Golden langurs (Trachypithecus geei) are an endangered primate species in Bhutan. We discuss their evolution in terms of phylogeny, ecology, and biogeography. We test the hypothesis that rivers and mountains in Bhutan isolated a population of capped langurs (Trachypithecus pileatus) that later speciated into the morphologically distinct T. geei. Trachypithecus, the genus to which both capped and golden langurs belong, spread north from a paleorefuge in south China, and Semnopithecus (gray langurs) spread east and northward from a refuge in south India. We show that the 2 genera both arrived in Bhutan and were separated from each other by the Sunkosh River and Black Mountains. Likewise, a population of capped langurs isolated from parental populations by rivers speciated into the distinct golden langurs. We conducted field surveys covering the entire range of langurs in Bhutan. The Sunkosh River and Black Mountain range in west Bhutan isolate gray langurs and golden langurs from each other. In the east, the Manas River system (Manas-Mangde) served as a barrier between golden and capped langurs. However, it is an imperfect barrier and a contact zone between the 2 species occurred on the banks of the Mangde River. Second, we reconstructed the evolutionary history of the langurs of Bhutan via molecular phylogenetic tools. We sequenced the cytochrome b region (cyt b) of the mitochondrial DNA (mtDNA) to model a phylogeny. It revealed the distinct evolutionary paths of the golden, capped, and gray langurs. As predicted, golden and capped langurs are closely related to each other and to other species in Trachypithecus from Southeast Asia. The gray langur of Bhutan grouped into a distinct clade with conspecifics in Semnopithecus from India and Nepal. The south Indian clade of gray langurs is more ancient, with the Bhutan and Nepal gray langurs having diverged later, which fits with the glacial models of Int J Primatol (ice sheet retreats and colonization of South Asia by gray langurs from south India north toward the Himalayas. Likewise, the golden and capped langur clade are the most derived and divergent from the older groups of Trachypithecus in Southeast Asia, which also fits with paleorefuge models of recolonization by Trachypithecus into the rest of Southeast Asia and north toward the Himalayas from paleorefuges in Southeast Asia. As predicted, golden and capped langurs are closely related to each other and gray langurs are only distantly related to them. The divergence between capped and golden langurs is more recent, while the split between Trachypithecus and Semnopithecus is more ancient and took place before the Pliocene.
Background Enhanced Recovery After Surgery (ERAS) is a multidisciplinary perioperative care program to optimize and enhance postoperative recovery. It has a beneficial role in decreasing the length of hospital stay and improving the quality of care. This study aims to observe the successful implementation of ERAS in reducing the length of hospital stay (LOS) among caesarean deliveries. Methods A pre-and post-implementation study of ERAS protocol was conducted, among cohort of women who underwent caesarean deliveries from January to December 2020 in the Department of Obstetrics and Gynaecology, Mongar Regional Referral hospital. Data collected retrospectively and analyzed in SPSS (IBM SPSS trial version); and comparison of length of hospital stay between the two groups were tested by t-test. Results One hundred seventy-one patients were included in the study: 87 in the pre-ERAS and 84 in the post-ERAS cohort. Post implementation, LOS decreased by an average of 21.0 (CI 16.11–24.64; p-value < 0.001) hours in the postoperative period. A greater proportion of patients were discharged on day-2 (2.3% in pre-ERAS and 81% in ERAS; p-value < 0.001). Conclusion Implementation of ERAS protocol can significantly decrease the postoperative length of hospital stay without increasing the complications and readmission rates.
Bhutan has reopened schools and colleges after an initial closure to contain coronavirus disease 2019 (COVID-19) transmission. However, the risk of transmissions is higher in the schools and colleges due to crowding. Therefore, this study aimed to assess the level of knowledge, attitude, and practice (KAP) toward COVID-19 among the students of Sherubtse College in Bhutan. A cross-sectional study using a questionnaire was conducted in September 2020 among the students of Sherubtse College, Bhutan. The questionnaire was made in the Google Forms and administered through a social forum WeChat app. The KAP scores were calculated that include mean scores. The association between the KAP was assessed using the Pearson's correlation coefficient. A total of 613 students participated in the survey. The majority of the participants (57%) were female and 56% were from the third year. The mean knowledge score was 10.7 (SD = 1.7; range 0–14), mean attitude score of 3.67 (SD = 1.0; range: 0–5), and mean practice score of 5.19 (SD = range: 0–6). A majority of the students had good knowledge (98%) and practice (93.5%) scores, and a positive attitude (86.6%) toward COVID-19. A positive but weak correlation between good knowledge and practice (r = 0.1, p = 0.0126) was observed. Having a positive attitude led to practicing appropriately most of the time (r = 0.1866, p < 0.001). The students had good KAP scores and followed the COVID-19 prevention protocols advocated by the government. Good knowledge and a positive attitude were translated into good practice. Therefore, the education campaign of the Bhutan government seems to be effective in the students.
The distributions of Assamese macaques (Macaca assamensis) and rhesus macaques (M. mulatta) in Bhutan have been only partially documented. In order to investigate the distribution patterns of these species, we conducted field observation and genetic assessment with mitochondrial DNA (mtDNA) typing of macaques in the Inner Himalayas of Bhutan. There were 24 sightings of macaque groups, and all were visually identified as Assamese macaques. No groups of rhesus macaques were sighted in this survey area, in contrast with the survey results in the Nepalese Himalayas. Molecular phylogenetic analysis revealed that the Bhutan macaques are closer in proximity to their counterparts in the Indo-Chinese region (Thailand and Laos) than to rhesus macaques in China, Laos and India. However, clustering results suggested the marked differentiation of the macaques in Bhutan from the Assamese macaques in Indo-China. We tentatively conclude that the macaques of the Inner Himalayan regions in Bhutan are Assamese macaques and that they appear to be of a lineage distinct from Assamese macaques in the Indo-Chinese region (subspecies M. a. assamensis). The degree of mtDNA diversity suggests that the Assamese macaques in Bhutan are of a more ancient ancestry than M. a. assamensis, thereby supporting the speciation hypothesis of the expansion of a sinica-group of macaques from South Asia to Southeast and then to East Asia (Fooden; Fieldiana Zool 45:1-44, 1988). Assignment of Assamese macaques in Bhutan to M. a. pelops is premature due to the lack of molecular data and recent taxonomic controversy. The mtDNA diversity of Assamese macaques was greater than that of rhesus macaques, suggesting the earlier speciation of Assamese macaques. The significance of the ecogeographic segregation model of macaque distribution is discussed in relation to the evolutionary range expansion into the Himalayan regions in South Asia.
I explicate here the conditions conducive to fostering democracy in Bhutan. Using an interdisciplinary framework, I argue that village society is fundamentally democratic, but the state is not, and that the state can be democratized by formalizing traditional institutions. However, I argue that anti-Bhutan rebels in Nepal cannot bring democracy to Bhutan.
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