Strengthening Active Aging through Older People’s Association and Economic Activity of the Older People in Nepal

Aging is a natural lifelong process ending in death. Many older people are living in poverty. Older people are generally considered dependent on others as they grow older. The purpose of this article is to explore the entrepreneurship activities of Nepalese older adults. Data for this study were collected from the project Help Age International (HAI) implemented in Nepal. Qualitative data observations and interviews were used to collect data. The findings of this study show the formation of the Older People’s Association (OPA) has supported many older people to participate outside the home in various social activities. Moreover, regular deposits through OPAs offer little help. OPAs support older people in their need of financial support to implement minor entrepreneurship. Older people who received support were pleased and were actively involved in their activities and also regularly deposited money in them. Subsequently, older people’s participation in social activities has increased and also helped to lower elderly abuse, loneliness, and depression. Local governments should promote such activities which will help with healthy aging.

Seedling potential of trees species along the elevational gradient in temperate hill forest of central Nepal

Regeneration status of tree species along elevation gradient in temperate hill forest was not understood greatly.Present research examined the tree diversity and its regeneration patterns along an elevation gradient in temperate hill forest,central Nepal.Data were collected from 300 sample plots within vertical elevation bands of 10,ranging from 1365 to 2450 m asl.A random sampling method was used for data collection in three seasons,winter,pre-monsoon and post monsoon seasons.Diameter at breast height(DBH)was used to broadly categorize the plant individual into trees,saplings and seedlings.The tree species richness ranged from 12 to 25 with density of 350 to 1200 individuals per hectare.Species richness of tree and sapling showed statistically significant unimodal pattern,which peaked at mid-elevation.Elevation showed a strong and positive linear correlation with the seedling density(Deviance=0.99,p<0.001)and a significant hump-shaped relationship with sapling density(Deviance=0.95,p<0.001).Similarly,elevations showed a statistically significant negative hump-shaped relationship with all trees,saplings and seedling stages(Deviances=0.89,0.87 and 0.57).The highest values of the Shannon-Wiener index and the lowest value of the Simpson index were found at mid-elevation for all growth forms.Nearly 92%of tree species were found at regenerating stage;49%in a good renewal regeneration status,32%in fair renewal regeneration,and 11%at a poor regenerating condition.Nevertheless,4%of tree species were reported as non-regenerating stages and 4%were newly introduced species.Hence,the regeneration status of the study area was considered fairly well since sapling(78.5%)>seedling(10.6%)≤mature(10.9%).Among tested environmental variables,elevation and annual mean rainfall were the most influential factors in the regeneration of tree species.

Impacts of road on plant invasions in the Middle Mountain region of central Nepal

Biological invasion is triggered by human development activities such as the construction and expansion of road networks.Road verges serve as important habitats and corridors for the distribution of invasive alien plant species(IAPS)between geographically distant habitats.However,the trajectory of plant invasion and the data regarding the impact of roads on IAPS distribution are relatively poor in Nepal.Here,we surveyed two road types(main roads and feeder road)in the Middle Mountain region of central Nepal in order to investigate how different road types are driving the dispersal of IAPS along road verges and the adjacent natural habitats.Systematic sampling was conducted at ca 2.5 km intervals along the roads.At each sampling site,paired plots(25 m×4 m)were sampled:one adjacent to and along the road,and another 20 m away and parallel to it in the interior habitat.Our results revealed that the main road verges had a higher cover(33%)and a larger number of IAPS(14 species)than the feeder road(25%;10 species).The IAPS cover and richness were significantly higher along verges than in the adjacent interior habitats for both road types,indicating that roads are contributing as corridors for the dispersal of IAPS in the Middle Mountain areas of central Nepal.Further,elevation,tree canopy,and disturbances(grazing/mowing/trampling)were found to be the key factors that determine spatial distribution of IAPS along road verges.We emphasize that regular monitoring of vegetation along the road verges can help with the early detection and control of potential IAPS in the region before they become problematic.

Diversity of Orchids in Terms of Their Distribution, Uses and Conservation in Annapurna Conservation Area of Nepal

The Annapurna Conservation Area (ACA), the first conservation area and the largest protected area (PA) in Nepal, is incredibly rich in biodiversity. Notwithstanding this, orchids in the ACA have not been explored enough yet thus making the need for ambitious research to be carried out. Previous study only included 81 species of orchids within ACA. This study aims to update the record of species and genera richness in the ACA. In total 198 species of orchids, belonging to 67 genera (40% and 62% of the total recorded orchid species and genera in Nepal) has been recorded in ACA. This represents an increase of 144% in species and 56% in genera over the previous data. Out of the 198 species, 99 were epiphytes, 6 were holomycotrophic and 93 were terrestrial. Among the 67 genera, Bulbophyllum (17) species were dominant, followed by Dendrobium (16), Herminium (10), Coelogyne, Plantanthera (9 each), Eria, Habenaria, Oberonia (8 each), Calanthe (7), and Liparis (6). Fifty-six species were found to be ornamentally significant and 85 species medicinally significant.

Aging Trend and Situation in Nepal

Aging is a natural lifelong process until death. The proportions of the older population are increasing rapidly in Nepal too. There are 2.97 million older people in Nepal as of the 2021 census which is a 38.2% increase compared to the previous census of 2011. The proportion of the older population reached 10.21% of the total population of Nepal. During this decade, Nepal’s average population growth rate is 0.92% and the older population growth rate is 3.29% per year. On the other hand, Nepal’s total fertility is below replacement level, infant mortality is around 23 per thousand live births and average life expectancy is now around 71 years. The median age of Nepal is 25 years and the index of aging increased rapidly from 23.3 in 2011 to 36.7 in the 2021 census of Nepal. These indicators show aging is taking place rapidly and the caregiving burden may increase rapidly in the coming days due to the tendency of migration of the young population to other countries. In this context, the Nepal government needs to focus on how to manage the population and provide quality services and social security for the growing older people of Nepal.

Probabilistic Analysis of Slope Using Finite Element Approach and Limit Equilibrium Approach around Amalpata Landslide of West Central, Nepal

The stability study of the ongoing and recurring Amalpata landslide in Baglung in Nepal’s Gandaki Province is presented in this research. The impacted slope is around 200 meters high, with two terraces that have different slope inclinations. The lower bench, located above the basement, consistently fails and sets others up for failure. The fluctuating water level of the slope, which travels down the slope masses, exacerbates the slide problem. The majority of these rocks are Amalpata landslide area experiences several structural disruptions. The area’s stability must be evaluated in order to prevent and control more harm from occurring to the nearby agricultural land and people living along the slope. The slopes’ failures increase the damages of house existing in nearby area and the erosion of the slope. Two modeling techniques the finite element approach and the limit equilibrium method were used to simulate the slope. The findings show that, in every case, the terrace above the basement is where the majority of the stress is concentrated, with a safety factor of near unity. Using probabilistic slope stability analysis, the failure probability was predicted to be between 98.90% and 100%.

Assessing Financial Management Practices and Accounting Mechanisms in Agricultural Cooperatives:A Case Study From Nepal

The study focuses on assessing the financial management practices and accounting mechanisms in agricultural cooperatives in Tulsipur Sub-Metropolitan,Dang District,Nepal with a focus on understanding their implications for financial performance and organizational effectiveness.The sample size of total cooperatives(n=46)was divided into Savings and Credit Cooperatives(n=18)and Multipurpose Cooperatives(n=28),respectively,with a total number of respondents(n=138)categorized into managing directors,employees,and general members.Using a mixed-methods approach that combines quantitative analysis of financial data with qualitative insights gathered through interviews and surveys,the study emphasizes the importance of modern financial practices,improved reporting mechanisms,and relevant staff training for long-term sustainability.Recommendations include the integration of criteria and evaluation tools to assess cooperative performance,with Hamro Pahunch Multipurpose Cooperative identified as a high performer.Emphasizing the need for robust financial management strategies to navigate the complexity of the agricultural sector,manage risks,and achieve sustainable development,the study notes frequent preparation of financial management reports on a monthly and annual basis,and predominantly annual accounting management.Most cooperatives are using computerized models to present financial positions,but face challenges such as lack of marketing infrastructure,cooperative skills,and technical support.Ultimately,the study advocates for educating policy makers,cooperative leaders,practitioners and stakeholders on the role of effective financial management and accounting in enhancing the resilience,expansion and socio-economic impact of agricultural cooperatives,thereby fostering their long-term prosperity and viability as drivers of rural development and empowerment.

Low-Cost Insulation for Energy Efficient Buildings in Terai Region of Nepal

There is a huge amount of energy savings potential in public building sector that has yet to be realized.By prioritizing energy efficiency in its own buildings and thus promoting the development of required knowledge in terms of new technology and construction methods,the public sector will lead the way in efforts to increase the rate of renovations.The low-cost insulation strategies and a comparison of cost with existing insulation materials has been described in this study.We have repeatedly faced energy crises and will continue to do so in the future if appropriate action is not taken in a timely manner.Properly implementing energy-saving initiatives in for achieving thermal comfort in buildings as well as reducing the energy costs would undoubtedly inspire the residential sector,resulting in significant reductions in energy usage.Simulations were carried out to study insulation layers on various building components like exterior walls,floor and roofs,generating different scenarios for a building as a base model,which were then compared and analysed to verify the literature used to develop the cases.The proposed recommendations,which have been validated,are certain to increase building energy efficiency,achieve thermal comfort in low cost than what is currently being used.

Rainfall erosivity and sediment dynamics in the Himalaya catchment during the Melamchi flood in Nepal

Rainfall erosivity is an indicator of rainfall potential to cause soil erosion.The Melamchi extreme flood occurred on June-15 and recurred on July-31,2021 in Nepal.During these flooding events,a large volume of sediments were eroded,transported and deposited due to the high rainfall erosivity of the basin.In this study,the temporal and the spatial distribution of rainfall erosivity within the Melamchi River Basin was estimated and further linked to sediment discharge and concentration at various sites along the river segments.The daily rainfall data for the event year 2021 of the entire basin were used.Validation was performed by post-flooding grain size sampling.The result showed that rainfall and rainfall erosivity exhibit pronounced intensity within the Melamchi River basin,particularly at Sermathang and Tarkeghang,both located in the middle section of the basin.The average annual rainfall in the Melamchi region was 3140.39 mm with an average annual erosivity of 18302.06(MJ mm)/(ha h yr).The average daily erosivity of the basin was 358.67(MJ mm)/(ha h)during the first event and 1241(MJ mm)/(ha h)for the second event.In the upper section of sampling,the sediment size ranged from 0.1 mm to>8 mm and was poorly graded.However,the lower region had smaller sediment ranging from 0.075 mm to>4.75 mm and also well graded.The smaller size(<1 mm)sediment passing was much higher in the Chanaute(78%)and Melamchi(66.5%)river segments but the larger size(>100 mm)sediments were passed relatively higher from the Kiwil(8.20%)and Ambathan(8.39%)river segments.During premonsoon and monsoon seasons,the highest sediment concentration was found to be 563.8 g/L and 344.3 g/L in Bhimtar and the lowest was 238.5 g/L and 132.1 g/L at the Ambathan,respectively.The sediment concentration during the pre-monsoon was found to be higher than the sediment concentration during the monsoon season in the Melamchi River.The more erosive regions in the basin were associated with the presence of highly fractured rock,weathered rocks and a thrust(weak)zone.The higher rainfall erosivity at upstream and the higher sediment concentration at downstream during flooding events have coincided well in the basin.Thus,the estimation of rainfall erosivity at the catchment scale and its influences on sediment concentration in the river are crucial for erosion control measures during flooding times in the Himalaya.

Understanding human-leopard conflict in the ‘Mid-hill’ region of western Nepal

Livestock rearing and agriculture are the main sources of community-based livelihoods in western Nepal.Across the rural mid-hills region of Gandaki Province,leopards are the top predator and frequently depredate livestock and attack humans.Spatiotemporal patterns of human-leopard conflicts(HLC) in Nepal are poorly known at the provincial and national scales,which are essential to formulating effective conflict mitigation strategies and implementing them in the field.This study aims to analyze the spatiotemporal pattern of HLC by applying Maxent modeling to covariates relating to known and registered conflict cases(n=842) collected from Nepalese government offices.We found that cases of HLC have been increasing significantly over the past five years.We also concluded that mid-elevation,south-facing slopes were more susceptible to HLC,but that mean annual temperature was by far the most important predictor of HLC;overall livestock density and proximity to roads were also important,but secondarily so.Although we found the increase in human fatalities to 2.16/year was significant(p<0.05),overall human injuries were down slightly,though not significantly(5.16/year;p>0.05).However,we also found an increasing trend in livestock depredation rates for this same five-year period(p<0.05),which averaged 159.6 head/year among incidents reported.We also found that winter was the main season when depredations occurred,and that goats were the most depredated of all livestock.A total US $86,892.25($17,378.45/year) of economic losses were incurred by communities during this time,with 78.57% of the total value reimbursed as compensatory relief through the government’s relief fund.We recommend that the use of predator-proof livestock corrals,greater awareness in local communities about wildlife behavior,better animal husbandry and security practices,and a more efficient compensation program,can improve coexistence between leopard populations and human communities in western Nepal.

The effects of climate and land use change on the potential distribution and nesting habitat of the Lesser Adjutant in Nepal

Climate change and land use change pose a threat to the world’s biodiversity and have significant impacts on the geographic distribution and composition of many bird species,but little is known about how they affect threatened large-sized waterbird species that rely on agricultural landscapes.To address this gap,we investigated how climate and land use changes influence the distribution and nesting habitats of the globally vulnerable Lesser Adjutant(Leptoptilos javanicus) in Nepal.Between 2012 and 2023,we collected distribution data from 24 districts and nesting site information from 18 districts.In a nation-wide breeding survey conducted in 2020,we documented a total of 581 fledglings from 346 nests in 109 colonies.The ensemble model predicted a current potential distribution of 15%(21,637 km2) and a potential nesting habitat of 13%(19,651 km2) for the species in Nepal.The highest predicted current suitable distribution and nesting habitat was in Madhesh Province,while none was predicted in Karnali Province.The majority of this predicted distributional and nesting habitat falls on agricultural landscapes(>70%).Our model showed a likely range expansion of up to 15%(21,573 km2) for the distribution and up to 12%(17,482 km2) for the nesting habitat under SSP5-8.5 scenarios for the 2070s.The range expansion is expected to occur mainly within the current distribution and breeding range(Tarai and some regions of Siwalk),particularly in Lumbini and Sudurpashchim provinces,and extend to the northern portions(Siwalik and Mid-hill regions) in other provinces.However,the current Protected Areas and Important Bird and Biodiversity Areas are inadequate for providing optimal habitats for the species.Although the model suggests range expansion,the use of such novel habitats is primarily contingent on the availability and protection of large-sized trees(particularly Bombax ceiba,observed in 65% of colonies) in agricultural regions where nesting occurs.Therefore,our research suggests that agricultural landscapes should be prioritized in management plans for the conservation of the Lesser Adjutant in Nepal.

The Journey of SRS: An Initial Experience of Starting Sterotactic Radiosurgery Facility at Purbanchal Cancer Hospital—First in Nepal

Introduction: Radiotherapy (RT) is a vital cancer treatment modality for both curative and palliative purposes. Nepal is a developing country with a population of around 30 million people. Cancer affects 100 - 120 people out of every 100,000, and the figure is increasing. The number of radiation facility machines in the country is still countable in fingers. Purbanchal Cancer Hospital, Nepal is the first comprehensive cancer facility capable of performing stereotactic radiosurgery (SRS). Our facility has cutting-edge Varian Truebeam Linear Accelerators with millennium MLC, which makes SRS and SRT’S for intracranial lesions such as small benign and malignant tumors much easier. In addition to SRS, we are the pioneers of SBRT for lung using 4DCT, interstitial & intraluminal brachytherapy, RPM Gated & DIBH modalities in Nepal. Methods & Materials: The purpose of this study is to share our experience in establishing an SRS facility in the country, which includes training the RT team on the importance of process accuracy, patient selection, patient assessment, mould preparation, and describing image data acquisition, target, and organ at risk delineation on CT and MRI images, treatment planning process, and quality assurance. Results & Discussion: The plans for all SRS and SRT cases are based on target coverage, OAR sparing, hotspot inside the target, conformity index, heterogeneity index, and dose fall off. To select the final plan, we used strict passing criteria such as a conformity index Paddick (CIPaddick) more than 0.85, a falloff between 100% and 50% of less than 5.5 mm (maximum 6 mm in irregular targets), and a hotspot inside the target between 115 to 140 percent, as per clinical standards. In addition, we determined the CILomax and CIRTOG for each case. Passing criteria for verification plans are set as minimum of 95% for a 2% percentage dose difference (% DD) and a 2-mm distance to an agreement (DTA). We also gathered demographic data from patients treated in the first year, such as diagnosis, lesion size, dose fraction, heterogeneity index (HI), conformity index (CI) and gamma index. SRS/SRT treatment was successfully implemented, and over 40 patients were treated with positive clinical outcomes. Conclusion: SRS now has a wider range of alternatives, thanks to technology advancements in recent years. SRS’s dosimetric advantages have steadily been extended to extracranial locations. Purbanchal Cancer Hospital, Birtamode, Nepal established a comprehensive cancer facility with qualified workforce with the goal of providing high-quality treatment to the people of Nepal.

Evolution and bathymetry of glacial lake at the lowest elevation in Nepal Himalaya

One of the prominent impacts of climate change induced glacier retreat in the Himalayas is the formation and expansion of glacial lakes. The newly formed glacial lakes are mostly located in higher altitudinal regions(4200-5800 m) of Himalaya,however, a new glacial lake(Kapuche, 28.446° N and 84.116° E) have been reported to be emerged in the relatively low elevation area of ~2450 m above sea level(masl) in the Nepal Himalaya. This short communication presents the remote sensing-based evolution and field-based bathymetry of Kapuche lake, and further discusses its formation process and lake type for being a glacial lake at the lowest elevation in Nepal Himalaya.

Seasonal variations and health risk assessment of trace elements in the Badigad River,lesser Himalayas,Nepal

The consumption of contaminated river water can have severe effects on human health.This study aims to investigate the trace elements(TEs)content and their health risk assessment in the Badigad River Basin in the lesser Himalayas of Nepal.In total,44 water samples were collected from 22 different sites during the pre-monsoon and monsoon seasons,and 25 TEs were analyzed.Correlation matrix and principal component analysis(PCA)were used to analyze the potential relationship between the measured TEs and their source tracking.Furthermore,the water quality index(WQI),metal index(MI),and cancer index(CI)were evaluated.The TEs content in all samples were found to be within the WHO recommended guideline for drinking and domestic purposes.The dominancy order of the TEs was observed as Sr>Ba>Li>Rb>Zn>Cr>Sc>Mn>Ti>Cu>As>Ni>Co>U>V>Pb>Cs>Ga>Y>Tl>Th>Zr>Bi>Cd>Nb.The PCA analysis suggested that TEs could have natural,anthropogenic,and mixed origins.The WQI indicated that the river water is safe from a human health perspective.The MI suggested that Badigad River can be considered safer for drinking purposes,and the cancer index(CI)showed that all the reported TEs are at low-risk levels.The findings of this study could be useful for government agencies in developing more sustainable water management policies in the region.However,it is suggested that further investigations should be conducted in terms of other hydrogeochemical variables,including major ions,at spatiotemporal levels for the sustainability of the river basin.

The Influence of Alluvial Mining on the Morphology and Ecological Health of the Jhimruk River in Pyuthan, Nepal

Historically, alluvial rivers have been a desirable source of sediment for various industrial purposes. However, the demand for sand is rapidly increasing, leading to environmental concerns associated with its extraction. The extraction of sediment from riverbeds has both visible and invisible effects. This research aims to investigate the dynamics of the Jhimruk River’s morphology and its impacts by evaluating the river’s quality and studying its changing morphology. To assess morphological changes, satellite images from different years were compared using Geographic Information System (GIS). Physical assessments were conducted by calculating a Habitat score based on various parameters. Water quality assessments involved measuring factors such as pH, temperature, nitrate levels, and alkalinity. A water quality map of the river was generated using color coding to indicate different conditions. The Habitat score demonstrated variations in the data collected from all sites, with factors such as instream cover, bottom substrate stability, riparian vegetation, and aesthetic of the river stretch playing crucial roles in influencing the total score. The Water Quality Index value for the disturbed site indicated moderate pollution, falling under class II. Aquatic macroinvertebrates displayed natural responses to increasing levels of stressors across their life stages, as observed through the analysis of the GRS-BIOS/ASPT index. With the exception of the disturbed site, all other sites were classified under water quality class II, while the disturbed site belonged to class III, indicating a moderate to critically polluted state for most of the Jhimruk River. Furthermore, an increase of 180.87 meters in the river width at the disturbed site provided evidence of morphological changes occurring over the specified period. Mining activities were identified as a significant contributor to the alteration in river morphology.

Impact of Right Ventricular Dysfunction in Morbidity and Mortality in Patients with Inferior Wall Myocardial Infarction Presenting to a Tertiary Care Center of Nepal

Introduction: In comparison to anterior wall myocardial infarction, inferior wall myocardial infarction is generally regarded as a low risk event. The aim of this study was to evaluate the prognostic impact of right ventricular (RV) myocardial involvement in patients with inferior wall myocardial infarction (IWMI). Methods: This is an observational study of 82 consecutive IWMI patients admitted and treated in Manmohan Cardiothoracic, Vascular and Transplant Center (MCVTC) from May 15 2018 to June 15 2019. The clinical characteristics, risk factors profile, electrocardiographic, echocardiographic, including RV function and angiographic characteristics, complications and in-hospital deaths were analyzed. Results: The mean age of patients presenting with IMWI was 64.8 ± 13.8 years with predominance of male (67%). Right ventricular myocardial infarction was present in 34.1% of patient with RV dysfunction in 25.6% patients. Mean Tricuspid Annular Plane Systolic Excursion (TAPSE), RV tricuspid annulus (S') and RV Fractional area change (FAC) in patients with RV dysfunction vs patients without RV dysfunction were 12.2 ± 3.3 mm vs 22.5 ± 3.5 mm (p < 0.001), 7.54 ± 0.91 cm/s vs. 12.79 ± 2.16 cm/s respectively (p Conclusion: In inferior wall myocardial infarction, RV involvement with RV dysfunction is an independent risk factor for in-hospital mortality along with advanced age, complete atrioventricular block, higher Killip class, delayed hospital presentation, left ventricular ejection fraction < 40% and angiographic evidence of triple vessel disease.

Prevalence of Preoperative Anemia in Elective Rheumatic Valve Surgery at a Tertiary Care Center in Nepal

Background: Rheumatic Valvular Heart disease (RVHD) is common in developing countries often associated with anemia;however its burden is often overlooked. Anemic patients undergoing surgery are likely to receive blood transfusion, increasing morbidity and mortality. Prevalence of anemia in cardiac surgical patients are studied extensively, however its burden in RVHD is lacking. This study attempted to investigate the prevalence of preoperative anemia in RVHD and its effect on blood transfusion, morbidity and mortality in patients undergoing valve surgery. Methods: This is a retrospective observational study conducted at a tertiary care hospital in Nepal. We considered 340 patients who underwent Rheumatic valve replacement surgery from 2014 January to December 2016 and data on their socio-demographic and clinical characteristics were extracted from the patient’s records. The analyses meeting the study objectives were conducted using IBM SPSS v25 for Windows (IBM Statistical Package for Social Sciences, 2015IBM Corporation, New York, United States). Results: The prevalence of no anemia, mild, moderate, and severe anemia was 34.1%, 57.7%, 39.6%, 2.5%, respectively. The units of Red Blood Cell used for transfusion were 1.2 units, 2.0 units, 2.3 units, and 1.6 units in patients without anemia, and those with mild, moderate and severe anemia respectively. The incidence of reexploration was higher in patients with severe anemia as compared to the non anemic with an incidence of 66.6%. A proportion of the patients with no anemia, mild, moderate and severe anemia with less than 7 days stay in the intensive care unit were 89%, 82%, 84.7% and 100% respectively. The length of hospital stay more than 10 days was seen in 58.9%, 71.6%, 63% and 100% in patients with no anemia, mild, moderate and severe anemia. An overall incidence of mortality in anemic patients was 11% while in non anemic patients was 5.3%. Conclusions: The prevalence of anemia was high in the Nepalese patients with Rheumatic valvular heart disease planned for elective surgery. There was an increased incidence of blood transfusion, longer hospital stay, and increased mortality in anemic patients compared to their non anemic counterparts.

Prevalence of Diabetes and Dyslipidemia Patterns amongst Hypertensive Patients in a Tertiary Cardiac Centre in Kathmandu, Nepal

Background: Dyslipidemia and hypertension are independent cardiovascular risk factors that are linked by insulin resistance and they require follow-up and more aggressive therapeutic strategies. Hence, the present study was done to study the prevalence of Diabetes and Dyslipidemia patterns in hypertensive patients. Methods: A cross-sectional observational study was done on patients with hypertension for duration of one year, i.e. from Feb 2022 to January 2023. A total of 726 hypertensive Patients were included. All calculations and statistical analyses were processed by SPSS 25.0. Results: A Total of 726 patients with a history of hypertension were included;the average age was 55, with 24.2% of patients belonging to the age group 51 - 60;55.8% were males and 44.2% were females. In the present study, the prevalence of diabetes was 29.06% and 35.5% of patients in the prediabetic stage. The most frequent dyslipidaemic form was reduced HDL, seen in 96.1% and 94% of new and old respectively;followed by elevated LDL, 86% and 48.2% in new and old respectively. It was followed by elevated TG level and Total cholesterol levels. Conclusion: There was a high prevalence of diabetes, pre-diabetes as well as dyslipidemia in hypertensive patients.

Microbiological and Antibiotic Susceptibility Patterns in Cardiothoracic and Vascular Intensive Care Unit of a Tertiary Level Hospital in Nepal

Background: Sepsis has been one of the most important conditions for morbidity and mortality of Intensive care unit (ICU) patients. Antibiotics remain one of the major combating factors for it. Indiscriminate antimicrobial usage and poor prescription practices have contributed to the development of multidrug resistant (MDR) organisms. Therefore, the current study was designed to evaluate the spectrum, and susceptibility patterns of pathogens isolated from patients admitted to our Cardiothoracic and Vascular Intensive care unit. Materials and Methods: The study was conducted in Cardiothoracic and Vascular ICU of a tertiary care teaching hospital from February 2019 to March 2021. Samples (blood, urine, wound swab, tracheal aspirate, and central venous catheter tip) for culture were taken from all the patients in Sepsis admitted in Cardiothoracic and Vascular ICU above 18 years of age during the study period. The culture reports (microbiological profile and their susceptibility pattern) were collected and data collection of all enrolled patients was done. Results: Out of the total 128 samples studied 75 (58.5%) were culture positive. The predominant organisms isolated were Gram negative organisms (Klebsiella, Pseudomonas, Acinetobacter, followed by E. coli). The highest prevalence of microbial growth was found in tracheal aspirate (46.8%), followed by blood (21.8%). Antibiotic susceptibility results showed the highest sensitivity of those common pathogens towards higher antibiotics only (especially Polymyxin B and Colistin). Conclusion: The emergence of multidrug resistant organisms and lesser availability of a higher group of antibiotics is a major concern. So there is a need for regular hospital based antibiograms, strict infection control programs, and implementation of antimicrobial stewardship programmes for guiding clinicians in choosing appropriate therapy and preventing the surge of multidrug resistant organisms.

Peri-urban Development:Discussion with Land Use Zoning,Statutory Provision,and Issues inside Katahari Rural Municipality,Nepal

The peri-urban area is a transitional zone between the city and its hinterlands characterized by mixed land use and intensive flows of resources,people,goods,and services from and to the city center.These zones are generally misguided and haphazardly developed without a proper planning framework.The peri-urban area at present will be the urban area in the future;therefore,it needs planning intervention in its initial stage of growth.Katahari,a peri-urban area of Biratnagar metropolitan city,is developing a spontaneous lack of land use plans.Recently,the Government of Nepal has encouraged the local government to implement land use plans in the provided framework,policy,and guidelines.This study,in this context,attempts to analyze and identify land use issues and potential zones for Katahari rural municipality that also supports planning urban development in the future.The study is based on primary and secondary data and information supported by maps and figures.It is concluded that Katahari has been developed as a multi-function center adjoining the Biratnagar metropolitan city,and future expansion of the city will cover a wide range of rural municipalities.The postal highway that passes through it has attracted a wide range of urban functions.Agriculture,residential,commercial,and industrial are the main land use category at present and needs development control through providing land use zoning and related planning instruments through the increasing role of the stakeholder and the government agencies in the decision-making processes and implementation of spatial development frameworks to regulate peri-urban development in the area which will guide the future planning for liability,economic viability,social inclusion,and environmental sustainability in the area.Spill-over development activities of Biratnagar,have increased the number of economic activities,population growth,and mixed-use development.