The 3500 km long Hindu-Kush Himalaya (HKH) region is one of the dynamic regions of the world. Natural and human-induced hazards impose threats to lives and infrastructures in this region. This region has four of the five most crucial yet vulnerable water towers in Asia. The ten major river basins in the HKH have a population of around 1.9 billion in the year 2015 with about 240 million in the mountains and hills. The existing geo-climatic characteristics of the region, rapidly increasing urbanization, environmental degradation, anthropogenic activities, and socioeconomic conditions, are increasing citizens' exposure to and risk from natural hazards and resulting in more frequent, intense, and costly disasters. Moreover, this region is extensively experiencing the negative effect of climate change, i.e., glacier melting forming glacial lakes. The formation of glacial lakes due to permafrost melting poses a high threat of Glacial Lake Outburst Flood (GLOF). This region has already witnessed a number of GLOF events in recent decades. It is found that one large event, i.e., GLOF can change the whole mountain landscape along with land use and land cover (LULC) changes. Similarly, the existing topography, roads excavated at the higher gradient, and the agricultural lands on the steeper slopes have been the hotspots for the large number of landslides There is a significant contribution of anthropogenic activities for LULC change. Therefore, this study aims to analyze the changing pattern of LULC due to human interferences and natural processes. This study will be helpful to understand the mountain dynamics and its relationship with increasing disasters in the HKH region. The number of pixels with a population density of over 100,000 per square KM was 122 in 2000, which was increased to 960 pixels in 2020. Overall, the data shows that the population density has increased in recent years in the HKH region. The HKH region had almost 20.85% (4075 of 19,547) major disaster events recorded in the past 32 years (between 1990 and 2022) in the Em-DAT global database, with death tolls of more than 28.71% in the region.

Background Subarachnoid block is one of the commonly used techniques of regional anesthesia and accurate placement of spinal needle is crucial. A conventional spinal needle may be too long for a lean patient or too short in obese patients leading to multiple attempts, inadvertent nerve injuries and patient discomfort. So a pre-procedural estimation of the skin to subarachnoid space depth may be beneficial. Objective To estimate the skin to subarachnoid space depth using ultrasound and correlate it with the length of spinal needle to be inserted during subarachnoid block. Method This was a prospective, observational study conducted at Bir Hospital, Kathmandu in patients undergoing elective surgeries under subarachnoid block. A pre-procedural ultrasound of lumbo-sacral spine using 2-5 Hz curvilinear probe was done to measure skin to subarachnoid space depth (SSD) at the level of L3-L4 interspace. Then under all aseptic precautions, subarachnoid block was performed and the length of spinal needle outside the skin was measured and that length was subtracted from the standard length of needle to get the inserted length of spinal needle. These two measurements were compared. Result In the fifty patients included in the study, ultrasound estimated skin to subarachnoid space depth was found to be 4.24 ± 0.48 cm and the inserted length of spinal needle was 4.24 ± 0.46 cm. A significant correlation r=0.96 (p < 0.05) was found between the two measurements in the study population. Conclusion Ultrasound estimated skin to subarachnoid depth in the study population was found to be 4.24 ± 0.48 cm which correlated with the inserted length of spinal needle. So, use of ultrasound can be very helpful in performing subarachnoid block.

Landslide risk reduction in the Nepal Himalayas is challenging due to its complexity and cost incured by the traditional structural measures while the non-structural measures like landslide early warning system (LEWS) are limitedly known. A community-based LEWS was piloted in Neelakantha Municipality (~200km2) of Dhading District in central Nepal. The locals participated in maintaining a comprehensive database of 162 field-verified landslides and identifying vulnerable areas. With the landslide and conditioning factors, a landslide susceptibility map (LSM) of the municipality was developed and a vulnerable catchment (~12km2) was delineated to undergo geotechnical investigation and unmanned-aerial-vehicle (UAV) survey. With the enhanced datasets, LSM and Factor of Safety (FoS) model of the catchment was developed. The study also brought to light the occurrence dates of 33 previously triggered landslides and gathered corresponding daily and 5-day antecedent rainfall data, leading toward the development of rainfall thresholds. To improve the quality of rainfall, volumetric soil moisture, and ground displacement, automated rain gauges, soil moisture sensors, and extensometers were strategically installed in the catchment. A dashboard was designed to analyze data received from these ground stations and integrate with the government-issued rain forecasts enabling the prediction of potential landslides and providing advance alerts to the community.

Background Male rigid cystoscopy is one of the most common outpatient procedures in urology because of it lower cost, better optical area and better orientation compared with flexible devices. However, performing rigid cystoscopy is not only painful but equally apprehensive in awake male patients. Objective The study was conducted to evaluate the efficacy of lidocaine gel and ketamine solution together compared with lidocaine gel alone during male rigid cystoscopy. Method A total of 76 male patients who visited the hospital for rigid cystoscopy were randomized into two groups before undergoing cystoscopy. The experimental group received 15 ml lidocaine with 2 ml (100 mg) Ketamine solution while the control group received 15 ml lidocaine gel with 2 ml Normal saline. Patient's heart rate and mean arterial pressure were recorded in five minutes interval till twenty minutes after completion of the procedure. The level of pain perception of all the patients was measured with Visual analogue scale (VAS) score, at the beginning, during and after cystoscopy. Independent sample t-test was used to compare outcome measures and p value of < 0.05 was considered statistically significant. Result Out of the total 70 patients analyzed at the end of study with 35 patients in each group, the VAS score in each stage were lower in lidocaine plus ketamine group compared to lidocaine gel alone. The difference was significant at the commencement and middle of the procedure (p < 0.05). Conclusion Intraurethral instillation of ketamine and lidocaine is more effective in reducing mean pain score during cystoscopy as compared to lidocaine alone.

Keywords: Nature Based Solutions, Climate Change Adaptation, Disaster Risk Reduction, rural livelihood , Nepal Himalayas Abstract: Climate has been changing and has considerable impacts on the livelihood of rural/urban communities all around the globe. The impacts however are more pronounced in the mountainous region such as in the Dudhkosi Basin (~4,063km2) in eastern Nepal. Studies suggested that the mountainous region of Nepal are climate-sensitive meaning that a small change in air temperature could bring significant impacts on the environmental degradation process and increase the frequency of climate-induced hazards and risk of disasters. In order to understand the dynamics of the changing climate on rural livelihood, this research attempted to model the environmental vulnerability of the basin considering the topographic and environmental attributes and assessed their contribution to the physical environmental degradation process. Multi-criteria based Decision Analysis (MCDA) approaches were implemented considering the seven primary topographic attributes such as slope, soil type, land use, NDVI, elevation, distance to drainage, and terrain wetness. The model was implemented for the three scenarios of rainfall such as historical and projected precipitation for RCP4.5 and RCP 8.5 as a climate change variable and distance to the rural roads as an anthropogenic factor to model the physical environmental degradation there by the vulnerability. The analysis depicted that the slope attributes has the highest contribution (20.21%) among all followed by precipitation, soil type, land use, distance to road, distance to drainage, terrain wetness and NDVI respectively 18.5%, 14.3%, 12.56%, 10.75%, 9.63%, 7.55% and 6.5%. The analysis clearly indicated that the slope is one of the most critical attributes where many settlements are located and have a significant contribution to the land-degradation process of the mountainous region. While the increasing trend of rainfall will cause more soil erosion and shallow landslides compounded due to the unplanned construction of rural roads thereby more area of the basin under the threat of degradation. The model also indicated that the increased amount of degraded land for the projected precipitation scenarios under RCP4.5 and RCP8.5 respectively increased from 7% to 15%. The increased amount of degradation will cause more communities living on the sloping terrain will turn to be vulnerable. The analysis demonstrated in this research suggested that the basin is at high threat of land degradation under the climate change scenarios for which an integrated basin management plan is to be developed. Integrated approach for Building Climate Resilience is the key in which the Nature-Based Solutions measures as climate change adaptation and disaster risk reduction. The measures also improve the watershed conditions that subsequently enhance the quality of the lives of the people with increased economic opportunities and coping capacity for the climate change induced disasters and community resiliency.

A detailed soil inventory study using Global Positioning System (GPS) and Geographical Information System (GIS) was conducted in Nalgad Municipality of Jajarkot, Nepal in 2019. A preliminary reconnaissance survey during pre–field activities and detail field work was carried out to study the soil type and physico-chemical properties based on the soil pit. A total of 51 soil pits were taken in the field representing varied micro topography. Soil Sample pits covering all the units were dug based on the interpreted soil map, topographical map, ZY-3 Satellite imagery for determination of soil profile. Soil classification of the area was done based on the USDA soil taxonomy and the dominant soil orders found in the region were Entisols (15.13 %) and Inceptisols (83.60%). A total of 51 geo-referenced composite soil samples from a depth of 0-20 cm was collected from each pit and analyzed in laboratory for texture, soil pH, soil organic matter, total nitrogen, available phosphorus and exchangeable potassium. Majority of the soil are loam and loamy sand type. There is very low to high level of organic matter present in the study area with more proportion of land under high range of organic matter (64.98%). Total Nitrogen content in soil of the study area ranges from very low to very high level with high level of Nitrogen (65.51%) in major proportion. Low to very high level of available phosphorous content was found in the study area with the dominance of very high level of phosphorous (71.40%). Exchangeable Potassium level in the study area is very high to low. Around 42% land have very high level of potassium. From the soil test result, major nutrients status in soil were found to be good but integrated land management practices should be encouraged for improving land productivity. The generated soil maps may be helpful to stakeholders for planning, monitoring and evaluating the soil status for effective agricultural production.

Background: Coronavirus disease 2019 (COVID-19) emerged as a challenging pandemic globally. The clinical manifestations range from asymptomatic infection to severe respiratory failure. In-hospital mortality varies from 18.9% to 20.3%. Old age, male gender, comorbidities, lower oxygen saturation, lymphopenia, raised C-reactive protein, and d-dimer levels increase the risk of critical illness and death. The objective of this study was to compare the clinical characteristics of COVID-19 patients and associated outcomes in a tertiary level hospital in Nepal. Methods: An analytical cross-sectional study was conducted in laboratory-confirmed COVID-19 patients admitted in a tertiary center of Nepal during the peak of the second wave of the pandemic. A non-probabilistic consecutive sampling technique was adopted. syndrome (8.62%) were the most common complications associated with higher mortality. Patients with older age had higher odds of mortality (adjusted OR, 1.077; p<0.001). The risk of mortality was higher in severe to critically ill patients (adjusted OR, 5.861; p=0.001), and those who were under mechanical ventilation (adjusted OR, 39.059; p<0.001). Likewise, the duration of hospital stay was significantly associated with mortality (adjusted OR, 0.795; p<0.001). Conclusions: The non-survivors of COVID-19 tended to be of older age, severe to critically ill at presentation, require mechanical ventilation, and have a shorter duration of hospital stay, compared to survivors. So, these groups of patients need special care and support during hospital admission.

Spontaneous pneumothorax as an initial presentation is very rare in COVID-19 patient. We present a case where the initial presentation was that of a mild disease and on investigation was found to have pneumothorax without any predisposing risk factors.

Nepalese labor industry of agriculture sector is dominated by female and has direct and indirect effect on food security. This paper has attempted to find and analyze consequences of male emigration and feminization in agriculture, and implication on food security. The study revealed foreign employment as major reason for international migration of Nepalese people. Higher male emigration 91.3% with large remittance inflow has ensured food secure condition in short run but there is long run food insecurity threats due to lower domestic production and higher investment on consumption. Further extra work burden in female due to absence of active male labor and limited agriculture knowledge and skills in agri-business has resulted land abandonment and underutilization of agricultural resources. The study suggested to develop female friendly agricultural practices, investment on productive enterprises and attract youth and female in agriculture to ensure sustainable food security

This article describes research undertaken in the Panchase Region of Western Nepal as part of the “Ecosystems Protecting Infrastructure and Communities” (EPIC) project 2012-2017, where three community-led bio-engineering demonstration sites were established along roadsides. The topic of Nature Based Solutions (NBS) and Eco-DRR/CCA is explored adopting interdisciplinary research methods, spanning both social and physical sciences, and citizen science alongside state-of-the art high resolution erosion monitoring and remote sensing. We examine the nexus between infrastructure design (traditional roads vs green roads) and landslides. Investigations included a watershed study of land use changes over time and erosion rates associated with road construction in the Phewa Lake Watershed (Kaski district, Western Nepal), an analysis of the effectiveness of vegetation in reducing erosion rates using LIDAR and drone measurements, and a cost-benefit analysis of conventional “grey” versus bio-engineered roads, or “eco-safe roads”.Results of the watershed study indicate a trend from erosion due to open grazing thirty years ago to increased erosion by new roads; Land IDAR measurements show that vegetation has been effective in reducing erosion rates. The cost benefit analysis (CBA) explores the net benefit of grey vs eco-safe roads using different time horizons and precipitation distributions associated to monsoonal activity and climate change trends. The CBA results demonstrate that initial costs in installing the bio-engineered eco-safe road are higher than for the “grey” road, however the bio-engineered road rapidly becomes more cost-effective, especially when factoring in avoided damages and multiple co-benefits to the population. Findings from this work have led to policy recommendations promoting and upscaling a more sustainable approach to bio-engineering for rural road construction in Nepal as well as methodological recommendations for replicating and up-scaling similar studies elsewhere.

Landslides are common in the mid-hill region of Nepal where the terrain slopes are steep and consist of fragile geo-morphology. In Nepal, the casual and triggering factors of the landslides are respectively the underlying geology, intense rainfall and unplanned construction of rural roads is highly recognized, which is however less known and limited in study. Establishment of rainfall threshold for landslides at the watershed landscape is data driven, which is scared in the context of Nepal. The only available long term daily rainfall and sparsely available historical landslides date has been used to develop the rainfall threshold model for the two watersheds in central and western mid-hill regions respectively the Sindhukhola and Sotkhola in Bagmati and Karnali Provinces of Nepal. The watersheds are located in two distinct hydro-climatic regions in terms of rainfall amount and intensity. Historical daily (monsoonal) rainfall data of over four decades (1970-2016) were analyzed available from the Department of Hydrology and Meteorology (DHM)/Government of Nepal and five days’ antecedent rain was calculated. With the limitedly available temporal landslides data, correlation was examined among the 5-days antecedent rain (mm/5days) and daily rainfall (mm/day) portrayed the rainfall threshold (RT) model (Sindhukhola=180-1.07RT5adt and Sotkhola = 110-0.83*RT5adt). Utilizing the five days’ antecedent rain fitted into the model, results the threshold rainfall. Deducting the five days’ antecedent rains to the RT described the threshold exceedance (R) for the landslides. The model can be plotted in simple spreadsheet (landslides date in Y-axis and threshold exceedance R in X-axis) to visualize the changes in the threshold exceedance over time, whenever the threshold exceedance progressively and rapidly increased and crossed the threshold line and reached to the positive (> 0) zone, the plots allows for the landslides warning notice. In case of the threshold exceedance is further increased there is likely to have landslides in the watersheds. The model was validated with the 35 dated landslides recorded in monsoon 2015 in Sotkhola watershed. The result indicated that the model preserves 72% coefficient of determination (R2) where there were landslides in the watershed during 2015 monsoon. Due to the simplicity and at the data scarce situation, the model was found to be useful to forecast the landslides during the monsoon season in the region. The model; however, can be improved for better performance whenever the higher resolution time-series landslides data and automated weather stations are available in the watersheds. Linking this model to the proper landslide susceptibility map, and the real time rainfall data through mobile communication techniques, landslide early warning system can be established. KEYWORDS: landslide, rainfall threshold, data-scare, antecedent rainfall References: Aleotti, P. (2004). A warning system for rainfall-induced shallow failures. Engineering Geology, 73(3-4), 247-265. Jaiswal, P. and van Westen, C.J., 2009. Estimating temporal probability for landslide initiation along transportation routes based on rainfall thresholds. Geomorphology, 112(1-2): 96-105. Acknowledgement: Comprehensive Disaster Risk Management Programme – UNDP in Nepal for the opportunity to conduct this research.

To assess the effect of Boron (B) application on cauliflower, we conducted a greenhouse pot experiment that consisted of soil application of five levels of nutrient i) no input of fertilizers, ii) N:P2O5:K2O at the rate of 200, 28.6, and 80 kg ha-1 respectively (recommended dose of NPK),iii) recommended dose of NPK plus 1.1 kg ha-1 B, iv) recommended dose of NPK plus 2.2 kg ha-1 B, and v) recommended dose of NPK plus 4.4 kg ha-1 B. Total plant biomass was 106 gplant-1 at 4.4 kg B ha-1 compared to 79 g plant-1 at the control of no nutrient inputs. Relative to the control treatment, there was a two-fold increase in fresh curd yield at 1.1 Kg B ha-1 application. Boron application improved the shoot B content as well as its partitioning towards curd and was associated with higher B concentration in the curd. While the soil residual B was 0.26 mg Kg-1 when no B was applied, it was 0.3 mg Kg-1 at 4.4 Kg B ha-1 application. It is concluded that soil B application tends to improve the yield and quality of cauliflower cultivated at the upland maize based system in mid-hill areas of Nepal.

Rural roads are important for the communities in the hilly areas of Nepal as they introduce livelihood opportunities at the local level, and provide better access to the healthcare, education, and resources. Yet, most of the rural roads in Nepal are unplanned and non-engineered, and these roads are often closed for many months during and after the monsoon. Such roads require huge investments, especially post-monsoon, to clear debris and to keep them operational. In parallel, there is evidence that such roads lead to a large number of slope failures and accelerated sedimentation, which degrade the environment and ecosystem services. To remedy such roadside slope failures, eco-engineering practices were tested and demonstrated in partnership with three communities in the Panchase Region of the Nepal’s Central–Western hills. Eco-engineering is a hybrid approach, combining civil engineering works for drainage and slope stability, with the plantation of deep-rooted vegetation. It is one activity contributing to nature-based solutions (NbS) for the sustainable and long-term operation of the rural roads in the Panchase geographic region. This paper describes the inter-disciplinary and community-based research, monitoring, and evaluation methods applied, including the establishment of onsite demonstration plots and rhizotrons in which key performance indicator (KPI) analysis of plant species was performed. The results demonstrated the effectiveness of eco-engineering for reducing risk, while creating ecological co-benefits along rural roads (or eco-safe roads) in hilly areas. Based on this research, an “eco-safe rural road assessment framework” was developed, outlining the systematic process to be followed for the design of eco-safe rural roads for more sustainable road construction and maintenance. The eco-engineering practices which are being promoted by this framework were accepted by communities and could be further implemented by local government bodies and upscaled in other similar hilly areas around the country.

In Nepal and many developing countries around the world, roads are vehicles for development for communities in rural areas. By reducing travel time on foot, opportunities are opened for quicker transportation of goods and better access to employment, education, health care and markets. Roads also fuel migration and numerous social changes, both positive and negative. Poorly constructed roads in mountainous areas of Nepal have increased erosion and landslide risk as they often cut through fragile geology, destabilizing slopes and altering local hydrological conditions, with costs to lives and livelihoods. The convergence of the newly constituted decentralized Nepali government with China's Belt and Road Initiative is likely to bring more roads to rural communities. The new provincial government administrations now have the opportunity to develop policies and practices, which can realign the current trend of poorly engineered, inefficient and hazardous road construction toward a more sustainable trajectory. This commentary provides an overview of some of the obstacles along the way for a more sustainable road network in Nepal and illustrates how good governance, development and landslide risk are intertwined. The opinion presented in this brief commentary lends little hope that Nepal's current pathway of unsustainable road construction will provide the country with the much-needed sustainable road network, unless checks and balances are put in place to curb noncompliance with existing laws and policies.

The number of deaths from landslides in Nepal has been increasing dramatically due to a complex combination of earthquakes, climate change, and an explosion of informal road construction that destabilizes slopes during the rainy season. This trend will likely rise as development continues, especially as China's Belt and Road Initiative seeks to construct three major trunk roads through the Nepali Himalaya that adjacent communities will seek to tie in to with poorly constructed roads. To determine the effect of these informal roads on generating landslides, we compare the distance between roads and landslides triggered by the 2015 Gorkha earthquake with those triggered by monsoon rainfalls, as well as a set of randomly located landslides to determine if the spatial correlation is strong enough to further imply causation. If roads are indeed causing landslides, we should see a clustering of rainfall-triggered landslides closer to the roads that accumulate and focus the water that facilitates failure. We find that in addition to a concentration of landslides in landscapes with more developed, agriculturally viable soils, that the rainfall-triggered landslides are more than twice as likely to occur within 100 m of a road than the landslides generated by the earthquake. The oversteepened slopes, poor water drainage and debris management provide the necessary conditions for failure during heavy monsoonal rains. Based on these findings, geoscientists, planners and policymakers must consider how road development affects the physical (and ecological), socio-political and economic factors that increase risk in exposed communities, alongside ecologically and financially sustainable solutions such as green roads.

An experiment was conducted to evaluate hybrid genotypes of tomato for fruit yield and fruit quality in Horticulture Research Division, NARC, Khumaltar, Lalitpur, Nepal during March to August, 2014 in open field condition. Eleven hybrid genotypes developed from the crosses between HRA and HRD lines, selected as good performer under late blight condition and ‘Srijana’as a local check were taken for the evaluation. Design of experiment was single factorial RCBD with three replications. Observation on traits related to plant morphology, maturity and yield component were recorded to develop, evaluate, identify and recommend high yielding hybrids of tomato. The fruit yield per hectare ranged from 80.83 t/ha (HRA 14 × HRD 7) to 45.89 ton/ha (HRA 15 × HRD 6). Fruit yields of the genotypes HRA 14 × HRD 7, HRA 13 × HRD 7, HRA 20 × HRD 1, HRA 20 × HRD 2, HRA 20 × HRD 6 and HRA 16 × HRD 1 had 80.83 ton/ha, 78.50 ton/ha, 73.75 ton/ha, 70.44 ton/ha, 68.72 ton/ha, 64.64 ton/ha were higher than the yield of ‘Srijana’ (62.33 ton/ha). Based on overall performance, genotypes HRA 14 × HRD 7, HRA 13 × HRD 7, HRA 20 × HRD 1 and HRA 20 × HRD 6 were observed as good performer than Srijana (Check) and selected as high yielder with good fruit quality.

Intense monsoonal rain is one of the major triggering factors of floods and mass movements in Nepal that needs to be better understood in order to reduce human and economic losses and improve infrastructure planning and design. This phenomena is better understood through intensity-duration-frequency (IDF) relationships, which is a statistical method derived from historical rainfall data. In Nepal, the use of IDF for disaster management and project design is very limited. This study explored the rainfall variability and possibility to establish IDF relationships in data-scarce situations, such as in the Central-Western hills of Nepal, one of the highest rainfall zones of the country (~4500 mm annually), which was chosen for this study. Homogeneous daily rainfall series of 8 stations, available from the government’s meteorological department, were analyzed by grouping them into hydrological years. The monsoonal daily rainfall was disaggregated to hourly synthetic series in a stochastic environment. Utilizing the historical statistical characteristics of rainfall, a disaggregation model was parameterized and implemented in HyetosMinute, software that disaggregates daily rainfall to finer time resolution. With the help of recorded daily and disaggregated hourly rainfall, reference IDF scenarios were developed adopting the Gumbel frequency factor. A mathematical model [i = a(T)/b(d)] was parameterized to model the station-specific IDF utilizing the best-fitted probability distribution function (PDF) and evaluated utilizing the reference IDF. The test statistics revealed optimal adjustment of empirical IDF parameters, required for a better statistical fit of the data. The model was calibrated, adjusting the parameters by minimizing standard error of prediction; accordingly a station-specific empirical IDF model was developed. To regionalize the IDF for ungauged locations, regional frequency analysis (RFA) based on L-moments was implemented. The heterogeneous region was divided into two homogeneous sub-regions; accordingly, regional L-moment ratios and growth curves were evaluated. Utilizing the reasonably acceptable distribution function, the regional growth curve was developed. Together with the hourly mean (extreme) precipitation and other dynamic parameters, regional empirical IDF models were developed. The adopted approach to derive station-specific and regional empirical IDF models was statistically significant and useful for obtaining extreme rainfall intensities at the given station and ungauged locations. The analysis revealed that the region contains two distinct meteorological sub-regions highly variable in rain volume and intensity.