The energy mix in Nepal is currently dominated by the traditional and inefficient use of biomass (66.54%) and fossil fuels (27.24%), and energy poverty remains extremely high. This paper reviews relevant literature to provide an overview of the current renewable energy status and energy mix in Nepal, and to discuss prospects for the country to achieve a sustainable energy transition. Nepal-specific papers from peerreviewed sources and other agency and academic reports were included insofar as these discussed renewable energy and provided recommendations for policy-making on sustainable energy and related development goals. Despite the rapidly falling cost of solar photovoltaic, the share of modern renewable energy in Nepal is currently less than 3%. On this basis, and given the country's sustainable energy goals, we conclude that favorable and aggressive policies and strategies are needed to support adoption of clean energy in Nepal, comprised of a high share of solar generation equipped with battery storage, and balanced with storage such as off-river pumped hydropower technology.

Background:Dengue is one of the most common mosquito-transmitted arboviral disease of tropical and a few subtropical areas in the world. It is estimated that approximately 100 million cases occur per year and approximately 2.5 billion people are at risk of developing dengue infection. Hemorrhagic complications causing encephalopathy are quite rare but fatal consequences of this deadly disease. This study was conducted to discuss the prognostic factors in the management of intracranial hemorrhage in dengue infected patients.Methods:This retrospective study was conducted in the neurosurgery department of our tertiary healthcare centre. Duration of the study was 1 year, and 18 patients who presented with intracranial bleed and required neurosurgical care were included in this study. All patients had deranged coagulation profile and were thrombocytopenic. All the patients were given platelet concentrates for correction of thrombocytopenia. Eight of these patients had deterioration in their neurological status, and 6 of them underwent surgery.Results:Out of 18 patients, 12 (66.66%) were managed conservatively, including one case of cervical extradural hemorrhage. Five patients who were conservatively managed died because they had deep-seated bleed and rapid deterioration. The remaining 7 patients who were managed conservatively improved well with few residual deficits. Six (33.33%) patients who underwent surgery had excellent outcome with one case of mortality.Conclusion:Very high index of suspicion is required in dengue infected patients for neurological complications, especially during the convalescence period. Special attention should be given to those patients who have altered sensorium, and should not be misinterpreted as fever delirium or toxic encephalopathy. It requires immediate attention and further neurological investigation (including thorough clinical examination). Timely diagnosis using a computed tomography scan and early neurosurgical intervention after rapid correction of thrombocytopenia can save many lives.

Climate change and its impact on human health and awareness constitute a set of complex and serious consequences to be tackled by an individual country. It is not merely an environmental issue, but it is also a threat that goes beyond the national borders. The purpose of this study is to assess the awareness on effect of climate change on human health among the secondary level students of Biratnagar. The research design was descriptive cross-sectional and data was collected from 110 samples through the census method using the semi-structured self-administered questionnaire. Among the respondents, 84.5% knew that climate change can be prevented. Moreover, 50.9% perceived that climate change is an unbreakable process; 77.3% of them perceived climate change is the cause of new disease; and 81.8% of them are concerned about preventing the effects of climate change on human health. Among the respondents, 10% had adequate awareness. The study concluded that half of the secondary level students have inadequate level of awareness on effects of climate change on human health in Biratnagar. It is recommended that awareness should be increased by involving them in the project work activities and reinforcing the component of curriculum.

Background Caudal block is the most common anaesthetic technique employed in children for managing perioperative pain of inguino-scrotal surgery. However, despite using long-acting local anaesthetics, caudal analgesia lasts relatively shorter. Dexmedetomidine, an alpha-2 agonist, augments local anaesthetic action. Objective To assess the analgesic effect of caudal Dexmedetomidine. Method This is a randomized, double-blinded study conducted on otherwise healthy children (one to five years) undergoing elective inguino-scrotal surgery. General anaesthesia was administered and a laryngeal mask airway was inserted for assisting ventilation. The caudal block was applied using 0.8 milliliters/kilogram drug volume comprising either two milligrams/kilogram Bupivacaine in group A (n=42) or two milligrams/ kilogram Bupivacaine mixed with 0.75 micrograms/kilogram Dexmedetomidine in group B (n=42). Intraoperatively, inhaled Halothane, intravenous Fentanyl, fluids, and ventilation were titrated to maintain monitored hemodynamic variables within 15% from baseline values. The primary endpoint comprised the duration of analgesia, defined by a time when postoperative pain score (face, legs, activity, cry, consolability; FLACC scale) reached four out of ten. Perioperative events were studied for 24 hours. Student’s t-test and Chi-square test were used for analysis, with p-value less than 0.05 considered as significant. Result Demographic, surgical, and anaesthetic characteristics were similar between the groups. Duration of analgesia was significantly prolonged in group B (group B, 413±101 minutes; group A, 204±40 minutes). The intraoperative requirement for supplement Fentanyl was significantly reduced in group B. Adverse events were comparable between the groups. Conclusion Dexmedetomidine prolongs the duration of analgesia when mixed with caudal Bupivacaine, without increasing adverse events.

The author presents a patient who developed a subacute subdural hematoma approximately 2 weeks after normal delivery with history of postnatal convulsion and lateralizing neurological symptoms. On day 12, she started to feel a nonpostural and severe throbbing headache with motor aphasia and right hemiparesis power grade 4, she was referred to our department. Left subacute subdural hematoma was confirmed by a computed tomography scan. Physical examination revealed only mild right hemiparesis. Left burr hole trepanation was performed and this was followed by uneventful postoperative course, and it completely recovered after 4 weeks. Chronic subdural hematoma should be considered when postpartum patients who have history of ecclampsia with mild to severe, persistent, and non-postural headache.Nepal Journal of Neuroscience. Vol. 13, No. 2, 2016, Page: 109-111