Himalayan Biodiversity Network

ABSTRACTObjectivePotentially Inappropriate Medications (PIMs) and Drug–Drug Interactions (DDIs) among geriatrics are a prominent issue and place a considerable burden on the quality health outcome. This study aimed to assess PIMs and DDIs particularly among geriatric cardiac elderly patients attending the outpatient department of a tertiary care hospital of Nepal.MethodologyA prospective cross‐sectional study was conducted on geriatrics patients (≥ 65 years) attending the cardiology out‐patient department of Bharatpur Central Hospital, Nepal. Beers criteria were used to assess PIM, and Medscape software was employed to assess DDIs. Regression analysis was performed to identify the predictors of PIM and DDIs experienced by patients.ResultsA total of 140 geriatric patients were enrolled in the study. A total of 683 drugs were prescribed to them, with an average of 4.59 medications per patient. 23.6% and 65% of patients were found to be prescribed PIMs and encountered DDIs, respectively. Proton Pump Inhibitors (PPI) (66.67%) were the most prescribed PIMs and involved in identified DDIs. The removal of PIMs was calculated to reduce 11.72% of the cost of patients prescribed PIMs and 19.88% of identified DDIs. The number of medications prescribed was found to be a significant predictor for PIM (Odd Ratio: 1.352) and DDIs (Odd Ratio: 2.217) encountered.ConclusionThis study highlights the concerning prevalence of potentially inappropriate medication and drug–drug interactions among ambulatory cardiac elderly patients. Integration of regular medication audits and evidence‐based prescribing practices is essential to optimize pharmacological management and enhance patient safety.

Himalayan Musk deer, Moschus chrysogaster is widely distributed but one of the least studied species in Nepal. In this study, we compiled a total of 429 current presence points of direct observation of the species, pellets droppings, and hoofmarks based on field‐based surveys during 2018–2021 and periodic data held by the Department of National Park and Wildlife Conservation. We developed the species distribution model using an ensemble modeling approach. We used a combination of bioclimatic, anthropogenic, topographic, and vegetation‐related variables to predict the current suitable habitat for Himalayan Musk deer in Nepal. A total of 16 predictor variables were used for habitat suitability modeling after the multicollinearity test. The study shows that the 6973.76 km2 (5%) area of Nepal is highly suitable and 8387.11 km2 (6%) is moderately suitable for HMD. The distribution of HMD shows mainly by precipitation seasonality, precipitation of the warmest quarter, temperature ranges, distance to water bodies, anthropogenic variables, and land use and land cover change (LULC). The probability of occurrence is less in habitats with low forest cover. The response curves indicate that the probability of occurrence of HMD decreases with an increase in precipitation seasonality and remains constant with an increase in precipitation of the warmest quarter. Thus, the fortune of the species distribution will be limited by anthropogenic factors like poaching, hunting, habitat fragmentation and habitat degradation, and long‐term forces of climate change.

The musk deer is one of the least studied species that distributes throughout an alpine ecosystem. The population of musk deer is declining because of anthropogenic pressure. Our study was conducted to understand the relationship between musk deer and their environments in the Khaptad National Park in western Nepal. We used a line transect survey to observe the pellet of the musk deer in the study site. Our study found that the pellet group of the musk deer was found higher in the forested environment followed by open grassland, trails, and edge. Musk deer preferred an altitudinal range between 2,400 m and 3,200 m. Our study did not find any signs of the musk deer below 2400 m and above 3200 m. We also found that the pellet group of the musk deer had been mostly associated with close distance to a water body; however, it was found far distance to the village. The presence of livestock and human pressure could have been the reason for the musk deer to avoid edge areas. Anthropogenic pressure should be reduced in the musk deer habitats for long-term musk deer conservation in Nepal.