Introduction: Tetanus is an acute onset neurological disease that is often lethal. It has a high disease burden in low and middle-income countries. Tetanus is caused by a toxin made by spores of the bacterium Clostridium tetani, which are found in soil, dust, and animal feces. The toxin impairs the motor neurons leading to muscle stiffness. However, with the development of a toxoid vaccine, the incidence has sharply declined and is now categorized as a vaccine-preventable disease. The treatment of tetanus is primarily supportive and focuses on managing the complications until the effects of toxins resolve. Case Report: We report the case of a 67-year-old farmer who previously sustained a laceration injury approximately 45 days prior to presenting to the emergency department with abdominal pain and rigidity. After a comprehensive evaluation to rule out other items in the differential diagnoses, he was diagnosed with tetanus based on clinical symptoms and ultimately required mechanical ventilation. The patient was then managed in the intensive care unit and later made an uneventful recovery. Conclusion: This case illustrates an uncommon presentation of tetanus and the latency of the infectious process. Often when patients present with atypical symptoms, it poses a diagnostic dilemma to the clinicians. Thus, it is very important to carefully elicit a history of contaminated injury. This case also highlights the importance of prophylactic vaccine in low and middle-income countries, which can reduce disease-related mortality and morbidity.

Splenic cysts are classified on the basis of epithelial lining, either primary or secondary. Primary cysts are further divided as parasitic and nonparasitic. The secondary cysts are usually post traumatic or after a splenic extension of pancreatic pseudocyst. However, not all pseudocysts are associated with trauma. Mostly, they are asymptomatic (30%-60%) and usually grow in size to cause compressive symptoms. Splenic pseudocysts should be differentiated with other malignant and nonmalignant pathology, specifically hydatid cysts, in order to manage them correctly. The walls of pseudocysts may be degenerative or calcified, which may resemble hydatid cysts. Here, we present a case of a non-traumatic splenic cyst masquerading as a hydatid cyst preoperatively. The patient was taken up for surgery and intraoperatively noted to be a hemorrhagic cyst with a non-splenic cyst wall. We decided to preserve the spleen with marsupialisation of cyst and omentoplasty. On histopathology, the diagnosis of a pseudocyst of spleen was made in view of absent epithelial lining. We would like to report this case because of the diagnostic dilemma, its clinical rarity and, even more, in the absence of any history of trauma.

In Nepal, potato basic seed production under contract farming is at the initial phase. However, pre-basic seed potatoes were produced in Nepal since 1989/90, production of the basic seed has been relatively low, despite the government's lucrative subsidy on the price of pre-basic seed. There have been very limited studies on the production and economics of potato-basic seed under contract farming. This study examines the cost of production, resources use efficiency, return to scale, and various problem associated with the production of basic seed under contract farming in Kavrepalanchok, Nepal. The authors used the Cobb Douglas production function to explore the technological relationship between inputs and outputs. As well as to estimate and analyze the return to scale. They used a scaling technique to construct an index for prioritizing the problems of potato seed production under contract farming as per farmers' perception. The authors found the cost of basicpotato seed production per 500m² areas under contract farming as Rs. 99129.0064. The high cost of production is due to the higher cost of pre-basic seed. They found the gross return from seed production as Rs. 171547.2 per 500m² areas and the Benefit-cost ratio as 1.72. Similarly, they found positive regression coefficients for seed cost and organic manure which is significant at 1% level and negative regression coefficients for human labor which is significant at 5% level. They observed the overutilization of inputs in potato seed production under contracting farming, which was primarily due to the restrictions impeached by the contract agencies on the contract farmers. The authors found that unavailability of pre-basic seed in required quantity as the major problem faced by the farmers of the study area. A comparative study of the seed production with contract and without a contract, may illustrate the better scenario of the study area. Only a few studies have examined the economics of seed production under contract farming in developing countries. The authors' findings suggest that productivity and profitability can be maximized if a proper allocation of the resources and existing problems of irrigation, insect.

Out of the 13 municipalities in the district, four (Banepa, Panauti, Panchkhal and Mandandeupur) were chosen based on their higher production potential, and 25 households from each of the four municipalities were then randomly chosen, yielding a sample size of 100. We used both primary and secondary data collection methods. According to the findings, the disease is one of the top five primary issues facing farmers in the research area, with an index value of 0.818. Information level was divided into four categories: 0, 1, 2, 3 and 4, respectively, denoting lack of knowledge, knowledge about one insect pest, knowledge about two insect pests, knowledge about three insect pests, and knowledge about four or more insect pests. In the study area, the majority of farmers (33%) were found to be knowledgeable of 2 insect pests. The majority of farmers (67%) thought the potato tuber moth was the worst problem. The majority of farmers (42%) thought that insect pests only had a minimal impact on plant populations (about 40%). The majority of farmers (44%) believed that insect pests had only slightly harmed (40% area affected) their fields or stores. The majority of farmers (71%) said chemical methods were the most effective for controlling insect pests. The majority of farmers (50.6%) were found to apply the recommended dose of chemical pesticides for insect pest management. The majority of farmers (51%) thought that the proliferation of insect pests was on the decline.

Introduction: The pituitary gland is regarded as the master endocrine gland of the body. Subtle alterations in the size can cause significant changes to other endocrine glands and hormonal status. Magnetic Resonance Imaging (MRI) is the investigation of choice to examine pituitary gland. It is important to know the range of normal size and variations according to age and gender to enable radiologists to suggest what might be an abnormal pituitary gland. Aims: This study aims to examine normal size, volume and shape of pituitary gland and to establish a normal reference value for pituitary size in different age groups and genders. Methods: MRI Brain of 137 patients were studied retrospectively and patients with endocrinal abnormalities were excluded from the study. Images were acquired in General Electronics 1.5 Tesla MRI machine and mid-sagittal T1WI and coronal T2WI were selected for accurate measurement of the gland. Height, AP diameter, Transverse diameter, and volume were calculated for each individual and the collected data was categorized based on age and sex for analysis. Pearson’s correlation test was done to establish a relation between age and volume of the gland and a p-value of <0.05 was considered as significant. Results: Our study included 137 patients (57 males, 80 females) with age ranging from 3 to 86 years. The study was divided into six age groups. Mean pituitary height, AP diameter, transverse diameter and volume of the gland were 6mm, 8.9mm, 12.3 mm, and 354.5 mm3 respectively. The gland observed a gradual increase in size up to the third decade and was more pronounced in the female population. A steady decline in the size of the gland was noted after 30 years for both populations. Conclusion: Good understanding of the normal size and shape of pituitary gland and its variation with age and gender is a must for every radiologist to compare with an abnormal increase in size.