Pregnancy Complicated by Acute Pancreatitis with Ascariasis.

Ascariasis lumbricoides infections are common in tropical and sub-tropical countries. As it is one of the common causes for common bile duct obstruction. But in pregnancy is a rare entity. It may present with complications like acute pancreatitis. Here we present a case of 24 year female gravida 2 para 1 at 34 weeks of pregnancy presented with chief complain of pain over epigastric region radiating to back and associated with two episodes of vomiting, non bilious, not mixed with blood. Ultrasonography showed long tubular hyperechoic structure in gallbladder lumen most likely ascariasis and then she was diagnosed as a case of acute pancreatitis with alive ascariasis.

Misleading Diagnosis of Dysgerminoma in a Young Asymptomatic Patient.

Dysgerminomas account for approximately one third of all malignant ovarian germ cell tumors (tumors arising from ovarian germinal elements) and are the most common ovarian malignancy detected during pregnancy. They are the only germ cell malignancy with a significant rate of bilateral ovarian involvement that is 15-20 percent. They have a variable gross appearance, but in general are solid, pink to tan to cream colored lobulated masses. They have the best prognosis of all malignant ovarian germ cell tumor variants. Two thirds are stage I at diagnosis, and prognosis is excellent even for those with advanced disease due to exquisite tumor chemosensitivity. The 5 year disease specific survival rate approximates 99 percent. This is a case report of a huge ovarian dysgerminoma in a young unmarried lady that was quite asymptomatic. She underwent laparotomy with right ovarian cystectomy.

COVID-19 Pandemic: An Experience of OBGYN Residents at Kathmandu Model Hospital.

COVID-19, a novel corona virus has affected the life of each and every individual worldwide. Nepal being the neighborhood country of china, though, we had a late case detection. But, since the month of July this virus has spread in an alarming manner in Nepal. Nepal being one of the developing countries, we lack in equipments, manpower resources and also in treatment centers. Looking into the devastating scenario of Covid 19 in China, Italy, New York, Brazil and our neighboring countries like India, Pakistan and Bangladesh is scary. We wondered how we were going to handle this pandemic if similar circumstances happened in our country too. At the same time being OBGYN residents, we all know pregnancy is very crucial and our patients have faced much difficulties to receive the maternal health services. In this manuscript, we have shared our experience regarding preparedness for COVID-19, management of positive cases and its effect in OBGYN trainee.

Phosphine Resistance in Cryptolestes ferrugineus (Coleoptera: Laemophloeidae) Collected From Grain Storage Facilities in Oklahoma, USA.

Phosphine gas (PH3) is one of the most commonly used fumigants for controlling stored-grain pests worldwide. We estimated the discriminating dose for Cryptolestes ferrugineus (Stephens) (Coleoptera: Laemophloeidae) adult insects using a laboratory susceptible strain. This discriminating dose was then used to determine presence or absence of PH3 resistance (resistance frequencies) in 19 field-collected populations of C. ferrugineus from Oklahoma, United States. The discriminating dose was estimated as 56.2 ppm of PH3 over a 20-h exposure period at 25 °C. Discriminating dose bioassay results showed that PH3 resistance was present in all 19 populations of C. ferrugineus tested. However, five populations-Stillwater (Stil), Enid Terminal 1 (ET-1), Enid Terminal 2 (ET-2), Johnson-Enid population (JE), and DK Farm 20 population (DK Farm 20) had ≥90% resistance frequencies. LC99 values estimated by probit analyses of dose-response mortality data for the laboratory susceptible strain (Lab-S), JE, and DK Farm 20 were 7.3, 636.4, and 968.6 ppm, respectively, over a 3-d exposure period. The level of resistance in DK Farm 20, the most resistant population, was 133.5 times that of the susceptible laboratory strain. This study shows that PH3 resistance in C. ferrugineus may be widespread in Oklahoma. Based on this study, there is a need for a wider PH3 resistance survey in grain-growing regions of Oklahoma and United States. Furthermore, results show there is a need to develop PH3 resistance management strategies for C. ferrugineus and other stored-product insect pest species to combat resistance and ensure continued effective future use of PH3.

Efficacies of spinosad and a combination of chlorpyrifos-methyl and deltamethrin against phosphine-resistant Rhyzopertha dominica (Coleoptera: Bostrichidae) and Tribolium castaneum (Coleoptera: Tenebrionidae) on wheat.

Highly phosphine-resistant populations of Rhyzopertha dominica (F.) (Coleoptera: Bostrichidae) and Tribolium castaneum (Herbst) (Coleoptera: Tenebrionidae) have recently been found in Oklahoma grain storage facilities. These findings necessitate development of a phosphine resistance management strategy to ensure continued effective use of phosphine. Therefore, we investigated the efficacies of two grain insecticides, namely, spinosad applied at label rate of 1 ppm and a mixture of chlorpyrifos-methyl and deltamethrin applied at label rates of 3 and 0.5 ppm, respectively, against highly phosphine-resistant R. dominica and T. castaneum. Adult mortality and progeny production suppression of spinosad- or chlorpyrifos-methyl + deltamethrin mixture-treated wheat that had been stored for 2, 84, 168, 252, and 336 d posttreatment were assessed. We found that both spinosad and chlorpyrifos-methyl + deltamethrin were effective against phosphine-resistant R. dominica and caused 83-100% mortality and also caused total progeny production suppression for all storage periods. Spinosad was not effective against phosphine-resistant T. castaneum; the highest mortality observed was only 3% for all the storage periods. Chlorpyrifos-methyl + deltamethrin was effective against phosphine-resistant T. castaneum only in treated wheat stored for 2 and 84 d, where it caused 93-99% mortality. However, chlorpyrifos-methyl + deltamethrin was effective and achieved total suppression of progeny production in T. castaneum for all the storage periods. Spinosad was not as effective as chlorpyrifos-methyl + deltamethrin mixture at suppressing progeny production of phosphine-resistant T. castaneum. These two insecticides can be used in a phosphine resistance management strategy for R. dominica and T. castaneum in the United States.