Pokhara University

To identify potential infectious agents in cases of seasonal hyperacute panuveitis syndrome (SHAPU) from vitreous biopsies of patients with this disorder. A retrospective cohort analysis. Vitreous biopsies were obtained during the course of care from 53 subjects with SHAPU. DNA extraction and whole genome shotgun sequencing was performed using Oxford Nanopore long read sequencing. Sequences were matched against microbial and human databases. Visual outcomes at presentation and at 6 months were recorded. Identification and characterization of metagenomic sequences in vitreous isolates from subjects with SHAPU. Adequate DNA for sequencing was obtained from 32 SHAPU subjects. Fifteen samples yielded bacteria on culture, with 14 S. pneumoniae and 1 S. aureus isolate recovered. Bacterial DNA was detected by whole genome sequencing in 29 of 32 cases. S. pneumoniae was the predominant organism recovered. Bacterial genomic loads ranged up to 10 000 bacteria/human cell, indicating active infection. No pathogens were detected in control samples. Reconstruction of bacterial genome was possible in 7 SHAPU cases and indicated diverse S. pneumoniae subtypes associated with individual cases. Sufficient DNA remained for analysis of torque teno virus by qualitative polymerase chain reaction in 17 cases, of which 13 were positive. Visual outcomes were mixed, with 7 patients having hypotonous eyes at 6 months, but 8 patients having better than 20/200 vision. No relationship could be discerned between presenting bacterial load and visual outcome. The majority of SHAPU cases show molecular evidence for concurrent S. pneumoniae infection. Good visual results are possible in treating SHAPU as endophthalmitis. The authors have no proprietary or commercial interest in any materials discussed in this article.

Hypertension is one of the most common leading causes of global public health emergencies and a major contributor to cardiovascular complications such as stroke and myocardial infarction, all of which adversely affect the quality of life (QOL) of people living with hypertension. Despite this burden, there remains a limited understanding of the various factors affecting the quality of life of people living with hypertension, particularly in low-and-middle income settings. This study aims to assess the quality of life among people living with hypertension along with the various factors associated with it, in the Kathmandu District, Nepal. A cross-sectional study was carried out in a selected hospital of Kathmandu District from February to March 2023, with a total sample size of 200 people living with hypertension. Data were collected using a semi-structured interview, and WHOQOL-BREF was used to measure the outcome variable. Descriptive statistics were used to summarize the socio-demographic, social, psychological, and behavioral factors. Bivariate analysis was performed using the chi-square test, and variables with a p-value < 0.2 were entered into the multivariable logistic regression model. In the final model, variables with p-values < 0.05 were considered statistically significant. All statistical analyses were conducted using Statistical Package for Social Sciences version 20. A total of 200 people living with hypertension participated, aged 30–80 years (mean ± SD: 51.4 ± 13.1), with slightly more males (53.5%). Most of the people were Hindu (74.0%) and from upper caste groups (46.5%), and 37% had a monthly income of < NPR 25,000, and 88% had a good quality of life. Lower income (p = 0.027) and illiteracy (p = 0.049), lack of family support (p = 0.001), non-consumption of meat and fish (p = 0.005), higher salt intake (p = 0.045), physical inactivity (p < 0.001), and irregular medication use (p = 0.001) were associated with poor QOL. In multivariable analysis, family support (aOR = 0.30, 95% CI: 0.10–0.87), meat and fish consumption (aOR = 0.22, 95% CI: 0.07–0.75), and physical activity (aOR = 0.08, 95% CI: 0.01–0.70) were significantly protective against poor QOL. Poor quality of life among people living with hypertension was primarily associated with both modifiable behavioral and social factors, and socio-demographic characteristics. Interventions that strengthen social support, promote healthy dietary practices, and encourage regular physical activity may substantially improve the quality of life among individuals living with hypertension.

This study presents flood hazard mapping and risk assessment using a hydrodynamic simulation in HEC-RAS tool, focusing on a 38 km stretch of the river from Chisapani to the Nepal-India border in the Lower Karnali River Basin (KRB). A time series of daily mean discharge records from the Chisapani gauging station was used for model simulations. Flood magnitudes of 10-, 20-, 50-, and 100- year return periods (YRPs) were estimated using Gumbel’s distribution, with the 100-YRP daily discharge of 20,343 m3/s. Field surveys were conducted in flood-prone areas of Rajapur Municipality using the Vulnerability and Risk Assessment (VRA) framework. Results show that parts of Rajapur Municipality, Wards #1, #3, #4, and #7 are susceptible to inundation, even during normal flood events, with water depths reaching upto 10 m posing significant risk to the communities inhabiting in these areas. Agricultural land is particularly exposed, posing serious risks to food security and livelihoods. Moreover, even after a five-year return period, the 2014 flood simulations (equal to a 100-YRP) indicate that these wards remains highly vulnerable. This findings emphasizes the urgent need for improved settlement planning and the development of effective flood control measures in Rajpur Municipality.

This Kathmandu Valley by integrating borehole data, microtremor survey results, and numerical evaluation techniques to assess soil liquefaction potential. Microtremor measurements were collected from 75 stations throughout the valley, and the vulnerability index (Kg) was calculated using Nakamura’s method, which factors in fundamental frequency and amplification characteristics. The resulting Kg values ranged from 0.091 to 13.463, highlighting the varying liquefaction risk across the valley. Borehole data from 29 excavation sites were used to validate the liquefaction potential, and a threshold Kg value was established in alignment with prior research benchmarks. Numerical evaluation through finite element modeling (FEM) using PLAXIS-2D was performed to further assess liquefaction susceptibility. The FEM analysis confirmed areas with a Kg value greater than 5 as highly vulnerable to liquefaction, while other regions exhibited low susceptibility. Liquefaction susceptibility maps identified critical high-risk zones, particularly in Kathmandu, including areas near Kantipath, Maitighar, and Teku, as well as in Lalitpur and Bhaktapur, such as near Chakupat, Patan Durbar Square, and Bhaktapur Durbar Square. This study demonstrates that integrating microtremor survey data, borehole information, and numerical analysis offers a comprehensive, reliable approach for seismic microzonation and liquefaction risk assessment in earthquake-prone regions like Kathmandu Valley.

Nepal lies within the Himalayan seismic belt, making it one of the most earthquake-prone regions globally. Non-engineered masonry structures, though widely used, are highly vulnerable to seismic disasters. Replacing these structures is impractical and culturally insensitive due to their deep traditional and cultural significance. Retrofitting is a practical and culturally appropriate approach to enhance a building’s strength and safety against earthquakes. This study evaluates retrofitting and reinforcement techniques for unreinforced masonry (URM) structures in Nepal's mid-Himalayan region through numerical modelling, non-linear static analysis, and fragility assessment. Pushover analysis revealed that reconstruction models significantly improve base shear capacity compared to the URM model. Although gabion wire retrofitting has a limited effect at the initial stage, it significantly improves strength at larger displacements. Vertical reinforcements and horizontal bands in the reconstruction model consistently enhance performance. The URM model exhibits concentrated cracking near openings and corners, while the retrofitted model improves stress distribution and reduces crack widths. Additionally, the reconstruction model confines cracks within bands, preventing vertical propagation and ensuring superior structural integrity. Fragility curves reveal that reinforcement significantly enhances seismic performance, as the retrofitted model improves resistance across damage states, with exceptional collapse resistance due to its ductility, allowing energy absorption and delayed failure. The reconstruction model offers consistent protection with lower probabilities of damage across all states, underscoring its reliability during seismic events. Although the reconstruction model incurs higher costs than the retrofitted model due to its extensive reinforcement features, both models provide substantial seismic benefits compared to the base URM model.

Democracy is a constitutional form of government. It consists of popular sovereignty, rights and freedom, democratic values, and fairness in socio-economic opportunities. The elected ruling elites govern the nation in accordance with the constitution, the rule of law, inclusion, and equality. But democracy cannot function efficiently unless it is supported by these factors and a compatible political culture with democracy. Democracy in a changing society faces numerous problems, as seen in Nepal, in developing and sustaining democratic governance. This article aims to critically analyze Nepal’s political trajectory, focusing on the structural factors responsible for continued political instability. The paper is based on a desk study, using an ontological, epistemological, and axiological philosophy approach. The paper argues Nepal’s political trajectory arises from the interaction of internal and external variables. Internally, an unstable government, polarization and fragmentation in parties and society, poor governance, weak institutional capacity, absence of accountability, constitutional ambiguity, and malpractices contributed to degrading citizens’ trust in institutions, making democracy dysfunctional and creating a space for the rise of populist leaders in various forms. Emerging democracies are inherently fragile states, creating an opportunity for external and regional powers' involvement in the internal matters. Externally, Nepal’s geo-political location, donor- based policy, global power shift, rivalry of regional and global powers, and the influence of international financial institutions promoted the accountability of the ruling elites toward external powers rather than internal accountability. Taking advantage of a weak state and intergenerational gaps, the youth-led protests forced the resignation of the ruling elites. It concludes that the Gen Z protest has an opportunity for new youth leaders to govern the nation in a democratic way, promoting accountability and transparency, constitutionalism and rule of law, and building trust in democratic institutions. On the other hand, it can carry political instability, social and political polarization, and economic disruption.

Plastic waste, largely composed of non-biodegradable petroleum-based polymers, has become a growing environmental and public health challenge in Pokhara Metropolitan City (PMC), Nepal. This study assesses plastic waste generation and recycling practices using four estimation approaches: household waste sampling, landfill volume density assessment, data from private waste contractors, and population based per-capita calculations. Findings from a survey of 400 households indicate that PMC generates nearly 11227.847 metric tons of plastic waste annually, with plastic comprising 16.86% of total municipal solid waste and Low-Density Polyethylene (LDPE) contributing the highest share due to its widespread use in packaging. At present, only 10.86% of this waste is recycled by existing private facilities. Economic and technical analysis shows that a well-equipped recycling center operated by at least three workers with one machine could recycle about 218.4 metric tons of plastic per year, reduce 582.4 metric tons of Greenhouse Gas (GHG) emissions, save 1,517 m³ of landfill space, and create meaningful revenue opportunities. Overall, the results emphasize the need for integrated waste management, improved source-level segregation, and increased investment in recycling infrastructure. Strengthening these systems can enhance environmental protection, reduce landfill pressure, support local employment, and contribute to long-term sustainability in PMC.

Road construction projects in decentralized local governments are commonly implemented through Users’ Committees and contractor-based procurement approaches; however, empirical evidence comparing their performance at the municipal level in Nepal remains limited. This study aims to compare the performance of road construction projects executed through Users’ Committees and contractors in Shuklagandaki Municipality, Tanahu. Primary data were collected through questionnaire surveys, field observations, and stakeholder consultations covering 42 road construction projects (21 Users’ Committee–executed and 21 contractor-executed), each with a project budget of NPR 2.4 million or above from fiscal year 2078/79 to 2080/81. A comparative quantitative research design was adopted, with respondents selected from Users’ Committee members, contractors, municipal officials, and project beneficiaries using purposive sampling. Data were analysed using descriptive statistics, reliability testing (Cronbach’s alpha), Relative Importance Index (RII), normality testing, and non-parametric analysis employing Kendall’s coefficient of concordance. The results indicate no statistically significant overall performance difference between Users’ Committee–executed and contractor-executed projects (Kendall’s W = 0.171, p = 0.886), leading to acceptance of the null hypothesis. Reliability analysis confirmed acceptable internal consistency across all performance dimensions (Cronbach’s alpha &gt; 0.60). While Users’ Committees perform better in stakeholder engagement, communication, and timely completion, contractor-executed projects demonstrate stronger performance in technical quality, safety measures, and compliance with specifications. The findings suggest that procurement effectiveness is context-dependent rather than universally superior for either approach, supporting the adoption of a context-sensitive procurement strategy by local governments.