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The World Health Organization has declared “with great hope” an end to COVID-19 as a public health emergency. The vaccination drive that started in December 2020 played a crucial role in controlling the pandemic. However, the pace at which COVID-19 vaccines were developed and deployed for general population use led to vaccine hesitancy, largely owing to concerns regarding the safety and efficacy of the vaccines. Radiology has been instrumental in demonstrating the extent of pulmonary involvement and identification of the complications of COVID-19, and the same holds true for vaccine-related complications. This review summarizes the existing body of radiological literature regarding the efficacy, adverse events, and imaging pitfalls that accompany the global rollout of various COVID-19 vaccines.

The identification and implementation of conflict reduction measures are necessary to reduce predator attacks on people and livestock and to minimize human encroachment into predator habitats. We identified potential human–tiger conflict reduction measures and prioritized these measures for Chitwan National Park, Nepal. We identified these measures through a literature review, key informant interviews and a local stakeholder workshop. We prioritized the identified measures using a questionnaire survey of victims of tiger attacks (farmers, forest users and fishers), beneficiaries of tiger conservation (tourist guides, Jeep and elephant safari operators, tour and hotel operators and business operators) and National Park managers. We identified 22 measures (12 preventative, five reactive and five mitigative) as having potential for reducing negative interactions between people and tigers. Amongst these, we identified compensation payments, tiger-proof fences and habitat and prey management as high-priority measures. Conflict reduction priorities also varied amongst stakeholder groups. The victims assigned the highest priority to the construction of tiger-proof fences, whereas beneficiaries identified the management of habitat and prey as their highest priority. Compensation payments were the first preference of National Park managers and were amongst the top two priorities of all stakeholder groups. We recommend the adoption of the identified stakeholder priorities for reducing human–tiger conflict around Chitwan National Park and encourage consideration of the variations in priorities between stakeholder groups during policy development and decision-making.

Bioengineering techniques are being increasingly adopted as a sustainable solution to soil slope instability. Despite their recognized benefits, however, the mechanistic contribution of vegetation to slope stability remains inadequately understood due to the intricate nature of soil–root interactions and the complexity of root architectures. Most existing research predominantly offers qualitative assessments of vegetation effectiveness. This study aims to numerically substantiate the role of vegetation as a bioengineering technique for soil slope stabilization. Various plant species used commonly for soil stabilization were identified, and undisturbed soil samples were collected to quantify the shear strength parameters of the soils from both barren and vegetated slopes, along with root tensile strengths. A comprehensive topographic survey was conducted to capture the precise topography of the study area. Utilizing these primary data, in this work we develop 3D models for five representative plants within each species category and employ the Spectral Element Method (SEM), an advanced higher-order formulation of the finite element method (FEM), within the 3D domain to evaluate the factor of safety for the soil slopes. The SEM offers superior accuracy and stability in numerical computations. The results obtained through the SEM were corroborated through the FEM modeling and were found to be consistent with other established methodologies. This innovative approach of 3D SEM aims to quantitatively assess the impact of vegetation on soil slope stability and provide a more rigorous understanding of bioengineering applications in geotechnical engineering.

Backgrounds & objectives: Dengue fever, transmitted by Aedes mosquitoes, is a significant public health concern in Nepal. An extensive Knowledge, Attitude, and Practice (KAP) survey related to Aedes mosquitoes and prevention of dengue was conducted along the route from Matihani (62 m above sea level) to Kalinchok (3840 m asl) in central Nepal. This research examined residents’ awareness of Aedes mosquitoes and the diseases they transmit, aiming to support the World Health Organization’s national and global fight against mosquito-borne diseases. Methods: The survey included 550 participants aged 18-75 years (249 males and 201 females). Door-to-door campaigns were conducted to gather data on knowledge scores, practices, and attitudes about Aedes mosquitoes using a standard structured questionnaire. Results: Findings of this study revealed a moderate level of knowledge across the study area, with a mean knowledge score of 5.525±2.58 (correct answer rate of 46.05%). While 99.6% of respondents were aware of dengue transmission by mosquitoes, only 64.5% were able to report Aedes mosquitoes as the key transmitter. Less than one-third of the participants (27.8%) were familiar with black-and-white stripes in Aedes. Additionally, only 36.7% were knowledgeable about the day-biting behavior of Aedes mosquitoes. Interpretation & conclusion: This KAP survey provides valuable insights into community understanding of Aedes mosquitoes and dengue prevention practices associated with various Nepalese communities residing in low to high altitudes of central Nepal. These findings can be adopted to address the increasing health burden faced by countries with low-to-high altitude regions within the Hindu Kush Himalayas.

The emergence of several complex environmental pollutants from various industrial activities has posed a global challenge for ecorestoration and sustainable development. The use of Plant Growth-Promoting Rhizobacteria (PGPR) for the remediation of soil pollution has gained recognition as a promising biotechnological tool for sustainable development. Recent advances in metagenomic approaches have allowed for the detection of rhizospheric bacterial communities from polluted soils revealing their contributions to the degradation of complex pollutants through the production of potential enzymes as a novel technique. In addition, protein/enzyme engineering and the fate of heavy metals accumulation in plant tissues, through bacterial-assisted phytoremediation, has expanded the role of PGPR in soil reclamation by improving their efficacy, understanding their mechanisms of action, and integrating them with other innovative approaches been reported as advance technique. These advancements give strong evidence for more efficient and sustainable soil remediation strategies, aiding in the restoration of contaminated soil and ensuring environmental sustainability. These techniques and PGPR attributes will provide a green technology for environmental safety.

The inclusion of lead in the Champion perovskite material MAPbI3 is a detrimental factor in the commercialization of lead based perovskite solar cells. This is mainly due to the toxicity of lead and also due to degradation of MAPbI3 in ambient condition into hazardous chemicals which are toxic to the environment [1]. Due to these factors, though the Hybrid Organic Inorganic Lead based PSCs exhibit excellent photovoltaic effect and photo conversion efficiency (PCE), yet numerous theoretical and experimental studies have been done to replace lead with suitable elements such as Sn, Ge, Bi etc. This research work focusses on replacing Pb from MAPbI3, with different wt% of Bi such as 1%, 2%, 4% and 8% and analyzing its effect on the stability and efficiency of the PSC. These solutions of Bi doped perovskite are coated on the FTOs and are fabricated under room ambient condition in the sandwich structure. The results exhibit lower efficiency of Bismuth doped PSCs but it shows remarkable stability comparable to that of MAPbI3.

Abstract Background Scrub typhus, caused by Orientia tsutsugamushi, rarely leads to central nervous system involvement. Although intracerebral bleeding is rare due to endemicity and a significant proportion of underdiagnoses, it should be considered a noteworthy differential diagnosis in endemic regions in patients with relevant history and clinical findings. Case presentation We present the case of a 40-year-old Nepali woman who visited the emergency department with complaints of left-sided weakness for 6 hours and an acute febrile illness with an eschar for 7 days and was diagnosed with scrub typhus by immunoglobulin M enzyme-linked immunosorbent assay of the serum. Imaging revealed a right-sided frontotemporal hematoma, and further examination revealed pulmonary edema with multiple organ dysfunction syndrome. The patient was mechanically ventilated and was treated with antibiotics, steroids, vasopressors, and antipyretics. However, the hematoma was treated conservatively, with ongoing neurological recovery at the 6-month follow-up. Conclusion Although neurological complications and intracranial hemorrhage are uncommon, physicians must be cautious when making differential diagnoses and initiating appropriate therapies to avoid serious or fatal complications.

Dental Caries is one of the major oral diseases that can be seen increasing among adults as well as in children. Many Artificial Intelligence (AI) based works have been caried out for early detection of dental caries but achieving a good accuracy is still a challenge. This work aims to develop a model that can classify the three classes of the dental caries namely enamel caries, dentin caries and pulpitis. The proposed design is a fine-tuned model based on the VGG16 model emulating deep learning-based classification of dentin caries. The dataset of Radio Visio Graphy (RVG) images which comprises of infected tooth is collected and labelled for this purpose. The proposed model is also compared with the fully train VGG16 and Bi-Long Short-Term Memory (Bi-LSTM) coupled with the transfer learning. The performance of these models is evaluated based on the Accuracy, Precision, Recall and F1 Score. Based on the evaluation metrics, it has been observed that the proposed method is able to achieve highest accuracy as compared to the fully train VGG16 and Bi-LSTM coupled with the transfer learning. The proposed model shows an overall accuracy of 97.87% with minimal loss. It’s performance has also been compared with state of the art models with similar settings to verify its performance upper hand.

Abstract When implementing optoelectronic devices through the stacking of heterogeneous materials, considering the bandgap offset is crucial for achieving efficient carrier dynamics. In this study, the bandgap offset characteristics are investigated when n‐type gallium nitride nanowires (n‐GaN NWs) are used as electron transport layers in methylammonium lead iodide (MAPbI3)‐based optoelectronic devices. n‐GaN NWs are grown on indium‐tin‐oxide (ITO)‐coated glass via the plasma‐assisted molecular beam epitaxy (PA‐MBE) process to form the “GaN NWs‐on‐glass” platform. A MAPbI3 thin film is then spin‐coated on the GaN NWs‐on‐glass. X‐ray photoelectron spectroscopy (XPS) shows that the valence and conduction band offsets in the MAPbI3/n‐GaN heterostructure are 2.19 and 0.40 eV, respectively, indicating a type‐II band alignment ideal for optoelectronic applications. Prototype photovoltaic devices stacking perovskite on GaN NWs‐on‐glass show excellent interfacial charge‐transfer ability, photon recycling, and carrier extraction efficiency. As a pioneering step in exploiting the diverse potential of the GaN‐on‐glass, it is demonstrated that the junction characteristics of MAPbI3/n‐GaN NW heterostructures can lead to a variety of optoelectronic device applications.

Bacterial cells produce a variety of exopolysaccharide (EPS) throughout their life cycle. EPS plays a crucial role in the formation of biofilms and the control of environmental processes in microbial communities. The bacterial community benefits from biofilms in several ways, including nutrient compartmentation and storage, environmental stress resistance and synergism. The generation of EPS by consortium-associated bacteria, which involves a variety of microorganisms, is versatile and efficient for use in industrial and environmental processes, such as biotechnology and pollution degradation. The qualitative and quantitative chemical characteristics of the consortium's EPS are mostly determined by the type of culture utilized, nutrient type, temperature, and pH. The main goal of the study was to find out how EPS biosynthesis works in a bacterial consortium culture. To achieve maximum EPS regeneration, pH, temperature, carbon, and nitrogen sources were optimized. A consortium of three bacterial strains i.e. Klebsiella pneumonia strain, Pseudomonas aeruginosa strain and Burkholderia cepacian strain that were distinguished by their capacity to produce biofilms were developed as part of the study. The maximum total EPS production was detected after 8 days of incubation at pH 7.5 (15.5 g/L) and a temperature of 35 °C (12.60 g/L). The optimum EPS production was identified as 17.84 g/L and 21.07 g/L when ammonium sulfate and glucose were employed as nitrogen and carbon supplements, respectively. The protein concentration of the EPS was 3067 µg/mL, which was more than the carbohydrate (263.10 µg/mL) and DNA (7.60 µg/mL) content. The total protein/carbohydrate ratio of the EPS detected in the present study was 11.65, which was much higher than in prior investigations. FTIR analysis of EPS confirmed the functional groups of carbohydrates, proteins, lipids and DNA, viz., CO, COOH, NH, OH, CH and OCH3. The study's findings revealed that enhancing the consortium's EPS molecules involves lowering biofilm-related infections and improving the efficacy of antimicrobial treatments in wastewater.

Ewing’s Sarcoma Family of Tumours (ESFTs) comprises locally aggressive, undifferentiated small round blue-cell tumours of neuroectodermal origin, predominantly seen in adolescents. These tumours arise from non random chromosomal translocations involving the Ewing’s Sarcoma (EWS) gene. ESFTs in the mandible are uncommon. A 14-year-old male patient presented with a painless swelling in the right jaw. Plain radiographs, ultrasonography, contrast-enhanced Computed Tomography (CT), and Magnetic Resonance Imaging (MRI) revealed a large, partially well-defined, highly vascular soft tissue mass in the right mandibular region. It measured approximately 80×82×75 mm (anteroposterior×transverse×craniocaudal), with both solid and cystic components. The mass was destroying the underlying right temporomandibular joint, head, ramus and posterior body of the right hemimandible, including extensive sunray-type bony spiculations. There were multiple lytic lesions in the skull and facial bones, as well as, altered marrow signal intensity in the calvarium, bilateral humeri and clavicles, and cervical and thoracic vertebrae, indicating a locally aggressive tumour with extensive metastasis into the bones and marrow. The diagnosis was confirmed by histopathology, which showed fibrocollagenous tissue infiltrated by sheets of small round cells with scanty eosinophilic cytoplasm and prominent nuclei. Management typically involves a combination of chemotherapy, radiation and surgery. However, metastatic Ewing’s Sarcoma has a poor prognosis.

Elevated dopamine (DA) levels in urine denote neuroblastoma, a pediatric cancer. Saccharide-derived carbon dots (CDs) were applied to assay DA detection in simulated urine (SU) while delineating the effects of graphene defect density on electrocatalytic activity. CDs were hydrothermally synthesized to vary graphene defect densities using sucrose, raffinose, and palatinose, depositing them onto glassy carbon electrodes (GCEs). Co3O4 nanoparticles (NPs) were encapsulated by the CDs. Cyclic (CV) and linear sweep (LSV) voltammetry measurements were obtained, drop-casting the CDs onto GCEs and measuring DA in a phosphate-buffer solution (pH = 7). DA had an oxidation peak at +0.2 V with SucCDs, with the highest current correlating with the highest defect density. PalCD-Co3O4 exhibited the largest signal for DA detection in simulated urine (SU) using the oxidation peak at +0.5 V; the composite had a lower defect density compared to SucCD-Co3O4. The Co3O4-PalCDs had a DA detection range of 1 to 90 µM with an LOD of 0.88 μM in SU. SEM-EDX analysis of the electrode surface revealed semi-spherical structures with an average particle diameter of 80 ± 19 nm (n = 347) with PalCDs decorating the Co3O4 NPs. XRD characterization showed the incorporation of PalCD and Co3O4 within the composite. XPS showed electron density donation from the PalCD to Co3O4.

Aflatoxins (AFs), secondary metabolites produced by fungi, pose significant health risks, especially to children and elderly individuals. In developing countries such as Nepal, the tropical climate promotes fungal growth, leading to elevated levels of AF in animal feed and milk. In this study, we aimed to investigate the occurrence of aflatoxin M1 (AFM1) in dairy milk from the Kathmandu District and to assess husbandry practices contributing to contamination. We collected 84 milk samples, including raw milk from farms, retailers’ milk, and packet milk, and analyzed them using the competitive enzyme-linked immunosorbent assay (c-ELISA) technique. We also interviewed farmers to gather information on feeding and storage practices. All the collected milk samples were contaminated with AFM1, with 97.6% of the samples exceeding the European Union (EU) maximum permissible limit of 50 ppt (0.05 μg/kg). The majority (98.5%) of the farms included paddy straw, and all farms (100%) included concentrate in their feed regimens. Only half (52%) of the farms had proper storage facilities. Straw was mostly stored in sacks outdoors or left open in a shed, while concentrates were stored in a closed room or shed. This study reveals very high levels of AFM1 contamination in the milk samples, presenting a serious public health issue, and recommends comprehensive surveillance and further investigations across the country, especially given the limited research and literature available.

ABSTRACT The study was based on primary data from 473 lentil farmers selected randomly to analyze productivity, profitability, efficiency, and sensitivity of lentil farms in Nepal. Methods like benefit–cost, break‐even, margin safety, and sensitivity analysis, scaling technique, Cobb–Douglas type of production function, and stochastic frontier were adopted to derive farm economics, allocative, and cost efficiency levels. With average productivity of 672 kg/ha, lentil farmers in the study area were earning about 41% profit as of gross return with a profitability index of 0.78. About 45% margin of safety and estimates of benefit–cost ratio above one on all sensitivity measures is indicative of low risk and robust enterprise. Resources allocated in lentil production were found inefficient, and to achieve maximum return, expenses on land preparation, seed, nutrient, and plant protection cum irrigation should be increased by 27.6%, 80%, 33.1%, and 97%, respectively. Similarly, expenses on labor and harvesting activities need to be decreased by 30.1% and 23.6%. Labor cost and seed cost were the most important variables, and a 1% increase would surge the total production costs by 0.42% and 0.19%, respectively. The cost efficiency was estimated as 1.137 mean value, meaning that over 13.7% of the costs in lentil farms is wasted while comparing best‐practiced farm. Only about 48% of farms is fairly efficient at efficiency levels 1.0 to 1.09, but the majority is inefficient, which needs to minimize the waste of resources. Although suffering from climatic risks and production‐related problems, lentil enterprise is profitable, less risky, less sensitive, and fairly to inefficient in resource use. Wise attention is need on the part of farm management and resource utilization. Farmers are suggested to maintain farm size around 0.5 ha or below 1 ha, use only improved varietal seed, cut labor expenses with the use of machinery, and perform adequate tillage during sowing followed by effective disease management practices.

The quality of service (QoS) in public transportation is not at an acceptable level in high-mobility scenarios as penetration loss severely degrades signal quality and reduces the achievable data rate. Also, high mobility requirement is included in 5G as an essential part of its design. In this paper, a background of mobility management in high-speed scenarios and a review of underlay mobility management are presented. After a discussion of the usual high mobility challenges, major techniques for dealing with mobility management are reviewed, including architectural support, handover optimization, and employing new techniques like non-orthogonal multiple access (NOMA), and energy efficiency maximization. Also, challenges and prospective research directions for each technique are provided. The primary objective of this research study is to enhance knowledge of mobility management in high-speed vehicular scenarios, specifically by employing network architectural support in an upcoming heterogeneous mobile network. The primary objective of this research study is to enhance knowledge of mobility management in high-speed vehicular scenarios, specifically by employing network architectural support in an upcoming heterogeneous mobile network.

Polycyclic aromatic hydrocarbons (PAHs) are considered as harmful pollutants for the environment and human health system. The most prevalent PAHs in the environment is benzo[a]pyrene when present in high concentrations are potentially hazardous because it is carcinogenic. The objective of the current study was to identify and screen benzo[a]pyrene-degrading bacterial strain that is adapted for various environmental and nutritional requirements in order to determine how well they can decompose the benzo[a]pyrene. The results showed that, after 45 days of incubation at 140 rpm in a temperature-controlled shaker, benzo[a]pyrene (initial concentration of 1000 mg/L) was degraded 87.5% by the isolated strain LOBP-19A at 37 °C, pH 9 in the presence of glucose (1%), and peptone (0.5%) from. Isolated strain performed worse when temperature and pH are different from optimal conditions. Enzymes were screened using bacterial strain (LOBP-1A) and also produced biosurfactant by different method. GCMS studied and characterized metabolites of benzo[a]pyrene of LOBP-19A strain are 1-(3-methylbutyl)-2,3,4,6-tetramethylbenzene, Tetrazole, 1-(2-flourophenyl)-5-[4-(1,1-dimethylethyl) benzythio], 1,4-Benzenediol,2,6-bis(1,1-dimethylethyl)-(CAS), Octadecanoic acid trimethylsilyl ester and 1-naphthalene-sulfonic acid. The isolated strain was identified as Stutzerimonas stutzeri (LOBP-19A) OP389146 based their 16s-rRNA sequencing. Thus the current study demonstrated the great potential of isolated bacterial strain for use in water bodies and field scale bioremediation of benzo[a]pyrene and PAHs contaminated sites.

Objectives The aim of this study was to develop age-specific nomograms for antral follicle count (AFC) in fertile and infertile Indian women and (2) to compare the influence of age on AFC in both groups.

Abstract Background With an increasing burden of stroke, it is essential to minimize the incidence of stroke and improve stroke care by emphasizing areas that bring out the maximum impact. The care situation remains unclear in the absence of a national stroke care registry and a lack of structured hospital-based data monitoring. We conducted this systematic review and meta-analysis to assess the status of stroke care in Nepal and identify areas that need dedicated improvement in stroke care. Methods A systematic literature review was conducted to identify all studies on stroke epidemiology or stroke care published between 2000 and 2020 in Nepal. Data analysis was done with Statistical Package for Social Sciences (SPSS) and Comprehensive Meta-analysis (CMA-3). Results We identified 2533 studies after database searching, and 55 were included in quantitative and narrative synthesis. All analyses were done in tertiary care settings in densely populated central parts of Nepal. Ischemic stroke was more frequent (70.87%) than hemorrhagic (26.79%), and the mean age of stroke patients was 62,9 years. Mortality occurred in 16.9% (13-21.7%), thrombolysis was performed in 2.39% of patients, and no studies described thrombectomy or stroke unit care. Conclusion The provision of stroke care in Nepal needs to catch up to international standards, and our systematic review demonstrated the need to improve access to quality stroke care. Dedicated studies on establishing stroke care units, prevention, rehabilitation, and studies on lower levels of care or remote regions are required.

This article introduces a novel numerical scheme within the finite element method (FEM) to study soil heterogeneity, specifically focusing on the root–soil matrix in fracture treatments. Material properties, such as Young’s modulus of elasticity, cohesion, and the friction angle, are considered as randomly distributed variables. To address the inherent uncertainty associated with these distributions, a Monte Carlo simulation is employed. By incorporating the uncertainties related to material properties, particularly the root component that contributes to soil heterogeneity, this article provides a reliable estimation of the factor of safety, failure surface, and slope deformation, all of which demonstrate a progressive behavior. The probability distribution curve for the factor of safety (FOS) reveals that an increase in the root area ratio (RAR) results in a narrower range and greater certainty in the population mean, indicating reduced material variation. Moreover, as the slope angle increases, the sample mean falls within a wider range of the probability density curve, indicating an enhanced level of material heterogeneity. This heterogeneity amplifies the level of uncertainty when predicting the factor of safety, highlighting the crucial importance of accurate information regarding heterogeneity to enhancing prediction accuracy.

The aim of this study was to investigate the antimicrobial activity of guava (Psidium guajava) and star gooseberry (Phyllanthus acidus) leaf extracts and their effects as dietary supplements on the growth performance, intestinal (hindgut) microflora composition, immuno-hematological parameters, and disease resistance of Nile tilapia (Oreochromis niloticus) against Aeromonas hydrophila. Three hundred and sixty Nile tilapia (8.9 ± 0.2 g/fish) were randomly distributed into twelve aquaria (30 fish per aquarium) within a recirculation system. The fish were fed diets supplemented with leaf extracts of guava (GLE), star gooseberry (SGLE), or a mixture of GLE and SGLE (MxLE) at 10 g/kg feed for a duration of 12 weeks, after which their growth performance and intestinal microbial composition were determined. A bacterial challenge with A. hydrophila was performed, and the immune-hematological parameters of the fish and their relative percentage survival (RPS) were determined. Results showed that gallic acid, p-coumaric acid, quercetin, and kaempferol were present in the GLE, SGLE, and MxLE extracts. The GLE and MxLE extracts had significantly higher antimicrobial activity against A. hydrophila than the SGLE. Growth and feed utilization were significantly improved in Nile tilapia after dietary supplementation with all the plant extracts. The intestinal microbial composition of the plant extract groups differed significantly and marginally from the control group. Notably, the post-challenge immune and hematological parameters were considerably enhanced. Furthermore, the RPS of tilapia was significantly higher in diets supplemented with GLE, SGLE, and MxLE extracts compared to the control. These results demonstrated that supplementing the tilapia diets with GLE, SGLE, and MxLE extracts could improve their growth and feed utilization, immuno-hematological response, and disease resistance against A. hydrophila. These plant extracts could also change the composition of the intestinal microbiota. Hence, GLE, SGLE, and MxLE extracts appear to be effective prophylactic and antimicrobial agents for use in Nile tilapia aquaculture.

Cholestasis is an impairment of bile formation or bile flow. The mechanisms of cholestasis can be broadly classified into intrahepatic and extrahepatic. Most of the time, etiology can be determined with proper history, physical examination, and diagnostic testing including laboratory and imaging tests. This is a case report of a patient with severe cholestasis who underwent extensive evaluation to determine the etiology of intrahepatic cholestasis. This Case Report details a 28-year-old male who presented with seven days’ history of yellowish discoloration of eyes, the passage of dark-colored urine, generalized body itching, and the passage of clay-colored stool. The patient had no similar episode in the past. Laboratory investigations showed unconjugated hyperbilirubinemia and increased alkaline phosphatase. Magnetic resonance cholangiopancreaticography was unremarkable and liver biopsy was suggestive of cholestatic pattern and negative for acute hepatitis. The bilirubin level started decreasing after a month. The etiology of intrahepatic cholestasis remained unknown. Genotyping could not be done due to limited available resources. It may have helped to diagnose familial hepatocellular cholestasis such as benign recurrent intrahepatic cholestasis (BRIC) and progressive familial intrahepatic cholestasis. Gamma-glutamyl transferase is normal or mildly elevated in patients with BRIC. A similar picture was seen in our case as well. If the patient presents again with similar symptoms and findings, we can consider the diagnosis of BRIC.

Abstract Introduction Respectful maternity care is an approach that involves respecting women’s belief, choices, emotions, and dignity during the childbirth process. As the workload among maternity care workforce affects intrapartum quality care, respectful maternity care might have also been affected, particularly during the pandemic. Thus, this study was conducted to examine the association between workload among healthcare providers and their practice of respectful maternity care, before and during the early phase of pandemic. Methods A cross-sectional study was conducted in South Western Nepal. A total of 267 healthcare providers from 78 birthing centers were included. Data collection was done through telephone interviews. The exposure variable was workload among the healthcare providers, and the outcome variable was respectful maternity care practice before and during the COVID-19 pandemic. Multilevel mixed-effect linear regression was used to examine the association. Results The median client-provider ratio before and during the pandemic was 21.7 and 13.0, respectively. The mean score of respectful maternity care practice was 44.5 (SD 3.8) before the pandemic, which was decreased to 43.6 (SD 4.5) during the pandemic. Client-provider ratio was negatively associated with respectful maternity care practice for both times; before (Coef. -5.16; 95% CI -8.41 to -1.91) and during (Coef. -7.47; 95% CI -12.72 to -2.23) the pandemic. Conclusions While a higher client-provider was associated with a lower respectful maternity care practice score both before and during the COVID-19 pandemic, the coefficient was larger during the pandemic. Therefore, workload among the healthcare providers should be considered before the implementation of respectful maternity care, and more attention should be given during the pandemic.

Abstract Background Person-centered maternity care is a component of quality care, which includes effective communication, respect, and dignity. Supportive care has a positive effect on mothers’ perinatal experience. In contrast, negative childbirth experiences can cause psychological problems. However, the impact of person-centered maternity care experience on mothers’ mental health after delivery remains unknown. Therefore, in this study, we examined the association between person-centered maternity care experience at healthcare facilities and maternal mental health after delivery among Nepali women. Methods We conducted a cross-sectional study in urban and rural areas in Dhading District, Nepal. Participants were women who gave birth at public healthcare facilities, and their baby’s age was between 1 and 12 months. After purposively selecting the target areas, we recruited the women from July to August 2019 and interviewed them using questionnaires. We conducted multiple regression analyses to analyze the association between delivery care experience and depressive symptoms and the association between delivery care experience and mental well-being. Results In total, 595 women were included in the data analysis. The experience of better person-centered maternity care was associated with lower depressive symptom scores in urban (unstandardized coefficient [B]= − 0.09, p

This review summarizes the predatory potential of Toxorhynchites mosquitoes as biological control agents for Aedes vectors. A single larva can consume hundreds of mosquito larvae during its development, with preference for larger prey and higher consumption rates at higher prey densities. Studies suggest Toxorhynchites can significantly reduce Aedes populations. Beyond direct predation, they may indirectly influence prey behavior and adult mosquito lifespan. Despite the demonstrably positive effects of Toxorhynchites species as biocontrol agents, there are acknowledged limitations that require further investigation. These limitations include potential variations in effectiveness across diverse habitats and mosquito developmental stages. Additionally, long-term ecological sustainability and potential ramifications warrant further research. Future efforts should prioritize optimizing rearing and release strategies to enhance effectiveness. Exploring the potential for combined control methods with other biocontrol agents or traditional methods is also crucial. Finally, investigating the influence of environmental factors on predation rates can further refine and optimize the application of Toxorhynchites in mosquito control programs.

The present study was carried out in a pot experiment to examine the bioefficacy of three biocontrol agents, viz., Trichoderma viride, Bacillus subtilis, and Pseudomonas fluorescens, either alone or in consortium, on plant growth promotion and activation of defense responses in potato against the early blight pathogen Alternaria solani. The results demonstrate significant enhancement in growth parameters in plants bioprimed with the triple-microbe consortium compared to other treatments. In potato, the disease incidence percentage was significantly reduced in plants treated with the triple-microbe consortium compared to untreated control plants challenged with A. solani. Potato tubers treated with the consortium and challenged with pathogen showed significant activation of defense-related enzymes such as peroxidase (PO) at 96 h after pathogen inoculation (hapi) while, both polyphenol oxidase (PPO), and phenylalanine ammonia-lyase (PAL) at 72 hapi, compared to the individual and dual microbial consortia-treated plants. The expression of antioxidant enzymes like superoxide dismutase (SOD) and catalase (CAT) and the accumulation of pathogenesis-related proteins such as chitinase and β-1,3-glucanase were observed to be highest at 72 hapi in the triple microbe consortium as compared to other treatments. HPLC analysis revealed significant induction in polyphenolic compounds in triple-consortium bioprimed plants compared to the control at 72 hapi. Histochemical analysis of hydrogen peroxide (H2O2) clearly showed maximum accumulation of H2O2 in pathogen-inoculated control plants, while the lowest was observed in triple-microbe consortium at 72 hapi. The findings of this study suggest that biopriming with a microbial consortium improved plant growth and triggered defense responses against A. solani through the induction of systemic resistance via modulation of the phenylpropanoid pathway and antioxidative network.

In this article, we utilize the method proposed by Tahir and Cordeiro (2016) to study a new family of distributions called the McDonald Generalized Poisson (McGP) family. This family is defined by using the genesis of the McDonald distribution and the zero truncated Poisson (ZTP) distribution. We provide some mathematical properties and parameter estimation procedures of the McGP family. Three real-life data are analyzed to illustrate the potential applications of the McGP family. Our examples illustrate that the development of new probability distributions is of great interest to capture the nature of the data under study. However, one can’t guarantee a better fit just because a probability distribution possesses a larger number of parameters than its sub-model.

Abstract Background Imidacloprid, a neonicotinoid insecticide, is widely used in agricultural settings. Consequently, cases of accidental and suicidal poisoning are increasingly seen in clinical practice. Although cases with varied clinical presentations and toxicological profiles have been reported, standard management principles are lacking. Case presentation We present a case of Imidacloprid poisoning in a 25-year-old previously healthy indigenous Tamang female without a classic toxidrome requiring ventilatory support, complicated by a prolonged neuropsychiatric sequela. Conclusions Although uncommonly reported, imidacloprid toxicity may lead to life-threatening complications and hence should be suspected in cases of unidentified poisoning with a relevant toxidrome. Vigilance on the part of treating physicians plays a crucial role in appropriate management.

Background and Objective: The prevalence of adenomyosis of the uterus varies from 5% to 70%, and there is no clear consensus on its imaging diagnostic criteria. The objective of this study was to evaluate the role of transvaginal sonography (TVS), combined TVS and color Doppler (TVS-CD), and magnetic resonance imaging (MRI) in the diagnosis of adenomyosis. Materials and Methods: This was a tertiary care hospital-based prospective study, in which 365 clinically suspected cases of adenomyosis were enrolled. All three types of imaging (TVS, TVS-CD, and MRI) were done in 233/365 patients, followed by hysterectomy in 50. Imaging features were correlated with the histopathological examination (HPE), which was taken as the gold standard for the diagnosis. The diagnostic performance of each imaging modality was assessed. Results: Among patients who underwent hysterectomy, 36/50 (72%) had adenomyosis on HPE, with or without associated benign gynecological abnormalities. Sensitivity, specificity, positive predictive value (PPV), negative PV (NPV), and diagnostic accuracy (DA) of MRI were higher than that of TVS-CD (91.67% vs. 77.78%, 85.71% vs. 78.57%, 94.29% vs. 90.32%, 80% vs. 57.89%, and 90% vs. 78%, respectively). TVS alone had lower diagnostic performance (specificity: 64.29%, PPV: 84.85%, NPV: 52.94%, and DA: 74%) than TVS-CD, but equal sensitivity (77.78%). Heterogeneous myometrium was the most sensitive (80.56%), while myometrial cyst was the most specific (92.86%) TVS feature. The maximum junctional zone thickness ≥12 mm was the most sensitive (97.22%), while the hyperintense myometrial focus was the most specific (100%) MRI feature. Conclusion: TVS-CD should be used as an initial diagnostic imaging modality in clinically suspected cases of adenomyosis; however, MRI due to better diagnostic efficacy should be the imaging modality of choice before subjecting such patients to hysterectomy.

Lentil is one of the important pulse crops of Nepal and has high export potential. This study aimed to analyze the technical efficiency of the lentil production system and its determinants. A multistage sampling technique was employed to select respondent farmers from four districts representing three provinces in Nepal. Primary data were collected through face-to-face interviews with randomly selected 473 respondents using a semi-structured interview schedule. To derive the results, the stochastic production frontier and Tobit model were adopted. The average lentil output in the study area was found 672.6 ​kg ha-1 and the input variables such as seed, labor, tractor use, and area were the significant inputs increasing the output of lentils. The mean technical efficiency percentage for the pooled sample was 61.5% with a range between 23.0% and 89.9%. Further, the result revealed that average-performing farmers and least-performing farmers need to reduce their costs by 42.82% and 85.65%, respectively to attain the status of the most efficient farmer. Education, membership in groups and cooperatives, weeding practice, use of improved seed, and lentil farm size were found as determinants of technical efficiency in lentil production and unit increment of those variables favor lentil yield by 0.3%, 2.6%, 21.5%, 3.1%, and 3.1% respectively. As there is room to increase lentil output by using inputs efficiently, the government and related stakeholders should motivate farmers to get involved in groups and cooperatives to pool resources together and share information. Based on the results, with the application of current available resources farmers are strongly recommended to maintain their lentil farm size between 0.5 and 1 ​ha, use improved varietal seed, and also follow at least one weeding operation to increase their farm technical efficiency level by 21.5%.

Key Clinical Message Disseminated tuberculosis (TB) resulting from lymphohematogenous dissemination of Mycobacterium tuberculosis during primary infection or reactivation of latent disease is rare among young immunocompetent patients. Central nervous system TB (CNS TB) is one of the most challenging clinical diagnoses with high fatality. Here, we describe a young immunocompetent female with no known comorbidities initially presented with military pulmonary TB and later developed CNS TB. This presentation of disseminated TB in immunocompetent patient warrant early diagnosis and treatment.

The present study aimed to investigate the effects of Moringa oleifera leaf (MLE) extract-supplemented diets on the growth, feed utilization, hematology, innate immune response, and disease resistance of Nile tilapia against Streptococcus agalactiae Biotype 2. Four hundred and fifty Nile tilapia (32.61 ± 0.2 g/fish) were randomly allocated into fifteen tanks (30 fish/tank). Different concentrations of MLE at 0%, 0.5%, 1%, 1.5%, and 2% were fed to the Nile tilapia for 30 days, and the growth, feed utilization, hematology, and innate immune response of the Nile tilapia were determined. After the feeding trial, the Nile tilapia were challenged with a S. agalactiae Biotype 2 infection, and the relative percentage of survival (RPS) was determined. Results revealed the presence of quercetin, kaempferol, and p-coumaric acid in the MLE extract, exhibiting stronger antimicrobial activity against S. agalactiae Biotype 2. The diets supplemented with the MLE-0.5 group showed a significantly higher growth, feed utilization, hematology, and innate immune response in the Nile tilapia compared to the control and other MLE groups. Additionally, the MLE-0.5 group exhibited a significantly higher RPS of the Nile tilapia against S. agalactiae Biotype 2. Therefore, MLE-0.5 can be employed as an alternative feed supplement in sustainable Nile tilapia farming to protect against S. agalactiae Biotype 2.

Background: Adenexal masses present diagnostic challenges. After identification of the ovarian mass, the most critical step is to determine the degree of suspicion for malignancy. It is mainly based on imaging modalities and clinicopathological correlation. Aims and Objectives: This radiological study was designed to differentiate benign and malignant ovarian masses by contrast enhanced-computed tomography (CECT) of abdomen and correlation of the radiological findings with histopathological report. Materials and Methods: This was a hospital-based prospective study conducted in Department of Radiodiagnosis, Nilratan Sircar Medical College and Hospital, Kolkata during January 2019–June 2020. The study was done on clinically suspected 50 patients of 15–50 years with ovarian mass having CECT diagnosed solid/complex solid cystic mass. Results: Among 50 cases under study, 37(74.0%) were benign which was significantly higher than that of malignant cases (26.0%). Malignancy was significantly associated with wall irregularity, solid-cystic composition, presence of thick septations, septal enhancement, presence of both septal, and solid enhancement pattern in CECT. Conclusion: Based on the results of the present study, multi-detector contrast-enhanced CT could be a rapid non-invasive and cost-effective step in the evaluation of ovarian masses.

Purpose The aim of this study was to evaluate the role of apparent diffusion coefficient (ADC) and hence diffusion-weighted imaging in prediction of pathological complete response (pCR) to neoadjuvant chemotherapy (NACT) in locally advanced breast cancer (LABC) and its molecular subtypes. Methods In this tertiary hospital-based prospective study, 30 patients aged 30 to 65 years, having clinically/cytologically diagnosed LABC, were included. Magnetic resonance imaging (MRI) was done to obtain prechemotherapy ADC (ADCpre), postchemotherapy ADC (ADCpost), change in ADC (ΔADC), and ΔADC% for each tumor and its subtype. Postsurgical pCR was used as the reference standard for determining tumor response. All four ADC parameters were compared between pCR and non-pCR groups. Results Of the 30 patients, 19 (63.3%) patients showed pCR, while 11 (36.7%) patients did not. The pCR group showed significantly lower mean ADCpre (p

Demand for a cleaner source of energy is increasing in India. In the search for alternate energy sources, coal bed methane gas receives considerable attention for its potential as a good energy source. During the coalification process, methane gas is captured in the coal seams and later released during coal mining operations. Coal bed methane separation is crucial for both economic benefit and methane emission reduction. The methane production from seams is an efficient way to reduce greenhouse emissions and provide a safe mining operation environment. In India, the production of coal bed methane on a commercial scale has been recently observed. In the present paper, an attempt is made to understand and establish a 3-D excavation of coal bed methane from reservoir simulation (COMET3) for Gondwana coal seams in the Sitarampur block of the Raniganj coalfield in India. The simulation study was carried out for a period of 25 years for the recovery of methane from the reservoir. It is observed from the simulation study that 372 million cubic meters CO2 equivalent greenhouse gas emissions can be prevented by the extraction of methane with space and time. The fracture gas concentration increases with time, and it is observed that fractures are fully saturated with gas in 3000 days.

We report the first record of Sikkim grass lizard, Takydromus sikkimensis Günther, 1888 in Nepal based on morphological characters such as the presence of four pairs of femoral pores, 12 rows of ventral scales, tail more than 3.6 times longer than snout-vent length. Our record of T. sikkimensis at Miklajung, Morang district represents the western-most observation of the species, ca. 94 km west of its type locality, Sikkim, India and is the first in Nepal for this species, genus, and family. This record is from Chure/Siwalik hill range which lies outside of Nepal’s protected area network. This species is listed as Endangered by the International Union for Conservation of Nature and Natural Resources and warrants detailed inventory and immediate conservation interventions.

Abstract Background The Asiatic wild water buffalo (Bubalus arnee) is an endangered species that is conserved in the Koshi Tappu Wildlife Reserve (KTWR), Nepal, and was recently translocated to the Chitwan National Park (CNP). Gastrointestinal (GI) parasites are the cause of significant negative health and production impacts on animals worldwide. Methods A coprological survey of GI parasites of wild water buffalo was carried out in the CNP in 2020. Fresh dung samples (n = 25) were collected from wild water buffaloes and analysed using sedimentation and flotation techniques for morphological identification of parasite cysts, oocysts and eggs. Results Nine different GI parasites were recorded of which Entamoeba spp. (20 samples, 80%) were the most common. The presence of Entamoeba spp. was further validated using polymerase chain reaction (PCR) analysis and DNA sequencing. The PCR results were positive for all of the microscopically positive samples, and the species was identified as Entamoeba bovis. Three samples were sequenced and formed a cluster of E. bovis, which was separated from other Entamoeba spp. in phylogenetic analysis. Conclusion This is the first report for molecular detection of E. bovis from wild water buffaloes in Nepal. Future work should focus on the prevalence of such infections in water buffaloes in forest environments.

Key Clinical Message Glycogen storage diseases (GSDs) are rare autosomal disorders that result from defects in glycogen metabolism. There are more than 12 types, each with distinct clinical features. Clinical scenario, biochemical abnormalities are useful for suspicion whereas liver biopsy and enzyme assay provides definite diagnosis. We report a case of two sisters with similar clinical symptoms suggestive of the disease.

Introduction: Cardiovascular disease is the leading cause of death globally, and ST elevation myocardial infarction remains main contributor to this mortality. Thrombolysis in myocardial infarction risk score which was derived from randomized clinical trials has been validated in non-selected western patient populations. The objective of this study was to find out the applicability of Thrombolysis in myocardial infarction risk score in our study population. Methods: A prospective observational study was conducted in admitted patients of cardiology unit, Manipal teaching hospital from February 25, 2020 to December 31, 2021. All consecutive patients admitted with diagnosis of acute ST elevation myocardial infarction were selected. Patients admitted with diagnosis of ST segment elevation myocardial infarction and undergone either primary, rescue or elective coronary reperfusion therapy were included for analysis. Results: Total of 339 cases with mean age of 60.62 ±12.64 were diagnosed to have acute ST elevation myocardial infarction and undergone coronary reperfusion therapy. Nearly two third cases were male and majority (61.35%) cases were below age of 65 years. Age of 65 years and above, Killip class III-IV [OR:20.54 (CI: 8.63–48.87), p100 beats/ min [(OR: 5.79 (CI: 2.81 – 11.92), p

ABSTRACT Background Variceal hemorrhage (VH) is a medical emergency. Prompt endoscopic variceal ligation (EVL) is therapeutic. Terlipressin is used in VH and continued for 2—5 days even after EVL. As hemostasis is primarily achieved by EVL, the benefit of continuing trelipressin after EVL is unknown. Objective To evaluate the efficacy of continuing terlipressin after EVL to prevent re-bleed and mortality. Methods In this pilot study, after EVL 74 patients of VH were randomized into two treatment groups TG2 & TG5, received terlipressin (1 mg IV bolus q 4 hourly) for 2 days and 5 days respectively and one control group (TG0), received 0.9% normal saline (10 mL IV bolus q 4 hourly) and followed up for 8 weeks. Results A total of 9 (12.6%) patients had re-bleed with maximum 4 (5.6%) patients in TG5 group followed by 3 (4.2%) in TG2 and 2 (2.8%) in TG0 groups (P=0.670). The overall mortality was 15 (21.1%) patients, 6 (8.5%) patients in TG0 group, followed by 5 (7.0%) in TG5 and 4 (5.6%) in TG2 group (P=0.691). Adverse drug reactions were significantly higher in treatment groups with maximum 18 (24.32%) patients in TG5, followed by 8 (10.8%) in TG2 and 2 (2.7%) in TG0 groups (P=0.00). Duration of hospital stay was also significantly higher in treatment group, 6.63 (±0.65) days in TG5 followed by 3.64 (±0.57) in TG2 and 2.40 (±0.50) days in TG0 groups (P=0.00). Conclusion The rational for continuing terlipressin after EVL is doubtful as it didn’t have any benefit for the prevention of re-bleed or mortality; rather it increased the risk of adverse drug reactions and duration of hospital stay. Further randomized clinical trials are encouraged to generate more evidence in support or against continuing terlipressin after EVL.

Abstract Social accountability is often put forward as a strategy to promote health rights, but we lack a programmatic evidence base on if, when, and how social accountability strategies can be used to promote access to quality Sexual and Reproductive Health (SRH) care for stigmatized populations and/or stigmatized issues. In this Commentary, we discuss the potential advantages and disadvantages of social accountability strategies in promoting the availability of a full range of SRH services for excluded and historically oppressed populations. We accomplish this by describing four programs that sought to promote access to quality SRH care for stigmatized populations and/or stigmatized services. Program implementers faced similar challenges, including stigma and harmful gender norms among providers and communities, and lack of clear guidance, authority, and knowledge of Sexual and Reproductive Health and Rights (SRHR) entitlements at local level. To overcome these challenges, the programs employed several strategies, including linking their strategies to legal accountability, budgetary expenditures, or other institutionalized processes; taking steps to ensure inclusion, including through consultation with excluded or stigmatized groups throughout the program design and implementation process; specific outreach and support to integrating marginalized groups into program activities; and the creation of separate spaces to ensure confidentiality and safety. The program experiences described here suggest some general principles for ensuring that social accountability efforts are inclusive both in terms of populations and issues addressed. Further empirical research can test and further flesh out these principles, and deepen our understanding of context.

Roads pose a major, and growing, challenge for the conservation of endangered species. However, very little is known about how endangered species behaviorally respond to roads and what that means for road mitigation strategies. We used the nation-wide lockdown in Nepal during the COVID-19 pandemic as a natural experiment to investigate how dramatic reductions in traffic volume along the national highway affected movements of two GPS-collared tigers (Panthera tigris)—a globally endangered species. This work is the first systematic research on tigers in Nepal using radiotelemetry or GPS tracking data since the 1980s. We found that the highway more strongly constrained the space use and habitat selection of the male in Parsa National Park than the female in Bardia National Park. Over the entire study period, the female on average crossed 10 times more often per week than the male, and when he was near the highway, he was over 11 times more probable to not cross it than to cross during the day. However, we also found that the cessation of traffic during the pandemic lockdown relaxed tiger avoidance of roads and made the highway more permeable for both animals. They were 2–3 times more probable to cross the highway during the lockdown than before the lockdown. In the month following the lockdown, the space use area of the male tiger tripled in size (160–550 km2), whereas the female’s shrunk to half its previous size (33–15 km2). These divergent patterns likely reflect differences between the two parks in their highway traffic volumes and regulations as well as ecological conditions. Our results provide clear evidence that vehicle traffic on major roads impede tiger movements, but also that tigers can respond quickly to reductions in human pressures. We conclude by identifying various actions to mitigate road impacts on tigers and other endangered species.

Abstract Background Previous studies on sternocleidomastoid flaps, have defined the importance of preserving sternocleidomastoid (SCM) branch of superior thyroid artery (STA). This theory drew criticism, as this muscle is known to be a type II muscle, i.e., the muscle has one dominant pedicle (branches from the occipital artery at the superior pole) and smaller vascular pedicles entering the belly of muscle (branches from STA and thyrocervical trunk) at the middle and lower pole respectively. It was unlikely for the SCM branch of STA to supply the upper and lower thirds of the muscle. We undertook a cadaveric angiographic study to investigate distribution of STA supply to SCM muscle. Methods It is a cross-sectional descriptive study on 10 cadaveric SCM muscles along with ipsilateral STA which were evaluated with angiography using diatrizoate (urograffin) dye. Radiographic films were interpreted looking at the opacification of the muscle. Results were analyzed using frequency distribution and percentage. Results Out of ten specimens, near complete opacification was observed in eight SCM muscle specimens. While one showed poor uptake in the lower third of the muscle, the other showed poor uptake in the upper third segment of muscle. Conclusion Based on the above findings we suggest to further investigate sternocleidomastoid muscle as a type III flap, as the STA branch also supplies the whole muscle along with previously described pedicle from occipital artery. However, this needs to be further corroborated intra-operatively using scanning laser doppler. This also explains better survival rates of superior thyroid artery based sternomastoid flaps.

Abstract Background Persons with disabilities can have physical, mental, intellectual, or sensory impairments which can hinder their social participation. Despite Sustainable Development Goals call for “universal access to sexual and reproductive health (SRH)”, women with disabilities (WwDs) continue to experience barriers to access SRH services in Nepal. This study evaluated factors affecting the utilization of SRH services among WwDs in Ilam district, Nepal. Methods A mixed-method study with 384 WwDs of reproductive age was conducted in Ilam district, eastern Nepal. Quantitative data were collected using a structured questionnaire. Relationships between utilization of SRH services and associated factors were explored using multivariate logistic regression analysis. Qualitative data were collected from focus groups with female community health volunteers and interviews with WwDs, health workers and local political leaders. They were audio-recorded, translated and transcribed into English and were thematically analyzed. Results Among 384 respondents (31% physical; 7% vision,16% hearing, 7% voice&speech,12% mental/psychosocial, 9% intellectual, 18% multiple disabilities), only 15% of them had ever utilized any SRH services. No requirement (57%) and unaware of SRH services (24%) were the major reasons for not utilizing SRH services. A majority (81%) of them reported that the nearest health facility was not disability-inclusive (73%), specifically referring to the inaccessible road (48%). Multivariate analysis showed that being married (AOR = 121.7, 95% CI: 12.206–1214.338), having perceived need for SRH services (AOR = 5.5; 95% CI: 1.419–21.357) and perceived susceptibility to SRH related disease/condition (AOR = 6.0; 95% CI:1.978–18.370) were positively associated with the utilization of SRH services. Qualitative findings revealed that illiteracy, poor socioeconomic status, and lack of information hindered the utilization of SRH services. WwDs faced socioeconomic (lack of empowerment, lack of family support), structural (distant health facility, inaccessible-infrastructure), and attitudinal (stigmatization, bad behaviour of health care providers, perception that SRH is needed only for married) barriers to access SRH services. Conclusions Utilization of SRH services among WwDs was very low in Ilam district, Nepal. The findings of this study warrant a need to promote awareness-raising programs to WwDs and their family members, sensitization programs to health service providers, and ensure the provision of disability-inclusive SRH services in all health facilities.

The main aim of anaerobic co-digestion of rice straw is to enhance volumetric methane yields and process stability to achieve synergetic effects. However, high carbon to nitrogen ratio of rice straw causes poor process stability for mono-digestion. This study investigated the co-digestion of rice straw and de-oiled rice bran, a nitrogen-rich by-product of the rice milling industry. The spent bio-slurry (having total solids concentration of 2.19%) from running de-oiled rice bran which inherently contains various types of microbes was used as an inoculum for process start-up. A series of experiments were conducted to optimise the methane yield in semi-continuous anaerobic digester operating at 30 days of hydraulic retention time at mesophilic temperature conditions. Co-digestion studies of rice straw and de-oiled rice bran with three different mixing ratios were conducted by maintaining a specific total solids concentration of 5.0, 7.5, and 10.0% total solids concentration for the designated digester. The biogas production, methane contents, volatile matter degradation efficiency were determined to evaluate the stability and performance of the system. The digester maintained at 5% and 7.5% TS showed nearly similar results in terms of methane yield and volatile matter conversion efficiency. During the entire experimentation the percentage of methane content in the produced biogas was in the range of 24.8–55.4%. The average methane yield of 0.169 and 0.173 L/g-VS was found for digester maintained at 5.0% and 7.5% TS respectively. However, the volatile solid mass removal efficiency of 40.13% and 37.94% was recorded for the digester maintained at 5% and 7.5% TS respectively. Since no chemical or thermal pre-treatment was adopted during the entire process it is highly economical and adaptable for concerned industries. Ultimately, the results of the present study were compared to the previous studies on anaerobic co-digestion of RS, which shows the promising result with no extra added input cost.

Introduction: Migrant workers support low- and middle-income economies through remittances, often bearing considerable health risks with long-term consequences. This study aims to understand the health and wellbeing issues of Nepalese migrant workers in Gulf Cooperation Council (GCC) countries, a major destination for low-skilled Nepalese workers. Methodology: We conducted a mixed-methods study in Dhading district of Nepal. A pilot survey was carried out with returnee migrants from GCC countries to understand key health and wellbeing issues faced by workers. In addition, in-depth interviews were conducted with a subset of these returnee migrants and their families, and related stakeholders. These aimed to understand broader societal and policy implications in relation to labour migration. Quantitative data from the survey were analysed using descriptive statistics and thematic analysis was used for qualitative interviews. Results: 60 returnee migrants (58 males, 2 females) took part in the survey (response rate, 100%). Median age of the survey participants was 34 (IQR, 9) years and 68% had completed school level education. Returnee migrants reported suffering from various physical and mental health issues during their stay in GCC countries including cold/fever (42%), mental health problems (25%) and verbal abuse (35%). 20 participants took part in the qualitative study:10 returnee migrants (8 males, 2 females), four family members (female spouses) and six key stakeholders working in organizations related to international migration. Interview participants reported severe weather conditions resulting in physical health problems (e.g. pneumonia, dehydration and kidney disease) as well as mental health issues (including anxiety, loneliness and depression). Participants raised concerns about the usefulness and appropriateness of pre-departure training, and the authenticity of medical tests and reports in Nepal. Female migrants reported facing stigma after returning home from abroad. Language difficulties, alongside issues related to payment, insurance and support at work were cited as barriers to accessing healthcare in destination countries. Conclusion: Our study shows that Nepalese migrant workers experience severe weather conditions and suffer from various physical and mental health issues, including workplace abuse and exploitation. The study highlights an urgent need for strategies to enforce compulsory relevant pre-departure orientation and appropriate medical screening in Nepal, and fair employment terms and full health insurance coverage in destination countries. Greater collaboration between the Nepalese government and GCC countries is needed to ensure necessary legislation and regulatory frameworks are in place to safeguard the health and wellbeing of migrant workers.

Three species of Taxus occur in Nepal T. contorta, T. maireii and Taxus wallichiana,. All are under pressure from collection for medicinal use, habitat destruction and changing land use. In 2017 and 2018 fieldwork was carried out to collect seed, herbarium specimens, cuttings and information to improve protection of these species, funded by Fondation Franklinia. Collections were made for propagation, herbarium and molecular studies. Population level Information was also gathered to make national assessments for these species. This article traces the status of the living collections in the National Botanic Garden of Nepal (NBG) and the assessments made by the team comprising staffs of Department of Plant Resources (DPR) and Nepal Academy of Science and Technology (NAST) and Freelance botanist. Reference is made to work done prior to 2017 on the taxonomy and distribution of the species and which enabled efficient fieldwork thereafter. The establishment of a conservation collection at NBG provides a basis for research into yew species in Nepal and highlights the benefits of internationally collaborative projects to maintain conservation collections of threatened species in their country of origin.

Three species of Taxus occur in Nepal T. contorta, T. maireii and Taxus wallichiana,. All are under pressure from collection for medicinal use, habitat destruction and changing land use. In 2017 and 2018 fieldwork was carried out to collect seed, herbarium specimens, cuttings and information to improve protection of these species, funded by Fondation Franklinia. Collections were made for propagation, herbarium and molecular studies. Population level Information was also gathered to make national assessments for these species. This article traces the status of the living collections in the National Botanic Garden of Nepal (NBG) and the assessments made by the team comprising staffs of Department of Plant Resources (DPR) and Nepal Academy of Science and Technology (NAST) and Freelance botanist. Reference is made to work done prior to 2017 on the taxonomy and distribution of the species and which enabled efficient fieldwork thereafter. The establishment of a conservation collection at NBG provides a basis for research into yew species in Nepal and highlights the benefits of internationally collaborative projects to maintain conservation collections of threatened species in their country of origin.

DefinitionWild edible plants (WEPs) grow naturally in self-maintaining ecosystems. WEPs are harvested for consumption, sale, and medicinal uses. We hypothesize that WEPs play a major role in supplying food and generating income for the rural people in a world that is increasingly recognising its emerging conservation issues. We tested this hypothesis by identifying the reasons for harvest, consumption, and conservation of WEPs using focus group discussion, field observations and questionnaire surveys in south eastern Bhutan in late 2019.MethodsFocused group discussions were held with the local people to identify reasons for harvest and consumption of WEPs. Data on the identified reasons for harvest, consumption, and conserving WEPs were determined using a questionnaire survey with ranking scales for a set of 76 randomly selected households. Representative field-observations and questionnaire surveys were carried out in villages close to forests. Parts of the plant used, how these were consumed, harvest season, and plant (life form) were recorded. The data was subjected to a Kruskal-Wallis rank sum test and weighted averages calculated.Result and conclusionA total of 120 WEPs belonging to 63 families (including Agaricaceae) were reported. Most of the WEPs recorded were trees (45.0%) then herbs (25.8%), vines (13.3%) and shrubs (10.8%). The commonly consumed plant parts were the fruit (43.3%), shoots (28.3%) and leaves (20.8%). The purposes for harvesting and consumption, conservation of WEPs were significantly (P sale > medicinal uses > preservation for future use > insufficient food from cultivated source's. The two most important strategies for conservation were to domesticate the WEPs and cultivate in forests. The findings reveal valuable lessons and insights about the reasons for harvesting, collection, consumption, and conservation of WEPs.