Introduction: Gall bladder cancer is the most common cancer of the biliary tree and one of the highly malignant tumors with poor prognosis. Although its incidence is low in west, it is common in our part of the world. There are very few studies regarding gall bladder cancer in Nepal. The incidence of gallstones in patients with gall bladder cancer is high. The aim of the study was to evaluate the clinicopathological aspect of the disease in patients with gallbladder cancer and to Asses the incidence of gallstones in patients with gall bladder cancer.Material and Methods: This was a retrospective study carried out in GI Surgery unit of National Academy of Medical Science, Bir Hospital, Kathmandu, Nepal. All patients diagnosed as gallbladder carcinomas during 12 years period from 2002 to 2014 were included in this study. Their clinical characteristics, laboratory data, tumor histopathology reports were obtained and analyzed using SPSS17.Results: Total of 47 patients who met inclusion criteria were included in the study. Male to Female ratio was 1:1.8. Age ranged from 32 to 72 years with mean age of 54. Most common presenting symptom was Pain abdomen (93.6%) followed by weight loss (51.1%) and Jaundice (46.8%). Most common finding on examination was Icterus (42.6%) followed by palpable gall bladder (34%) and Hepatomegaly (29.8%). Gall Stones were seen in 37 (72.3%) patients. Most common histopathology was Adenocarcinoma (93.6%).Conclusion: Most of the patient with gall bladder cancer remained asymptomatic until late. Pain abdomen was most common presenting symptom and icterus was most common findings. There was strong association between gall bladder cancer and gallstones. There should be high index of suspicion if patient with gallstones has constant pain in right hypochondrium and has jaundice.

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Background: As ovarian malignancies are one of the commonest malignancies in female population, timely and accurate diagnosis helps in early treatment resulting in better survival. Ultrasound is easily available diagnostic tool not only to diagnose but also accurately distinguish malignant from benign ovarian masses. Aims and Objectives: To evaluate sensitivity, specificity and accuracy of ultrasound in diagnosing and differentiating benign from malignant ovarian masses in comparison with histopathological findings. Materials and Methods: A prospective study was carried out from August 2015 to August 2018 for a period of 3 years. Total 150 patients with ovarian masses who were operated in our hospital and their final histopathological reports were available, were included in our study. Ultrasound diagnosis and histopathological diagnosis were compared. Results: Sensitivity, specificity and accuracy of ultrasound in diagnosing and differentiating malignant from benign ovarian masses were found to be 78.94%, 98.47% and 88.23% respectively compared with histopathological findings. Conclusion: Ultrasound is very sensitive, specific and accurate in not only diagnosing ovarian mass but also in differentiating malignant from benign entities making it invaluable and important diagnostic tool in evaluation of ovarian masses.

Background: Doppler provides assessment of uteroplacental and fetoplacental circulation during pregnancy. It is a sensitive tool in early detection of fetal compromise and allows needful intervention. Aims and Objective: To study the role of umbilical artery doppler in clinically suspected IUGR and its implication on neonatal outcome. Materials and Methods: A total of 104 singleton pregnancies with gestational age of more than 34 weeks who had clinical suspicion of IUGR were evaluated using obstetric ultrasound and doppler. Umbilical arteryvelocimetry with S/D >3 and RI >0.7 were considered abnormal. Newborns were classified as either small for gestational age (SGA) ie, IUGR or appropriate for gestational age (AGA). Neonatal outcome were classified as either normal or adverse events that included still birth, NICU admissions, perinatal asphyxia and/or neonatal death. Results: Out of 104 clinically suspected IUGR, 55 were born with small for gestational age. Among these SGA neonates, 45 subjects had abnormal umbilical artery S/D and 42 had abnormal RI. Abnormal umbilicalartery S/D ratio had a sensitivity of 81.8 %, specificity of 59.2 %, the positive predictive value of 69.2 % and negative predictive value of 74.4 %. Abnormal Umbilical artery RI had a sensitivity of 76.4 %, specificity of 69.4 %, positive predictive value of 73.7 % and negative predictive value of 72.3 % in diagnosing IUGR. Abnormal umbilical artery velocimetry was associated with increased morbidity and mortality in IUGR neonates. Conclusions: Umbilical artery doppler plays an important role in diagnosing IUGR and predicting neonatal outcome.

A biloma is an encapsulated collection of bile located in the abdomen. It usually occurs spontaneously or can be secondary to traumatic injury (hepatobiliary surgery) and in rare condition it can occur as complication of cholecystitis and cholangiocarcinoma. The diagnosis can be suggested on the basis of patient’s medical history, clinical symptoms and imaging findings but final definitive diagnosis can only be made by aspiration of the content and biochemical analysis. We here report a case of 62 years male patient admitted with acute abdominal pain in the right hypochondrium caused by a spontaneous biloma. We discuss the role of the various diagnostic imaging techniques, particularly which of ultrasound and CT. The biloma was identified on computed tomography in this case.