Labor migration triggered by COVID-19 and its impact on climate change adaptation of producers in Sunsari district, Nepal

Due to the COVID-19 pandemic, many temporary labor workers who were employed in foreign countries lost their jobs and had to return to their homeland. These skilled laborers are involved in daily household tasks and farming decision-making processes. This study investigates the role of labor migrants who returned to their households due to COVID-19 on the climate change adaptation of farmers. The migrant laborers are relatively better educated, willing to adopt modern technology, and receive training. An ordered logistic regression was used to analyze the impact of COVID-19 on household’s access to institutional factors (Extension services, subsidies, and internet) as well as other relevant explanatory variables on the farmer’s adoption of climate change adaptation practices. 443 smallholder farmers were selected from Sunsari district based on convenience, Nepal for a face-to-face interview. The results indicated migrant labor’s return to households had an effect on the climate change adaptation of farmers. With the impact of COVID on labor migration being temporary, the migrant laborers are expected to return to their jobs overseas, it is expected that it may result in a potential negative impact on the local climate change adaptation of farmers. Since institutional factors (Extension, subsidy, and internet) have a positive impact on adaptation it could be used to complement the gap created by returning migrant laborers. An increase in an additional unit of access to Extension and subsidy decreased the likelihood of low-intensity climate change adaptation strategies (i.e., one or two practices adopted) whereas access increased the likelihood of adopting high intensity climate change adaptation strategies (i.e., three, four or five practices adopted). Specifically, increasing access to Extensions and subsidies should be greatly beneficial for rice producers in the Sunsari district. Among the three institutional factors, access to Extension should be prioritized over access to subsidy because of its greater impact on the adoption of climate change adaptation practices

Analysis of umbilical cord blood gas in term and near term asphyxiated newborn babies

Introductions: This study aims to determine the incidence of perinatal asphyxia in neonates with low Apgar and Hypoxic Ischemic Encephalopathy (HIE) in asphyxiated babies. Methods: This was a cross sectional study from November 1, 2010 to July 30, 2011. Babies with Apgar score of less than seven at five minute were enrolled in the study. Blood was drawn from umbilical cord artery for blood gas analysis. Neonates were followed up in every six hours for at least 48 hours. Staging of HIE according to Sarnat staging was done in babies with Apgar score of <7 at five minutes within 24 hours of birth.  Results: Total of 2,425 live births, 56 (2.30%) were born with an Apgar of < 7 at five minute, six were excluded (due to set exclusion criteria) and remaining 50 were analysed. Thirty-four (68% of 50) of babies with low Apgar score had maternal risk factors – meconium stained liquor being the commonest risk factor. Majority (46%) had cord blood pH of >7.2, 40% had between 7.1 to 7.2, 12% between 7 to 7.1 and remaining 2% had pH < 7. HIE developed in 22% (11/50) of the asphyxiated babies. Conclusions: More than 1/3rd (46%) of babies with low Apgar had low cord blood pH, 1/4th (26%) had base excess, and 22% developed features of HIE. Cord blood pH were better predictors than Apgar in asphyxiated babies. Keywords: Apgar score, cord blood, hypoxic ischemic encephalopathy (HIE

Comparative Fiscal Performance of Provincial Governments

In Nepal, obstacles and mal practices experienced at the federal level have been cascaded down to lower tiers of the government. The province governments have carried out the financial legacy of federal government, a legacy which has drawn much criticisms for its failure to ensure transparency and accountability. The spending of province and local governments has not been as expected. This has largely stifled development activities

Clinical profile of culture proven enteric fever in children at university teaching hospital, Nepal

Introductions: Enteric fever is one of the major public health issues in Nepal.The present study was designed to analyze the clinical profile and antibioticsensitivity pattern in the cases of culture positive typhoid fever.Methods: This is a cross sectional study done by reviewing the hospitalrecord files of children admitted in paediatric ward of Patan Hospital withculture positive enteric fever over a period of seven years from January2007 to December 2013. The mode of presentation, sensitivity pattern ofisolates from blood culture, response to therapy and the complications wererecorded and analyzed.Results: There were total of 119 culture positive enteric fever admitted tochildren ward during this period, 64 (53.7%) males and 55 (46.3%) females.Common symptoms were fever (100%), Common symptoms were fever(100%), vomiting 37 (31.09%), diarrhea 27 (22.68%), abdominal pain 31(26%) cough 24 (20%), and constipation six (5%). Common clinical signswere hepatomegaly 41 (34.4%), splenomegaly 25 (21%), and chest signs 10(8.4%). Sensitivity to ceftriaxone was 96.6% in this study. Ninety four percentof salmonella typhi in 2013 were resistant to quinolones.Conclusions: Apart from fever, diarrhea, vomiting, abdominal pain and coughwere major manifestations and encephalopathy was common complicationof enteric fever in this study. Resistance to many of the drugs are emerging.An appropriate antibiotic has to be initiated only after culture sensitivity intyphoid fever.Keywords: clinical profile, enteric fever, salmonella typh

Public Finance Management in Federalism

The importance of public financial management in the successful operation of federalism should be realised at all levels and more collaborative approaches to PFM reforms should be pursued involving local authorities, development partners and international organisations, and professional accounting institutions such as the ICAN

Determinants of gross income from carp production in Bara district, Nepal

A study was conducted from March to June 2020 to analyze the determinants of gross income from carp production in the Bara district of Nepal. Altogether, 90 carp producers, 45 each from Simraungadh and Pachrauta municipality in equal basis were sampled by using cluster sampling technique. Primary information was collected through a pre-tested semi-structured interview-based schedule while secondary information was collected reviewing the relevant publications. Data was entered in SPSS 25 and analyzed using STATA 12.1. The results  revealed that the cost of labor, cost of feed, assistances and services, and training had significant positive effect on gross income from carp prodcuiton. Furthermore, lack of quality inputs was identified as the most severe production problems whereas Dhalta to be given was recognized as the most severe marketing problems. Thus, encouraging the carp producer to manage the cost of labor and cost of feed deliberately, rationally providing the assistance and services and strengthening the skills and knowledge of producer through training could significantly increase gross income from carp production

Outcome of surgical management of ruptured Achilles tendon

Introductions: The incidence of Achilles tendon rupture has been increasing worldwide. The optimal management of this problem is controversial but the surgical intervention is being applied widely. Methods: We retrospectively analyzed patients who had Achilles tendon (AT) rupture treated surgically at Patan Academy of Health Sciences from January 2010 to December 2015. Functional outcome assessment of ankle was done by using American Orthopedic foot and Ankle Society Score (AOFAS). Results: Total 71 patients (male 45, female 26) had surgery for AT, 38 right and 33 left side. The mean age of the patient was 36.14 years (range 18-67 years). The mean AOFAS score was 83.32 (range 75-93) after first year follow up and 90.36 (range 80-99) after second year, difference was statistically significant (p<0.05). Conclusions: The study showed high AOFAS score for surgical management of ruptured Achilles tendon.   Key words: Achilles tendon rupture, American Orthopedic foot and Ankle Society Score (AOFAS

Orthopaedic services during COVID-19 lockdown at Patan Hospital, Nepal

Introduction: The COVID-19 pandemic has paralyzed the world, including elective health care services. To prevent the spread of infection, most countries have gone into lockdown and adjustments have been made to provide urgent medical care, including Orthopaedic services. In accordance with the guidelines from worst affected countries and neighboring India, Patan Hospital followed instructions from Ministry of Health and Population to provide only urgent and semi-urgent Orthopaedic services. This study aims to audit the patient profile during lockdown so as to have a clearer picture, which will enable us to be prepared for similar epidemic in the future. Method: All patients admitted to the Orthopaedic ward of Patan hospital from 24 March to 27 April 2020, during the lockdown, were included. Clinical profile, including cause of admission, management, hospital stay were descriptively analyzed. Ethical approval was obtained. Result: Out of 44 admissions, there were male 27 and female 17. Trauma cases were 38, and 18 were in age group 20-26 years. Admission due to infections were four. Conservative management were done in seven while 33 were treated surgically, out of which 30 accounted for trauma. Average 6.14 days hospital stay, range 1-22 days. Conclusion: Trauma comprised of major bulk of patients seeking urgent Orthopaedic care. Hospital needs to be prepared with necessary measures to ensure safety of health care workers and yet provide urgent Orthopaedic services. Keyword: COVID-19, lockdown, orthopaedic

Case Report on Secondary Peritonitis Caused by Jejunum Perforation

The small intestine is third in frequency intraperitoneal organ injured after blunt trauma of abdomen. Peritonitis caused by isolated jejunum perforation is very rare. As most of these cases are accompanied with injuries with other structures in the abdomen, hence it is not suspected. Therefore failure in diagnosis and delay in treating these injuries significantly increase the morbidity and mortality of these patients. Here, we report a case of a 60 year old gentleman admitted in surgery department with severe abdominal pain, multiple episodes of vomiting followed to fast breathing and reduced consciousness. Our patient presented in septic shock, with toxic looks and clear cut rigid abdominal wall. To the best of our knowledge this is the first time we describe a case report on isolated jejunum perforation as a result of physical assault.  Journal of Gandaki Medical College Vol. 10, No. 1, 2017, Page: 57-5