Karnali Region Research Articles

Ectoparasitic infestations among patients attending the dermatology OPD: A hospital-based study

Background: Ectoparasites are organisms that live in the skin for varying lengths of time and can cause disease. These infestations are highly prevalent in poor and underdeveloped areas. There is a paucity of studies regarding their prevalence in rural areas like the upper Karnali region of Nepal. We conducted a hospital-based study to know the burden of these infestations in the area. Methods: A hospital-based descriptive study was done from March 2023 to February 2024. Data were collected from medical records of the dermatology outpatient department (OPD) and all the clinically diagnosed cases of ectoparasitic infestation were studied. Data were presented as frequency and percentage; seasonal pattern of the diseases was also reported. Results: A total of 6,698 patients attended dermatology OPD during the study period, among whom 1340 had ectoparasitic infestations, resulting in a proportion of 20.01% in this group. Two infestations were found, namely, scabies and pediculosis capitis, with a proportion of 18.36% and 1.65%, respectively. Females represented almost half of the patients with ectoparasitic infestations (49.63%), but about 98% with pediculosis. Ectoparasitic infestation was most common in children aged 0–9 years, i.e., 31.31% and pediculosis was most common in children of 10–19 years (31.81%). Ectoparasitic infestations (41.94%), both scabies (41.7%) and pediculosis (44.55%) were most common during the monsoon season. Conclusion: The ectoparasitic infestations were common the patients presenting to the hospital. Scabies was the most common ectoparasitic infestation and a major public health problem.

The Legacy of the Khasa Chhetris: Unraveling Ancient Roots, and Cultural Traditions

The Khasa Chhetris are an integral group of the Nepali society. The Nepali language (Khaskura) is believed to have sprung from the tongues of the Khasas such as Mugali, Achhami, and mainly Sinjali or Jumli spoken in the Karnali region. This paper seeks to make the representation of the Chhetris as the direct descendants of the ancient Khasas, and to highlight their distinct traditions and customs from the historical perspective. It argues that the Khasas are the ancient settlers of western Nepal having the amalgamation of shamanic and Vedic traditions. Their matrilineal society transformed into patrilineal framework owing to the accumulation of wealth in the hands of males and the consequent idea of private property. This study would encourage the scholars to look at this issue from the perspectives or the oral narratives of the Khasa Chhetris.

Local Government’s Effort for the Conservation of Rara Lake, Karnali, Nepal

Rara, the largest Lake in Nepal, has enormous potential for the total development of the region. It is located in the Mugu district of Karnali region at an elevation of 2990 m. However, the federal and provincial governments’ current plans and strategies are ineffective in protecting and promoting the Lake from both present and future viewpoints. Participation theory was the most commonly used idea in this study. In order to provide baseline data for the formulation of efficient strategies and policies for the sustainable development of the Lake and its environs, this study intends to investigate the role of Rara Lake in the socioeconomic development of the Province. The study uses a questionnaire survey with a variety of stakeholders, including local people, business owners, and members of local political parties. The outcome shows that, in the current situation, the Lake’s promotion and conservation are solely dependent upon national park policies, as neither the provincial nor municipal governments have taken any direct action to further these goals. The results show that for the long-term conservation and promotion of the Lake, local inhabitants, and local government must adopt an integrated approach. The Lake would have a significant impact on the Province’s and the nation’s overall development if this strategy had been successfully applied.

Ethics of Memory in Manjushree Thapa’s Forget Kathmandu: An Elegy for Democracy

This paper is an attempt to explore the ethical use of memory in Manjushree Thapa’s Forget Kathmandu: An Elegy for Democracy (2005). In her book, Thapa critically observes the history of Modern Nepal and recounts the experiences of her visits to the war-ravaged regions of the Mid-Western hills during the Maoist insurgency. The study analyzes the narrative data from the text to see how the narrator remembers the impact of “bad politics” and the Maoist insurgency on the common people of the hinterlands of Karnali region. For this purpose, the study applies the memory theory of Avishai Margalit from The Ethics of Memory (2004). Margalit claims that too much memory is detrimental to the health of an individual as well as a society; so such excessive memory of traumatic experiences should be narrated and ventilated to bring about forgiveness and reconciliation. The paper contends that Manjushree Thapa in the selected text ‘condemns’ historical foul plays, attempts to reveal the anxieties of excessive thoughts induced by ‘bad politics’ and the civil war, at individual and collective levels, and contributes to healing and recovery. It recommends bringing the suppressed communal feelings from the ‘social unconscious’ into public discussion leading it to ‘social catharsis’ and reparation. Literature can play this role as a medium that will help society come out of ‘poisonous feelings’ like anger, hatred, and revenge, which ultimately contributes to the prevention of the repetition of violence.

Evaluation of Garlic Genotypes under Farmer’s Field Condition of Jumla, Nepal

On-farm trial on different garlic genotypes selected from Advance Yield Trial was carried out at Patrashi Rural Municipality of Jumla (2430 masl) for two consecutive years 2017/18 and 2018/19 to evaluate garlic genotypes suitable for the high hills of Karnali region of Nepal. Twelve different garlic genotypes: ARM 01, ARM 02, ARM 03, ARM 04, ARM 05, ARM 07, ARM 09, Mugu Local, Kathmandu Local, Chinese, Holeri and Malikabota were tested on Randomized Complete Block Design (RCBD). Each treatment was replicated three times. Compost was used at 20t/ha at the time of land preparation. There was no use of chemical fertilizer. Selected cloves of garlic were planted with 15 cm x 10 cm spacing of row to row and clove to clove respectively. Planting and harvesting were done on the third week of September and first week of July respectively. Tested genotypes differed significantly for vegetative as well as yield parameters. The genotype ARM01 produced the bulbs with the highest (50.49 mm) diameter followed by ARM 04 (45.14 mm), Kathmandu Local (34.52 mm) and Chinese (33.44 mm) respectively. The highest bulb yield (29.73 t/ha) was recorded from genotype ARM 01 followed by Kathmandu Local (19.4 t/ha), ARM 04 (18.51 t/ha) and Chinese (17.59 t/ha). Based on the average result of both years, genotypes ARM 01, Kathmandu Local, ARM 04, and Chinese showing above mentioned average productivity ranging from 17.59 t/ha to 29.73 t/ha, were identified as the promising genotypes for commercial cultivation in the high hills of Karnali region of Nepal.

Assessment of Proso millet Genotypes against Blast Caused by Pyricularia grisea (Cooke) Sacc. under Field Condition at Mid Hill Region of Nepal

A total of 14 proso millet genotypes, including the farmers' variety, which was the most commonly cultivated landrace in the Karnali region and most susceptible to blast disease as a susceptible check, were evaluated for resistance to leaf blast at the Hill Crops Research Program, Kabre, Dolakha, Nepal during the summer seasons of 2020 and 2021. The experiment was conducted under natural epiphytotic conditions. The experiment revealed that none of the tested genotypes were found immune or highly resistant. Most of the genotypes showed moderately susceptible and susceptible reactions to the leaf blast disease for both experimental years. However, genotypes C04654, Humla-239, and C04651 were found to have lower blast severity and produce higher grain yields. Genotype C04654 was found as resistant with 34.6% disease severity and high yielding (2.6 t/ha), followed by Humla-239 and C04651 as moderately susceptible with 44.8 and 45.9% disease severity resulting grain yields of 2.5 and 2.4 t/ha, respectively. The higher disease severity (68.1%) with lower grain yield (1.4 t/ha) was recorded in the farmer's variety (susceptible check). The genotypes reported with lower blast severity and higher grain yield could be the source for the release of a leaf blast resistant and high-yielding proso millet variety in the mid-hill region of Nepal.

Climate change and high-altitude food security: a small-scale study from the Karnali region in Nepal

ABSTRACT This study attempted to understand the local perspective on climate change and its impacts on agriculture and household food security in the Karnali region of Nepal – one of the most inaccessible and least researched mountain regions in Nepal. Using the small-scale survey data collected in 2017 from farm households in Tatopani rural municipality of Jumla district, the study found that a majority of households perceived changes in temperature and rainfall patterns, timing of seasons, incidence of drought and water availability, compared with the situation 10 years ago (2007 or earlier). They perceived mixed impacts of climate change on the production of major crops: a decline in the production of brown rice, wheat and barley, and an increase in the production of potato and local beans. Food security analysis showed that farm households had low dietary diversity, and 42% of them were food insecure. Regression analysis found that perceived climate-induced changes in water availability, timing of seasons, incidence of hazards and incidence of crop pest attacks had negative relationship with household food security. Based on the findings, the study suggested some key strategies to improve local food security in the face of climate change in the study area and other similar areas.

Essential Emergency Surgical Care in Remote Hilly Districts of Karnali - A Cross-Sectional Survey

Background: Remote hilly areas of Karnali Province has one in all the very best burdens of surgically treatable conditions within the world and therefore, the highest unmet need. The first objective of our study was to gauge the capacity of first-referral health facilities in remote districts of Karnali Province to perform basic surgical procedures. The aim is to assess the status of Essential Emergency Surgical Care in remote hilly districts of Karnali region of Nepal.
 Method: The screening Tool was Situational Analysis to Assess Emergency and Essential Surgical Care, to spot the health facility’s capacity to perform basic surgical (including obstetrics and trauma) and anesthetic procedures by investigating four categories of data: human resources, infrastructure, equipment and interventions available. The tool interrogated the supply of eight sorts of care providers, 35 surgical interventions and 67 items of apparatus.
 Results: on the average, 72.83% of all admissions required either minor or major surgical interventions. Oxygen supplies, electrical power backup, running water, blood bank, hospital guidelines were inconsistent. Only 1 Hospital have trained Surgeons, Anesthesiologist and Obstetrician/Gynecologist. Only 1 hospital can perform around 97.1% of procedures.
 Conclusion: The capacity for essential surgery is severely limited in Karnali region of Nepal. Limitations was seen in basic equipment, human resources, infrastructure, and supplies.

Bergenia pacumbis from Nepal, an astonishing enzymes inhibitor

BackgroundThe Bergenia species are perennial herbs native to central Asia, and one of the most promising medicinal plants of the family Saxifragaceae which are popularly known as ‘Pashanbheda’. The aim of this study was to evaluate antioxidant and α-amylase, α-glucosidase, lipase, tyrosinase, elastase, and cholinesterases inhibition potential of Bergenia pacumbis of Nepali origin collected from the Karnali region of Nepal.MethodsThe sequential crude extracts were made in hexane, ethyl acetate, methanol, and water. Antioxidant activities were analyzed by 2,2-diphenyl-1-picrylhydrazyl (DPPH) and 2,2′-azino-bis (3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) assay. The α-amylase, α-glucosidase, lipase, tyrosinase, elastase, acetylcholinesterase, and butyrylcholinesterase inhibition were analyzed by the 3,5-Dinitrosalicylic acid (DNSA), p-Nitrophenyl-α-D-glucopyranoside (p-NPG), 4-nitrophenyl butyrate (p-NPB), l-3,4-dihydroxyphenylalanine (L-DOPA), N-Succinyl-Ala-Ala-p-nitroanilide (AAAPVN), acetylthiocholine, and butyrylcholine as a respective substrate. The major metabolites were identified by high performance liquid chromatography with electron spray ionization- quadrupole time-of-flight mass spectrometry (HPLC-ESI-QTOF-MS) profiling.ResultsOur results revealed the great antioxidant ability of crude extract of B. pacumbis in ethyl acetate extract against both DPPH (IC50 = 30.14 ± 0.14 μg/mL) and ABTS (IC50 = 17.38 ± 1.12 μg/mL). However, the crude methanol extract of B. pacumbis showed the comparable enzymes inhibitions with standard drugs; α-amylase (IC50 = 14.03 ± 0.04 μg/mL), α-glucosidase (IC50 = 0.29 ± 0.00 μg/mL), lipase (IC50 = 67.26 ± 0.17 μg/mL), tyrosinase (IC50 = 58.25 ± 1.63 μg/mL), elastase (IC50 = 74.00 ± 3.03 μg/mL), acetylcholinesterase (IC50 = 31.52 ± 0.58 μg/mL), and butyrylcholinesterase (IC50 = 11.69 ± 0.14 μg/mL). On the basis of HPLC-ESI-QTOF-MS profiling of metabolites, we identified major compounds such as Bergenin, Catechin, Arbutin, Gallic acid, Protocatechuic acid, Syringic acid, Hyperoside, Afzelechin, Methyl gallate, Paashaanolactone, Astilbin, Quercetin, Kaempferol-7-O-glucoside, Diosmetin, Phloretin, and Morin in methanol extract which has reported beneficial bioactivities.ConclusionOur study provides a plethora of scientific evidence that the crude extracts of B. pacumbis from Nepalese origin in different extracting solvents have shown significant potential on inhibiting free radicals as well as enzymes involved in digestion, skin related problems, and neurological disorders compared with the commercially available drugs.

Automated Respiratory Rate Counter to Assess Children for Symptoms of Pneumonia: Protocol for Cross-Sectional Usability and Acceptability Studies in Ethiopia and Nepal.

BackgroundManually counting a child’s respiratory rate (RR) for 60 seconds using an acute respiratory infection timer is the World Health Organization (WHO) recommended method for detecting fast breathing as a sign of pneumonia. However, counting the RR is challenging and misclassification of an observed rate is common, often leading to inappropriate treatment. To address this gap, the acute respiratory infection diagnostic aid (ARIDA) project was initiated in response to a call for better pneumonia diagnostic aids and aimed to identify and assess automated RR counters for classifying fast breathing pneumonia when used by front-line health workers in resource-limited community settings and health facilities. The Children’s Automated Respiration Monitor (ChARM), an automated RR diagnostic aid using accelerometer technology developed by Koninklijke Philips NV, and the Rad-G, a multimodal RR diagnostic and pulse oximeter developed by Masimo, were the two devices tested in these studies conducted in the Southern Nations, Nationalities, and Peoples’ Region in Ethiopia and in the Karnali region in Nepal.ObjectiveIn these studies, we aimed to understand the usability of two new automated RR diagnostic aids for community health workers (CHWs; health extension workers [Ethiopia] and female community health volunteers [Nepal]) and their acceptability to CHWs in Ethiopia and Nepal, first-level health facility workers (FLHFWs) in Ethiopia only, and caregivers in both Ethiopia and Nepal.MethodsThis was a prospective, cross-sectional study with a mixed methods design. CHWs and FLHFWs were trained to use both devices and provided with refresher training on all WHO requirements to assess fast breathing. Immediately after training, CHWs were observed using ARIDA on two children. Routine pneumonia case management consultations for children aged 5 years and younger and the device used for these consultations between the first and second consultations were recorded by CHWs in their patient log books. CHWs were observed a second time after 2 months. Semistructured interviews were also conducted with CHWs, FLHFWs, and caregivers. The proportion of consultations with children aged 5 years and younger where CHWs using an ARIDA and adhered to all WHO requirements to assess fast breathing and device manufacturer instructions for use after 2 months will be calculated. Qualitative data from semistructured interviews will be analyzed using a thematic framework approach.ResultsThe ARIDA project was funded in November 2015, and data collection was conducted between April and December 2018. Data analysis is currently under way and the first results are expected to be submitted for publication in 2020.ConclusionsThis is the first time the usability and acceptability of automated RR counters in low-resource settings have been evaluated. Outcomes will be relevant for policy makers and are important for future research of this new class of diagnostic aids for the management of children with suspected pneumonia.International Registered Report Identifier (IRRID)DERR1-10.2196/14405

Use of Very High-Resolution Optical Data for Landslide Mapping and Susceptibility Analysis along the Karnali Highway, Nepal

The Karnali highway is a vital transport link and the only primary roadway that connects the remote Karnali region to the lowlands in Mid-Western Nepal. Every year there are reports of landslides blocking the road, making this area largely inaccessible. However, little effort has focused on systematically identifying landslides and landslide-prone areas along this highway. In this study, landslides were mapped with an object-based approach from very high-resolution optical satellite imagery obtained by the DigitalGlobe constellation in 2012 and PlanetScope in 2018. Landslides ranging from 10 to 30,496 m2 were detected within a 3 km buffer along the highway. Most of the landslides were located at lower elevations (between 500–1500 m) and on steep south-facing slopes. Landslides tended to cluster closer to the highway, near drainage channels and away from faults. Landslides were also most prevalent within the Kuncha Formation geologic class, and the forested and agricultural land cover classes. A susceptibility map was then created using a logistic regression methodology to highlight patterns in landslide activity. The landslide susceptibility map showed a good prediction rate with an area under the curve (AUC) of 0.90. A total of 33% of the study arealies in high/very high susceptibility zones. The map highlighted the lower elevated areas between Bangesimal and Manma towns with the Kuncha Formation geologic class as being the most hazardous. The banks of the Karnali River, its tributaries and areas near the highway were also highly susceptible to landslides. The results highlight the potential of very high-resolution optical imagery for documenting detailed spatial information on landslide occurrence, which enables susceptibility assessment in remote and data scarce regions such as the Karnali highway.

A Retrospective Study of Endoscopic Findings in Patients Presenting with Dyspepsia in a Rural Teaching Hospital

Introduction: Dyspepsia is a common problem faced in our country and elsewhere. Benign causes predominate with occasional incidences of carcinoma of the stomach, esophagus. The presence of warning signs helps indicate the presence of such carcinomas though various studies differ as to its usefulness.
 Methods: Patients presenting with dyspepsia were investigated with a gastroscope to see the etiological pattern seen in the Karnali region and the usefulness of the warning signs. This study included the initial 100 patients undergoing upper gastrointestinal endoscopy for dyspepsia evaluation in our institution.
 Results: The majority of the patients (53%) showed normal findings on visual examination despite being symptomatic suggestive of functional dyspepsia. The most common warning sign was weight loss which had a positive predictive value of only 4%. Malena was present in 10% of the patients with a positive predictive value of 30%.
 Conclusions: Significant weight loss as a warning sign to screen patients for gastrointestinal pathology seems unsuitable in the rural setting.

Performance of Bhote type garlic genotypes under Karnali region of Nepal

Advance Yield Trial on different Bhote type garlic genotypes collected from different districts of Nepal was carried out at Horticultural Research Station, Rajikot, Jumla for two consecutive years 2013/14 and 2014/15 to evaluate garlic genotypes suitable for the Karnali region of Nepal. Minimal work has been done in past on garlic, almost all of which centered at terai and mid hills that's why this study was carried out to select suitable bhote type garlic genotypes for high hill. Eleven different garlic genotypes were tested on Randomized Complete Block Design (RCBD) with three replication. Tested genotypes differed significantly for vegetative as well as yield parameters. During 2013, the highest bulb yield (47.41 t/ha) was recorded from ARM 01 followed by Mugu Local (47.01 t/ha), ARM 04 (46.98 t/ha), Kathmandu Local (45.41 t/ha), Chinese (37.91 t/ha) and the lowest from ARM 08 (20.1 t/ha). Similarly, during 2014/15, the highest bulb yield was observed from ARM 01 (50.32 t/ha) followed by Mugu Local (49.91 t/ha), Kathmandu Local (41.62 t/ha), Chinese (29.60 t/ha) and the lowest from ARM 05 (12.51 t/ha). Based on the average result of both years, ARM 01, Mugu Local, Kathmandu Local, ARM 04 and Chinese showed the better productivity ranged from 29.6 t/ha to 50.32 t/ha which are the promising garlic genotypes for the Karnali region of Nepal.

Grassland Management for Climate Change Adaptation and Watershed Protection in Karnali Watershed Area

Natural grasslands cover approximately 14% of geographical area of Nepal and are important areas in terms of biodiversity and sources of forage for wild and domestic animals, and for medicinal and herbal plants. Karnali watershed area is very sensitive and need of scientific management of highland grasslands which are rich in number of plants and animal species that have significant role and contribution in national economy and ecology. However, these grass lands are in threat and exist in their natural state within protected areas as neighbouring grasslands and forest habitats have been rapidly degraded. At Higher altitudes, trans-Himalayan and alpine rangelands are home to a diverse array of wildlife and are grazed by livestock, which are an integral part of the livelihood of several different ethnic groups. However, these grasslands are being overgrazed, little is known about the ecology and sustainability of prevailing land use practices. The prime concern of the paper is to address the existing issues, challenges along with biodiversity characteristics of the higher altitude grasslands. Thus, the focus of the paper is to point out the major grassland ecological research conducted to date and devise effective research and management strategies suggested to management of grassland beyond the protected areas and adjoin areas. Discussion of the paper explores some applicable measures to high elevation grassland management strategies with active participation of local communities with a view to provide comprehensive policy guidance for the management of grasslands and shrub lands in the Karnali region.

Grassland Management for Climate Change Adaptation and Watershed Protection in Karnali Watershed Area

Karnali watershed area is very sensitive and need of scientific management of highland grasslands which are rich in number of plants and animal species that have significant role and contribution in national economy and ecology. However, these grass lands are in threat and exist in their natural state within protected areas as neighboring grasslands and forest habitats have been rapidly degraded. At higher altitudes, trans-Himalayan and alpine rangelands are home to a diverse array of wildlife and are grazed by livestock, which are an integral part of the livelihood of several different ethnic groups. These grasslands are being overgrazed and little is known about the ecology and sustainability of prevailing land use practices at the community level. In this context, the prime concern of the paper is to address the existing issues, challenges along with biodiversity characteristics of the higher altitude grasslands of the region. Thus, the main focus of the paper is to point out the major issues of grasslands along with location specific as well as innovative measures and devises for the effective management of grassland beyond the protected and adjoin areas. Further, the paper explores some applicable measures to high land grassland management strategies with active participation of local communities with a view to provide comprehensive policy guidance for the sustainable management of grasslands in order to build the capacity of locals on the road to climate change adaptation and watershed protection in the Karnali region.

Variation on agro-morphological traits in Nepalese foxtail millet (Setaria italica (L) P Beauv)

Foxtail millet (Setaria italica (L) P Beauv) falls on the category of underutilized crops in Nepal and mainly cultivated in Karnali region of the country. It is hardy crop and considered as one of the potential crops for future food security with respect to climate change. Five accessions of Nepalese foxtail millet were purposefully selected for evaluation of the agro-morphological characteristics. Foxtail landraces from Dolpa, Mugu, Bajura, Bajhang and Lamjung districts of Nepal were evaluated at Khumaltar, Lalitpur, Nepal during 2010. The plot size was 1m2 and there were five samples. Days to heading and days to maturity varied from 33-56 and 59 to 87 days after germination respectively. Similarly, flag leaf length/breadth ratio, flag leaf sheath length, ligule length, peduncle length, peduncle exertion and plant height varied from 3.84-10.90, 5.47-9.84 cm, 0.1-0.2 mm, 10-22.57 cm, 2.7-13.58 cm and 41.67-120 cm, respectively. Fruit and apiculus color varied from straw to black. All accessions were actively growing with very slight lodging. Similarly, the thousand grain weight varies from 1.064 g to 2.172 g. This variation is useful in foxtail millet breeding program. Similarly, the significant correlation between thousand kernel weight and total basal tiller (r=-0.975) showed that foxtail millet lines with low tillering ability is better for yield enhancement. DOI: http://dx.doi.org/10.3126/ajn.v2i0.7528 Agronomy Journal of Nepal (Agron JN) Vol. 2: 2011 pp.133-138