Visualizing Sustainability of Selective Mountain Farming Systems from Far-eastern Himalayas to Support Decision Making

Mountain farming systems rely on both empirical and academic knowledge. Their sustainability depends on how effectively diverse knowledge is used for solution-oriented decision making. For mountains, decisions must be conducive to rural farmers whose livelihoods depend on agriculture and related activities. Adopting transdisciplinary research approach, we define a composite Sustainability Space indicator that will help decision makers better understand the ingredients for sustainability, and formulate policy and management decisions to reinforce on-the-ground sustainability. Sustainability Space was derived through analysis of the positive and negative impact factors co-defined by community and disciplinary experts, and visualized through a radar diagram. We used Principal Component Analysis to understand relationships between factors. The results on Sustainability Spaces for eight cases of farming systems from the far-Eastern Himalayas indicated that the sustainability of farming systems is strengthened if decisions holistically cater to (i) geophysical pre-requisites, (ii) ecological foundations, (iii) integrated processes and practices, (iv) resources, knowledge, and value systems, (v) stakeholders’ development and economic aspirations, (vi) well-being of farming communities, and (vii) government support mechanisms. More equitable the attention to these seven components, the higher the sustainability of farming systems in this region could be

Prophylactic administration of ondansetron in prevention of intrathecal morphine-induced pruritus and post-operative nausea and vomiting in patients undergoing caesarean section

Background: Intrathecal morphine is commonly used for post caesarean analgesia. However, their use is frequently associated with the incidence of troublesome side effects such as nausea, vomiting and pruritus. Various mechanisms have been postulated for the opioid-induced pruritus, with a variety of medications with different mechanisms of actions formulated for the prevention and treatment. But, the results are inconsistent and hence the prevention and treatment of opioid-induced pruritus still remains a challenge. Ondansetron which is antiemetic, non-sedative and has no antianalgesic effect is an antagonist to 5-HT3 receptor, the receptor with which opioids interacts and imparts its effects. Ondansetron, thus, would be an attractive treatment strategy for both opioid-induced pruritus and post-operative nausea and vomiting. Methods: After the approval from institutional review committee and written consent received from the patient, 50 healthy parturients of ASA I and II physical status undergoing caesarean section under spinal anaesthesia were enrolled for the study. They were randomly categorized into placebo group (2 ml normal saline) and treatment group (2 ml of 4 mg ondansetron), each group containing 25 patients. Pruritus and post-operative nausea and vomiting scores were recorded up to 24 hours after the administration of intrathecal morphine. Statistical analysis was performed using chi-square test. Results: The incidence, severity and necessity of treatment for pruritus in the treatment group was significantly reduced compared to the placebo group (16% vs 88%). Similarly, the risk of post-operative nausea and vomiting in the treatment group was less compared to the placebo group (8% vs 56%). Conclusion: Prophylactic administration of ondansetron to parturients receiving intrathecal morphine for post-operative analgesia provides a significant reduction of intrathecal morphine-induced pruritus and nausea and vomiting

Condom Tamponade in the Management of Massive Obstetric Hemorrhage: An Experience at a Teaching Hospital

All in-text references underlined in blue are linked to publications on ResearchGate, letting you access and read them immediately

Menopausal Health Status of the Nepalese Women

Introduction: Menopause is an unavoidable and sometimes problematic condition in which women may suffer from a number of health problems. Knowledge of the major symptoms associated with menopause helps reduce the burden and stress associated with the condition. In this context, a study was conducted to establish baseline data regarding menopausal health problems among Nepalese women. Methods: A descriptive cross-sectional study was conducted among 2000 women aged over 40 years to identify their knowledge, attitude and practice related to menopausal health problems. Data was collected by interviewing the women and doing physical examination. Analysis was done using descriptive statistics and SPSS software was used for data analysis. Results: A cohort of 2073 women (ages 40-60 years) participated in the research, among them 2000 yielded complete response. The study revealed that 820 (41%) women had reached menopause. The average age of menopause was 48.7 years. Majority of the women 1183 (59.2%) in the study did not know about menopausal health problems. Abnormal bleeding 353 (17.65%), sweating 315 (15.75%), hot flushes 299 (14.95%), joint/muscle pain 285 (14.25%) were the most common menopausal symptoms known by the women. Joint pain 736 (36.8%), hot flushes 584 (29.2%), irregular bleeding 582 (29.1%) were the most common experienced symptoms of menopause and only 586 (29.3%) consulted the health workers to alleviate menopausal symptoms. Moreover, most of the women 926 (46.3%) accepted menopause as a part of life. Conclusions: The research has tried to establish the baseline of menopausal health problems in the Nepalese women. The average age of menopause was 48.7 years. Majority did not know about menopausal health problems. Further researches with nationally representative sample are recommended to further explore the menopausal health problems of Nepalese women. Keywords: health problems; menopause; Nepal; women