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• Range-wide habitat suitability model for the Ganges river dolphin is created. • Highly suitable areas are largely concentrated in southern and eastern basin. • Less than 7% of predicted suitable habitats are currently under protection. • Potential hotspot zones as habitat refugia for the species are delineated. • Systematic classification of suitable areas for efficient conservation is proposed. The Endangered Ganges river dolphin is a flagship species that inhabits the Ganges-Brahmaputra-Meghna and Karnaphuli-Sangu river systems. Exposed to a multitude of environmental stresses and anthropogenic perturbations, the species has experienced severe population decline and shrinking of potential habitat in much of its distribution range. A range-wide mapping of its potential habitat and assessment of factors associated with species occurrence therefore bears immense relevance for conservation planning. We used an ensemble of species distribution models (SDM) using occurrence data to investigate dolphin distribution in relation to hydrological, climatic, physiographic, land cover and anthropogenic variables across the species entire range. We followed a systematic prioritization approach to identify highly suitable habitat patches (potential hotspots) for dolphins that require immediate protection. We identified nearly 7945 sq. km of river area as highly suitable for dolphins as habitat refugia for the species, more than 93% of which are outside the protected area regime, thus demanding immediate conservation attention. This study is a step towards delivering evidence required for spatial risk assessments and conservation planning wherein the habitat suitability maps will help in developing better management plans and strategies, and the predicted three tier classification of suitable habitats will facilitate decision making and prioritization of river segments for inclusion in the protected area network. We recommend that the inferences drawn from our study must be implemented on priority to ensure species conservation in the riverscape. Besides, our study provides huge scope for fine scale assessment and validation of the predicted suitable areas for model improvement. [ABSTRACT FROM AUTHOR]

Hemodialysis is one of the treatment modalities for advanced kidney disease and can help an individual live an active life despite failing kidneys. Although it improves the quality of life, it is not completely risk-free. It has several complications, among which, thrombus formation is common. We report a case of a 63-year-old man who presented at our institution for regular hemodialysis with recurrent arteriovenous graft failure. Because doppler ultrasound is a non-invasive procedure that can identify a thrombus in a vein, it is the best initial option for patients with internal jugular vein thrombosis. The use of ultrasound not only can guide a catheter pathway but can also help in early diagnosis and prevent complications following catheterization in a vein with a thrombus., Keywords: central venous catheterization; chronic kidney disease; hemodialysis; thrombus.

Influenza has a common occurrence during its peak seasons. It usually causes disease of the respiratory tract including severe acute respiratory distress syndrome. However, it may also cause disease and complication of other organ systems. We present a rare complication of influenza in which a patient secondary to influenza developed massive middle cerebral artery ischemic stroke. The patient however survived following recovery of both severe acute respiratory distress syndrome and ischemic stroke after decompressive craniectomy and a prolonged intensive care unit stay. This case report is to highlight the importance of influenza related complications besides the pulmonary infliction which can lead to morbidity and even mortality if not managed on time.

Introduction: COVID-19 is an emerging global health pandemic causing tremendous morbidity and mortality worldwide. Chronic symptoms progressing to poor functional status have been reported in a substantial proportion of COVID-19 patients worldwide. This study aimed to determine the prevalence of functional limitation in COVID-19 recovered patients using the post-COVID-19 functional status scale., Methods: A descriptive cross-sectional study was conducted at Tribhuvan University Teaching Hospital. COVID-19 recovered patients with reverse transcription-polymerase chain reaction negative status were included and assessed using the post-COVID-19 functional status scale. Data entry and analysis was done in Statistical Package for the Social Sciences version 20.0. Descriptive statistics were performed., Results: A total of 106 patients were included for the final analysis. More than half of the patients (56.6%) reported having no functional limitation (grade 0), while the prevalence of some degree of functional limitation was observed in 46 (43.4%) patients (grade 1 to 4)., Conclusions: Some form of functional limitation should be anticipated after COVID-19 infection. Post-COVID-19 functional status scale can be a valuable tool in determining the prevalence of functional limitation in COVID-19 recovered patients in acute health care settings. It can potentially guide in planning rehabilitative measures in post-acute care management of COVID-19 survivors.

Introduction: Respiratory diseases are a leading cause of morbidity and mortality worldwide imposing a significant global health burden. The admission rate of patients is the indication of the overall workload in the ward. The aim of this study was to find the prevalence of admission of patients in the pulmonology ward among patients visiting the pulmonology department of a tertiary care hospital., Methods: A descriptive cross-sectional study was conducted at Tribhuvan University Teaching Hospital. Medical records of all patients visiting the pulmonology department and admitted to the pulmonology ward from May 2018 to April 2020 were retrospectively reviewed. Data entry and analysis was done in SPSS version 20.0. Descriptive statistics were performed., Results: A total of 30,480 patients visited the pulmonology department in the two-year study period. Out of them, 1296 (4.25%) patients were admitted to the pulmonology ward. Eleven respiratory diseases were identified as primary causes for admission. Acute exacerbation of chronic obstructive pulmonary disease (44.5%), pneumonia (26.3%), tuberculosis (11%), lung cancer (5%), and bronchiectasis (3.9%) ranked the top five causes for admission., Conclusions: Respiratory diseases impose a tremendous burden in the health care setting. Acute exacerbation of the chronic obstructive pulmonary disease, pneumonia, and tuberculosis remains an important cause of respiratory admissions in our study.