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•Ecosystems provide essential goods and services for human well-being.•Governance is a combined outcome of policies, legislation, and institutions.•Effective implementation of policies and legislation is weak.•Overarching framework is imperative for sustained provision of ecosystem services.

Iron deficiency anemia remains a significant public health concern, particularly among pregnant women and children. The prevalence of anemia is higher in lower middle income countries including Nepal. Despite government efforts, progress in reducing anemia in the last 15 years has been slow, especially in remote hilly regions. While investing in anemia control can yield substantial economic returns, there have not been adequate studies to cover diverse geographical areas of Nepal. This study aims to determine the prevalence of anemia in a hilly district of western Nepal. A retrospective cross-sectional study was conducted among the 350 pregnant women visiting for ante natal checkup in Burtibang primary hospital from July 15, 2022 to Jan 15, 2023. The factors associated with the prevalence of anemia was calculated by using multivariate logistics regression analysis at P < .05 and ANOVA test was done to calculate the differences in hemoglobin level across the different characteristics of the pregnant women. More than 2 out of 5 pregnant women (43.1%) had anemia with 57.6% having mild anemia and 42.4% of the women having moderate to severe level of anemia. The mean Hb level of the pregnant women was 10.8 (±1.0) g/dL. Women on second (adjusted odds ratio [aOR]: 0.06; 95% CI: 0.03–0.11) and third trimester of their pregnancy (aOR: 0.06; 95% CI: 0.02–0.16) had lower odds of having anemia. A moderate level of correlation of Hb level with the gestational age (R = 0.574, Pvalue: <.001) was seen in the study. The prevalence of anemia is a serious public health problem among the women visiting ante natal checkup in Burtibang hospital. Later trimester of the pregnancy had higher risks of having anemia in comparison to the first and the gestational age of the women was a significant predictor of Hb level among the population.

Successful implementation of climate change adaptation (CCA) actions in the agriculture sector requires comprehensive policies that have specifically focused aims and targets. Integration of CCA into agricultural policy can provide an enabling environment for planning and implementing CCA actions in a coordinated way. This work undertook an assessment of the integration of CCA into agricultural policies in Nepal. In total, 23 policies, plans, strategies, and frameworks published over more than two decades were assessed. Content analysis and knowledge mining were conducted based on five proxy criteria: focus, adaptation strategies, institutional setup, financial management, and monitoring and evaluation. The results indicate that the focus of the policies in terms of agricultural adaptation to climate change vary from protection of the environment to climate-smart agriculture. Agroforestry was found to be a highly prioritized CCA action in the documents. Most of the policy documents (16) make provisions for three tiers of institutional setup, while only 10 specifically allocate their required budgets with clear identification of their sources and monitoring and evaluation mechanisms at the national and subnational levels. The results also show that overlapping roles and responsibilities across ministries, the prioritization of adaptation action without quantified outcomes and a low priority being given to climate action—particularly at subnational levels—are major constraints on the implementation of these policies. In light of this, programs, activities, institutions and legal provisions are essential components in achieving the goals and objectives of any policy. So, each policy should have implementable programs and activities, institutional provisions with clearly defined responsibilities and legal provisions to overcome the obstacles.

The study of mountain vertical natural belts is an important component in the study of regional differentiation. These areas are especially sensitive to climate change and have indicative function, which is the core of three-dimensional zonality research. Thus, based on high precision land cover and digital elevation model (DEM) data, and supported by MATLAB and ArcGIS analyses, this paper aimed to study the present situation and changes of the land cover vertical belts between 1990 and 2015 on the northern and southern slopes of the Koshi River Basin (KRB). Results showed that the vertical belts on both slopes were markedly different from one another. The vertical belts on the southern slope were mainly dominated by cropland, forest, bare land, and glacier and snow cover. In contrast, grassland, bare land, sparse vegetation, glacier and snow cover dominated the northern slope. Study found that the main vertical belts across the KRB within this region have not changed substantially over the past 25 years. In contrast, on the southern slope, the upper limits of cropland and bare land have moved to higher elevation, while the lower limits of forest and glacier and snow cover have moved to higher elevation. The upper limit of alpine grassland on the northern slope retreated and moved to higher elevation, while the lower limits of glacier and snow cover and vegetation moved northward to higher elevations. Changes in the vertical belt were influenced by climate change and human activities over time. Cropland was mainly controlled by human activities and climate warming, and the reduced precipitation also led to the abandonment of cropland, at least to a certain extent. Changes in grassland and forest ecosystems were predominantly influenced by both human activities and climate change. At the same time, glacier and snow cover far away from human activities was also mainly influenced by climate warming.

In order to advance land use and land cover change (LUCC) research in Nepal, it is essential to reconstruct both the spatiotemporal distribution of agricultural land cover as well as scenarios that can explain these changes at the national and regional levels. Because of rapid population growth, the status of agricultural land in Nepal has changed markedly over the last 100 years. Historical data is used in this study, encompassing soils, populations, climatic variables, and topography. Data were revised to a series of 30 m grid cells utilized for agricultural land suitability and allocation models and were analyzed using a suite of advanced geographical tools. Our reconstructions for the spatiotemporal distribution of agricultural land in Nepal reveal an increasing trend between 1910 and 2010 (from 151.2 × 102km2to 438.8 × 102km2). This expanded rate of increase in agricultural land has varied between different eco, physiographic, and altitudinal regions of the country, significantly driven by population changes and policies over the period of this investigation. The historical dataset presented in this paper fills an existing gap in studies of agricultural land change and can be applied to other carbon cycle and climate modeling studies, as well as to impact assessments of agricultural land change in Nepal.

Anti NMDAR encephalitis is a neuropsychiatric syndromic disease caused by an immunological response. Acute behavioral changes, psychosis, and catatonia are common clinical manifestations, are seizures, amnesia, speech difficulties, dyskinesia, and autonomic dysregulation.

Introduction. Cooccurrence of hypertension and depression/anxiety increases the chance of cardiovascular mortality and morbidity. Therefore, this study is aimed at assessing the prevalence of anxiety and depression and their association with hypertension among hypertensive adults in a tertiary care hospital in Kathmandu, Nepal. Methods. A descriptive cross-sectional study was conducted using a semistructured self-administered questionnaire based on Hamilton Anxiety and Hamilton Depression Rating Scale. The data was entered in EPI Data and analyzed using descriptive and inferential statistics in SPSS version 22. P value < 0.05 was considered statistically significant. Results. A total of 260 individuals participated in the study, with a mean age of 42.6 years. About 46% of patients did not have any symptoms of depressed mood, and 73 (28.1%) of the participants experienced feelings of depressed mood only on questioning. Similarly, (151) 58.1% did not have feelings of guilt, and 48 (18.5%) participants who had the feeling of guilt had let people down. Among 260 respondents, most participants ((102) 39.2%) had mild symptoms of anxious mood, followed by (86) 33.1% participants with moderate symptoms. Only (4) 1.5% of participants had severe symptoms. Similarly, the majority of participants ((114) 43.8%) had a mild form of mental and emotional strain, followed by (72) 27.7% with moderate mental and emotional strain while (43) 16.5% had no mental and emotional strain. The occupation and marital status of the hypertensive individual was associated with anxiety and depression (P=≤0.01). Conclusion. In conclusion, anxiety and depression were common among patients with hypertension. Anxiety and depression were linked to some of the patients’ sociodemographic and clinical features. This study demonstrates that treating hypertension alone is not enough to improve patients’ quality of life; mental illness screening among chronically ill individuals is also required.