Introduction Extradural schwannoma arising from high cervical spinal root is a rare entity in children. We report a case of extradural cervical schwannoma in a 14-year-old boy. Case presentation Our patient is a 14-year-old Madhesi boy presenting with swelling in the posterior triangle of his neck. The radiological features suggested solitary extradural cervical schwannoma which was confirmed later by histopathological findings. There were no postoperative neurological complications in our patient. Conclusion Extradural spinal schwannoma is a benign tumor. Gross total resection with good clinical outcome can be achieved with minimal risks.

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: Ultrasound is one of the best tools for the scanning of the female pelvis. It is easy to operate and very helpful in acute condition to rule out different lower abdominal pathology. Ultimately fast and accurate diagnosis of the pathology by ultrasound is key to further management and treatment. The aim of preset study was to find the common causes of the acute pelvic pain in the non-pregnant reproductive age females. Methods: The study was conducted in Department of Radiology and Imaging of college of medical sciences. Patients with acute pelvic pain of reproductive age non-pregnant female are included in our study. All ultrasound examinations were performed using Toshiba Aplio 500. A prospective cross-sectional study was conducted on 48 patients in college of medical science, Bharatpur, over the period of one year (November 2018 to October 2019). Data obtained were compiled and ana­lyzed using standard statistical analysis. Statistical Package for the Social Sciences (SPSS) version 20.0 and Microsoft Excel were used for the data analysis and presentation Results: Present study showed the most common cause of acute pelvic pain to be ovarian cysts in which 20.8% were hemorrhagic cysts, followed by corpus luteal cyst (14.58%) and endometrioma (12.50%). Non-gynecological case like cystitis, acute appendicitis and ureteric calculus were seen in equal number which is 10.41% each. Similar way ovarian torsion and pelvic inflammatory disease were seen in 8.33 and 4.10% respectively. In 8.33% cases no diagnosis was made. Conclusions: Ultrasound plays a crucial role in diagnosis of the acute pelvic pain in female. It helps in rapid assessment and immediate decision making for operative planning.

Background: Presently the most effective way to date pregnancy is by use of ultrasound. Several sonographically derived fetal parameters used to date pregnancy include fetal crown - rump length (CRL), biparietal diameter (BPD), head circumference (HC), femur length (FL),and abdominal circumference (AC). Placental thickness measured at the level of the umbilical cord insertion can be used as a new parameter to estimate gestational age of the fetus. The present study was undertaken to evaluate the relationship between placental thickness and gestational age of the fetus. Methods:  Cross-sectional study was conducted in the College of Medical Science and Teaching Hospital, Bharatpur, Nepal among 150 patients with normal singleton pregnancies presenting for routine antenatal visit of all gestational ages from 11 weeks to 40 weeks. Patients with pregnancy induced hypertension, diabetes mellitus, intrauterine growth retardation, hydrops foetalis, congenital malformation and twins are excluded. Placental thickness value, in mm, was calculated by averaging the three best measurements for each case. We studied the relationship of placental thickness, in mm, measured at the level of insertion of umbilical cord with advancing gestational age in weeks. Correlation of mean placental thickness with gestational age from 11 weeks to 40 weeks was calculated. Results: It was observed that the placental thickness gradually increased from approximately 11 mm at 11 weeks to 38.33 mm at 40 weeks of gestation. From 11 to 34 weeks of gestation, the placental thickness (in mm) almost matched the gestational age in weeks, thereafter from 35 to 40 weeks; the placental thickness was lower by 1 to 2 mm. Conclusion: The relationship between the placental thickness and gestational age was linear and direct. Placental thickness (in mm) measurement can be an important additional parameter for estimating gestational age along with other parameters especially from 11 to 34 weeks of gestation.

The use of grey-scale ultrasound morphology to characterize a pelvic mass may also be called ‘pattern recognition’. The grey-scale ultrasound image provides as much information as that obtained by the surgeon or pathologist when they cut a surgical specimen to see what it looks like inside. Aim of our study is to characterize the ovarian mass by ultrasound. The study was conducted in Department of Radiology and Imaging, College of Medical Sciences, Bharatpur. Patients with suspected ovarian mass in Gynecology OPD were included in our study. A prospective cross-sectional study was conducted on 60 patients in college of medical science, Bharatpur, over the period of one year (from November 2019 to October 2020). Present study showed benign ovarian (90.0%) pathology are the most commonly encountered ovarian mass. Ovarian mass is most common in adult female of age 15-30 years and malignant ovarian mass was most common among the age group of 30-60 years. Among benign pathology of ovary simple follicular cysts are most common (39.0%), followed by hemorrhagic cyst (31.0%), dermoid cyst (17.0%), chocolate cyst (9.0%) and ectopic pregnancy (4.0%). Among the malignant ovarian mass serous cystadenocarcinoma and mucinous cystadenocarcinoma showed similar frequency (33.0% each) and followed by immature teratoma and krukenberg tumor (17.0% each). Ultrasound parameters like size, septal thickness, solid component and spectral doppler (RI ans PI) are very helpful for determination of malignant pathology. In this study the sensitivity and specificity of size parameter is least (40.3% and 60.2%) and highest in solid component and spectral Doppler parameter (PI) being (82.0% and 92.0%). Combined study of grey scaleand spectral Doppler study plays crucial role in characterization of ovarian mass to differentiate between benign and malignant pathology.