Objective: The purpose of this study was to categorize patients into different grades of nonalcoholic fatty liver disease (NAFLD) by ultrasonography and to compare the findings with their serum lipid profile. Materials and Methods: Descriptive, cross-sectional study design was used. One hundred and nine patients without a history of alcohol consumption of age more than 16 years attending general health checkup were selected at Tribhuvan University Teaching Hospital, Maharajganj, Kathmandu, as per the exclusion and inclusion criteria. Ultrasound scanning of the patients was done and their liver size, as well as grading of fatty liver, was done. Data were collected in predesigned pro forma and were analyzed using Statistical Package for the Social Sciences (SPSS) 16.0, IBM (SPSS Inc., Chicago, IL). Results: In this study, the mean age of fatty liver in males was found to be 44.3 years and in females was found to be 51.9 years. 22.9% of patients with NAFLD had increased liver size. Significant association with increasing grades of fatty liver was found with increasing levels of cholesterol ( P = 0.028), low-density lipoprotein (LDL) ( P = 0.017), liver size ( P = 0.001), and body mass index (BMI) ( P = 0.045) in patients diagnosed with NAFLD. No significant association with increasing grades of fatty liver was found with increasing levels of triglyceride ( P = 0.32) and high-density lipoprotein ( P = 0.25). Conclusion: Ultrasound is a safe and first-line modality for the evaluation of fatty liver and its grading. Increasing grades of fatty liver had significant association with increasing levels of cholesterol LDL, increasing liver size, and BMI of patients.

Background: Superior mesenteric artery syndrome is a rare but vital cause of upper gastrointestinal obstruction which occurs when the third portion of the duodenum is trapped between aorta and superior mesenteric artery. The sig­nificant decrease of the angle and distance between the superior mesenteric artery and aorta is the etiology of Superior mesenteric artery syndrome.The study aimed to identify the angulations and distance of superior mesenteric artery from aorta and their correlation with body mass index in patients re­ferred for contrast enhanced computed tomography of abdomen examination in Chitwan Medical College. Methods: The angle between the aorta and superior mesenteric artery was measured in arterial phase of the abdominal scan in the multiplanar recon­structed image in sagittal plane. The distance between the superior mesen­teric artery and aorta was measured in axial plane at the level of 3rd part of duodenum. Results: The aortomesenteric distance was obtained to be 13.30 ± 4.75 mm and the aortomesenteric angle was obtained to be 54.7±16.91 degree for a to­tal of 210 patients. There was a positive correlation between body mass index and aortomesenteric distance (p=0.086) and significant positive correlation between body mass index and aortomesenteric angle (p=0.122). Additionally, it showed there was significant positive correlation between aortomesenteric angle and aortomesenteric distance. Conclusions: The distance and angle between the superior mesenteric artery and the aorta correlates significantly with the body mass index which indicates that the decrease in body mass index can be used as a risk factor of superior mesenteric artery syndrome.

Background: Corona virus disease 2019 (COVID-19) has become a global public health issue with significant impacts upon the healthcare delivery systems. Previous studies have consistently found elevated levels of C-Reactive Protein and D-dimer with disease severity. In this study, we aimed to investigate the relationship between C-Reactive Protein, D-dimer level and Computed Tomography severity score in patients with SARS-COV-2 pneumonia. Methods: Our study included 76 patients with COVID-19, admitted in COVID Unit of Chitwan Medical College and Teaching Hospital from June 2020 to December 2020. We included COVID-19 cases confirmed by a RT-PCR test and those undergoing High resolution Computed Tomography of chest and having C-Reactive Protein and D-dimer levels done on admission. A semi-quantitative CT score was calculated based on the extent of lobar involvement (0:0%; 1, < 5%; 2:5–25%; 3:26–50%; 4:51–75%; 5, > 75%; range 0–5; global score 0–25. Results: Overall the median CTSS was 15. Mild, moderate and severe CT severity scoring was reported in 5.3%, 60.5% and 34.2% respectively and D-dimer progressively increased across the CTSS severity groups. The difference was significant for CRP, P = 0.007 but not for D-dimer, P = 0.42. Moreover, higher CTSS scores were significantly associated with higher ICU stay, lower recovery rate and higher O2 requirement at discharge. Conclusions: Radiological severity of COVID-19 pneumonia has significant association with elevated C-Reactive Protein level but not with D-dimer level and other routine laboratory parameters.

Post caesarean pelvic abscess is a rare complication   which may present without typical features of endometritis. It should remain as one of the differential diagnoses in any patient with refractory puerperal fever.  Despite the use of antibiotic   prophylaxis, it still can occur causing significant maternal morbidity requiring a complicated course of management with the need of an intensive care unit, drainage of pus under ultrasound guidance or sometimes may need surgical re-exploration or even hysterectomy. We report a case of pelvic abscess in a young   lady following caesarean section   who presented   with puerperal pyrexia. She did not respond to broad spectrum antibiotic treatment and underwent ultrasound-guided transabdominal drainage of the pelvic abscess following which she had rapid clinical improvement and good recovery.

Introduction: Modern advances in radiology, imaging, and novel surgical methods have greatly aided doctors in making both surgical and non-surgical decisions. During surgery, anatomical variances are frequently encountered by surgeons, making operation complex and occasionally challenging. The purpose of our study was to evaluate the hepatic artery and its variants, including the length and diameter of the right and left hepatic arteries. This information is vital for patients undergoing major hepatic surgeries and hepatic transplantation Methods: A total of 120 patients who underwent contrast-enhanced Triphasic CT of the abdomen were evaluated with the consent of the ethics committee at Chitwan medical college. Study subjects were selected on a random basis, who had no previous abdominal or hepatic surgeries, and without the known hepatic disease. Results: Out of 120 participants, 63 (52.5%) were male and the rest 57(47.5 %) were females. Normal anatomy was observed in 104 cases (86.7%) and the rest of the 16 cases showed an anomalous hepatic arterial pattern, which consisted of Michel’s type III in 6 cases (5%), Type IV in 1 case (0.8%) and Type X in 3 cases (2.5%); and 5 cases (4.2%). did not fall under Michel’s Classification. Supply to segment IV of the liver was observed from Left hepatic artery in 97 cases (80.8%) and from the right hepatic artery in 23 cases (19.2%). Conclusions: Many hepatic arterial variants which did not fall under Michel’s classification were observed in our population.