Ectopic Pregnancy Following Interval Tubal Sterilization

Introduction:  Tubal sterilization is a highly effective method of permanent contraception. However, pregnancy can still occur following a successful procedure. Published literatures report a failure rate of 0.13-1.3% and 15-33% of such pregnancies are likely to be ectopic. Case report: A 33 years para three lady with prior history of tubal ligation presented with generalized abdominal pain and several episodes of vomiting. Bimanual examination revealed a soft and mobile mass of 2 x 3 cm in right adnexa. Urine pregnancy test was positive and ultrasonogram showed a heterogeneous mass of 3.4 x 3.3 cm in right adnexa with empty uterine cavity. Culdocentesis resulted in aspiration of frank non-clotting blood. She then underwent emergency laparotomy with bilateral salpingectomy for ruptured ectopic pregnancy. Conclusion: Ectopic pregnancy after tubal sterilization though rare is not entirely impossible. All women who are offered this procedure should always be educated about its failure rate. And in women presenting with acute abdomen, a prior history of tubal sterilization doesn't preclude the possibility of ectopic pregnancy

Evaluation of rice genotypes for growth, yield and yield components

Twelve rice genotypes were evaluated under irrigated lowland and upland rainfed conditions in a randomized complete block design with three replications at Khumaltar, Lalitpur, Nepal in 2019. Data on plant height, panicle length, effective tillers per plant, fertile grain number per panicle and grain yield were taken. The variation was observed for plant height, panicle length, effective tillers per plant, fertile grain number per panicle among the evaluated rice genotypes. The rice genotype NR 11375-B-B-21 produced the highest grain yield (3974.75 kg/ha) followed by NR 11374-B-B-23 (3615.26 kg/ha) and NR 11145-B-B-B-6 (3597.56 kg/ha) under irrigated low land condition. Similarly, the rice genotypes, NR 11375-B-B-21 produced the highest grain yield (3837.15 kg/ha) followed by NR 11321-B-B-7-3 (3588.71 kg/ha) and NR 11305-B-B-1-3 (3292.36 kg/ha) under upland rainfed condition. The combined analysis showed that rice genotype NR 11375-B-B-21 produced the highest grain yield (3905.95 kg/ha) followed by NR 11374-B-B-23 (3494.63 kg/ha), and NR 11321-B-B-7-3 (3409.89 kg/ha) respectively. Thus, after evaluation of yield, two genotypes namely NR 11375-B-B-21, NR 11374-B-B-23, were selected as outstanding genotypes, which can be used as potential breeding materials for upland and low land environments of mid hills of Nepal

Variability for growth and yield traits in single cross hybrids of maize (Zea mays L.)

Saabunud / Received 29.09.2021 ; Aktsepteeritud / Accepted 18.11.2021 ; Avaldatud veebis / Published online 18.11.2021 ; Vastutav autor / Corresponding author: Jiban Shrestha [email protected] single-cross hybrids of maize were evaluated in a randomized complete block design with three replications to investigate genetic variability and correlation among growth and yield traits at Khumaltar, Lalitpur, Nepal from March 13 to September 05, 2021. The hybrids were grouped into four clusters using Euclidean Average Linkage method. The cluster analysis showed the presence of genetic variability in the evaluated hybrids. The maximum distance between cluster centroids (194.28) was found between cluster 2 and cluster 4, indicating genetic dissimilarity. Grain yield had the maximum values of phenotypic coefficient of variation (PCV) (35.02%), followed by ear height (17.82%) and plant height (12.22%). Similarly, grain yield had the maximum values of genotypic coefficient of variation (GCV) (26.24%) followed by the number of kernel rows/cob (8.77%) and days to 50% silking (8.72%). Days to 50% silking and days to 50% tasseling had the highest values of heritability (86%) followed by cob diameter (84%) and no. of kernel rows in cob (68%). The leaf area per plant had the maximum values of genetic advance (GA) (74.87 cm2), followed by plant height (27.80 cm) and days to 50% silking (9.66 days). Similarly, the maximum values of genetic advance as percent of the mean (GAM) was found for grain yield (40.50%) followed by days to 50% silking (16.70%) and days to 50% tasseling (16.17%). The hybrids namely KWM-91 × KWM-93 produced the maximum values of grain yield (9.99 t ha–1) followed by KWM-93 × KWM-91 (9.63 t ha–1) and KWM-92 × KWM-93 (9.40 t ha–1). Grain yield showed positive and significant phenotypic correlation with days to 50% silking (r = 0.41), days to 50% tasseling (r = 0.39), plant height (r = 0.37), cob diameter (r = 0.49) and the number of kernel rows in cob (r = 0.38). Therefore, utilization of present genetic variability along with indirect selection for traits having significant association with grain yield, high heritability and GAM could aid in the improvement of maize productivity

Late blight of potato and its management through the application of different fungicides and organic amendments: a review

Late the blight  of  potato is  a  devastating  and  one of  the  economic diseases  of potato  and  other plants  belonging  to family Solanaceae. Late blight, caused by Phytophthora infestans, is one of the most threatening pathogenic diseases which not only results in direct crop losses but also cause farmers to embrace huge monetary expenses for disease control and preventive measure. It was first reported during the Irish Potato Famine, leading to massive starvation in Ireland and other parts of Europe during the middle of 19th century. Phytopthora harms the foliar portion in the field and also the tuber in the storage that can result in complete crop failure in potato. The pathogen has distinct survival mechanisms and two life cycles infection processes. The development of a sexual spore known as oospore includes two types of pairs, A1 and A2. The spores are introduced to good plants by wind and rain. Different methods for prevention of crops from late blight has been developed and used worldwide. An integrated disease management strategy includes successful control of this disease. Cultural control, chemical management, and advanced disease management are the most effective interventions. Integration of late blight control in tropical regions with abundant fungal inoculants in most months of the year was also seen as one of the best choices in disease management. This paper reviews the significance of late blight of potato and controlling strategies adopted for minimizing yield losses incurred by this disease by the application of synthetic fungicides and different organic amendments

Shisham (Dalbergia sissoo) decline by dieback disease, root pathogens and their management: a review

Shisham or sissoo (Dalbergia sissoo) is an important multipurpose tree with great economic importance, but this tree has been infected by various root pathogens. This review article shows the works conducted on root pathogens and die back disease of Shisham and their management. Around seventy-one endophytic fungus has been found in sissoo trees in Nepal. Several fungi, including, Fusarium solani, F. oxysporum, Ganoderma lucidum, Phellinus gilvus, Polypours gilvus, Rhizoctonia solani, Polyporus spongiosum, etc. cause sissoo diseases. Ganoderma Lucidum and F. Solani are two main pathogenic agents in Shisham, all of which causes root rot and vascular wilt diseases, and are the causes for the large-scale death of this tree species. Root rot ganoderma is wide spread in both natural and plant-based forests. Older trees in Shisham are usually attacked by these pathogens and cause large-scale death. However, when sissoo is grown as a re-forested pure plant without the removal of the stumps or root of the initial plant, a serious problem of root rot can develop. Field sanitation and proper management of field are necessary to control the fungal diseases of Shisham. Another deleterious disease of  Shisham is dieback disease, where sissoo plantations have been confirmed to this disease when the infected trees begin to get dry from the top. There is no suitable solution for control of dieback of Shisham. There is a need of developing resistant varieties and to improve the quality of seed. This review may be useful tool for Forest Pathologists and other persons who are working in forestry and natural conservation sectors. &nbsp

Otorhinolaryngologic Evaluation of Patients with Obstructive Sleep Apnea Syndrome in Tertiary Hospital of Nepal

Background: Obstructive sleep apnea is a global health problem characterized by collapse of upper airway during sleep. It is commonly associated with road traffic accidents, diabetes mellitus and cardiovascular disease. The study aimed to measure the different otorhinolaryngologic parameters of patients with obstructive sleep apnea and to compare these findings with different class of polysomnography. Methods: A hospital based cross-sectional study was carried out among patient coming to department of Otorhinolaryngology of Kathmandu Medical College and Teaching Hospital. In total 74 patients with obstructive sleep apnea participated in this study. Sociodemographic details, co-morbid illness and anthropometric measurements were recorded. Data was presented in the form of mean, standard deviation and percentage. Chi-square, student’s t-test were done using Statistical Package for the Social Sciences version 16. A p-value of <0.05 was considered statistically significant. Results: The mean age of the patient was 47.43±11.30 years. Majority of the patients were male. Out of 74 patients, 24 (32.4%) patients were obese, 22 (29.7%) were overweight. The PSG showed 49 (66.2%) participant had severe obstructive sleep apnea.  According to Modified Mallampati score, 28 (37.8%) of patients belonged to Class 3, 20 (27%) belonged to Class 2. There was no significant association observed between the studied variables and polysomnographic results. Conclusion: Male and old age were the predominant factor in obstructive sleep apnea patients. In patients with snoring, the Otorhinolaryngologists should rely on thorough medical history, anatomic examination, radiological examination of head and neck should be done.    Keywords: Modified Mallampati Score; Obstructive sleep apnea; Otolaryngology: Polysomnography

Variation in brachial plexus formation, branching pattern and relation with major vessels

Background: Anatomical variations in the formation, branching pattern and relations of the brachial plexus have been described in humans by many authors; however these have not been extensively catalogued. The aim of the study was to describe variations in brachial plexus formation, branching pattern and relation with major vessels.Methods: This study included thorough dissection of 60 brachial plexuses which belonged to 30 cadavers (male: female ratio = 28:02 ) with age range of 20-60 years, obtained from the Department of Anatomy, College of Medical Sciences (CMS-TH), following standard guidelines. Results: Out of 60 limbs dissected in present study, the variation in formation was found in 20 limbs (33.3%), out of which 12 limbs (20%) had variations in the trunk and 8 limbs (13.3%) had variations in the cord, remaining 40 limbs (66.6%) were normal in the formation of brachial plexus. Normal branching pattern of the posterior cord was encountered in 52 (86.67%) limbs, the remaining 8 (13.33%) being variants in one form or the other. The upper subscapular nerve, the thoracodorsal nerve, the lower subscapular nerve and the axillary nerve were found to arise normally in 91.66%, 96.66%, 96.66% and 98.33% of the limbs respectively.Conclusion: The present study carried out on adult human cadavers revealed some rare variations in the formation, branching pattern and relations of the brachial plexus. These variations are of clinical significance for the surgeons, radiologists and the anesthesiologists.

Raisins and additional walking have distinct effects on plasma lipids and inflammatory cytokines

<p>Abstract</p> <p>Background</p> <p>Raisins are a significant source of dietary fiber and polyphenols, which may reduce cardiovascular disease (CVD) risk by affecting lipoprotein metabolism and inflammation. Walking represents a low intensity exercise intervention that may also reduce CVD risk. The purpose of this study was to determine the effects of consuming raisins, increasing steps walked, or a combination of these interventions on blood pressure, plasma lipids, glucose, insulin and inflammatory cytokines.</p> <p>Results</p> <p>Thirty-four men and postmenopausal women were matched for weight and gender and randomly assigned to consume 1 cup raisins/d (RAISIN), increase the amount of steps walked/d (WALK) or a combination of both interventions (RAISINS + WALK). The subjects completed a 2 wk run-in period, followed by a 6 wk intervention. Systolic blood pressure was reduced for all subjects (P = 0.008). Plasma total cholesterol was decreased by 9.4% for all subjects (P < 0.005), which was explained by a 13.7% reduction in plasma LDL cholesterol (LDL-C) (P < 0.001). Plasma triglycerides (TG) concentrations were decreased by 19.5% for WALK (P < 0.05 for group effect). Plasma TNF-α was decreased from 3.5 ng/L to 2.1 ng/L for RAISIN (P < 0.025 for time and group × time effect). All subjects had a reduction in plasma sICAM-1 (P < 0.01).</p> <p>Conclusion</p> <p>This research shows that simple lifestyle modifications such as adding raisins to the diet or increasing steps walked have distinct beneficial effects on CVD risk.</p

Nepal paediatric society clinical guidance for management of sepsis and septic shock in the paediatric intensive care units in Nepal

Justification: Sepsis is a major cause of morbidity and mortality in Nepal. There is a lack of standardisation in the management of severe sepsis and septic shock. Additionally, international guidelines may not be completely applicable to resource limited countries like Nepal. Objective: Create a collaborative standardised protocol for management of severe sepsis and septic shock for Nepal based on evidence and local resources. Process / Methods: Paediatricians representing various paediatric intensive care units all over Nepal gathered to discuss clinical practice and delivery of care of sepsis and septic shock under the aegis of Nepal Paediatric Society. After three meetings and several iterations a standardised protocol and algorithm was developed by modifying the existing Surviving Sepsis Guidelines to suit local experience and resources. Recommendations: Paediatric sepsis and septic shock definitions and management in the early hours of presentation are outlined in text and flow diagram format to simplify and standardise delivery of care to children in the paediatric intensive care setting. These are guidelines and may need to be modified as necessary depending on the resources availability and lack thereof. It is recommended to analyse data moving forward and revise every few years in the advent of additional data

Improving decision support system in identifying vulnerability rating and prioritizing the best interventions for sustainable watersheds in Pakistan, Nepal, and Sri Lanka

Quantification of watershed vulnerability rating and prioritization of the best watershed management intervention is always a challenge for multidisciplinary experts in developing consensus. Consequently, the lack of a decision support system (DSS) negatively affects the adoption of promising interventions leading to reduced watershed communities’ resilience to climate change. Therefore, a DSS has been developed to integrate local multi-disciplinary knowledge in identifying the watershed vulnerability ratings and prioritizing the best site-specific watershed management interventions. The DSS developed was applied to selected watersheds using 25 local experts each in Pakistan, Nepal, and Sri Lanka. The results showed the DSS is conveniently applicable and effective in developing consensus among multidisciplinary experts. The DSS recommended that the best interventions for the selected watersheds should primarily reduce the existing accelerated land and water degradation through engineering and biological actions, namely the control the rainwater run-off losses through appropriate harvesting systems and their subsequent efficient utilization for improving food security, climate change resilience and livelihood of vulnerable watershed communities. The DSS developed can be helpful in developing local adaptation plans and strengthening the policy support for promoting sustainable watersheds in Pakistan, Nepal, and Sri Lanka. However, the system needs further refinement through the incorporation of the design, specifications and costing of the interventions and making the data acquisition and analysis automatic using an online electronic system for quicker results and appropriate resource allocation for stimulated adoption.Quantification of watershed vulnerability rating and prioritization of the best watershed management intervention is always a challenge for multidisciplinary experts in developing consensus. Consequently, the lack of a decision support system (DSS) negatively affects the adoption of promising interventions leading to reduced watershed communities’ resilience to climate change. Therefore, a DSS has been developed to integrate local multi-disciplinary knowledge in identifying the watershed vulnerability ratings and prioritizing the best site-specific watershed management interventions. The DSS developed was applied to selected watersheds using 25 local experts in Pakistan, Nepal, and Sri Lanka. Results showed that DSS is conveniently applicable and effective in developing consensus among multidisciplinary experts. The DSS recommended that the best interventions for the selected watersheds should primarily reduce the existing accelerated land and water degradation through engineering and biological actions. These actions may include controlling the rainwater run-off losses through appropriate harvesting systems and their subsequent efficient utilization for improving food security, climate change resilience and livelihood of vulnerable watershed communities. The DSS developed can be helpful in developing local adaptation plans and strengthening the policy support for promoting sustainable watersheds in Pakistan, Nepal, and Sri Lanka. However, the system needs further refinement through the incorporation of the design, specifications and costing of the interventions and making the data acquisition and analysis automatic using an online electronic system for quicker results and appropriate resource allocation for stimulated adoption