorded using Hadlock 1 formula gave the beer correlation with the actual birth weight though the difference between four Hadlock formulae was all insignificant.

Introduction: Facet joint arthropathy is one of the myriad of abnormalities for low back pain and since conventional Magnetic resonance Imaging detects the facet joint pathologies poorly when compared to fat suppressed MRI sequences, fat suppressed MRI promises to be contributory to proper diagnosis and management. Objective: The objective of this study was to find the prevalence of lumbar facet joint arthrosis among patients with low back pain and comparing conventional versus fat saturated sequence in detecting the MRI findings of facet joint arthrosis. Methodology: A cross sectional study was conducted at the Department of Radiodiagnosis and Department of Orthopedics at Birat Medical College Teaching Hospital from February 15, 2020 to May 15, 2020. Ethical clearance was taken and 100 participants having low back pain were enrolled for Magnetic Resonance imaging after informed consent. Data were Results: 57% study participants were found to have facet joint arthrosis (FJA) in their lumbar spine and on comparing the detection rate of the grades of arthrosis between the conventional and FS MRI, the difference in diagnosis of grade 2 and grade 3 changes of FJA were 87.9% and 42.9% respectively whereas no difference was found in diagnosing grade 4 changes in both the sequences. Data was entered in MS excel and analysed by SPSS. Conclusion: This study showed that facet joint arthrosis is frequently seen in the patients presenting with low back pain and these changes are better diagnosed by fat saturated MRI sequence as compared to conventional sequence.

Introduction: Ultrasound (USG) is the most commonly used imaging method to evaluate thyroid nodules. The sonographic features of thyroid nodules are very important to determine whether the nodule is benign or malignant. Fine Needle Aspiration Cytology (FNAC) is the gold standard to determine whether the nodule is benign or malignant. Objective: The purpose of this study was to compare ultrasound and color Doppler features of thyroid nodules with ultrasound-guided FNAC results to determine the relative importance of these features in predicting the risk of malignancy. Methodology: This prospective cross-sectional study was conducted in Birat medical college teaching hospital in Tankisinuwari, Morang, Nepal. The study was conducted from September 2019 to April 2021.  In total sixty-one patients with thyroid nodules were evaluated for sonographic characteristics. Finally, USG guided FNA for cytopathological examination was performed. Both descriptive and inferential statistics were used to analyze the result. Results: Out of the 61 patients, 34 (55.7%) were females and 27 (44.2%) were males. Majority of the malignant nodules were solid 11 (91.6%), whereas cystic and mixed nodules were predominantly seen in benign nodules 18 (36.7%) and 30 (61.2%) respectively. In malignant nodules 10 (83.3%) were heterogeneous and 2 (16.6%) were isoechoic. In benign nodules 29 (59.1%) were heterogeneous and 15 (30.6%) were anechoic with comet-tail artifact and 5 (10.2%) were isoechoic. Among 12 malignant cases, internal and peripheral vascularity were equally present in six cases each. Benign nodules showed peripheral vascularity in 48 (97.9%) and internal vascularity was noted in only one nodule. All of the malignant nodules showed calcification. None of the benign nodules showed micro-calcification. In malignant cases, cervical lymph nodes were present in 7 (58.3%) and absent in 5 (41.6%). In benign cases, cervical lymph nodes were present in 4 (8.1%) and absent in 45 (91.83%). Conclusion: The ultrasound features associated with malignancy in thyroid nodules are predominantly solid component, presence of micro-calcifications and internal vascularity. Enlarged cervical lymph nodes are good predictors for malignancy. USG guided FNAC confirms the suspicious features of thyroid nodules seen on USG.

Introduction: Functional endoscopic sinus surgery has emerged as a superior technique in sinus surgery with a lower incidence of associated complications as compared to traditional surgeries; however, it still carries risks of possible complications, some of which could be attributable to the variations that exist in the nose and paranasal sinus anatomy. Variations in the uncinate process, one of the important structural landmarks in functional endoscopic sinus surgery can have implications during sinus surgery. Therefore, identifying the variations in the uncinate process becomes a very important consideration. The objective of this study was to identify the variations of the uncinate process on Multidetector Computed Tomography of paranasal sinuses  Methods: This cross-sectional study was conducted in the Department of Radiodiagnosis, Birat Medical College and Teaching from December 2021 to June 2022 after obtaining ethical clearance from IRC. A total of 240 participants referred to the Department of Radiodiagnosis for CT of paranasal sinuses were included in the study.  Results: The most frequent superior attachment of uncinate was found to be Type I and the least common was Type IV. The least frequent variation was UP pneumatisation. Most of the cases showed typical angulation followed by medial orientation and lateral orientation.  Conclusion: Variations in the uncinate process exist and Multidetector CT is a commendable tool for identifying these variations.