Trade Liberalization and Poverty in Nepal: an Applied General Equilibrium Analysis

Nepal aggressively liberalized its foreign trade during the 1990s. This paper attempts to estimate the impact of trade liberalization on household welfare and poverty in Nepal through the construction of a regional CGE model. The model disaggregates factors of production - capital, land, and labor - by region (urban, Terai and hills/mountains) in order to establish direct links between sector of activity, factor remuneration, and household income. In particular, certain activities are more intensive in factors from a given region (e.g. the manufacturing sector is more intensive in urban factors of production and the agriculture sector is more intensive in Terai factor of production). Regional factor remuneration in turn maps into regional household income. We find that trade liberalization reduces the nominal returns to urban factors of production in comparison with rural factors of production, resulting in a reduction in the relative income of urban households. Rural and urban households consume roughly the same share of industrial goods, but rural households consume relatively more agricultural goods and fewer services. As the fall in consumer prices in the latter two sectors are similar, there is little rural-urban difference in the variation in consumer price indices. Consumer prices generally fall in roughly the same proportion as nominal incomes such that there are negligible welfare changes. However, poverty falls substantially, with the greatest impact in rural Terai, followed by the rural hills and the mountain region, and least in urban areas.Computable general equilibrium modeling, international trade, poverty, Nepal

Fatal Salmonella Typhi Necrotising Fasciitis following Intra-articular Steroid Injection

Intra-articular steroids administration in the absence of aseptic precautions can have disastrous consequences. Immunocompromised patients are at an increased risk of developing infections following such procedures. Salmonella has been infrequently reported as a causative organism for necrotising fasciitis. Gram negative endotoxemia with disseminated intravascular coagulation resulted in fatality in this patient. The case study is being presented to emphasise the need for aseptic precautions and sterile techniques while administering intra-articular steroids, to have a low threshold towards treating early joint infections expeditiously, and to consider possibility of a gram negative organism as a cause of septicaemia and necrotising fasciitis especially in debilitated patients

An investigation into the associations between reported corporate governance and corporate social responsibility practices, and corporate financial performance in Nepalese listed public companies

Purpose – There are three main purposes of this research. Identifying the level of reported corporate governance (CG) practices and reported corporate social responsibility (CSR) practices in the annual reports of listed public companies on the Nepal Stock Exchange (NEPSE). A further purpose is to investigate the relationship between reported corporate governance (CG) practices and corporate financial performance (CFP) as well as the relationship between reported corporate social responsibility (CSR) practices and CFP for these companies. In addition to this examination of the individual relationships with CFP, the final purpose is to test, collectively, the relationship between reported CG practices and reported CSR practices on CFP for these companies. Design/methodology/approach – This study investigates the three identified purposes using the 2015-16 annual reports for 155 of the 222 listed public companies on the Nepal Stock Exchange (NEPSE). Necessary data were not available in the 2015-16 annual reports for the remaining 66 listed companies. This single year was selected due to events that occurred in previous years that may have a significant compounding impact on CFP at that time. The data were analysed (using content analysis, multivariate analysis, and regression analyse) to test the hypothesised relationships. Findings ̶ This study is useful for academics and companies seeking to understand the extent of reported CG practices and reported CSR practices that are undertaken in Nepalese companies in different sectors. As there were no significant relationships found between reported CG practices and CFP, or reported CSR practices and CFP, as well as CG and CSR, collectively, on CFP, additional analyses were undertaken. The findings were significant for the different phases of sustainability acceptance on the extent of CSR reported practices. Although there was no significant interaction (moderating) effect by CG and CSR on CFP, the mediating effect of CSR on the CG to CFP relationship was tested using structural equation modelling (SEM). The SEM found significant indirect results to support this mediating effect of CSR. Research limitations ̶ The research is subject to two limitations. Firstly, the study examines only one year of annual reports and therefore will be subject to the normal limitation of a cross-sectional study. Secondly, the study analyses the reported CG and CSR, not actual CG and CSR. Research implications ̶ This study contributes to an understanding of the reason for inconsistent results in prior studies. Future research should consider contingency theory related to the phase of sustainability adopted by the organisations on their reported CSR practices. Furthermore, future studies should examine the indirect sequential relationships between CG and CSR as well as CSR and CFP. Originality/Value – This research is original and a significant contributor for future researchers, the government of Nepal and other stakeholders to understand reported practices in publicly listed Nepalese companies in both banking and finance and non-banking sectors. This research was conducted on 155 companies from banking, finance and non-banking sectors

Laparoscopic Cholecystectomy in Chronic Calculus Cholecystitis

Introduction: Laparoscopic cholecystectomy has clearly become the choice over open cholecystectomy in the treatment of hepatobiliary disease since its introduction by Mouret in 1987. This study evaluates a series of patients with chronic calculus cholecystitis who were treated with laparoscopic and open cholecystectomy and assesses the outcomes of both techniques. Objective: To evaluate the efficacy of laparoscopic vs open cholecystectomy in chronic calculus cholecystitis and establish the out-comes of this treatment modality at Lumbini Medical College and Teaching Hospital. Methods: This was a retrospective analysis over a one-year period (January 1, 2012 to December 31, 2012), per-formed by single surgeon at Lumbini Medical College and Teaching Hospital located midwest of Nepal. 166 patients underwent surgical treatment for chronic calculus cholecystitis. Patients included were only chronic calculus cholecystitis proven histopathologocally and the rest were excluded. Data was collected which included patients demographics, medical history, presentation, complications, conversion rates from laparoscopic. cholecystectomy to open cholecystectomy, operative and postoperative time. Results: Patients treated with laparoscopic cholecystectomy for chronic calculus cholecystitis had shorter operating times and length of stay compared to patients treated with open cholecystectomy for chronic calculus cholecystitis. Conversion rates were 3.54% in chronic calculus cholecystitis during the study period. Complications were also lower in patients who underwent laparoscopic cholecystectomy versus open cholecystectomy for cholelithiasis. Conclusions: Laparoscopic cholecystectomy appears to be a reliable, safe, and cost-effective treatment modality for chronic calculus cholecystitis

Glycemic control in smokers and risk of type 2 diabetes

Chronic cigarette smoking seems to markedly aggravate insulin resistance that could be due to the increase in counter-regulatory hormones such as GH, cortisol and catecholamine's that elevates blood glucose, Weight gain usually follows the cessation of smoking and increasingly, fear of weight gain discourages many smokers from attempting to quit Yet, weight gain after quitting smoking has proved so unresponsive  to preventive attempt  as to suggest that weight control  might even be incompatible with successful smoking cessation . Innovative treatments that can prevent or minimize weight gain are badly needed to encourage quitting smoking. However recently featured review and research on smoking and diabetes concluded the evidence that smoking is associated with the preparation for development of type 2 diabetes in men and women Therefore, this review focuses in the possible features of smoking cessation on the glycemic control and risk of type 2 diabetes.key words: Hyperglycemia,Smokers, types 2 diabete

Smoking and Thromboangitis Obliterans– Are they related

Introduction: In 1908 Leo Buerger first gave the world the clinical picture of this dreadful disease which he called Thromboangitis Obliterans. Virtually all investigators believe that smoking or tobacco use in some form is a requirement for the diagnosis of Thromboangitis Obliterans. We studied the demographic profile and smoking pattern of patients with Thromboangiitis Obliterans. Methods: Retrospective study carried out in a tertiary level hospital of South India from 1st January 1997 to 31st December 2003. Patients fulfilling Shionoya’s criteria form the study group. Incidence of Thromboangitis Obliterans, relation to smoking habits, type and nature of manifestation were analyzed. Results: A total of 105 cases were studied and found to have declining pattern of incidence from 0.9%-0.3%. All patients were males, smokers at the time admission and 76% out of them were from low socioeconomic background. Patients smoking 5-15 cigarettes per day, for 5-10 years duration constituted 45% of the study group. The most frequent reasons for being referred to hospital were ischemic ulcers (83.80%), claudication (78.0%) and rest pain (26.66%).   Conclusions: In those who present early with the disease the number of cigarettes and duration of smoking shows no direct correlation to the severity. Most patients continue to smoke inspite of counseling and awareness that the disease progresses due to smoking. Ulcer, intermittent claudication and rest pain are the three common presenting symptoms of Thromboangitis Obliterans.  Keywords: smoking; thromboangitis obliterans

Initial Experience of Percutaneous Nephrolithotomy at Lumbini Medical College

  Introduction: Renal stone disease is a challenging problem in urologic practice especially in our locality because of large stone burden and recurrence. Since ,the early 1980s when percutaneous nephrolithotomy (PCNL) was established for management of renal stones, open surgical procedures have virtually been replaced. PCNL is a safe, effective and minimally invasive approach compared to open surgery for patients with large single, multiple or staghorn stones. The aim of this prospective study was to evaluate and to review our experience with PCNL in management of renal and upper ureteric stones.   Methods: Prospective study carried out at Lumbini Medical College and Teaching Hospital during 1stJanuary 2011 to 31st October 2011. Sixty patients were evaluated and subjected to PCNL. After clinical investigations like ultrasonography (USG) and intravenous urography (IVU), once patients were found to have renal or upper ureteric stones they were informed and explained about PCNL, its likely complications, probable hospital stay, the cost of treatment and data were recorded along with the operative time, estimated blood loss, stone burden, stone-free rate, length of hospitalization and complications .Patients were followed up after three months to rule out recurrence of stones by plain abdominal x-ray of kidney, ureter and bladder and USG.   Results: Out of 60 patients 35 were male and 25 were female (M: F=1.4:1) with mean age of 37 years and were subjected to PCNL monotherapy. With the average stone size of 3.26cm, the mean operative time was 78 minutes. Complete stone removal achieved by PCNL alone in 60 cases, with insignificant residual small stones we achieved 97% stone clearance rate. The mean hospital stay was 3.7 days. No Serious complications were encountered, 9 (15%) patients required blood transfusion and 3 (5%) patients developed transient post-operative pyrexia.   Conclusion: PCNL is the first line treatment option for management of large renal stones which as monotherapy has advantages in removal of renal and upper ureteric stones and achieving excellent results with minimal morbidity

Anger;it's impact on human body

Anger is one of our most powerful and vital emotions with behavioural manifestation. It is described as an intense feeling in response to frustration , hurt, disappointment, or threatening.The benefits of anger include overcoming fears and building confidence to counter dangerous phenomenon  or threats which leads to the fight or flight response while the disadvantages of anger consist of excess anger serving as a numbing agent emotionally, physically and cognitively.Physiologically, emotions is considered to commence  from  brain nucleus named as  amygdale , part of brain   responsible for identifying threats to our well-being, and  relaying out an alarm when threats are identified that result in taking steps to protect ourselves. It is important to recognize the physiological effects of anger especially with all the damage this emotion might produce to our body system.This review article examines the physiology, causes of anger and impact of anger on the body

Experience of Laparoscopic Cholecystectomy at Lumbini Medical College Teaching Hospital

  Introduction: The difficult gallbladder is the most common difficult laparoscopy being performed by generalsurgeons all over the world and the potential one that places the patient at significant risk. The present study aimed to study all the cases of laparoscopic cholecystectomy conducted in current setup at Lumbini Medical College and Teaching Hospital, to compare the results with the published literature and also analyze the complications and ways to decrease the incidence of conversion to open procedure.   Methods: Five hundred twenty five patients age 10-90 years, male:female ratio of 1:3.86 with body weight 45-65 kilogram, who had undergone laparoscopic cholecystectomy for symptomatic cholelithiasis without choledocholithiasis from April 2011 to April 2013 were studied.   Results: All the laparoscopic cholecystectomy (LC) were without major complications. Only nineteen out of five hundred twentyfive (3.6%) required conversion to open cholecystectomy (OC). Reasons for conversion included: dense omental or visceral adhesions; two (0.38%), unclear anatomy; 16 (3.04%), common bile duct injury; one (0.19%). There were 20 cases of shrunken gallbladder suspicious of malignancy but didn’t required conversion.   Conclusion: Laparoscopic cholecystectomy is the preferred method in our setup even in difficult cases

Rice production in Chitwan district of Nepal: An analysis from economic and environmental perspectives

Rice (Oryza sativa L.) is the major staple food in the Nepalese context. Chitwan district of Nepal was purposively selected to analyze the rice production from the socio-economic and environmental perspective. A total of 100 rice growing farmers, 50 organic and 50 inorganic were selected as the sample for the purpose of the study using the simple random method of sampling. Primary data were collected through a pre-tested semi-structure interview schedule and key informant interviews; secondary data were collected reviewing related publications. Descriptive statistics, multiple regression and chi-square test were used for data analysis. The multiple regression revealed that the four explanatory variables included in the model: age of the household head, primary occupation of the household head, number of family members involved in agriculture and subsidy in inputs for rice farming were found to have positive and statistically significant effect on rice yield (P<0.01). Moreover, chi-square test revealed that the farming practices that contributes to climate change mitigation such as: minimum tillage practice (P<0.05), crop diversification (P<0.01), green manuring (P<0.01), agro forestry practice (P<0.05), incorporating crop residues (P<0.1), weed management practice (P<0.01) and pest management practice (P<0.01)were found to be well adopted by the organic rice farmers, in contrast, the farming practices of inorganic rice farmers were statistically and significantly different in this respect. Government should make such policy that could grave the attention of the Nepalese people towards organic agriculture; moreover, encouraging them to make it their primary occupation