Introduction: Stroke is a major public health burden worldwide and is responsible for a large proportion of disability. It ranks third in the causation of morbidity and mortality. This study was carried out to establish the pattern of various types of cerebrovascular accident (CVA) in western Nepal, to correlate the clinical data and radiological findings in cases of stroke, and to identify the common risk factors associated with stroke.   Methods: A total of 200 patients presented at the department of Radiodiagnosis from emergency or ward within six months of study period from 18th of September 2015 to 17th of March 2016 with clinical diagnosis of stroke. Brain CT scan was done within 14 days of onset.   Results: There were 200 patients with stroke (124 males and 76 females), aged 19 to 92 years in which infarction was more common than hemorrhage (57% Vs 41.5%) clinically. Hypertension was the commonest risk factor noted in 59% cases followed by Diabetes Mellitus in 39%. Middle cerebral artery (MCA) territory infarction was the most common site of infarction. Clinical and CT localization of hemorrhage and infarct was correct in 153 cases (75%) which was statistically significant.   Conclusion: Infarction is more common than hemorrhage as the type of stroke. Hypertension is the commonest risk factor followed by diabetes mellitus.

Introduction: As suggested through several autopsy studies there is a high prevalence of latent prostate  cancer in the population. A much smaller proportion of prostate  cancer is detected because of clinical symptoms. This study was done to identify the rates of incidentally detected prostate cancer in patients undergoing surgical management of Benign Prostatic Hyperplasia (BPH) in our centre.   Methods: A retrospective review was done on all transurethral resections of the prostate (TURP)  cases from May 2014 to May 2015 at a single tertiary care institution. One hundred and three men, aged 40 to 88 year, underwent TURP and their specimens were sent for the  histopathological analysis.   Results: Five (4.85%) patients were diagnosed with the prostate  cancer. All the five patients had Gleason score of seven or more. Two patients had moderately differentiated adenocarcinoma  with Gleason score of seven. Three patients had poorly differentiated adenocarcinoma with Gleason score of eight or above. The Prostate cancer was seen only  in the age group above 65 years but it was not statistically significant.   Conclusion: Our series demonstrated that 4.85% of patients had latent prostate  cancer. It occurs mainly in men above 65 years of age though this was not statistically significant.

ABSTRACT:Introduction: Cerebrovascular Accident (CVA) is defined as abrupt onset of a neurological deficit that is attributable to a focal vascular cause. CT scan is a widely available, affordable, non-invasive and relatively accurate investigation in patients with stroke and is important to identify stroke pathology and exclude mimics. Aim of this study is to establish the diagnostic significance of computed tomography in cerebrovascular accident and to differentiate between cerebral infarction and cerebral haemorrhage with CT for better management of CVA. Methods: A one year observational cross sectional study was conducted in 100 patients that presented at the department of radiodiagnosis from emergency or ward within the one year of study period with the clinical diagnosis of stroke, and had a brain CT scan done within one to fourteen days of onset. Results: A total of 100 patients were studied. 66 were male and 34 were female with a male/female ratio of 1.9:1. Maximum number of cases (39%) was in the age group of 61-80 yrs. Among 100 patients, 55 cases were clinically diagnosed as hemorrhagic stroke and 45 cases were clinically diagnosed with an infarct. Out of the 55 hemorrhagic cases, two cases were diagnosed as both hemorrhage and infarct by CT scan, one case had normal CT scan findings and one had subdural haemorrhage. These four cases were excluded while comparing the clinical diagnosis with CT scan finding. Among 51 clinically diagnosed cases of hemorrhagic stroke, 32(62.7%) cases were proved by CT scan as hemorrhagic stroke and among clinically diagnosed cases of infarct, 39(86.7%) cases were proved by CT scan as infarct which is statistically significant (p <0.001). A significant agreement between clinical and CT diagnosis was observed as indicated by kappa value of 0.49. Sensitivity, specificity, positive predictive value and negative predictive value of clinical findings as compared to CT in diagnosing hemorrhage were 84.2%, 67.2%, 62.8% and 86.7% respectively. The accuracy of clinical diagnosis is 74%. Conclusion: This study showed that CT scan is a useful diagnostic modality to identify stroke pathology and to exclude mimics.

Background: The clavicle, modified long bone, presents morphological and bilateral variations. This may be due to genetic factors, hormones, or environmental and occupational influences. Anthropometric studies in clavicle of Nepalese population using radiograph has not been reported to best of our knowledge. This study, aimed to determine the sexual dimorphism and bilateral asymmetry of clavicle in Nepalese Population using Postero-Anterior Chest X Ray. Methods: Chest x-rays with normal and clearly visible both clavicles of 1260 Nepalese adults (591 male, 669 female), aged above 20 years were utilized. Inbuilt software “Computed Radiography Fuji Computer System 7” was used for measurements (in centimeter) of sternal head length, acromial end length, mid shaft diameter and length of clavicle. Demarcating point and identification point were calculated. Patients having history of clavicles fractures in the past were excluded. Results:  All the parameters in male is greater than female which is significant except Length/Mid Shaft Diameter. Similarly, all the parameters of right clavicle is significantly greater than left clavicle in both sexes except Sternal Head Length and Mid Shaft Diameter. Demarcating point calculated from length of the clavicle (right >16.17, left >16.10 for male and right <11.20, left <10.65 for female) and Mid Shaft Diameter (right >1.33, left >1.38 for male and right <0.66 and left <0.67 for female) are important parameters to determine sex.    Conclusions:The clavicle shows significant sexual dimorphism and bilateral asymmetry in Nepalese population. The result of this study is helpful to anthropologist and forensic medicine. Keywords: Anthropometry; clavicle; demarcating point; postero-Anterior chest x-rays; sexual dimorphism

ABSTRACT:Introduction: Seizure occurs in up to 10% of the population, whereas epilepsy is a chronic disease characterized by recurrent seizures that may affect up to 2% of the population. Modern neuroimaging is useful in diagnosis of abnormalities underlying the epilepsies, but the information provided by imaging techniques can also contribute to proper classification of certain epileptic disorders and can delineate the genetics of some underlying syndromes. Neuroimaging is even more important for those patients who have medically intractable seizures. This study was carried out to establish different etiologies of seizures, to correlate the clinical data and radiological findings in cases of seizure, and to identify the common etiologies in different types of seizures. Methods: This was a retrospective hospital-based study conducted in the Department of Radiodiagnosis of Lumbini Medical College Teaching Hospital. Records of patients of past two years, admitted in any department of the hospital with history of seizure disorder and underwent a Computed Tomography (CT) of brain were included. The CT patterns were assessed and the data were tabulated and statistically analyzed. Results: There were a total of 480 cases out of which 263 (55%) were male and 217 (45%) were female with M:F ratio of 1.2:1. Generalized seizure was more frequent than partial seizure in both gender. In 274 cases of generalized seizures, CT scan findings were abnormal in 151 cases and normal finding observed in 123 cases. In 206 cases of partial seizures, 125 cases were abnormal and 81 having normal CT scan findings. Age wise distribution showed highest number (n=218) of cases in young group (<20 yr) and least number (n=45) in eldest group (>60 yr). The most common cause of seizure was calcified granuloma (n=79, 16.5%) followed by neurocysticercosis (NCC, n=64, 13%). Diffuse cerebral edema, sub-arachnoid hemorrhage, and hydrocephalus was seen only in lower age group particularly among 1-20 years. Infarct and diffuse cortical atrophy were most common cause of seizure in older age group. NCC and tuberculoma are the most common cause of partial seizure whereas cerebral infarcts, hemorrhage, malignancy, diffuse cortical atrophy are the most common cause of complex seizure. Few rare diseases like Fahr disease and tuberous sclerosis were also found in CT scan of seizure patients. Conclusion: NCC and tuberculoma are the most common cause of partial seizure whereas cerebral infarcts, hemorrhage, malignancy, and diffuse cortical atrophy are the most common cause of complex seizure. CT scan plays an important role as a preliminary tool in radiological assessment of patients presenting with seizures.