Mountain Medicine Society of Nepal

Introduction: In times of disaster in rural settings, helicopter rescue is crucial. Since the 1990s, helicopters without any medical support have been used to transport patients from remote areas to tertiary care centers. In 2013, private organizations improved pre-hospital care by adding medical teams and equipment, making Helicopter Emergency Medical Services (HEMS) a critical part of emergency care, particularly in remote areas. Methods: This retrospective observational study analyzes patients who were transferred by helicopter to Grande International Hospital (one of the tertiary centers in Kathmandu, Nepal) between May 10, 2018, and May 9, 2024. Patient’s demographics (age, gender, ethnicity), medical conditions/outcomes, and geographic origins were analyzed. Data was analyzed using SPSS version 25. Results: The 782 helicopter rescues show that 68.8% of the participants were men, with a mean age of 47.21 years. Of them, 90.92% were Nepalese, and the majority of cases (42.23%) were transferred from Province 4 of the country. Pneumonia (211 cases), trauma (107), neurological emergencies (85), cardiovascular emergencies (44), and COVID pneumonia (140) were among the major medical reasons for transfer. The COVID pandemic highlighted the importance of HEMS. 40.4% of cases were self-landed, whereas 59.6% of cases were accompanied by HEMS physicians. Interhospital transfers and a sizable portion of high-altitude operations were part of many rescues. With an average hospital stay of 13.73 days and a 14.3% mortality rate, the majority of patients were admitted to the intensive care unit. Conclusion: HEMS has significantly saved lives over the years at a particular tertiary hospital. This data allows for advancing HEMS use in a rural setting like Nepal, especially during times of disaster, to provide acute medical and rescue care. It is imperative to address and evaluate HEMS accessibility and its importance regarding infrastructure, cost, geographic diversity, and the country’s vulnerability to disaster.

Chinese pangolin (Manis pentadactyla Linnaeus, 1758) is a nocturnal, solitary, and highly threatened mammal belonging to the order Pholidota and family Manidae. This study assessed habitat preference, distribution, and major threats to the Chinese pangolin in the Terai and Chure community forests of Morang District, eastern Nepal, to support evidence-based conservation strategies. Field surveys were conducted using a block transect method (900 × 500 m²) whenever burrows or indirect signs were detected. Within each block, a 900 m central transect was established, and five 100 × 100 m² plots were laid at 100 m intervals to record habitat variables. A total of 104 burrows were documented, with 25 located in the Terai and 79 in the Chure region, indicating greater occurrence in the Chure forests. The species showed a clear preference for Shorea robusta-dominated forests. Burrows were frequently associated with specific herb and shrub species and were recorded at elevations ranging from 150 to 1200 m, with the highest density between 600–900 m. Pangolin burrows were most commonly found on slopes of 25°–50°, in areas with moderate canopy cover (25–50%), and predominantly in yellow soil. Ground cover was generally sparse (0–25%). Aspect analysis showed that burrows mainly faced northeast in the Terai and east to southeast in the Chure region. Burrow density decreased with increasing distance from water sources, highlighting the importance of water availability in habitat selection. Conversely, burrow occurrence increased with distance from roads and settlements, indicating sensitivity to anthropogenic disturbance. Interviews and field observations identified illegal hunting, habitat fragmentation, mining activities, and deforestation as major threats to the species in the study area. These findings provide quantitative evidence of habitat preferences and human-induced pressures affecting Chinese pangolins in Morang District. Strengthening law enforcement, promoting community awareness, and implementing sustainable forest management practices are essential to ensure long-term conservation of this critically endangered species.

Mountain treelines are among the most climate-sensitive ecosystems on Earth, yet their fine-scale structural and species level dynamics remain poorly resolved in the Himalayas. In particular, the absence of three-dimensional, crown level measurements have hindered the detection of structural thresholds and species turnover that often precede treeline shifts. To bridge this gap, we introduce UAV LiDAR—applied for the first time in the Hindu Kush Himalayas—to quantify canopy structure and tree species distributions across a steep treeline ecotone in the Manang Valley of central Nepal. High-density UAV-LiDAR data acquired over elevations of 3504–4119 m was used to quantify elevation-dependent changes in canopy stature and cover from a canopy height model derived from the 3D point cloud, while individual tree segmentation and species classification were performed directly on the 3D, height-normalized point cloud at the crown level. Individual trees were delineated using a watershed-based segmentation algorithm while tree species were classified using a random forest model trained on LiDAR-derived structural and intensity metrics, supported by field-validated reference data. Results reveal a sharply defined treeline characterized by an abrupt collapse in canopy height and cover within a narrow ~60–80 m vertical interval. Treeline “threshold” was quantified as a breakpoint elevation from a piecewise model of tree cover versus elevation, and the elevation span over which modeled cover and height distributions rapidly declined from forest values to near-zero. Segmented regression identified a distinct structural breakpoint near 3995 m elevation. Crown-level species predictions aggregated by elevation quantified an ordered turnover in dominance, with Pinus wallichiana most frequent at lower elevations, Abies spectabilis peaking mid-slope, and Betula utilis concentrated near the upper treeline. Species classification achieved high overall accuracy (>85%), although performance varied among taxa, with broadleaf Betula more difficult to discriminate than conifers. These findings underscore UAV LiDAR’s value for resolving sharp ecological thresholds, identifying elevation-driven simplification in forest structure, and bridging observation gaps in remote, rugged mountain ecosystems.

Background: Hypertension is a leading modifiable risk factor for cardiovascular morbidity and mortality worldwide. In Nepal, prevalence is rising, yet determinants of blood pressure (BP) control remain insufficiently understood. This study examined socio-demographic, lifestyle, and clinical factors associated with BP control among hypertensive patients attending a tertiary hospital. Methods: A descriptive cross-sectional study was conducted at the cardiology outpatient department of Bir Hospital, Kathmandu, between July and August 2018. A total of 360 hypertensive patients, aged ≥18 years with at least one year since diagnosis, were recruited using convenience sampling. Data on socio-demographics, hypertension knowledge, and lifestyle practices were collected using a validated bilingual questionnaire. BP was measured twice, and control was defined as <140/90 mmHg. Logistic regression was applied to identify independent predictors of BP control. Results: The mean age of participants was 50.8 ± 15.3 years; 59.4% were female, 52.5% resided in rural areas, and 48.9% lived in joint families. Overall, 21.9% (79/360) of participants achieved BP control, while 78.1% (281/360) were uncontrolled. Logistic regression showed that rural residence (OR 0.47, 95% CI 0.27–0.84, p = 0.012), alcohol use (OR 0.28, 95% CI 0.13–0.58, p = 0.001), and family history of hypertension (OR 0.50, 95% CI 0.28–0.89, p = 0.021) were associated with poorer control. Conversely, joint family structure (OR 1.51, 95% CI 1.10–2.08, p = 0.011) and reported normal salt intake (~5 g/day) (OR 7.69, 95% CI 2.68–22.0, p < 0.001) were positively associated with BP control. Conclusion: Socio-demographic and lifestyle factors strongly influence BP control in Nepal. Strengthening rural outreach, promoting family-based interventions, and delivering culturally appropriate counseling on alcohol reduction and dietary salt are essential. Future community-based longitudinal studies are recommended to validate these findings and inform national strategies.

Australia's nursing workforce is under intensifying strain, yet an increasing subset of registered nurses (RNs) are not seeking permanence-they are choosing to work exclusively through agencies. This trend is commonly framed as a matter of flexibility or pay. However, such explanations understate what exclusive agency nursing does to professional identity, how it operates as a response to organizational dysfunction, and how policy-practice arrangements enable transient careers within a regulated high-income system. To generate an interpretive, policy-relevant account of how exclusive casual agency employment shapes nurses' professional identities, motivations, career trajectories, and engagement with collective professional advocacy. An interpretivist, constructionist qualitative design was employed. Semistructured interviews were conducted with 16 Melbourne-based RNs who worked exclusively through nursing agencies. Data were analyzed using reflexive thematic analysis (RTA), and the manuscript was reported in line with the Reflexive Thematic Analysis Reporting Guidelines (RTARG). Five themes were constructed. Exclusive agency nursing involved the crafting of a professional self "beyond the ward," marked by transactional workplace relationships, strategic emotional boundary-setting, and a shift toward adaptability as a core competence. Agency work was frequently narrated as strategic withdrawal and resistance to permanent-role conditions-bureaucratic overload, inflexible rostering, and unsupportive leadership cultures associated with burnout. Participants situated their careers within a "casualization ecosystem" in which organizational reliance on contingent labor, agency intermediation, and policy/funding dynamics collectively sustain demand for agency nurses. Yet, this work model generated persistent ambivalence about long-term sustainability and was perceived to fragment professional belonging and weaken collective voice in advocacy and industrial representation. Exclusive agency nursing is not simply an individual preference for flexibility; it is an identity project and a system-level signal of deteriorating employment conditions in permanent roles. Workforce responses that focus only on recruitment incentives or short-term staffing solutions risk entrenching casualization and its downstream effects. Nurse leaders should treat agency reliance as both a staffing strategy and an organizational diagnostic. Reforming permanent roles requires actionable changes-credible roster flexibility, visible supportive leadership, and working conditions that reduce burnout-alongside structured integration practices for agency nurses to protect team cohesion, care continuity, and professional sustainability.

Mushrooms are recognized for their therapeutic qualities in addition to their nutritional value. Numerous substances with therapeutic properties are present even in inedible mushrooms. These substances can be used to make potent medications once they have been refined and examined. The present study aims to explore the biological activities of the extracts of Microporous xanthopus and Phylloporia pectinata , collected from Gulmi District, Nepal. The methanolic and ethyl acetate extracts of both species were subjected to phytochemical screening, total phenolic content (TPC), total flavonoid content (TFC), and antioxidant and antibacterial activity. The LC–MS analysis was performed to identify the compounds present in the extract by detecting and analyzing their molecular ion peaks. The TPC (611.89 and 319.16 mg GAE/g) and TFC (57.18 and 142.37 mg QE/g) were found highest in the ethyl acetate extract of P. pectinata and M. xanthopus, respectively. The antioxidant activity (DPPH radical scavenging %) of the methanolic extract and the ethyl acetate extract of M. xanthopus was found to be 41.7% and 21.6%, whereas that for P. pectinata was found to be 78.6% and 55.4%, respectively. Those extracts were found to inhibit the growth of S. aureus, E. coli , and S. typhi . The LC–MS analysis of the extract of P. pectinata showed eight important secondary metabolites present in the extract. These mushrooms, with their rich content of bioactive compounds, demonstrate significant antioxidant and antibacterial properties, indicating their potential for medicinal applications.

The study was conducted with the main purpose of assessing the existing situation of Wild Water Buffalo (Bubalus arnee) in Koshi Tappu Wildlife Reserve (KTWR). The Wild Water Buffalo, categorized as Endangered on the IUCN Red List, is restricted to South and Southeast Asia. It is considered one of the most threatened large herbivores in the region due to habitat loss, hybridization with domestic buffaloes, and increasing human disturbances. Nepal’s only population survives in KTWR, which is located in the floodplain of the Koshi River, a dynamic wetland ecosystem providing critical habitat for this species and supporting rich biodiversity. Distribution of Wild Water Buffalo was studied using a random sampling method. To scientifically record their occurrence and habitat use, the reserve was divided into blocks using ArcGIS 10.4, and in each block, two transect lines were recognized. Direct findings, as well as indirect evidence such as footprints, wallows, and dung, were noted to assess distribution and activity patterns. The present study showed that Wild Water Buffaloes were distributed across all designed blocks, with the highest concentrations in the northern site (Block B and Block C) and along the eastern part of the Koshi River. These areas were characterized by open grasslands and wetland mosaics that provide abundant forage, water, and wallowing sites. Seasonal flooding and human activities, including livestock grazing, influenced their distribution. Although the population appears stable within the reserve, its restricted range and dependency on specific habitats make it vulnerable to anthropogenic pressures, highlighting the need for targeted habitat management, monitoring, and conservation interventions to ensure long-term survival.

Road traffic crashes are the 12th leading cause of death, and is the leading cause of death among the age group of 5-29 globally. Worldwide, nearly 500 children die daily, and many children suffer serious injuries. Nationally, 200 children lost their lives and 805 suffered from serious injuries as a result of road crashes in fiscal year 2024/25 (Nepal Police, 2025) in Nepal. To contribute towards improving child road safety, iRAP introduced a tool for assessing road conditions around school zones to ensure better facilities for road safety furniture, called the Star Rating for Schools (SR4S). The study is based on a school along an urban arterial road in Lalitpur district. All parameters, as outlined in the SR4S coding guide and checklist, including road environment, road features, road type, intersection, flow, speed, curve, sidewalks, and crossings, were collected based on field observations. The initial rating was obtained after coding the data into the SR4S web application. Various interventions were simulated using the SR4S System Demonstrator to analyze improvements to the existing road infrastructure and enhance safety for students. One of the major improvements was observed when the operating speed was reduced to 30 km/h, which improved the star rating to 4.3. The findings offer valuable insights for implementing targeted safety measures in the Nepalese school environment.

Background: The rural people from different ethnic groups in Nepal possess vast knowledge regarding medicinal plants and their use in the treatment of human ailment. The aim of this study is to record the local’s knowledge about traditional medicine in Bethanchowk Rural Municipality, Central Nepal. Methods: The ethnomedicinal information was collected with the help of door-to-door interviews and focus group discussions using open ended questionnaire with local people and key informants. A linear regression and Spearman correlation were performed to observe the relationship between the age of respondents and the number of plants described by them. The quantitative data were analyzed by informant consensus factor (ICF) and fidelity level (FL). Results: The present study has recorded 227 medicinal plant species under 94 families and 200 genera. The most frequently occurring plants were herbs (n = 103) and leaves (n = 54) as plant parts. There was no significant difference (p = 0.401) in the knowledge of medicinal plants possessed and the number of plants described by the genders. The Spearman correlation (ρ = 0.225) and linear regression justified the weak relationship between the age of the respondents and the number of plants described by them. The ICF value ranged from 0.5 to 0.93, and the highest was observed for gynecological disorder. The FL value ranged from 6.94 to 98.20, with the highest for Ageratina adenophora for bleeding, cuts, and wounds. Conclusion: The traditional medicinal knowledge of local people of Bethanchowk Rural Municipality has been documented in the study. The necessity for such additional documentation and scientific validation of recorded species has been determined by the current investigation. Keywords: Traditional knowledge, ICF, FL, ailments, knowledge transfer