Assessment of COVID-19 pandemic in Nepal: A lockdown scenario analysis

The Government of Nepal issued a nationwide lockdown from 24 March to 21 July 2020, prohibiting domestic and international travels, closure of the border and non-essential services. There were only two confirmed cases from 610 Reverse Transcription Polymerase Chain Reaction (RT-PCR) tests and no fatalities when the government introduced nationwide lockdown. This study aimed to explore the overall scenario of COVID-19 including spatial distribution of cases; government efforts, and impact on public health, socio-economy, and education during the lockdown in Nepal. We collated and analyzed data using official figures from the Nepalese Ministry of Health and Population. Nepal had performed 7,791 RT-PCR tests for COVID-19, the highest number of tests during the lockdown. It has recorded its highest daily rise in coronavirus infections with a total of 740 new cases from the total of 4,483 RT-PCR tests performed on a single day. Nepal had reported a total of 17,994 positive cases and 40 deaths at the end of lockdown. The spatial distribution clearly shows that the cases were rapidly spreading from the southern part of the country where most points of entry and exit from India are located. To contain the spread of the virus, the government has also initiated various preventive measures and strategies during the lockdown. The Government of Nepal needs to allocate more resources, increase its capacity to test and trace, establish dedicated isolation and quarantine facility and impose local restrictions such as a local lockdown based on risk assessment rather than a nationwide lockdown

Cost-benefit analysis and resource use efficiency of rice production system in different agriculture landscapes in Chitwan district, Nepal

The study was conducted to determine the cost-benefit analysis and resource use efficiency of the rice production system in different agriculture landscapes in the Chitwan district in 2018. The sample size of 102 rice-growing farmers out of 600 farmers, having an area of farm size greater than 0.5 hectares, was determined using Raosoft Inc. Software. A simple random sampling technique was used to collect 102 rice-growing household information in four municipalities (2 in plain and 2 in hilly area) using a semi-structured questionnaire. Data were analyzed using descriptive and statistical tools including Cobb-Douglas production function. Results showed that the use of inputs like seeds, chemical fertilizer and machinery like tractor were found significantly higher in the plain area whereas the use of inputs like labor, farmyard manure (FYM) and bullocks was found in higher in the hilly area. The costs of fertilizer, machinery, pesticide, and transportation were found higher in the plain area whereas the costs of seed, FYM, labor and bullocks were significantly higher in the hilly area. Production of rice per household was 1.87 ton whereas productivity was 5.2 ton/ha, gross profit was NRs. 41435and benefit-cost ratio was 1.59 in the plain area which was found significantly higher than the hilly area. The return to scale was found to be 0.48 which revealed that inputs used in rice production were ineffectively utilized in which organic fertilizer and labor resource were overused and seed, fertilizer, machinery and bullocks, pesticides and transportation were underused resources. The optimal allocation of these resources will increase the profitability of rice farming

Weed dynamics, wheat (Triticum aestivum) yield and irrigation water-use efficiency under conservation agriculture

A field experiment was conducted to evaluate the impacts of a 12-year old conservation agriculture (CA)- based pigeon pea-wheat system on weeds, wheat crop, and resource use during winter (rabi) 2021–22. Results indicated that surface retention of residue irrespective of ZT permanent bed and N dose led to significant reduction in weed interference at 60 DAS. CA-based systems reduced weed density and dry weight considerably than CT. CA- based systems led to significantly higher wheat grain yield (by 11.6–14.9%) and net B:C (by 24.0 –28.0%) than CT, and PFBR100N and PBBR100N were slightly superior to others. PBBR100N and PBBR75N had lower irrigation water use and significantly higher irrigation water productivity than CT. Contrast analysis showed that wheat yield and water productivity were comparable between 75% N and 100% N in CA, indicating a saving of 25% N under CA

A prospective study of comparison between open trendelenburg operation, radiofrequency ablation, EVLA, and glue technique for the management of varicose veins

Background: Varicose veins are a subset of Chronic Venous disorders, including spider, reticular, varicose, and leg oedema. In our country, varicose veins are common surgical problems most commonly seen in low socio-economic groups and associated with certain occupation(s). Varicose veins have been known to affect the quality of life (QoL) leading to changes in occupation. Surgical treatment methods such as Saphenofemoral Junction (SFJ) Ligation and Great Saphenous Vein (GSV) stripping with spinal or general anaesthesia, Radio Frequency Ablation (RFA), Endovascular Laser Ablation (EVLA) and GLUE Technique within the operating room are considered in patients who remain refractory to conservative management and continue being symptomatic. Aim & Objectives: The study aimed to compare the outcome and associated post-operative complications, including Deep Venous Thrombosis, Pulmonary Embolism or Paresthesia, and Ecchymosis, with various modalities in the management of varicose veins. Material and Methods: The study was performed at a tertiary care centre which included 200 patients over a period of one year and was evaluated in the basis of VCSS & VDS scores. Results: We observed that all treatment protocols demonstrated results which improved the general physical condition of patients with the least number of complications. Treatment for varicose veins encompasses open surgeries and Endovenous techniques (EVLA and RFA), which show comparative results in clinical improvement, complications and postoperative hospital stay. Both VCSS and VDS are sensitive tools for measuring clinical outcomes of treatments of venous disease. However, the choice of appropriate tool is dependent upon the type of treatment, the Surgeon 's personal experience, availability of resources, durations of hospital admission and cost of treatment

Long-Term Conservation Agriculture Influences Weed Diversity, Water Productivity, Grain Yield, and Energy Budgeting of Wheat in North-Western Indo-Gangetic Plains

Wheat is grown in an area totalling 31.1 million hectares in India. The North-western Indo-Gangetic Plains (IGP) constitutes the major share of area and production of wheat in India and is known as the wheat belt of India. However, sustaining wheat production under declining/lower resource-use efficiency in the existing rice–wheat cropping system has led to considerations about diversifying this system with a pigeon pea–wheat system (PWS) in the IGP of India. However, little or no information is available on the impact of CA-based PWS on weed dynamics, productivity, profitability, and resource-use efficiencies. Therefore, we studied these aspects in wheat under a long-term (~12 years) conservation agriculture (CA)-based PWS. Treatments were conventional till flatbed (CT), ZT permanent narrow beds (PNBR & PNB), broad beds (PBBR & PBB), and flat beds (PFBR & PFB) with and without residue (R) retention and different N levels (75% and 100% of the recommended N). The results showed that the Shannon–Weiner index and the Simpson dominance index were higher under the CA system in 2021–2022 than in 2010–2011 and 2015–2016, indicating a change in weed diversity over the period. Furthermore, the Sorensen similarity index showed that there was not much difference in weed diversity for 2010–2011. However, in 2015–2016 and 2021–2022 respectively, only 89% (0.89) and 62% (0.62) of weed species were common to both CT and CA systems, indicating a shift in weed species in the long-term CA system in 2021–2022. Residue retention and N dose decreased weed density at 30 days after sowing (DAS). All the CA-based (PFBR100N, PBBR100N, PNBR100N, PFBR75N, PBBR75N, and PNBR75N) treatments reduced the weed density and dry weight compared to CT at 30 DAS. Wheat grain yield and net returns increased by 11.6–14.9% and 19.4–23.8% over CT in CA treatments, of which PFBR100N and PBBR100N were superior. The PBBR100N and PBBR75N systems had water productivity significantly higher than CT. Residue retention in ZT permanent beds reduced energy productivity in CA than CT and no residue treatments. In the 12th year, CA with 75% N (PFBR75N, PBBR75N, PNBR75N) resulted in a higher partial factor productivity of N and total NPK applied. Contrast analysis showed that 75% N was comparable with 100% N on crop, water, and energy productivities and 75% N was superior to 100% N on partial factor productivity of N and total NPK. Thus, the permanent broad bed with residue and 100% N in the initial years and 75% N in later years can be adopted in the north-western IGP for better weed suppression, higher yield, profitability, and resource-use efficiency

30-Day Morbidity and Mortality of Bariatric Surgery During the COVID-19 Pandemic: a Multinational Cohort Study of 7704 Patients from 42 Countries.

BACKGROUND There are data on the safety of cancer surgery and the efficacy of preventive strategies on the prevention of postoperative symptomatic COVID-19 in these patients. But there is little such data for any elective surgery. The main objectives of this study were to examine the safety of bariatric surgery (BS) during the coronavirus disease 2019 (COVID-19) pandemic and to determine the efficacy of perioperative COVID-19 protective strategies on postoperative symptomatic COVID-19 rates. METHODS We conducted an international cohort study to determine all-cause and COVID-19-specific 30-day morbidity and mortality of BS performed between 01/05/2020 and 31/10/2020. RESULTS Four hundred ninety-nine surgeons from 185 centres in 42 countries provided data on 7704 patients. Elective primary BS (n = 7084) was associated with a 30-day morbidity of 6.76% (n = 479) and a 30-day mortality of 0.14% (n = 10). Emergency BS, revisional BS, insulin-treated type 2 diabetes, and untreated obstructive sleep apnoea were associated with increased complications on multivariable analysis. Forty-three patients developed symptomatic COVID-19 postoperatively, with a higher risk in non-whites. Preoperative self-isolation, preoperative testing for SARS-CoV-2, and surgery in institutions not concurrently treating COVID-19 patients did not reduce the incidence of postoperative COVID-19. Postoperative symptomatic COVID-19 was more likely if the surgery was performed during a COVID-19 peak in that country. CONCLUSIONS BS can be performed safely during the COVID-19 pandemic with appropriate perioperative protocols. There was no relationship between preoperative testing for COVID-19 and self-isolation with symptomatic postoperative COVID-19. The risk of postoperative COVID-19 risk was greater in non-whites or if BS was performed during a local peak

Safety of Bariatric Surgery in ≥ 65-Year-Old Patients During the COVID-19 Pandemic

Background Age >= 65 years is regarded as a relative contraindication for bariatric surgery. Advanced age is also a recognised risk factor for adverse outcomes with Coronavirus Disease-2019 (COVID-19) which continues to wreak havoc on global populations. This study aimed to assess the safety of bariatric surgery (BS) in this particular age group during the COVID-19 pandemic in comparison with the younger cohort.Methods We conducted a prospective international study of patients who underwent BS between 1/05/2020 and 31/10/2020. Patients were divided into two groups - patients >= 65-years-old (Group I) and patients < 65-years-old (Group II). The two groups were compared for 30-day morbidity and mortality.Results There were 149 patients in Group 1 and 6923 patients in Group II. The mean age, preoperative weight, and BMI were 67.6 +/- 2.5 years, 119.5 +/- 24.5 kg, and 43 +/- 7 in Group I and 39.8 +/- 11.3 years, 117.7 +/- 20.4 kg, and 43.7 +/- 7 in Group II, respectively. Approximately, 95% of patients in Group 1 had at least one co-morbidity compared to 68% of patients in Group 2 (p = < 0.001). The 30-day morbidity was significantly higher in Group I ( 11.4%) compared to Group II (6.6%) (p = 0.022). However, the 30-day mortality and COVID-19 infection rates were not significantly different between the two groups.Conclusions Bariatric surgery during the COVID-19 pandemic is associated with a higher complication rate in those >= 65 years of age compared to those < 65 years old. However, the mortality and postoperative COVID-19 infection rates are not significantly different between the two groups

Effect of BMI on safety of bariatric surgery during the COVID-19 pandemic, procedure choice, and safety protocols - An analysis from the GENEVA Study

Background: It has been suggested that patients with a Body Mass Index (BMI) of > 60 kg/m2 should be offered expedited Bariatric Surgery (BS) during the Coronavirus Disease-2019 (COVID-19) pandemic. The main objective of this study was to assess the safety of this approach. Methods: We conducted a global study of patients who underwent BS between 1/05/2020 and 31/10/2020. Patients were divided into three groups according to their preoperative BMI -Group I (BMI < 50 kg/m2), Group II (BMI 50-60 kg/m2), and Group III (BMI > 60 kg/m2). The effect of preoperative BMI on 30-day morbidity and mortality, procedure choice, COVID-19 specific safety protocols, and comorbidities was assessed. Results: This study included 7084 patients (5197;73.4 % females). The mean preoperative weight and BMI were 119.49 & PLUSMN; 24.4 Kgs and 43.03 & PLUSMN; 6.9 Kg/m2, respectively. Group I included 6024 (85 %) patients, whereas Groups II and III included 905 (13 %) and 155 (2 %) patients, respectively.The 30-day mortality rate was higher in Group III (p = 0.001). The complication rate and COVID-19 infection were not different. Comorbidities were significantly more likely in Group III (p = < 0.001). A significantly higher proportion of patients in group III received Sleeve Gastrectomy or One Anastomosis Gastric Bypass compared to other groups. Patients with a BMI of > 70 kg/m2 had a 30-day mortality of 7.7 % (2/26). None of these patients underwent a Roux-en-Y Gastric Bypass. Conclusion: The 30-day mortality rate was significantly higher in patients with BMI > 60 kg/m2. There was, however, no significant difference in complications rates in different BMI groups, probably due to differences in procedure selection