IntroductionLemierre syndrome is a serious condition that associates oropharyngeal infection and thrombosis of the internal jugular vein (IJV) with subsequent distant septic emboli, most frequently in the lungs.Case presentationA 70-year-old female with retropharyngeal abscess developed features of Lemierre syndrome. The condition was managed with serial aspiration of the abscess and prolonged usage of intravenous antibiotics.DiscussionLemierre syndrome is most frequently caused by the anaerobic bacterium, Fusobacterium necrophorum. Although rare, there is evidence of a resurgence in the condition in recent years, most probably due to reduced use of antibiotic therapy for sore throats. Although there is a characteristic clinical picture, many clinicians are unaware of this condition, leading to delayed diagnosis with potentially fatal consequences.ConclusionEarly diagnosis of this condition and prompt treatment with intravenous broad spectrum antibiotics results in a complete resolution of this condition. Surgery is indicated in the case of abscess formation.

Background: COVID19 pneumonia is caused by novel corona virus. The HRCT chest is helpful in identification of COVID-19 Pneumonia. CT chest play a crucial role in assessing the pattern of manifestation and severity of lung involvement in COVID-19. The objective of this study is to described high resolution computed tomography (HRCT) chest findings in COVID-19 Pneumonia patients in college of medical sciences Bharatpur Nepal. Method: A prospective, HRCT Chest findings were analaysed in 375 patients. Patients with high CORADS score and suspicious for COVID-19 pneumonia were further tested positive in PCR examination. The study was done for a year period of time Result: A total 375 patients suspected for COVID-19 pneumonia in HRCT, 341 were PCR positive. The mean age affected by viral pneumonia was 51.9 (51-60 year group). The male were 240 and female were 135. Ground glass opacities is noted in 188 patients, followed by GGO and consolidation in 177, consolidations only in 7 and others findings chest findings in 3 patients. Conclusion: HRCT chest can help in early detection of COVID-pneumonia. It can also asses the percentages of lung involvement and severity of disease that can guide physician.

IntroductionSpine injury is one of the leading caused for disability in Nepal. Patients with trauma relatedspine injury leads to neurological dysfunction, focal deficits and even fatal life threating events.The timely intervention in acute spinal trauma injury could save the patients from disability andmortality risk. Imaging modalities like Xray, CT Scan and MRI helps in diagnosis and managementof spinal trauma. MRI plays crucial role in detection of spinal cord and soft tissue injuries. It issuperior than CT scan in evaluation of spinal cord injuries, ligament, soft issue structures, disc,and occult osseous injuries. The objective of this research is to evaluate MRI in acute spinal traumain tertiary center of Nepal. MethodsThis is descriptive hospital based observational study in those patients who were admitted andreferred in hospital for MRI with acute spinal trauma injury. Data were analysed by SPSS 2022. ResultsAcute spinal trauma is most common in male with ratio of 1.7 with the mean±SD of age was foundto be 50.98±19.26 years. Most common mode of injury were fall injury (76%). Most common spinalregion involved were lumbar (42%) followed by thoracic (36%), dorso-lumbar (14%) and cervical(8%) region respectively. Spinal cord contusion with edema, disc rupture, paravertebral collectionand ligament injury were seen. Most common type of fractures were simple compression fracture(72%), followed by burst fracture (16%), both (6%) and listhesis and sub/dislocations (6%). Spinalcord injury were seen in 22%, followed by disc rupture, paravertebral collection and ligamentinjury. ConclusionsMRI helps in evaluating vertebrae, spinal cord, ligament and disc injuries. We can assess the cordcontusion, edema and canal compression. It provides involvement, extension and severity of cordinjury. It endowed about outcome of surgery as well as conservative management in patient ofspinal injury.

Background: Peripheral arterial disease is one of the most important causes of morbidity. Non-invasive characterization of peripheral arterial disease is possible by using CT angiography. The aim of this research is to evaluate CT angiographic findings in patients with peripheral arterial disease, to characterize lesion, risk factors and site of lesion. Methods: This hospital based prospective study was conducted in 40 consecutive patients with lower limb peripheral arterial disease who underwent CT angiography in the Department of Radiodiagnosis College of Medical Sciences-Teaching Hospital from January 2018 to Jan 2019. Results: Atherosclerotic peripheral disease was most common in elderly male patient with history of smoking, hypertension, diabetes or dyslipidemia and usually presents in the late stages with single or multiple arterial segmental involvement including the abdominal aorta. However, non- atherosclerosis peripheral arterial disease was seen in younger patients and presents with vascular thrombosis. Conclusions: CT angiography is a reliable non-invasive imaging modality for evaluating patients with peripheral arterial disease and lesion characterization. Keywords: CTA; Peripheral arterial disease.  

Nonalcoholic fatty liver disease is being increasingly recognized as one of the major causes of chronic liver disease. It is associated with various metabolic condition including obesity and diabetes. As the incidence of diabetes and obesity is increasing every day due to change in lifestyle, the incidence of nonalcoholic fatty liver disease is also increasing and so does its related chronic liver disease. Doppler ultrasound is easily available, noninvasive modality to see the hemodynamics of portal vein in various diffuse liver diseases. Our objective in our study is to show the correlation between the nonalcoholic fatty liver disease and Doppler findings of portal vein. The study was conducted in Department of Radiology of College of medical sciences, Bharatpur. Total 70 participants with in group of 30-60 years were included in our study (50 patients with fatty liver disease and 20 with normal liver parenchyma). All ultrasound examination performed with the Toshiba Aplio 500 with convex array deep probe of frequency 3.5MHZ. Prospective cross-sectional study was conducted over the period of one year between September 2020 to August 2021. The mean age of our patients with fatty liver was 42.1 ± 8.4 years, mean BMI was 30.6 ± 3.6 similarly mean V_min and V_max of portal vein is 20.0 ± 7.7cm/s and 24.6 ± 7.4cm/s respectively. Same way the control group without fatty liver had 40.6 ± 9.7 years mean age, 23.55 ± 4.8cm/s mean BMI, 30.05 ± 5.1cm/s mean V_min and 34 ± 5.0cm/s mean V_max. There is statistically significant difference of mean BMI (p<0.001), Minimum Portal Vein Velocity (p<0.001) and Maximum Portal Vein Velocity (p<0.001) among the patients having fatty liver disease and not having fatty liver. Our findings suggest that patients with nonalcoholic fatty liver have lower portal venous velocities than normal healthy study participants.