Introduction: Acute Respiratory Infection (ARI) is one of the leading causes of morbidity and mortality in under five-year children. Risk factors include age, sex, socio‐economic status, indoor air pollution, passive smoking, lack of basic health services, and lack of awareness. In this study, we aimed to determine the associated risk factors of ARI in children under five-years of age. Methods: We carried out a hospital-based descriptive cross-sectional study in the peak period of of November 2017 to February 2018. The study was conducted in Fishtail Hospital and Research Center (FHRC), Pokhara, Nepal. Non probability, purposive sampling technique was used and a structural interview was taken for data collection. The tool comprised of two main parts. Part I- questions related to socio-demographic variables of mother and baby. Part II- questions related to risk factors of ARI. The collected data was analyzed using Statistical Package for Social Science (SPSS) software, version 16. The Chi Square statistic is used for testing relationships between categorical variables. Results: In total of 302 children visited to FHRC with the symptoms of ARI, only 188 (63%) were diagnosed as ARI. The most common symptoms were fever (42.2%), cough (35.7%), running nose (34.1%), difficulty in breathing (28.5%) and chest in drawing (11.6%). The age of children with ARI ranged from one to sixty month with the mean age of 21.46 ±13.52. Among 188 children, 51% were males whereas 49%were females. There were no statistically differences of children weight at birth among ARI. Our results revealed environmental and social factors associated with ARI. Conclusions: The risk factors significantly associated with ARI were malnutrition, exposure to wood smoke and mosquito coil and contact with person having ARI. Reducing these conditions may reduce the morbidity and mortality associated with ARI in children.

Introduction: Snakebite is an environmental hazard associated with significant morbidity and mortality. It is an important medical emergency and cause of significant numbers of hospital admissions in many parts of the Asian region. In this study, we assess the epidemiology and clinical outcome of snake bite. Methods: This was a retrospective study of all patients with snake bites admitted to the Department of Internal Medicine, Manipal Teaching Hospital, Pokhara, kaski, Nepal. A total numbers of 265 snake bite cases in the period of 2013 to 2016 were enrolled in this study. Snake bite cases by person, place and time along with month of snake bite and time of bite, were analyzed. We also identified the types of snake and site of the bite. Sign and symptoms were clinically observed and the management of the snake bite cases was clinically done. Prothrombin time (PT) test along with INR value was performed by Medical Technologist at the Department of Laboratory, Manipal Teaching Hospital. Data was entered in to the Microsoft excel and analyzed by SPPS version 21.0. Percentages were applied to find the results. Results: Total numbers of snake bite cases were 265. More than half, 60.4% of the snake bite cases were females. Regarding the age group, nearly half, 47.9% were in the age group of 20 - 40 years and 9.8% cases were in the age group of 60 years and above. In this study, 50.6% bite cases were held at the day time and most of the bites were reported/ observed in the limb, 53.6% in lower limb, and 43.4% in the upper limb. Very few bites were in the head, neck and trunk. Our result shows 49.1% were green snake and 30.9% snake were unidentified. When we observed the sign and symptoms, 153 (57.7%) cases showed local swelling, 83 (31.3%) showed fang mark. Hematological manifestation were 144 (54.3%) cases and complication observed in 145 (54.7%) cases. Snake bite cases were managed after PT/INR test, INR. Antibiotic were prescribed in 154 cases and in 135 (50.9%) cases blood was transfused. There were no fetal cases noticed among hospital admitted snake bite cases. Conclusion: There is gross disparity in the management and outcomes of snake bite in different hospitals. Snake bite cases should manage in tertiary care hospital as early as possible.

Purpose: The policymakers are found to be undecided which assures the need for a refined policy on local governance in the formation of a user committee. It is expected to be beneficial for the project management team to point out the factors that directly or indirectly affect project performance. To assess the effectiveness of the construction projects implemented through Users Committees in comparison to the Contract Approach. Design/Methodology/Approach: The number of Informal Consultations was conducted at each sector of the project location involving UCs and beneficiaries. Furthermore, the key Informant's Interview was taken with the Planning officials, Implementing officials, and elected representatives followed by policy maker and department representative. A comparison is also made with contractor-based work. Using Content Analysis as a data analysis technique, the raw data was presented in the form of explanation, understanding or interpretation. Findings/Result: Need of empowerment & awareness to the beneficiaries too for their commitment by contributing to the construction projects and also providing orientation training to develop technical and managerial skills to UCs. A mandatory system of feasibility study of the projects for the financing of beneficiaries' contributions is essential. The work schedule or work plan should be attached to the agreement. Proper combination of both approaches would be better to be followed in a single project based on the nature, content, and complexity of rural road construction work. Originality/Value: Both relevant and practical aspects for projects implemented through users in comparison to contractors have been significant for policymakers to decide the correct approach for correct work. Paper Type: Research paper

The projects in Nepal continuously faces issues of expected performance though at local level performance is strictly time bounded. To measure the performance of the completed construction projects through Users Committees in terms of execution time & cost contribution. The study was solely the project performance of the Municipality implementing through UCs of the 33 sites using Opinion survey, checklist survey. The primary and secondary data and information were collected through different tools as questionnaire survey, Key Informant’s Interview, Checklist and field visits. The Descriptive content analysis produces the measures of selected project performance. Overall performance of project executing by UCs was satisfactory. The projects through UCs have been completed within the budget. There is not time control mechanism in the projects since work schedule was not prepared and followed. Most of projects were completed on time of one year and all projects were completed within estimated cost. Due to less managerial and technical skill of UCs, inadequate supervision by the technicians, unavailability of skill persons at local levels and with no laboratory provision in the projects implementing through UCs, the quality of construction work could not be assured as QAP was not in use. For the transparency, the project information board is displayed at sites in the projects budgeting equal to or greater than 10 lakhs. Public Audits are also conducted in all the projects. The projects after the work completion have been examined and cleared within 30 days after completion. The empirical aspects of project implemented through users committee has been analyzed and pragmatic recommendations have been made for assuring effective performance.