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Sustainable forest management usually involves the use of criteria and indicators (C&I) allowing the monitoring, reporting and assessment of management activities at national, regional and forest management unit levels. Experiences of such concepts are scarce in Nepal, particularly with regard to the evaluation of management activities within a Multi-Criteria Analysis (MCA) framework. In this contribution we describe how a MCA approach can be used to efficiently exploit information, knowledge, and preferences of stakeholders to address community forest management problems. Beside rating and ranking techniques, the Analytic Hierarchy Process (AHP) is used to examine the importance of six criteria and forty-four indicators in a sustainable forest management context with a broad range of stakeholder groups. An evaluation of four management strategies in the Shree Gyneshwar community forest user group allows to demonstrate the relevance of changing priorities for different criteria. A passive adaptive management strategy focusing on a multiple use of natural resources and the introduction of production-oriented measures were identified as the most preferable option. The results of this study show that the multi-criteria analysis approach, and in particular the AHP, can assist decision-makers in efficiently evaluating management problems and generating ideas for the long-term strategic planning process of community forest management, even under complex socio-economic and ecological conditions. In that context, compromise solutions enjoy a higher possibility of being successful, taking into account the different views of stakeholder groups.

The Lorentz transformation of space and time between two inertial frames of reference is one of the pillars of the special theory of relativity. Until now, the Lorentz transformation equations have been considered on the base of one-dimensional motion between the inertial frames. The goal of this article is to extend the ordinary one-dimensional Lorentz transformation to motion along X-, Y-, and Z-directions, i.e., to achieve a space-time coordinate transformation in the three-dimensional (3D) space. We particularly discovered the modified Lorentz transformation equations along 3 directions, and this helped us to analyze the space contraction phenomena of a cuboid due to the relative motion between the inertial frames in the 3D space. As a final point, this study concluded that all length, breadth and height of a cuboid appeared to be shortened to the observer if there is the relative motion between the cuboid and an observer in the 3D space.

The paper demonstrates the incompleteness of the relativistic space contraction formula for space-time coordinates transformation between inertial frames of reference in the existing normally acknowledged version of the theory of special relativity. The reason is the lack of a formula expressing the space contraction in terms of the cosines of the direction of an object’s movement. Thus a modified version of the special relativity theory has been presented through a natural extension of the Lorentz transformation to three dimensions of space. The new transformations are based on the same mathematical operation as the Lorentz transformation, and provide mathematical information similar to that of a single-axis movement. An expression for the new transformation between inertial frames, when there was simultaneous relative motion in three directions, was introduced. The presence of relative motion in three directions between a parallelepiped and an observer (were introduced) made it possible to obtain the formulas of the directions of the ends of the parallelepiped. In fact, the Lorentz transformation was interpreted, revealing transformation of space-time coordinates in three dimensions. This offers ample scope for finding the space contraction within moving frame of reference.

Background: Otomycosis is a fungal infection of external auditory canal with worldwide prevalence of 9% to 30%. Treatment includes elimination of predisposing factor, thorough canal cleaning and topical or systemic antifungal agents. Clotrimazole is a specific topical antifungal agent with effectiveness varying from 95% to 100%. Gentian violet is an aniline dye and its use as antifungal has been mentioned in literature with effectiveness up to 80%. This study was aimed at comparing the effectiveness of these two commonly used treatments in otomycosis.This is a conducted in Department of ENT-HNS, Patan Academy of Health Sciences, Lalitpur, Nepal over one-year period after approval from institutional review committee. Patients with otomycosis were randomized into arm A and arm B group. Arm A patients were treated with one percent clotrimazole topical drops. Patients in Arm B were treated with application of one percent Gentian Violet paint. Effectiveness was measured on the basis of clinical response and recovery at end of second week. Data analysis was done with Epi Info application. Chi-square test was used and p-value less than 0.05 was considered significant., Results: Total 90 patients were treated for otomycosis over one year. Recovery was better in clotrimazole group at second week i.e., 86.84% vs 71.43%., Conclusions: Clotrimazole was more effective in treatment of otomycosis compared to Gentian Violet paint, though the result was not statistically significant.

Background: Antepartum hemorrhage is defined as any bleeding from or into the genital tract during pregnancy, after the period of viability until delivery of the fetus. APH complicates 2-5% of pregnancies and is a primary cause of perinatal and maternal mortality globally. Aim of this study is to evaluate maternal and perinatal outcome in patients with APH at a tertiary care hospital., Methods: The present study was a cross sectional study conducted in Obstetrics and Gynaecology department of Paropakar Maternity and Women's Hospital, during a period of 5 months from December 2022 to April 2023. 50 cases of APH were enrolled with gestational age ≥ 34 weeks of gestation., Results: Incidence of APH after 34 weeks of gestation was 0.51%. The most common type of APH was abruption placenta (44%) followed by placenta previa (32%) and undetermined (24%). The age range of 26 to 30 years old accounted for the highest number of APH patients i.e., 21(42%). In placenta previa, 75% and in abruption placenta 63.64% were multigravida. APH was presented mostly between 37-40 weeks. Around 26% of the patients had anemia at the time of admission. Most common mode of delivery was cesarean section (82%). Most common maternal complications were PPH (40%), blood transfusion (28%), DIC (4%), cesarean hysterectomy (4%). Low birth weight and preterm were the most common causes of fetal complications. Maternal mortality was 2% and perinatal mortality was 18% overall., Conclusions: APH is primary cause of maternal and perinatal morbidity and mortality. In our study, an abruption placenta was the most frequent cause of APH. Cesarean section was the most commonly used mode of delivery. PPH with blood transfusion was the most prevalent maternal complication, while fetal complications included low birth weight and preterm..

An alarming increase in the occurrence of extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-PE) has threatened the treatment and management of bacterial infections. This systematic review and meta-analysis aimed to provide a quantitative estimate of the prevalence of ESBL among the members of the Enterobacteriaceae family by analyzing the community-based and clinical studies published between 2011 and 2021 from Nepal and determine if ESBL-PE correlates with multidrug resistance (MDR). The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were followed for systematic review and meta-analysis and the articles' quality was assessed using the Newcastle-Ottawa scale. Of the 2529 articles screened, 65 articles were systematically reviewed, data extracted, and included in in-depth meta-analysis. The overall pooled prevalence of ESBL-producers in Enterobacteriaceae was 29 % (95 % CI: 26-32 %) with high heterogeneity (I 2  = 96 %, p < 0.001). Escherichia coli was the predominant ESBL-producing member of the Enterobacteriaceae family, followed by Citrobacter spp. and Klebsiella spp. The prevalence of ESBL-PE increased from 18.7 % in 2011 to 29.5 % in 2021. A strong positive correlation (r = 0.98) was observed between ESBL production and MDR in Enterobacteriaceae. ESBL-PE isolates showed high resistance to ampicillin, cephalosporins, and amoxicillin-clavulanic acid, and bla CTX-M type was the most reported gene variant among ESBL-PE. In conclusion, this study demonstrated an increased prevalence of ESBL-PE in Nepal over the last decade, and such isolates showed a high level of MDR against the β-lactams and non-β-lactam antibiotics. Tackling the rising antibiotic resistance (AR) and MDR in ESBL-PE would require concerted efforts from all stakeholders to institute effective infection control programs in the community and clinical settings., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Key Clinical Message: To rule out underlying developmental brain defects such as schizencephaly, pediatric seizures necessitate a thorough examination. Adults who receive a diagnosis later in life may face severe management and prognosis difficulties. To avoid underdiagnosis of developing brain abnormalities, imaging should be a part of the workup for pediatric seizures. Imaging is critical to the diagnosis and therapy of such cases., Abstract: Closed-lip schizencephaly with the absence of the septum pellucidum is a rare congenital malformation of the brain that can be associated with a variety of neurological conditions. We report the case of a 25-year-old male with left hemiparesis who presented with recurrent seizures from childhood, poorly controlled with medications, and increased tremors. He has been taking anticonvulsant for the last 7 years and is under symptomatic management. Magnetic resonance imaging of the brain revealed closed-lip schizencephaly with absent septum pellucidum., Competing Interests: The authors have no conflict of interest to declare., (© 2023 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd.)

Tuberous sclerosis complex (TSC) is a rare genetic multisystem disorder that was first described by Von Recklinghausen. We describe a case of a female, who initially presented with hematuria and was later found to have multiple manifestations of the disease. The report emphasizes the value of investigations on suspected cases., Competing Interests: The authors declares no conflict of interests., (© 2023 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd.)

Objective: This systematic review and meta-analysis aimed to assess the pool estimates of extended-spectrum β-lactamases producing K. pneumoniae (ESBL-KP) and study their drug resistance profile by evaluating the studies from Nepal., Methods: A literature search was carried out in PubMed, Google Scholar, and NepJOL to screen all articles on ESBL-KP published between 2011 and 2021 from Nepal. This review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Relevant data were extracted, and R language 4.2.0 software was used for statistical analysis., Results: The pooled prevalence of K. pneumoniae was 5%, while the pooled prevalence of ESBL and multidrug resistance (MDR) in K. pneumoniae were 23% and 55%, respectively. Imipenem was the drug of choice (in vitro) against ESBL-KP infection., Conclusion: Our analyses showed a high prevalence of ESBL-KP and their high resistance toward commonly used drugs. This study highlights the need for the development of new antibiotics for the management of ESBL-KP infections., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article., (© The Author(s) 2023.)

Pseudomonas aeruginosa is an opportunistic human pathogen that has developed antibiotic resistance (AR) and causes a range of illnesses, including respiratory pneumonia, gastrointestinal infections, keratitis, otitis media and bacteremia in patients with compromised immune system. The production of metallo-β-lactamases (MBLs) is one of the major mechanisms of AR in this bacterium with ensuing infections difficult to treat. The main goal of this study was to provide a quantitative estimate of MBLs producing clinical P. aeruginosa isolates among the Nepalese patients and determine if MBL correlates with multi-drug resistance (MDR). Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guideline was followed for meta-analysis of relevant literature using PubMed, Research4Life, and Google Scholar. The prevalence of MBLs in P. aeruginosa from clinical samples was determined using R 4.1.2 for data pooled from studies published until 2021. The meta-analysis of a total of 19 studies selected (of 6038 studies for which titles and abstracts were reviewed) revealed the prevalence of MBLs producing P. aeruginosa (MBL-PA) was 14 % (95 % CI: 0.10-0.19) while MDR isolates among P. aeruginosa was 42 % (95 % CI: 0.30-0.55) in Nepal. Combined Disc Test was predominantly used phenotypic method for confirming MBLs phenotypes among the studies. Sputum was the most common specimen from which MBL-PA was recovered. A significant positive correlation was observed between MDR and MBL production in P. aeruginosa. We conclude that MBL producing strains are widespread among the clinical isolates of P. aeruginosa in Nepal and responsible for emerging MDR strains. It is paramount that antibiotics prescription against the bacterium should be monitored closely and alternative therapeutic modalities against MBL-PA explored., Competing Interests: Declaration of competing interest Lok R. Pokhrel reports financial support was provided by East Carolina University., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Dactylorhiza hatagirea is a terrestrial orchid listed in Appendix II of the Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES) and classified as threatened by International Union for Conservation of Nature (IUCN). It is endemic to the Hindu-Kush Himalayan region, distributed from Pakistan to China. The main threat to its existence is climate change and the associated change in the distribution of its suitable habitats to higher altitudes due to increasing temperature. It is therefore necessary to determine the habitats that are suitable for its survival and their expected distribution after the predicted changes in climate. To do this, we use Maxent modelling of the data for its 208 locations. We predict its distribution in 2050 and 2070 using four climate change models and two greenhouse gas concentration trajectories. This revealed severe losses of suitable habitat in Nepal, in which, under the worst scenario, there will be a 71-81% reduction the number of suitable locations for D. hatagirea by 2050 and 95-98% by 2070. Under the most favorable scenario, this reduction will be 65-85% by 2070. The intermediate greenhouse gas concentration trajectory surprisingly would result in a greater reduction by 2070 than the worst-case scenario. Our results provide important guidelines that local authorities interested in conserving this species could use to select areas that need to be protected now and in the future.

Programme-based Planning of Natural Resources (PBPNR) is an evolving planning frame for solving complex land use, environmental and forest management problems within hierarchically administrated funding and decision-making schemes. PBPNR acknowledges that an effective planning process requires the combined consideration of environmental, technological, economic and socio-political factors. To reach acceptability, commitment and operability, PBPNR processes need to foster collaboration and learning. For this study, an analysis of 43 collaborative planning methods was conducted to examine their potential to be applied within PBPNR. We present the approach of screening the applicability of methods for specific needs that may occur in PBPNR. The approach is based on a list of key criteria for the phases of a collaborative planning process: problem identification, problem modelling and problem solving. The features of each method were qualitatively assessed and peer-reviewed by a team of experts. Most of the methods are able to deal with qualitative data, support processes to increase transparency in planning and capture the preferences of the participating stakeholders. They also produce understandable results for the three phases. Contrarily, many methods do not offer features to handle uncertainty, nor do they satisfactorily stimulate creativity and innovation in the planning process. The results show that the overall applicability of the reviewed methods for the three planning phases varies according to a cluster analysis basing on the capabilities of the methods. Methods such as "Planning for Real", "Open Space" and "A'WOT" seem to be particularly promising for a broad range of planning situations., (Copyright © 2014 Elsevier Ltd. All rights reserved.)