COVID-19 impacts on agriculture and food systems in Nepal: Implications for SDGs.

The objective of this study was to understand the impacts of COVID-19 crisis in agriculture and food systems in Nepal and assess the effectiveness of measures to deal with this crisis. The study draws policy implications, especially for farming systems resilience and the achievement of SDGs 1 and 2. The findings are based on (i) three panel discussions over six months with policy makers and experts working at grassroots to understand and manage the crisis, (ii) key informants' interviews, and (iii) an extensive literature review. Results revealed that the lockdown and transport restrictions have had severe consequences, raising questions on the achievement of SDGs 1 and 2, especially in the already vulnerable regions dependent on food-aid. This crisis has also exposed the strengths and limitations of both subsistence and commercial farming systems in terms of resiliency, offering important lessons for policy makers. Traditional subsistence farming appears to be somewhat resilient, with a potential to contribute to key pillars of food security, especially access and stability, though with limited contributions to food availability because of low productivity. On the other hand, commercial farming - limited to the periphery of market centres, cities, and emerging towns and in the accessible areas - was more impacted due to the lack of resilient supply networks to reach even the local market. Lower resiliency of commercial farming was also evident because of its growing dependence on inputs (mainly seeds and fertilizer) on distant markets located in foreign countries. The observation of crisis over eight months unleashed by the pandemic clearly revealed that wage labourers, indigenous people, and women from marginalized groups and regions already vulnerable in food security and malnutrition suffered more due to COVID-19 as they lost both external support and the coping mechanisms. The findings have implications for policies to improve both subsistence and commercial farming systems - in particular the former by improving the productivity through quality inputs and by diversifying, promoting and protecting the indigenous food system, while the latter through sustainable intensification by building reliant supply network linking farming with markets and guarantying the supply of inputs.

Bilateral indirect ovarian inguinal hernia in a young female with type 1 Mayer-Rokitansky-Küster-Hauser syndrome: An extremely rare clinical context.

Key Clinical Message: Incidence of bilateral inguinal hernia encompassing bilateral ovaries in adult female is very thin and concomitant association with Mayer-Rokitansky-Küster-Hauser syndrome is out of ordinary. Along with surgical management of hernia, these females need multidisciplinary slant to manage gynecological, social, and emotional issues. Abstract: In mature females, bilateral ovarian inguinal hernias are a rarity. In this situation, ultrasonography is the basic adjunct to confirm the diagnosis. Mayer-Rokitansky-Küster-Hauser syndrome is typically linked to ovarian hernias in grown-up females. The most important ways to avoid problems are early diagnosis and surgical repair. A 25-year-old lady presented to our outpatient clinic with a history of swelling in bilateral inguinal region for 1 month. On the ultrasound examination, the right ovary was visualized in the right high inguinal canal, and the left ovary was seen at the level of deep inguinal ring with no visualization of the uterus in its normal anatomical position. The patient underwent bilateral inguinal exploration under spinal anesthesia, and herniated contents were successfully reduced back to anatomical locations. Clinical care for such a clinical condition must be multifaceted, involving intensive counseling, relocating the uterus, fallopian tube, and ovary to preserve fertility, and preventing consequences like incarceration and strangulation.

Seroprevalence of SARS-CoV-2 infection in the general population of Nepal during the first and second generalized waves of the COVID-19 pandemic-2020-2021.

Few seroprevalence studies have been conducted on coronavirus disease (COVID-19) in Nepal. Here, we aimed to estimate seroprevalence and assess risk factors for infection in the general population of Nepal by conducting two rounds of sampling. The first round was in October 2020, at the peak of the first generalized wave of COVID-19, and the second round in July-August 2021, following the peak of the wave caused by the delta variant of SARS-CoV-2. We used cross-sectional probability-to-size (PPS)-based multistage cluster sampling to estimate the seroprevalence in the general population of Nepal at the national and provincial levels. We tested for anti-SARS-CoV-2 total antibody using the WANTAI SARS-CoV-2 Ab ELISA kit. In Round 1, the overall national seroprevalence was 14.4%, with provincial estimates ranging from 5.3% in Sudurpaschim to 27.3% in Madhesh Province. In Round 2, the estimated national seroprevalence was 70.7%, with the highest in the Madhesh Province (84.8%) and the lowest in the Gandaki Province (62.9%). Seroprevalence was comparable between males and females (Round 1, 15.8% vs. 12.2% and Round 2, 72.3% vs. 68.7%). The seroprevalence in the ecozones-Terai, hills, and mountains-was 76.3%, 65.3%, and 60.5% in Round 2 and 17.7%, 11.7%, and 4.6% in Round 1, respectively. In Nepal, COVID-19 vaccination was introduced in January 2021. At the peak of the first generalized wave of COVID-19, most of the population of Nepal remained unexposed to SARS-CoV-2. Towards the end of the second generalized wave in April 2021, two thirds of the population was exposed.

Transforming environmental governance: critical action intellectuals and their praxis in the field.

Over the past decade, widespread concern has emerged over how environmental governance can be transformed to avoid impending catastrophes such as climate change, biodiversity loss, and livelihood insecurity. A variety of approaches have emerged, focusing on either politics, technological breakthrough, social movements, or macro-economic processes as the main drivers of change. In contrast, this paper presents theoretical insights about how systemic change in environmental governance can be triggered by critical and intellectually grounded social actors in specific contexts of environment and development. Conceptualising such actors as critical action intellectuals (CAI), we analyze how CAI emerge in specific socio-environmental contexts and contribute to systemic change in governance. CAI trigger transformative change by shifting policy discourse, generating alternative evidence, and challenging dominant policy assumptions, whilst aiming to empower marginalized groups. While CAI do not work in a vacuum, nor are the sole force in transformation, we nevertheless show that the praxis of CAI within fields of environmental governance has the potential to trigger transformation. We illustrate this through three cases of natural resource governance in Nepal, Nicaragua and Guatemala, and Kenya, where the authors themselves have engaged as CAI. We contribute to theorising the 'how' of transformation by showing the ways CAI praxis reshape fields of governance and catalyze transformation, distinct from, and at times complementary to, other dominant drivers such as social movements, macroeconomic processes or technological breakthroughs.

Complete Genome Sequence of a 2019 Novel Coronavirus (SARS-CoV-2) Strain Isolated in Nepal.

A complete genome sequence was obtained for a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) strain isolated from an oropharyngeal swab specimen of a Nepalese patient with coronavirus disease 2019 (COVID-19), who had returned to Nepal after traveling to Wuhan, China.

The use of pedicled appendix graft for substitution of urethra in recurrent urethral stricture.

BACKGROUND: Recurrent posterior urethral strictures after failed urethroplasty may need urethral substitution. Skin or mucosal grafts, currently used for this purpose, have a high complication rate. The authors describe the use of pedicled appendix for posterior urethral substitution. METHODS: Two boys with pelvic fracture urethral distraction injuries were treated for recurrent posterior urethral strictures after a failed perineal anastomotic urethroplasty. Through a perineal-transpubic approach the stricture tissue was excised, which resulted in a gap of 5 to 7 cm between the healthy ends. The vermiform appendix was mobilised on its own pedicle and transposed to the perineum; the proximal end of appendix was anastomosed to the prostatic urethra and the distal end (tip discarded) to the bulbar/penile urethra. Omentum was transposed to wrap the anastomosis and fill the dead space. RESULTS: Normal micturition was restored in both patients. No further treatment was required after 1 dilatation in the first case. Both patients are continent. Potency status remains unchanged from the preoperative period with normal erections in 1 case. Follow-up (1 to 3 years) has been satisfactory with no complications. CONCLUSIONS: The appendix is a promising organ for posterior urethral replacement. It can be brought to the perineum on its own vascular pedicle.