8th Britain-Nepal Academic Council Annual Lecture

Dr Rajendra Pradhan is currently Dean of Nepâ School of Social Sciences and Humanities and was a founding member and the Chair of Social Science Baha (January 2002 - June 2010). He received his PhD from the Department of Sociology, University of Delhi. He has conducted research on several topics, including religion among Hindu Newars of Kathmandu, care of the elderly in a Dutch village, food habits of Tarai inhabitants, water rights in Nepal, legal history of land, forest and water in Nepal, traditional dispute settlement processes, and more recently court cases. He has served as research consultant to various organisations, including the International Water Management Institute, the International Food Policy Research Institute, the World Bank and the Asian Development Bank. He has conducted several research workshops and training sessions for Nepali and international participants, including on topics such as legal pluralism, ethnography, and water rights. His publications include several edited and co-edited books such as Water Rights, Conflict and Policy (1997), Water, Land and Law: Changing Rights to Land and Water in Nepal (2000), Law, History and Culture of Water in Nepal (2003), Legal Pluralism and Unofficial Law in Social, Economic and Political Development (2003) and articles in books and journals on a wide range of topics. He is currently co-editing a book entitled Unpacking Water Rights: A Comparative Reader to be published in 2011 by Sage and is working on a manuscript on Supreme Court cases pertaining to women’s rights and gender justice.In the nineteen nineties, encouraged by the restoration of multiparty parliamentary democracy, a new more liberal constitution, better organized and funded social movements, and the increasing influence of international organizations and laws, legal activists filed numerous public interest litigations pertaining to women’s rights and gender justice in the Supreme Court of Nepal. These cases concerned a wide range of issues, including ancestral property, marriage, divorce, marital rape, sexual harassment, and citizenship. The decisions of the Supreme Court were on the whole favourable to women’s rights and contributed to the changes in the laws, especially discriminatory provisions in the Muluki Ain (National Code), making them more supportive of gender equality and justice. In today’s lecture, I will offer one reading or interpretation of these laws and court cases using a legal anthropological perspective to make two points. First, I will demonstrate the usefulness of using the concept of legal pluralism to understand the historical as well as contemporary legal fields in Nepal and make a case for state legal pluralism. I will then discuss the ‘paradigm of argument’ (Comaroff and Roberts 1977) used by the petitioners, the respondents (Government) and the judges in the Supreme Court, paying attention to the different laws they cite to justify their arguments, including the Constitution, international law, customary law and Hindu norms and ‘Nepali culture’ to demonstrate legal pluralism in the Supreme Court. Second, I will argue that these court cases are not only about women’s rights and gender justice but more importantly they are cultural contestations concerning gender relations, family, marriage, property, individuals, citizenship, and so on and more generally about different visions of Nepali society. In conclusion, I will reflect on the relations between law and culture and law and social change in a legal pluralistic, multicultural, predominantly rural society.Digital Himalaya Project & the Britain-Nepal Academic Counci

Correlation of Posterior Curve Length of Sternum and Stature: A Postmortem Study in Delhi Population

Background: The primary characteristics to establish the identification of an individual are sex, age, and stature [1]. Determination of stature is easy if a complete body or the entire skeleton is found. When only some parts of the body or skeleton are available, it is necessary to have different formulae for determination of stature from their osteometric measurements. The present study aims to assess the stature of an individual from his or her sternum with the help of Posterior Curve Length (PCL). Methods: The study was conducted on 100 cadavers, including 50 females and 50 males, died 18 years or older age. The cases were referred for medico-legal postmortem examination to the Department of Forensic Medicine, Maulana Azad Medical College, New Delhi. Sternum samples were obtained during autopsy (as fresh sternum) and after removal of muscular coverings, cleaned and dried at room temperature (as dry sternum) for the study. PCL was measured and linear regression was used to recognize sternum correlation with stature. Results: In our study which was conducted on fresh and dry samples of sternum, the stature can be estimated by 68% accuracy with linear regression equation of Y=91.51+3.5 (Posterior Curve Length of fresh sternum) with standard error±3.5 cm and correlation coefficient of 0.872. Also the stature can be estimated through Y=96.1+3.4 (Posterior Curve Length of dry sternum) with standard error of ±3.9 cm and correlation coefficient of 0.610. Conclusion: From the present study we found some synergistic factors which are helpful for estimation of stature from respective PCL of sternum which clearly shows that sample of sternum obtained from decomposed body, or in cases where long bones are missing, PCL of sternum acts as an alternative to estimate stature in Delhi population

Giant cavernous malformation in the child: Case presentation

Cerebral cavernous malformations (CCMs) are rare lesions that occurs 5 to 13% of all intracranial vascular malformations, develop in 0.02-0.13% of the population. Extra axial cavernous Malformations are even more rare and estimated to be 0.4 to 2% of all the intra cranial cavernous hemangiomas. CCMs that are greater than six cm in size have been described as “giant” in the literature. We report ten year-old male who presented with right lower limb weakness and recurrent seizure disorder. The computed tomography and the magnetic resonance imaging scans demonstrated giant vascular malformation (10CM x 8CM x 6CM) on left parietal lobe. Surgical excision of a giant cavernous malformation (GCM) was performed with good surgical skills. To the best of our knowledge, such large GCMs are extremely rare lesion seen in neurosurgical practice

Implications of Legal Pluralism for Natural Resource Management

Summaries This article illustrates the implications of legal pluralism for our understanding of natural resource management and policies toward resource tenure, using the example of water rights. There is widespread recognition that property rights play a fundamental role in shaping how people manage natural resources. But many conceptions of property rights have focused only on static definitions, usually as defined in statutory law. The legal anthropological perspective highlights the coexistence and interaction between multiple legal orders such as state, customary, religious, project and local laws, all of which provide bases for claiming property rights. These multiple legal frameworks also facilitate considerable flexibility for people to manoeuvre in their use of natural resources, thus helping to cope with uncertainty. In many parts of the world, water rights are dynamic, flexible and subject to frequent negotiations because of uncertain water supply, damages to intake structures due to floods and landslides, and social, economic and political changes. The article demonstrates how multiple, flexible and dynamic legal orders are more responsive to these uncertainties and changes than a single, fixed legal system with a static property regim

Arachnoid cyst complicated by spontaneous chronic subdural hematoma in the infant

Arachnoid cyst is collections of fluid that develop within the arachnoid membrane because of splitting or duplication of this structure. Arachnoid cyst can present at any age with or without symptoms. Chronic Subdural Hematoma most common in elderly patients several weeks after a head injury prior to onset of symptoms. But here we report 1 year-old-boy presented with epileptic seizures for one month. Computed tomography and Magnetic resonance imaging of brain disclosed that left parietal an arachnoid cyst and fronto-temporo-pareital chronic subdural hematoma. After admission, cyst was excised and hematoma was evacuated through fronto-parietal craniotomy approach. The patient had a good recovery postoperatively. Arachnoid cyst with Chronic Subdural Hematoma in the infant is a serious condition with a high mortality rate. However, surgical resection seems to be very favorable.&nbsp

Prevalence and Indications of Cesarean Section in a Community Hospital of Western Region of Nepal

  Introduction: Cesarean section is one of the common obstetric procedures done when the childbirth is not anticipated to occur by the normal vaginal delivery. There has been increased rate of cesarean section globally as well as in our country in recent decades. Methods: This descriptive cross-sectional study has been carried out by reviewing a year of data from maternity ward of Paschimanchal Community Hospital, Prithvi Chowk, Pokhara. The total number of delivery, their modes either vaginal or cesarean, indications for the cesarean section and their outcomes were analyzed. The obtained data was entered and analyzed in Microsoft Excel. Results: Total of 257 cases underwent delivery during the study period and 174 (63.27%) were by cesarean section. Oligohydramnios is the most common indication for cesarean section. Around 25 (14.36%) of the women underwent repeat cesarean section. Conclusions: The rate of cesarean section was quite high in our study and further studies are recommended for understanding of causes and other associated factors with it

Recurrent intracranial epidural hematoma following ventriculoperitoneal shunt in a child

Intracranial hematoma is commonly observed in neurosurgical practice. However, recurrent intracranial epidural hematoma following ventriculoperitoneal (VP) shunt is more of an exception than the norm. It is a rare but serious cause of morbidity and mortality in patients with VP shunt. However, treatment is very promising especially with surgical intervention in time. Here we report a case of a ten-year-old girl who presented with chronic headache for a couple of years whose imaging features suggested a hydrocephalus with tonsillar herniation. Initially, she developed right frontotemporal hematoma and then bilateral frontal epidural hematoma following a VP shunt. Emergency decompression was done

Utilisation of antimicrobial agents in intensive care unit at a tertiary care teaching hospital in eastern India

Background: Antimicrobial agents (AMAs) are the most frequently used drugs in the intensive care units (ICU) and regular auditing can prevent the development of resistance to AMAs, reduce the cost and incidence of adverse drug reactions. The present study was conducted to assess the drug utilisation pattern by measuring the defined daily dose (DDD) per 100 bed days for the AMAs used and their correlation with the APACHE score II.Methods: This was a prospective observational study, conducted in the Central ICU of SCB Medical College and Hospital, Cuttack, Odisha for 4 months. Data regarding demographic profile, diagnosis, APACHE II score, microbiologic investigation, length of stay, outcome and utilisation pattern of AMAs assessing anatomic therapeutic chemical (ATC) classification and measuring the antimicrobial consumption index (ACI) equal to DDD per 100 bed days were collected and subjected to descriptive analysis. Multinomial logistic regression model was used to predict probabilities of different possible outcomes of categorically distributed variables and independent variables.Results: Mean age of study population was 44.70±14.814 with male and female ratio of 1.63:1. Septicaemia was the most common cause of admission. AMAs were prescribed to 92.66% of patients during their stay which constitutes 37.32% of the total drugs used. The DDD per 100 bed days for the AMAs were 118.59 and ceftriaxone was found to be most frequently used. Patients having higher APACHE II score received more no of AMAs (4.20±1.30). Patients having low APACHE II Scores received less number of antibiotics as compared to patients having higher score.Conclusions: AMAs were prescribed to 92.66% patients in the central ICU and there is significant relation between the APACHE II score and number of AMAs prescribed

Full-resolution Lung Nodule Segmentation from Chest X-ray Images using Residual Encoder-Decoder Networks

Lung cancer is the leading cause of cancer death and early diagnosis is associated with a positive prognosis. Chest X-ray (CXR) provides an inexpensive imaging mode for lung cancer diagnosis. Suspicious nodules are difficult to distinguish from vascular and bone structures using CXR. Computer vision has previously been proposed to assist human radiologists in this task, however, leading studies use down-sampled images and computationally expensive methods with unproven generalization. Instead, this study localizes lung nodules using efficient encoder-decoder neural networks that process full resolution images to avoid any signal loss resulting from down-sampling. Encoder-decoder networks are trained and tested using the JSRT lung nodule dataset. The networks are used to localize lung nodules from an independent external CXR dataset. Sensitivity and false positive rates are measured using an automated framework to eliminate any observer subjectivity. These experiments allow for the determination of the optimal network depth, image resolution and pre-processing pipeline for generalized lung nodule localization. We find that nodule localization is influenced by subtlety, with more subtle nodules being detected in earlier training epochs. Therefore, we propose a novel self-ensemble model from three consecutive epochs centered on the validation optimum. This ensemble achieved a sensitivity of 85% in 10-fold internal testing with false positives of 8 per image. A sensitivity of 81% is achieved at a false positive rate of 6 following morphological false positive reduction. This result is comparable to more computationally complex systems based on linear and spatial filtering, but with a sub-second inference time that is faster than other methods. The proposed algorithm achieved excellent generalization results against an external dataset with sensitivity of 77% at a false positive rate of 7.6