A series of radiocarbon determinations have been carried out of lacustrine deposits contained in three playa basins, namely at Sambhar, Didwana and Lunkaransar, in Rajasthan, in conjunction with stratigraphical and palynological investigations. It is revealed that the lake deposits, which overlie thick beds of sand at each site, date back from early Holocene times (ca. 10,000 B.P.).The authors present the radiocarbon evidence together with an outline of the stratigraphy of the deposits, and attempt to reconstruct the sedimentary sequence in the three basins since the beginning of the lacustrine phase. The significance of the more or less synchronous development in all the three playa basins is discussed with reference to postglacial climatic oscillations in northwest India.

The results from stratigraphy, radiocarbon dating and pollen analysis of three salt-lake deposits at Sambhar, Lunkaransar and Didwana in western Raj'asthan, and one freshwater lake deposit at Pushkar in the Aravalli Hills, are described in conjunction with pollen analysis of some archaeological soil samples from the Indus Valley site at Kalibangan in northern Rajasthan. The salt-lake deposits studied are stratigraphically divisible into (a) pre-lacustrine, (b) lacustrine and (c) post-lacustrine sections. The pre-lacustrine section is characterized by a thick bed of aeolian sand underlying lacustrine sediments, while the lacustrine and post-lacustrine sections are broadly circumscribed by laminated clay and nonlaminated silt respectively. The pollen record from the four lake profiles studied is divided into local pollen zones. Four regional pollen assemblage zones are delineated for the area west of the Aravalli Range in Rajasthan. The environmental history deduced from the pollen record is divisible into phases I-V, of which phases II-V follow the regional pollen assemblage zones. Phase I is stratigraphically determined, and is representative of severe arid environments under which the sand dunes, now stabilized, are suggested to have been active. The plant microfossils first appear in phase II with the deposition of lacustrine sediments dated to around 10000 b . p . The vegetation comprises an openland steppe which is rich in grasses, Artemisia and sedges and poor in halophytes. Artemisa, Typha angustata, Mimosa rubicaulis and Oldenlandia , which now grow under areas of comparatively higher average annual rainfall (above 50 cm), appear to have flourished in the semi-arid belt, while the first two plant taxa had encroached even as far as the arid belt, both suggesting that a general westward shift of the rainfall belts had taken place. Vegetation destruction through burning by man is suggested to have started together with the first occurrence of Cerealia-type pollen at about 7500 b . c . and continued thereafter throughout phases III and IV. The increase in swamp vegetation and the intensification of vegetation cover inland together with the maxima of all mesophytic elements in phase IV ( ca. 3000 b .c . to ca. 1000 b .c .) indicate an increase in the rainfall, apart from a short relatively drier time about 1800-1500 b . c . at Sambhar which correlates with the decline of the Indus culture in northwest India. Phase IV is immediately followed by aridity for which there is stratigraphic evidence that the salt lakes started drying. At Pushkar, there is evidence that the vegetation showed a marked change in the Aravallis. The onset of this aridity is suggested to have been widespread. The climate did not ameliorate until about phase V (? early centuries a .d . to present) at which time the Rangmahal culture perhaps flourished in Rajasthan, the remains of which imply good water supply. In conclusion it is suggested that the Rajasthan desert is primarily natural, its history punctuated by at least one more vegetated, humid period during the Holocene, the climatic control of which as indicated by the vegetation history is consistent with climatic events elsewhere in the world.

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The prevalence of DR was 38 % among the admitted diabetic cases and the DR was significantly associated with the duration of diabetes and systemic hypertension. Almost half of the cases had been unaware of DR before referral. This emphasizes the importance of the collaboration of the physician and the ophthalmologist for an early DR detection.

Capacity building is needed in low-and middle-income countries (LMICs) to combat antimicrobial resistance (AMR). Stewardship programs such as post-prescription review and feedback (PPRF) are important components in addressing AMR. Little data are available regarding effectiveness of PPRF programs in LMIC settings. An adapted PPRF program was implemented in the medicine, surgery, and obstetrics/gynecology wards in a 125-bed hospital in Kathmandu. Seven "physician champions" were trained. Baseline and post-intervention patient chart data were analyzed for changes in days of therapy (DOT) and mean number of course days for intravenous and oral antibiotics, and for specific study antibiotics. Charts were independently reviewed to determine justification for prescribed antibiotics. Physician champions documented recommendations. Days of therapy per 1,000 patient-days for courses of aminoglycoside (P < 0.001) and cephalosporin (P < 0.001) decreased. In the medicine ward, data indicate increased justified use of antibiotics (P = 0.02), de-escalation (P < 0.001), rational use of antibiotics (P < 0.01), and conforming to guidelines in the first 72 hours (P = 0.02), and for definitive therapy (P < 0.001). Physician champions documented 437 patient chart reviews and made 138 recommendations; 78.3% of recommendations were followed by the attending physician. Post-prescription review and feedback can be successfully implemented in LMIC hospitals, which often lack infectious disease specialists. Future program adaptation and training will focus on identifying additional stewardship programming and support mechanisms to optimize antibiotic use in LMICs.

The study explores the use of multiple criteria decision techniques in predicting spatial niche of Brown oak (also known as Kharsu oak, Quercus semecarpifolia Sm.) formation in midaltitude (2,400-3,500 meter amsl) Kumaun Himalaya. Predictive models using various climatic and topographical factors influencing Brown oak's growth and survival were developed to define its current ecological niche. Analytical Hierarchical Process (AHP) method involving Saaty's pair-wise comparison was performed to rank the explanatory powers of each compared variable. Variables were suitably weighted using fuzzy factor standardization scheme to reflect their relative importance in defining species niche. An optimum indicator was then chosen for deriving a site suitability map of brown oak. This study establishes the role of aspect in the current distribution of the species along with known influence of altitude. Future niches of oak has been tracked in the projected climate change scenario of +1 o C and +2 o C rise in temperature and 20 mm in precipitation. The results show that on predicted +1 o C and +2 o C increase in temperature, present habitat of brown oak distribution may be reduced by 40 per cent and 76 per cent respectively.

Background: For diagnosis of enteric fever, the culture of the organism from different body fluids is the gold standard. After diagnosis, it is important to treat with the right antibiotic before any complications can occur. The retrospective study is designed to explore the antibiotic sensitivity trend in blood culture positive typhoid fever cases and the extent of drug resistance before treatment is administered. Methods:A retrospective study was carried out for culture isolated enteric fever patients admitted in Kathmandu Model Hospital. The discharged records from January 2012 to December 2016 were analyzed. The patients above 15 years and with culture isolated enteric fever were included in the study. Results:One hundred fifty-nine strains of Salmonella typhi and paratyphi were isolated from Jan 2012 to Dec 2016 at Kathmandu Model Hospital. Out of 159 isolated, 125 (78.6%) were Salmonella typhi and 34 (21.4%) were paratyphi. Among them co-trimoxazole, chloramphenicol, ceftriaxone, cefotaxime, cefixime, and ofloxacin demonstrated 100% sensitivity. Similarly, amoxicillin sensitivity was 98.1% (n=156) while ciprofloxacin was sensitive in 6.3% (n=10), intermediately sensitive in 49.1% (n=78) and resistance in 44.7% (n=71).The newer quinolone levofloxacin showed 78.5% (n=11) sensitivity. Azithromycin was sensitive in 99.2% (n=132) of total isolated Salmonella species both typhi and paratyphi. Conclusions:A high degree of sensitivity was noted to chloramphenicol and co-trimoxazole, showing sensitivity has returned to conventional antibiotics. The drug-like ofloxacin is still the best responding drug in our contest whereas ciprofloxacin resistance is still high, but five years patterns show a trend of rollback of sensitivity.

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