Status of Water Sources and Its Impact on Livelihood Practices in Sardhukhola Watershed of Eastern Nepal (Sunsari)

Watershed resources are the foundation of ecosystem integrity and livelihoods of mountain people. In this regard, this study entitled "status of water sources and its impact on livelihood practices in the Sardhukhola watershed of Eastern Nepal" was carried out to understand the status of water resources and its impact on rural livelihood practices. This study was conducted in Sardhukhola Watershed of Sunsari district. This research was conducted to know the present status of the water source around Sardhu River, including its trend of availability, human interventions and it’s overall. This study analyses the change in cropping pattern within watershed. Both field observation and social survey were carried out during research work. Finding of this study shows that sources of water have been decreasing such as rivers, wells and water springs are being degraded. Frequent occurrence of landslide, sedimentation and seepage of water in both upstream and downstream as well as household garbage and improper infrastructure development are seen to be the major reasons behind the degradation. There is an increasing gap between demand and supply of water resources and people are expected to face severe scarcity of drinking water in the near future. After earthquake of 2015, water availability within the watershed is also found to be decreasing. Moreover, there is a weak co-ordination between upstream and downstream people to solve the major issue of watershed. Nevertheless people are interested to be involved in payment for ecosystem services mechanism, especially for proper water supply.Key words: Upstream, Downstream, Payment for Ecosystem Service, Degradatio

Spatial and temporal variability of rainfall in the Gandaki River Basin of Nepal Himalaya

Landslides, floods, and droughts are recurring natural disasters in Nepal related to too much or too little water. The summer monsoon contributes more than 80% of annual rainfall, and rainfall spatial and inter-annual variation is very high. The Gandaki River, one of the three major rivers of Nepal and one of the major tributaries of the Ganges River, covers all agro-ecological zones in the central part of Nepal. Time series tests were applied for different agro-ecological zones of the Gandaki River Basin (GRB) for rainfall trends of four seasons (pre-monsoon, monsoon, post-monsoon and winter) from 1981 to 2012. The non-parametric Mann-Kendall and Sen’s methods were used to determine the trends. Decadal anomalies relative to the long-term average were analyzed using the APHRODITE precipitation product. Trends in number of rainy days and timing of the monsoon were also analyzed. We found that the post-monsoon, pre-monsoon and winter rainfalls are decreasing significantly in most of the zones but monsoon rainfall is increasing throughout the basin. In the hill region, the annual rainfall is increasing but the rainy days do not show any trend. There is a tendency toward later departure of monsoon from Nepal, indicating an increase in its duration. These seasonally and topographically variable trends may have significant impacts for the agriculture and livestock smallholders that form the majority of the population in the GRB

Evaluation of Trends of Inpatient Hospitalisation for Significant Haemorrhage in Patients Anticoagulated for Atrial Fibrillation before and after the Release of Novel Anticoagulants.

Compared to Vitamin K antagonists (VKA), novel oral anticoagulants (NOACs) appear to be safer in terms of major bleeding risks with added advantage of having fixed dosing schedules when used in patients with non-valvular atrial fibrillation (AF). We sought to study the differences as sources and severity of anticoagulant-associated haemorrhage in patients with AF in the year preceding introduction of NOACs (first cohort) as compared to post approval of the NOACs (second cohort) by retrospectively reviewing the hospital admissions, as well as the pharmacodynamic and pharmacokinetic interactions between time periods. There were 359 patients for the first cohort and 405 patients for the second cohort, including 57 patients prescribed NOACs. There was no significant difference in age, deaths, source of bleeding, or rate of pharmacokinetic or pharmacodynamic interaction between the two time periods. Comparing all VKA patients to patients prescribed NOAC\u27s, there were non-significant but higher rates of intracerebral bleed, significantly higher rates of pharmacokinetic (194 (25.4%) versus 0 (0%),

Mesenteric vein thrombosis in a patient heterozygous for factor V Leiden and G20210A prothrombin genotypes.

Mesenteric venous thrombosis (MVT) is a rare but life threatening form of bowel ischemia. It is implicated in 6%-9% of all cases of acute mesenteric ischemia. The proportion of patients with primary (or idiopathic) MVT varies from 0% to 49%, with a decrease in frequency secondary to more recent availability of newer investigations for hypercoagulability. The presence of factor V Leiden (FVL) and prothrombin G20210A mutations (PGM) have been well documented in these cases. However, there have been scarce case reports describing MVT in heterozygotes of both these mutations occurring simultaneously and its implications on long term management. Our case describes acute MVT in a previously asymptomatic young patient with no prior history of venous thromboembolism. The patient was found to be heterozygous for FVL and PGM and treated with lifelong anticoagulation with warfarin (goal international normalized ratio: 2-3) and avoidance of hormonal contraceptives

Postoperative thrombotic thrombocytopenic purpura after aortofemoral bypass

Thrombotic thrombocytopenic purpura (TTP) is uncommon in the postoperative setting, even more so after vascular surgery. We present a case of thrombocytopenia after aortofemoral bypass, which highlights the importance of a high index of suspicion for postoperative TTP to avoid life-threatening consequences