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This paper describes the dataset associated with the paper "Product-Specific Human Appropriation of Net Primary Production (HANPP) in US Counties" (Paudel et al., 2023). This dataset comprises human appropriation of net primary production (HANPP) values for 3101 counties in the conterminous US for the years 1997, 2002, 2007, and 2012. For this dataset, HANPP is the carbon content of specific crop, timber, and livestock grazing products appropriated by humans in a county in a year. To calculate HANPP, raw agricultural data were downloaded from public databases such as USDA-National Agricultural Statistics Service Quick Stats and Cropland Data Layer, US Forest Service Timber Product Output, and NPP data from MODIS. These data were processed in Microsoft Excel using stoichiometry derived from established scientific literature. HANPP was partitioned by year, county, product, used and unused and above- and below-ground. This complete dataset is published in Mendeley Data and the methods used to compile them are included to make our research well documented, reproducible, and useful for future studies.
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Presence of Nepal in global clinical trials has been visibly negligible despite the history of conducting large scaled randomized controlled trial on Hepatitis E vaccine decades ago. Majority of the problem is attributed to the lack of collaborative work, financial and human resource constrains. COVID-19 pandemics seems to have triggered urgency among the authorities of Nepal leading to a substantial increase in the number of clinical trials in collaboration with national and international organizations/institutions. Immediately after detection of the first COVID-19 case on 13 January 2020, the Ethical Review Board (ERB) of NHRC received several research proposals, subsequently leading to the approval of the first clinical trial for COVID-19 on 01 July 2020 to investigate potential of traditional Ayurveda based medicine for COVID treatment. Soon, number of other clinical trial proposals received approval and implemented in the country, however budgetary allocation from the Government of Nepal (GON) was prioritized for COVID-19 outrage management and vaccination coverage only. Collaborations with various international institutions played a significant role in the successful implementation of large-scale clinical trials in the country and further laid the path for future. In this review paper we present the recent developments in clinical trials in Nepal, budgetary allocation from the government and the mechanisms in place for regulation of clinical research in the country along with challenges and way forward.
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Introduction and importance: Left-sided gall bladder, a rare biliary abnormality with an incidence of 0.04-0.3%, is characterized by the presence of the gall bladder to the left of the ligamentum teres. However, they are often missed during pre-operative imaging and often encountered intraoperatively, thus challenging the surgical intervention for the surgeons. Case presentation: We herein present a 40-year-old male presented with colicky right hypochondriac pain and epigastric discomfort, diagnosed incidentally during laparoscopic cholecystectomy as a left-sided sided gall bladder without situs inversus, which was missed during pre-operative ultrasonography and was treated without any complications with conventional four-port technique without changes in the trocar placement. Clinical discussion: Gall bladder is normally found in the gall bladder fossa to the right of the ligamentum teres in the plane of the von Rex-Cantlie line; however, left-sided gall bladder is found to the left of the ligamentum teres and is frequently associated with inversus of the abdominal structures and associated vessels. They are frequently overlooked during preoperative diagnostic imaging, ultrasound for colicky discomfort, and encountered during intraoperative operations, confounding the treating surgeon's anatomic expertise. Intra-operative cholangiography is sometimes used as an adjunct, and operations can be accomplished with or without modifications in trocar position. Conclusion: Despite preoperative imaging, biliary abnormalities can be discovered accidently during laparoscopic cholecystectomy. Thus, diligent recognition of structures and related anomalies by the treating surgeon has a high value in the best possible outcome for the patient, and left-sided gall bladder can be done with minimum difficulty even without interposition of trocar placement.
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Wild honey has been used for several purposes in South-Asia and Eastern Europe since long ago. One of the commonest is medicinal purposes, especially for gastrointestinal disorders (peptic ulcer disease, dyspepsia, and gastritis), hypertension, and an aphrodisiac (sexual stimulant). However, honey produced from the nectar of few rhododendron species contains a toxin known as grayanotoxin, which acts on the sodium channel and prevents its inactivation leading to vagal activation, causing hypotension and bradycardia. Here, we report a case of 55 years woman who reported to our Emergency Department with complaints of dizziness and vomiting as well as bradycardia and hypotension. Most of the cases of wild honey poisoning resolve within the first 24 h, but in our case, the symptoms persisted for 72 h. So, we must observe patients for 72 h as some cases may last longer. Timely management of the patient can prevent fatal complications.