Background: Pulmonary Tuberculosis (PTB) is a major public health problem in Nepal. Diag­nosis of pulmonary tuberculosis is done by bacteriological confirmation of respiratory speci­men however Negative smear needs clinical and radiological evaluation for the diagnosis in suspected patient. This study focuses on radiological findings in both Pulmonary bacterio­logically confirmed (PBC) and pulmonary clinically diagnosed (PCD) Tuberculosis. Methods: This observational study was conducted at Chitwan Medical College between Feb 2019 to July 2019. 45 Patient diagnosed with PTB were enrolled. Chest X-ray (CXR) and High Resolution Computed Tomography (HRCT) chest reports were analysed for the presence of findings that suggest active infection like cavity, consolidation, tree in bud, etc in PBC and PCD. Results: A total of 45 PTB patients with mean age: 54.60 ± 19 years were included. 53.3 % were PBC and 46.7 % were PCD tuberculosis, CXR findings in PBC and PCD tuberculosis was nodular infiltrate 45.8% versus 2.4%, consolidation 45% versus 42.9%, cavity 8.3% versus 14.3% respectively however 12.5% PBC tuberculosis patient had a normal chest x-ray. HRCT chest in PBC and PCD showed cavity in 45.8% versus 23%, tree in bud 25% versus 52.4%, con­solidation 62.5 versus 57.1%, ground glass opacity 29.2% versus 23.8% respectively and none of the HRCT chest was normal. In comparison to the CXR, HRCT chest shows more cavitary lesions in PBC and tree in bud was more common in PCD. Conclusions: This study has found that radiological findings suggestive of active PTB was more obvious in HRCT than CXR. Presence of cavity, lobar consolidation and tree in bud lesion in HRCT chest were more frequently observed in both PBC and PCD Tuberculosis.

Introduction: Chronic Kidney Disease (CKD) is a progressive loss in renal function over period of many months or years. As compared to the past decades, the number of kidney diseases leading to end CKD is increasing in Nepal. The disease is associated with the decreased glomerular filtration rate (GFR). There is decline in nephron function and number generally quantitated as reduction in glomerular filtration rate. As the GFR declines, there is accumulation of metabolic end products excreted by Kidney. Chronic kidney disease is identified by blood tests, creatinine and urea are two such substances routinely measured. Serum amylase is a pancreatic digestive enzyme that normally acts extracellular to cleave starch into smaller carbohydrate groups and, finally, into monosaccharide's. It is produced by 40-45% from the pancreas and (45%) reabsorbed by tubular cells. Elevations in serum total amylase among patients with CKD is due to impaired renal clearance and seen mostly when the creatinine clearance is below 50 ml/min. Several studies have been reported on this but there are no studies that have been done so far in Nepalese context.Objectives: This study is designed to correlate serum amylase with CKD stage three to stage five in patients of chronic renal disease irrespective of hemodialysis and prevalence of risk factors of CKD and different factors that may affect the level of serum amylase in patients presenting to Bir Hospital Nephrology department, Nepal.Methods: The study was a cross-sectional, observational, descriptive, hospital based carried out in Nephrology Unit of Bir hospital both inpatient or outpatient irrespective of hemodialysis from March 2014 to March 2015. Patients with increased serum amylase due to acute Pancreatitis, Mumps, Intestinal Obstruction, Peptic Ulcer, Cancer, other than renal cause were excluded. The results were analyzed using SPSS version 11 and Microsoft Excel by correlation coefficient. Result: Present study shows that among 126 patients, the prevalence of age group was from 15 years to 78 years with majority being male. The serum amylase levels were significantly higher in Chronic Kidney Disease Stage V with significant p-value. At 80-100 Serum Amylase level had strong correlation of 0.504 for CKD III stage and significant at 10 percent level. The correlation between CKD IV at 80-100 was significant at 10 percent but weak of 0.189. Whereas, CKD V was highly significant but negative at more than 161 Serum Amylase.Conclusion: From the study it was concluded that in Chronic Kidney Disease, Serum amylase was found to be higher as the eGFR decreases. BJHS 2018;3(2)6:403-407.

Background: Pulmonary Tuberculosis (PTB) is a major public health problem in Nepal. Diag­nosis of pulmonary tuberculosis is done by bacteriological confirmation of respiratory speci­men however Negative smear needs clinical and radiological evaluation for the diagnosis in suspected patient. This study focuses on radiological findings in both Pulmonary bacterio­logically confirmed (PBC) and pulmonary clinically diagnosed (PCD) Tuberculosis. Methods: This observational study was conducted at Chitwan Medical College between Feb 2019 to July 2019. 45 Patient diagnosed with PTB were enrolled. Chest X-ray (CXR) and High Resolution Computed Tomography (HRCT) chest reports were analysed for the presence of findings that suggest active infection like cavity, consolidation, tree in bud, etc in PBC and PCD. Results: A total of 45 PTB patients with mean age: 54.60 ± 19 years were included. 53.3 % were PBC and 46.7 % were PCD tuberculosis, CXR findings in PBC and PCD tuberculosis was nodular infiltrate 45.8% versus 2.4%, consolidation 45% versus 42.9%, cavity 8.3% versus 14.3% respectively however 12.5% PBC tuberculosis patient had a normal chest x-ray. HRCT chest in PBC and PCD showed cavity in 45.8% versus 23%, tree in bud 25% versus 52.4%, con­solidation 62.5 versus 57.1%, ground glass opacity 29.2% versus 23.8% respectively and none of the HRCT chest was normal. In comparison to the CXR, HRCT chest shows more cavitary lesions in PBC and tree in bud was more common in PCD. Conclusions: This study has found that radiological findings suggestive of active PTB was more obvious in HRCT than CXR. Presence of cavity, lobar consolidation and tree in bud lesion in HRCT chest were more frequently observed in both PBC and PCD Tuberculosis.

Background: Interstitial lung disease (ILD) is a heterogeneous group of diffuse parenchymal lung diseases, characterized by restrictive physiology, impaired gas exchange, pulmonary inflammation and fibrosis. Chest radiograph (CXR) may appear normal during initial course of the disease and may show few abnormalities. High resolution computed tomography (HRCT) chest is a most ac­curate non-invasive, high spatial resolution descriptive imaging modality for evaluation of lung parenchyma. It assesses presence, location, type and characterization of ILD in appropriate clinical setting. Our aim was to study radiological patterns and its distribution in CXR and HRCT chest of ILD patients. Methods: This was an observational, single centered, cross-sectional study conducted at author’s place over the period of 6 months starting from January 2018 using convenient sampling method. Data analysis was done using students t-test for comparison of means and chi-square test for proportions. Results: A total of 30 suspected or diagnosed patients of ILD were enrolled in our study and pat­terns found on CXR were correlated with that on HRCT chest. The number of findings in HRCT chest for a patient was significantly higher than CXR (Median number: 4 verses 2, P<0.001), commonest reticular opacity 50% in CXR and 56.6% HRCT. One subject had normal CXR. Conclusion: HRCT was superior to CXR in detection of all basic patterns and their distribution as­sociated with ILD as higher numbers of findings were detected by HRCT chest as compared to CXR. HRCT chest could characterize the abnormality and specify its location much more accurately.

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