Evaluation of toxicity of biorational insecticides against larvae of the alfalfa weevil.

The alfalfa weevil, (Coleoptera: Curculionidae), is a major pest of alfalfa L. (Fabaceae). While usually causes the most damage before the first cutting, in summer of 2015 damaging levels of the pest persisted in Montana well after the first harvest of alfalfa.

Cerebral venous thrombosis presenting with intracerebral hemorrhage in a patient with paroxysmal nocturnal hemoglobinuria.

Cerebral venous thrombosis (CVT) is an uncommon cause of stroke. Paroxysmal nocturnal hemoglobinuria (PNH) is a rare type of hemolytic anemia, frequently associated with thrombophilia. PNH may rarely present with CVT.

Comparison between long- and short-axis techniques for ultrasound-guided cannulation of internal jugular vein.

Context: Real-time ultrasound guidance for internal jugular (IJ) vein cannulation enhances safety and success.

Aims: This study aims to compare the long- and short-axis (LA and SA) approaches for ultrasound-guided IJ vein cannulation.

Subjects And Methods: Patients undergoing surgery and in intensive care unit requiring central venous cannulation were randomized to undergo either LA or SA ultrasound-guided cannulation of the IJ vein by a skilled anesthesiologist.

Macular thickness and macular volume measurements using spectral domain optical coherence tomography in normal Nepalese eyes.

Purpose: To record the normative values for macular thickness and macular volume in normal Nepalese eyes.

Methods: In all, 126 eyes of 63 emmetropic subjects (mean age: 21.17±6.

Anaesthetic Management of Patients with Takayasu's Arteritis for Open Cholecystectomy.

Takayasu's arteritis is a well known yet rare form of large vessel vasculitis.1 This inflammatory disease often affects the ascending aorta and aortic arch, causing obstruction of the aorta and its major arteries.2 Anaesthetic management for these patients is complicated by severe hypertension, end-organ dysfunction, stenosis of major blood vessles and difficulties in monitoring blood pressure.

Integrative analyses reveal signaling pathways underlying familial breast cancer susceptibility.

The signaling events that drive familial breast cancer (FBC) risk remain poorly understood. While the majority of genomic studies have focused on genetic risk variants, known risk variants account for at most 30% of FBC cases. Considering that multiple genes may influence FBC risk, we hypothesized that a pathway-based strategy examining different data types from multiple tissues could elucidate the biological basis for FBC.

Phlyctenular keratoconjunctivitis among children in the tertiary eye hospital of Kathmandu, Nepal.

Background: This study was conducted to determine clinical profile and etiological factors for phlyctenular keratoconjunctivitis (PKC) in our patients.

Materials And Methods: In the descriptive study, 50 pediatric cases of PKC were enrolled into the study from outpatient department of BP Koirala Lions Center for Ophthalmic Studies between August 2011 and August 2012. The age, sex, exposure to tuberculosis, ocular symptoms, and systemic complaints were recorded.

Delivering neurocritical care in resource-challenged environments.

Purpose Of Review: Resource-challenged environments of low and middle-income countries face a significant burden of neurocritical illness. This review attempts to elaborate on the multiple barriers to delivering neurocritical care in these settings and the possible solutions to overcome such barriers.

Recent Findings: Epidemiology of neurocritical illness appears to have changed over time in low and middle-income countries.

Adaptations in a Community-Based Family Intervention: Replication of Two Coding Schemes.

Although program adaptation is a reality in community-based implementations of evidence-based programs, much of the discussion about adaptation remains theoretical. The primary aim of this study was to replicate two coding systems to examine adaptations in large-scale, community-based disseminations of the Strengthening Families Program for Parents and Youth 10-14, a family-based substance use prevention program. Our second aim was to explore intersections between various dimensions of facilitator-reported adaptations from these two coding systems.

Successful lumbar puncture with Taylor's approach for the diagnostic workup of meningitis in a patient with Ankylosing spondylitis.

Meningitis and encephalitis are the neurological emergencies. As the clinical findings lack specificity, once suspected, cerebrospinal fluid (CSF) analysis should be performed and parenteral antimicrobials should be administered without delay. Lumbar puncture can be technically challenging in patients with ankylosing spondylitis due to ossification of ligaments and obliteration of interspinous spaces.

Point-of-care Ultrasonography in Critically Ill Patients.

Point-of-care ultrasonography has been used frequently by the physicians involved in managing critically ill patients. It allows direct visualization of pathology or abnormal physiological state at the bed side. The examination may be safely and effectively repeated as needed to follow the evolution of illness and the response to therapy.

Errors in cause-of-death statement on death certificates in intensive care unit of Kathmandu, Nepal.

Background: Death certificates (DC) are one of the most important medico-legal documents that physicians work through. DCs are extensively used in health statistics for epidemiological studies, and in health policy planning as a public health resource tool. Cause-of-death (COD) statement, which is vulnerable to various errors, is the vital part of a DC that has the potential to mislead the policy makers and statisticians.

Intranasal midazolam for rapid sedation of an agitated patient.

Rapidly, establishing a difficult intravenous access in a dangerously agitated patient is a real challenge. Intranasal midazolam has been shown to be effective and safe for rapidly sedating patients before anesthesia, for procedural sedation and for control of seizure. Here, we report a patient in intensive care unit who was on mechanical ventilation and on inotropic support for management of septic shock and who turned out extremely agitated after accidental catheter removal.

Topographic corneal changes in children with vernal keratoconjunctivitis: A report from Kathmandu, Nepal.

Purpose: The present study was conducted to determine corneal topographic characteristics of children with vernal keratoconjunctivitis (VKC) and compare the corneal topographic indices in VKC subjects with normal subjects

Material And Method: In the hospital based comparative study, 115 consecutive subjects with VKC and 102 age and sex matched normal subjects were selected for the videokeratography with NIDEK ophthalmic operating system. Keratoconus-like topography was determined based on the expert classifier system. Other assessments included visual acuity testing with LogMAR chart, slit lamp biomicroscopy, dilated fundus examination, measurement of central corneal thickness and intraocular pressure.

Intravenous ketamine for treatment of super-refractory convulsive status epilepticus with septic shock: A report of two cases.

Refractory and super-refractory status epilepticus is a life-threatening neurological emergency, associated with high morbidity and mortality. Treatment should be aimed to stop seizure and to avoid cerebral damage and another morbidity. Published data about effectiveness, safety and outcome of various therapies and treatment approaches are sparse and are mainly based on small case series and retrospective data.

Letharia vulpina, a vulpinic acid containing lichen, targets cell membrane and cell division processes in methicillin-resistant Staphylococcus aureus.

Context: Antibiotic resistance in humans is a major concern. Drugs that target traditional sites and pathways are becoming obsolete; thus, compounds affecting novel targets are needed. Screening lichen metabolites for antimicrobials has yielded promising antimicrobial compounds, yet their mode of action is poorly understood.

Bedside sonographic evaluation of the diaphragm in ventilator dependent patients with amyotrophic lateral sclerosis. A report of two cases.

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease with progressive and inexorable loss of bulbar and limb functions. Respiratory muscle weakness and failure is a common complication late in the course of disease. Bedside ultrasonography of the diaphragm was done in two ventilator dependent patients with ALS.

Comparison of acute physiology and chronic health evaluation II and acute physiology and chronic health evaluation IV to predict intensive care unit mortality.

Context: Clinical assessment of severity of illness is an essential component of medical practice to predict the outcome of critically ill-patient. Acute Physiology and Chronic Health Evaluation (APACHE) model is one of the widely used scoring systems.

Aims: This study was designed to evaluate the Performance of APACHE II and IV scoring systems in our Intensive Care Unit (ICU).

Effectiveness of measuring the central field with the Berkeley field test.

Introduction: There are several limitations of the Amsler chart as a screening tool due to its low sensitivity and high false-negative results. The Berkeley central visual field test (BCFT), which is a simple power-point presentation of a 50-point scoring system for the central 10-degree of the visual field, was devised as an alternative to the Amsler chart.

Objectives: To compare the efficacy of measuring the central visual field using the Berkeley central field test (BCFT) and the Amsler grid test.