Search results for: Dil Bahadur Gurung

Authors: Dammar Bahadur Adhikari

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Community forestry in Nepal has got disproportionately high level of support from government and other actors in forestry sector. Even though master plan for forestry sector (1989) has highlighted community and private forestry as one component, the government policies and other intervention deliberately left out private forestry in its structure and programs. The study aimed at providing the pathway for formulating appropriate policies to address need of different kind of forest management regimes in Rautahat district, Nepal. The key areas the research focused were assessment of current status of private forestry, community forest users' understanding on private forestry; criteria for choosing species of private forestry and factors affecting establishment of private forestry in the area. Qualitative and quantitative data were collected employing questionnaire survey, rapid forest assessment and key informant interview. The study found out that forest policies are imposed due to intense pressure of exogenous forces than due to endogenous demand. Most of the local people opine that their traditional knowledge and skills are not sufficient for private forestry and hence need training on the matter. Likewise, local use, market value and rotation dictate the choice of species for plantation in private forests. Currently district forest office is the only government institution working in the area of private forestry all other governmental and non-governmental organizations have condoned. private forestry. Similarly, only permanent settlers in the area are found to establish private forests other forest users such as migrants and forest encroachers follow opportunistic behavior to meet their forest product need from community and national forests. In this regard, the study recommends taking appropriate step to support other forest management system including private forestry provide community forestry the benefits of competition as suggested by Darwin in 18th century, one and half century back and to help alleviate poverty by channelizing benefits to household level.

Keywords: community forest, forest management, poverty, private forest, users’ group

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Authors: Pascale Brasseur, Binu Gurung, Nicholas Halfpenny, James Eaton

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Development of minimally invasive treatments in recent years provides a potential alternative to invasive surgical interventions which are of limited value to patients with spinal metastases due to short life expectancy. A systematic review was conducted to explore the efficacy and safety of radiofrequency ablation (RFA), a minimally invasive treatment in patients with spinal metastases. EMBASE, Medline and CENTRAL were searched from database inception to March 2017 for randomised controlled trials (RCTs) and non-randomised studies. Conference proceedings for ASCO and ESMO published in 2015 and 2016 were also searched. Fourteen studies were included: three prospective interventional studies, four prospective case series and seven retrospective case series. No RCTs or studies comparing RFA with another treatment were identified. RFA was followed by cement augmentation in all patients in seven studies and some patients (40-96%) in the remaining seven studies. Efficacy was assessed as pain relief in 13/14 studies with the use of a numerical rating scale (NRS) or a visual analogue scale (VAS) at various time points. Ten of the 13 studies reported a significant decrease in pain outcome, post-RFA compared to baseline. NRS scores improved significantly at 1 week (5.9 to 3.5, p < 0.0001; 8 to 4.3, p < 0.02 and 8 to 3.9, p < 0.0001) and this improvement was maintained at 1 month post-RFA compared to baseline (5.9 to 2.6, p < 0.0001; 8 to 2.9, p < 0.0003; 8 to 2.9, p < 0.0001). Similarly, VAS scores decreased significantly at 1 week (7.5 to 2.7, p=0.00005; 7.51 to 1.73, p < 0.0001; 7.82 to 2.82, p < 0.001) and this pattern was maintained at 1 month post-RFA compared to baseline (7.51 to 2.25, p < 0.0001; 7.82 to 3.3; p < 0.001). A significant pain relief was achieved regardless of whether patients had cement augmentation in two studies assessing the impact of RFA with or without cement augmentation on VAS pain scores. In these two studies, a significant decrease in pain scores was reported for patients receiving RFA alone and RFA+cement at 1 week (4.3 to 1.7. p=0.0004 and 6.6 to 1.7, p=0.003 respectively) and 15-36 months (7.9 to 4, p=0.008 and 7.6 to 3.5, p=0.005 respectively) after therapy. Few minor complications were reported and these included neural damage, radicular pain, vertebroplasty leakage and lower limb pain/numbness. In conclusion, the efficacy and safety of RFA were consistently positive between prospective and retrospective studies with reductions in pain and few procedural complications. However, the lack of control groups in the identified studies indicates the possibility of selection bias inherent in single arm studies. Controlled trials exploring efficacy and safety of RFA in patients with spinal metastases are warranted to provide robust evidence. The identified studies provide an initial foundation for such future trials.

Keywords: pain relief, radiofrequency ablation, spinal metastases, systematic review

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Authors: Kumar Y., Suman D., Sumathi

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Introduction: Burns to the face account for between one-fourth and one-third of all burns. The loss of an eyebrow due to a burn or infection can have negative physical and psychological consequences for patients because eyebrows have a critical functional and aesthetic role on the face. Plastic surgeons face unique challenges in reconstructing eyebrows due to their complex anatomy and variations within genders. As a general rule, there are three techniques for reconstructing the eyebrow: superficial temporal artery island flap, a composite graft from the scalp, and mini or micro follicular grafts from the scalp. In situations where a sufficient amount of subcutaneous tissue is not available and the defect is big such as the case of burns, flaps like the superficial temporal artery scalp flap remain reliable options. In 2018, a 17-year-old female patient presented to the department of Burns Plastic and reconstructive Surgery of Guru Teg Bahadur Hospital, Delhi, India. A scald-burn injury to the face occurred two years before admission, resulting in bilateral eyebrow loss. We reconstructed the bilateral eyebrows using bilateral scalp island flaps based on the posterior branch of the superficial temporal artery. The reconstructed eyebrows successfully assumed a desirable shape and exhibited a natural appearance, which was consistent with preoperative expectations and the patient stated that she was more comfortable with her social relationships. Among the current treatment procedures, the superficial temporal artery island flap continues to be a versatile option for reconstructing the eyebrows after alopecia, especially in cases of burns. Results: During the 30 days follow-up period, the scalp island flap remained vascularised with normal hair growth, without complications. The reconstructed eyebrows successfully assumed a desirable shape and exhibited a natural appearance; the patient stated that she was more comfortable with her social relationships. Conclusion: In this case report, we demonstrated how scalp island flaps pedicled by the superficial temporal artery could be performed very safely and reliably to create new eyebrows.

Keywords: alopecia, burns, eyebrow, flap, superficial temporal artery

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Authors: Prem Bahadur Giri, MathineeYucharoen

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Community forest user groups (CFUGs) have been the core stone of forest management efforts in Nepal. Due to the lack of a smooth transition into the local governance structure in 2017, policy instruments have not been effectively cascaded to the local level, creating ambiguity and inconsistency in forest governance. Descriptive mixed-method research was performed with community users and stakeholders of the Tarpakha community forest, Siranchowk Rural Municipality, to understand the role of the political economy in CFUG management. The household survey was conducted among 100 households (who also are existing members of the Tarpakha CFUG) to understand and document their energy consumption preferences and practices. Likewise, ten key informant interviews and five focus group discussions with the municipality and forest management officials were also conducted to have a wider overview of the factors and political, socio-economic, and religious contexts behind the utilization of renewable energy for sustainable development. Findings from our study suggest that only 3% of households use biogas as their main source of energy. The rest of the households mention liquid petroleum gas (LPG), electricity, and firewood as major sources of energy for domestic purposes. Community members highlighted the difficulty in accessing firewood due to strict regulations from the CFUG, lack of cattle and manpower to rear cattle to produce cow dung (for biogas), and lack of technical expertise at the community level for the operation and maintenance of solar energy, among others as challenges of the resource. Likewise, key informants have mentioned policy loopholes at both the federal and local levels, especially with regard to the promotion of alternative or renewable energy, as there are no clear mandates and provisions to regulate the renewable energy industry. The study recommends doing an in-depth study on the feasibility of renewable energy sources, especially in the context of CFUGs, where biodiversity conservation aspects need to be equally taken into consideration while thinking of the promotion and expansion of renewable energy sources.

Keywords: community forest, renewable energy, sustainable development, Nepal

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Authors: Bidisha Chatterjee, Sonal Grover, Rekha Gurung

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Postpartum dissection of the internal carotid artery is a relatively rare condition and is considered as an underlying aetiology in 5% to 25% of strokes under the age of 30 to 45 years. However, 86% of these cases recover completely and 14% have mild focal neurological symptoms. Prognosis is generally good with early intervention. The risk quoted for a repeat carotid artery dissection in subsequent pregnancies is less than 2%. 36-year Caucasian primipara presented on postnatal day one of forceps delivery with tachycardia. In the intrapartum period she had a history of prolonged rupture of membranes and developed intrapartum sepsis and was treated with antibiotics. Postpartum ECG showed septal inferior T wave inversion and a troponin level of 19. Subsequently Echocardiogram ruled out post-partum cardiomyopathy. Repeat ECG showed improvement of the previous changes and in the absence of symptoms no intervention was warranted. On day 4 post-delivery, she had developed symptoms of droopy right eyelid, pain around the right eye and itching in the right ear. On examination, she had developed right sided ptosis, unequal pupils (Rt miotic pupil). Cranial nerve examination, reflexes, sensory examination and muscle power was normal. Apart from migraine, there was no medical or family history of note. In view of Horner’s on the right, she had a CT Angiogram and subsequently MR/MRA and was diagnosed with dissection of the cervical portion of the right internal carotid artery. She was discharged on a course of Aspirin 75mg. By 6 week post-natal follow up patient had recovered significantly with occasional episodes of unequal pupils and tingling of right toes which resolved spontaneously. Cervical artery dissection, including VAD and carotid artery dissection, are rare complications of pregnancy with an estimated annual incidence of 2.6–3 per 100,000 pregnancy hospitalizations. Aetiology remains unclear though trauma during straining at labour, underlying arterial disease and preeclampsia have been implicated. Hypercoagulable state during pregnancy and puerperium could also be an important factor. 60-90% cases present with severe headache and neck pain and generally precede neurological symptoms like ipsilateral Horner’s syndrome, retroorbital pain, tinnitus and cranial nerve palsy. Although rare, the consequences of delayed diagnosis and management can lead to severe and permanent neurological deficits. Patients with a strong index of suspicion should undergo an MRI or MRA of head and neck. Antithrombotic and antiplatelet therapy forms the mainstay of therapy with selected cases needing endovascular stenting. Long term prognosis is favourable with either complete resolution or minimal deficit if treatment is prompt. Patients should be counselled about the recurrence risk and possibility of stroke in future pregnancy. Coronary artery dissection is rare and treatable but needs early diagnosis and treatment. Post-partum headache and neck pain with neurological symptoms should prompt urgent imaging followed by antithrombotic and /or antiplatelet therapy. Most cases resolve completely or with minimal sequelae.

Keywords: postpartum, dissection of internal carotid artery, magnetic resonance angiogram, magnetic resonance imaging, antiplatelet, antithrombotic

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Authors: Lata Shakya, Toshio Otsuki, Saori Imoto, Bijaya Krishna Shrestha, Umesh Bahadur Malla

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2015 Gorkha Nepal earthquake have damaged the human settlements in 14 districts of Nepal. Historic core areas of three principal cities namely Kathmandu, Lalitpur and Bhaktapur including numerous traditional ‘newari’ settlements in the peripheral areas have been either collapsed or severely damaged. Despite Government of Nepal and (international) non-government organisations’ attempt towards disaster risk management through the preparation of policies and guidelines and implementation of community-based activities, the recent ‘Gorkha’ earthquake has demonstrated the inadequate preparedness, poor implementation of a legal instrument, resource constraints, and managerial weakness. However, the social capital through community based institutions, self-help attitude, and community bond has helped a lot not only in rescue and relief operation but also in a post-disaster temporary shelter living thereby exhibiting the resilient power of the local community. Conducting a detailed case study of ‘Kaminani’ community with 42 houses at ward no. 16 of Bhaktapur municipality, this paper analyses the local community’s response and activities on the Gorkha earthquake in rescue and relief operation as well as in post disaster work. Leadership, the existence of internal/external aid, physical and human support are also analyzed. Social resource and networking are also explained through critical review of the existing community organisation and their activities. The research methodology includes literature review, field survey, and interview with community leaders and residents based on a semi-structured questionnaire. The study reveals that community carried their recovery process in four different phases: (i) management of emergency evacuation, (ii) constructing community owed temporary shelter for individuals, (iii) demolishing upper floors of the damaged houses, and (iv) planning for collaborative housing reconstruction. As territorial based organization, religion based agency and aim based institution exist in the survey area from pre-disaster time, it can be assumed that the community activists including leaders are well experienced to create aim-based group and manage teamwork to deal with various issues and problems collaboratively. Physical and human support including partial financial aid from external source as a result of community leader’s personal networking is extended to the community members. Thus, human/social resource and personal/social network play a crucial role in the recovery process. And to build such social capital, community should have potential from pre-disaster time.

Keywords: Gorkha Nepal earthquake, local community, recovery process, social resource, social network

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Authors: Indra Bahadur Chand

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This paper will focus on the need for development and application of global protocols and policy in planning, designing, development, and management of systems of eco-towns and eco-villages so that sustainable development will be assured from the perspective of environmental, economical, peace, and harmonized social dynamics. This perspective is essential for the development of civilized and eco-friendly human settlements in the town and rural areas of the nation that will be a milestone for developing a happy and sustainable lifestyle of rural and urban communities of the nation. The urban population of most of the town of developing economies has been tremendously increasing, whereas rural people have been tremendously migrating for the past three decades. Consequently, the urban lifestyle in most towns has stressed in terms of environmental pollution, water crisis, congested traffic, energy crisis, food crisis, and unemployment. Eco-towns and villages should be developed where lifestyle of all residents is sustainable and happy. Built up environment of settlement should reduce and minimize the problems of non ecological CO2 emissions, unbalanced utilization of natural resources, environmental degradation, natural calamities, ecological imbalance, energy crisis, water scarcity, waste management, food crisis, unemployment, deterioration of cultural heritage, social, the ratio among the public and private land ownership, ratio of land covered with vegetation and area of settlement, the ratio of people in the vehicles and foot, the ratio of people employed outside of town and village, ratio of resources recycling of waste materials, water consumption level, the ratio of people and vehicles, ratio of the length of the road network and area of town/villages, a ratio of renewable energy consumption with total energy, a ratio of religious/recreational area out of the total built-up area, the ratio of annual suicide case out of total people, a ratio of annual injured and death out of total people from a traffic accident, a ratio of production of agro foods within town out of total food consumption will be used to assist in designing and monitoring of each eco-towns and villages. An eco-town and villages should be planned and developed to offer sustainable infrastructure and utilities that maintain CO2 level in individual homes and settlements, home energy use, transport, food and consumer goods, water supply, waste management, conservation of historical heritages, healthy neighborhood, conservation of natural landscape, conserving bio-diversity and developing green infrastructures. Eco-towns and villages should be developed on the basis of master planning and architecture that affect and define the settlement and its form. Master planning and engineering should focus in delivering the sustainability criteria of eco towns and eco village. This will involve working with specific landscape and natural resources of locality.

Keywords: eco-town, ecological habitation, master plan, sustainable development

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Authors: Purna Bahadur Lamichhane

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Education planning and management are foundational pillars for developing effective educational systems. However, in many educational contexts, especially in developing nations, technology-enabled management is still emerging. In such settings, manual-based systems, where instructions and guidelines are physically documented, remain central to educational planning and management. This paper examines the effectiveness, challenges, and potential of manual-based education planning systems in fostering structured, reliable, and adaptable management frameworks. The objective of this study is to explore how a manual-based approach can successfully guide administrators, educators, and policymakers in delivering high-quality education. By using structured, accessible instructions, this approach serves as a blueprint for educational governance, offering clear, actionable steps to achieve institutional goals. Through an analysis of case studies from various regions, the paper identifies key strategies for planning school schedules, managing resources, and monitoring academic and administrative performance without relying on automated systems. The findings underscore the significance of organized documentation, standard operating procedures, and comprehensive manuals that establish uniformity and maintain educational standards across institutions. With a manual-based approach, management can remain flexible, responsive, and user-friendly, especially in environments where internet access and digital literacy are limited. Moreover, it allows for localization, where instructions can be tailored to the unique cultural and socio-economic contexts of the community, thereby increasing relevancy and ownership among local stakeholders. This paper also highlights several challenges associated with manual-based education management. Manual systems often require significant time and human resources for maintenance and updating, potentially leading to inefficiencies and inconsistencies over time. Furthermore, manual records can be susceptible to loss, damage, and limited accessibility, which may affect decision-making and institutional memory. There is also the risk of siloed information, where crucial data resides with specific individuals rather than being accessible across the organization. However, with proper training and regular oversight, many of these limitations can be mitigated. The study further explores the potential for hybrid approaches, combining manual planning with selected digital tools for record-keeping, reporting, and analytics. This transitional strategy can enable schools and educational institutions to gradually embrace digital solutions without discarding the familiarity and reliability of manual instructions. In conclusion, this paper advocates for a balanced, context-sensitive approach to education planning and management. While digital systems hold the potential to streamline processes, manual-based systems offer resilience, inclusivity, and adaptability for institutions where technology adoption may be constrained. Ultimately, by reinforcing the importance of structured, detailed manuals and instructional guides, educational institutions can build robust management frameworks that facilitate both short-term successes and long-term growth in their educational mission. This research aims to provide a reference for policymakers, educators, and administrators seeking practical, low-cost, and adaptable solutions for sustainable educational planning and management.

Keywords: educatoin, planning, management, manual

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