Nakhara : Journal of Environmental Design and Planning
Urban green spaces provide important recreational, social, and ecological benefits in urban setti... more Urban green spaces provide important recreational, social, and ecological benefits in urban settings. Understanding of the use and benefits associated with green spaces amongst urban residents is crucial in developing appropriate urban green infrastructure strategies. This study explored visitors’ levels of satisfaction with the benefits, characteristics, and determined factors influencing visitor satisfaction with urban green spaces. Data were collected through a questionnaire survey from a random sample of 125 visitors from three urban green spaces in the capital city of Bhutan, Thimphu. Visitors' satisfaction with urban parks was assessed based on their quality, social, and environmental benefits. Descriptive statistics and an ordered logistic-regression model were used to analyze the data. Results indicate that visitors were satisfied with quality as well as the social and ecological benefits of green spaces. Results also revealed that factors significantly influencing visi...
Introduction: Shoulder joint dislocations account for nearly 50% of all dislocation of joints in ... more Introduction: Shoulder joint dislocations account for nearly 50% of all dislocation of joints in our body. If dislocated joints are left untreated, it becomes very difficult to manage subsequently leading to poorer outcome. Method: We present a 54-year-old gentleman, who was initially managed by traditional bone setter as a case of dislocation of shoulder 3 months ago. However, patient noticed no improvement and visited to our center with deformed painful right shoulder and reduced range of motion of right shoulder. Intervention: Clinical-radiological evaluation showed irreducible anterior dislocation of his shoulder. We managed him with an open reduction by coracoid osteotomy without other extensive procedure like bone grafting. Conclusion: Chronic or neglected dislocated shoulder joint can be managed by less extensive open procedure without any complications or the need to perform extensive procedures
The Tibetan plateau of China is one of the world's major pastoral areas, in which rangeland m... more The Tibetan plateau of China is one of the world's major pastoral areas, in which rangeland management underwent fundamental changes in the twentieth century. This article reviews the rangeland privatisation process in the Tibetan plateau over the last ten years, examining cases from Hongyuan, Zoige and Maqu Counties in the eastern part of the plateau, Nyima County in the northwestern part and Dingri County in the southwestern part. Rangelands have been allocated to individual households or 'the least contracting unit' starting from 1996, but the process of rangeland privatisation was diverse and is still ongoing in the western part of the Tibetan plateau. Rangeland privatisation has some significant impacts on local people and their environment. First, many rangelands are inequitably allocated due to their highly variable topography, productivity and availability of water resources. Secondly, access to social and economic services has been made more difficult for some, ...
Introduction The Pharmaceutical and Research Unit (PRU) under the Institute of Traditional Medici... more Introduction The Pharmaceutical and Research Unit (PRU) under the Institute of Traditional Medicine Services (ITMS) of the Ministry of Health, manufactures 98 essential traditional medicines and supplies them to twenty districts and a few selected Basic Health Units (BHUs) in Bhutan (ITMS 2005). Medicinal plants are the main ingredients of these essential traditional medicines and the commercial products produced. Around 70 % of these plant materials are sourced from within the country (Wangchuk et al. 2007).
Asian Research Journal of Arts & Social Sciences, 2021
Climate change has been a global threat, however, promoting awareness of climate change will redu... more Climate change has been a global threat, however, promoting awareness of climate change will reduce its risk. The study analyzed awareness on three aspects of climate change—causes, impacts, and mitigation among 90 teachers from three high schools, selected using stratified random sampling. We identified a total of 15 statements or variables from each of the causes, impacts, and mitigation to study the teacher’s awareness of climate change. We found that teachers have a medium level of awareness, being more aware of impacts than causes and mitigation of climate change. Three factors– teaching field, education level, and seminar attendance have significantly influenced the teachers’ awareness level on climate change. The result suggests that upgrading education, incorporating environmental studies in educational curriculum, and promoting seminar and workshop on environmental issues increases awareness on climate change.
This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
This paper aims to identify a survival curve involving risk factors for cardiovascular diseases p... more This paper aims to identify a survival curve involving risk factors for cardiovascular diseases patients in Bhutan. There are 5,206 cardiovascular diseases patients recorded in Jigme Dorji Wangchuck National Referral Hospital (JDWNRH) medical record department as of January 2006 to December 2016. In addition, it examines a relationship between survival time and some risk factors by using univariate and multivariate Cox's proportional hazard models. Application of Log-rank test and Cox's proportional hazard model compares the survival curves and find the covariates that affects the survival time. The results showed that, during the follow up a total of 844 (16.2%) CVD patients died which 216 (13.3%) was young-aged, 201 (13.7%) a middle-aged and 427 (20.2%) an old-aged. The survivorship curves are plotted using Kaplan Meier method and identified some risk factors using univariate and multivariate Cox's model. The risk factors were identified as, namely, age, sex, frequency of hospital visits, CVD subtype, number of diagnosis, ward, hypertension, diabetes, myocardial infarction, and cerebral infarction. Further, risk factors for each age group are illustrated at the significant p-value <0.05.
Background: The traditional g.so-ba-rig-pa hospitals in Bhutan uses more than 100 polyingredient ... more Background: The traditional g.so-ba-rig-pa hospitals in Bhutan uses more than 100 polyingredient medicines that are manufactured by the Menjong Sorig Pharmaceuticals (MSP). The MSP has been collecting medicinal plants from Lingzhi region for about 48 years and therefore the ecological pressure on these plants have increased. It is MSP's top priority to identify an alternative collection site to ease the problem. Therefore, this study was carried out to determine whether Dagala region could potentially be an alternative collection site for MSP. Methods: First the multidisciplinary research team generated a tentative plant list by reviewing a body of ancient g.so-ba-rig-pa literature, current formulations, and the MSP medicinal plants inventory documents. Second, the research team visited the study areas in Dagala region for spot identification of medicinal plants. Third, we confirmed our traditional and botanical identification by crosschecking the descriptions with the series of books on traditional texts, Flora of Bhutan, scientific papers on medicinal plants, and the plant databases. Results: We have identified 100 species of high altitude medicinal plants from Dagala region. Of these, 24 species grow abundantly, 29 species grow in moderate numbers and 47 species were scarce. More than 85 species belonged to the herbaceous life form and 51 of them are used as a whole plant. A total of 68 species grow in between 4000 and 4999 meter above sea level. These 100 medicinal plants represented 39 different families and 80 genera and the maximum number of plants belonged to the family Asteraceae. Of 60 species that are currently used for formulating medicines at MSP, 16 species have economic importance with potential for commercial collection. Out of seven areas covered by the survey, Kipchen hosted maximum number of medicinal plants (21 species). Conclusions: Our survey identified 100 medicinal plants from Dagala region and of these, 16 species has economic potential that could benefit both MSP and Dagala communities. It is feasible to establish an alternative medicinal plants collection center in Dagala Gewog.
Background: Wegener's granulomatosis (WG), Churg Strauss syndrome (CSS) and microscopic polyangii... more Background: Wegener's granulomatosis (WG), Churg Strauss syndrome (CSS) and microscopic polyangiitis (MPA) are primary systemic vasculitides (PSV), the clinical features of which have been described from tertiary centres. Aim: To provide the first clinical description of MPA from a general hospital and compare clinical features with WG and CSS. Design: Retrospective analysis of patient records. Methods: Records of 99 PSV patients attending a single hospital, from 1988 to 2000, were reviewed for: clinical features, date/age at diagnosis, sex, duration of illness, anti-neutrophil cytoplasmic antibodies (ANCA), treatment, comorbidity and deaths. Cases were classified using ACR, CHCC and Lanham criteria/definitions. Birmingham vasculitis activity scores (BVAS) and damage index (VDI) were calculated. Survival was assessed using Cox proportional hazards model and standardized mortality ratios (SMRs). Results: Compared to previous reports there was more ENT (29%) and respiratory (29%) but less renal (92%) involvement in MPA, and less ENT involvement in WG (81%). CSS showed high neurological (72%), cardiovascular (28%) and gastrointestinal (17%) involvement and the highest median (range) VDI (p ¼ 0.01 vs. WG; p ¼ 0.001 vs. MPA). BVAS1 was significantly lower in MPA than in WG [median (range) 15 (4-29) vs. 21 (6-39), (p ¼ 0.001)] but not in CSS [20 (7-28), p ¼ 0.08]. SMR (95%CI) for PSV was 4.8 (3.0-6.6); 5-year survival was 45.1% for MPA, 75.9% for WG and 68.1% for CSS. Age was a significant risk, but only to the same extent as in the reference population. When age was adjusted for, no other significant factor was found. Discussion: The clinical characteristics seen here are similar to those in previous series. There are difficulties in using the MPA CHCC definitions in classification. There is a high proportion of neurological involvement in CSS, causing permanent damage. MPA may have a poorer prognosis than WG or CSS.
The Tibetan plateau of China is one of the world's major pastoral areas, in which rangeland m... more The Tibetan plateau of China is one of the world's major pastoral areas, in which rangeland management underwent fundamental changes in the twentieth century. This article reviews the rangeland privatisation process in the Tibetan plateau over the last ten years, examining cases from Hongyuan, Zoige and Maqu Counties in the eastern part of the plateau, Nyima County in the northwestern part and Dingri County in the southwestern part.Rangelands have been allocated to individual households or 'the least contracting unit' starting from 1996, but the process of rangeland privatisation was diverse and is still ongoing in the western part of the Tibetan plateau.Rangeland privatisation has some significant impacts on local people and their environment. First, many rangelands are inequitably allocated due to their highly variable topography, productivity and availability of water resources. Secondly, access to social and economic services has been made more difficult for some, wh...
Nakhara : Journal of Environmental Design and Planning
Urban green spaces provide important recreational, social, and ecological benefits in urban setti... more Urban green spaces provide important recreational, social, and ecological benefits in urban settings. Understanding of the use and benefits associated with green spaces amongst urban residents is crucial in developing appropriate urban green infrastructure strategies. This study explored visitors’ levels of satisfaction with the benefits, characteristics, and determined factors influencing visitor satisfaction with urban green spaces. Data were collected through a questionnaire survey from a random sample of 125 visitors from three urban green spaces in the capital city of Bhutan, Thimphu. Visitors' satisfaction with urban parks was assessed based on their quality, social, and environmental benefits. Descriptive statistics and an ordered logistic-regression model were used to analyze the data. Results indicate that visitors were satisfied with quality as well as the social and ecological benefits of green spaces. Results also revealed that factors significantly influencing visi...
Introduction: Shoulder joint dislocations account for nearly 50% of all dislocation of joints in ... more Introduction: Shoulder joint dislocations account for nearly 50% of all dislocation of joints in our body. If dislocated joints are left untreated, it becomes very difficult to manage subsequently leading to poorer outcome. Method: We present a 54-year-old gentleman, who was initially managed by traditional bone setter as a case of dislocation of shoulder 3 months ago. However, patient noticed no improvement and visited to our center with deformed painful right shoulder and reduced range of motion of right shoulder. Intervention: Clinical-radiological evaluation showed irreducible anterior dislocation of his shoulder. We managed him with an open reduction by coracoid osteotomy without other extensive procedure like bone grafting. Conclusion: Chronic or neglected dislocated shoulder joint can be managed by less extensive open procedure without any complications or the need to perform extensive procedures
The Tibetan plateau of China is one of the world's major pastoral areas, in which rangeland m... more The Tibetan plateau of China is one of the world's major pastoral areas, in which rangeland management underwent fundamental changes in the twentieth century. This article reviews the rangeland privatisation process in the Tibetan plateau over the last ten years, examining cases from Hongyuan, Zoige and Maqu Counties in the eastern part of the plateau, Nyima County in the northwestern part and Dingri County in the southwestern part. Rangelands have been allocated to individual households or 'the least contracting unit' starting from 1996, but the process of rangeland privatisation was diverse and is still ongoing in the western part of the Tibetan plateau. Rangeland privatisation has some significant impacts on local people and their environment. First, many rangelands are inequitably allocated due to their highly variable topography, productivity and availability of water resources. Secondly, access to social and economic services has been made more difficult for some, ...
Introduction The Pharmaceutical and Research Unit (PRU) under the Institute of Traditional Medici... more Introduction The Pharmaceutical and Research Unit (PRU) under the Institute of Traditional Medicine Services (ITMS) of the Ministry of Health, manufactures 98 essential traditional medicines and supplies them to twenty districts and a few selected Basic Health Units (BHUs) in Bhutan (ITMS 2005). Medicinal plants are the main ingredients of these essential traditional medicines and the commercial products produced. Around 70 % of these plant materials are sourced from within the country (Wangchuk et al. 2007).
Asian Research Journal of Arts & Social Sciences, 2021
Climate change has been a global threat, however, promoting awareness of climate change will redu... more Climate change has been a global threat, however, promoting awareness of climate change will reduce its risk. The study analyzed awareness on three aspects of climate change—causes, impacts, and mitigation among 90 teachers from three high schools, selected using stratified random sampling. We identified a total of 15 statements or variables from each of the causes, impacts, and mitigation to study the teacher’s awareness of climate change. We found that teachers have a medium level of awareness, being more aware of impacts than causes and mitigation of climate change. Three factors– teaching field, education level, and seminar attendance have significantly influenced the teachers’ awareness level on climate change. The result suggests that upgrading education, incorporating environmental studies in educational curriculum, and promoting seminar and workshop on environmental issues increases awareness on climate change.
This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
This paper aims to identify a survival curve involving risk factors for cardiovascular diseases p... more This paper aims to identify a survival curve involving risk factors for cardiovascular diseases patients in Bhutan. There are 5,206 cardiovascular diseases patients recorded in Jigme Dorji Wangchuck National Referral Hospital (JDWNRH) medical record department as of January 2006 to December 2016. In addition, it examines a relationship between survival time and some risk factors by using univariate and multivariate Cox's proportional hazard models. Application of Log-rank test and Cox's proportional hazard model compares the survival curves and find the covariates that affects the survival time. The results showed that, during the follow up a total of 844 (16.2%) CVD patients died which 216 (13.3%) was young-aged, 201 (13.7%) a middle-aged and 427 (20.2%) an old-aged. The survivorship curves are plotted using Kaplan Meier method and identified some risk factors using univariate and multivariate Cox's model. The risk factors were identified as, namely, age, sex, frequency of hospital visits, CVD subtype, number of diagnosis, ward, hypertension, diabetes, myocardial infarction, and cerebral infarction. Further, risk factors for each age group are illustrated at the significant p-value <0.05.
Background: The traditional g.so-ba-rig-pa hospitals in Bhutan uses more than 100 polyingredient ... more Background: The traditional g.so-ba-rig-pa hospitals in Bhutan uses more than 100 polyingredient medicines that are manufactured by the Menjong Sorig Pharmaceuticals (MSP). The MSP has been collecting medicinal plants from Lingzhi region for about 48 years and therefore the ecological pressure on these plants have increased. It is MSP's top priority to identify an alternative collection site to ease the problem. Therefore, this study was carried out to determine whether Dagala region could potentially be an alternative collection site for MSP. Methods: First the multidisciplinary research team generated a tentative plant list by reviewing a body of ancient g.so-ba-rig-pa literature, current formulations, and the MSP medicinal plants inventory documents. Second, the research team visited the study areas in Dagala region for spot identification of medicinal plants. Third, we confirmed our traditional and botanical identification by crosschecking the descriptions with the series of books on traditional texts, Flora of Bhutan, scientific papers on medicinal plants, and the plant databases. Results: We have identified 100 species of high altitude medicinal plants from Dagala region. Of these, 24 species grow abundantly, 29 species grow in moderate numbers and 47 species were scarce. More than 85 species belonged to the herbaceous life form and 51 of them are used as a whole plant. A total of 68 species grow in between 4000 and 4999 meter above sea level. These 100 medicinal plants represented 39 different families and 80 genera and the maximum number of plants belonged to the family Asteraceae. Of 60 species that are currently used for formulating medicines at MSP, 16 species have economic importance with potential for commercial collection. Out of seven areas covered by the survey, Kipchen hosted maximum number of medicinal plants (21 species). Conclusions: Our survey identified 100 medicinal plants from Dagala region and of these, 16 species has economic potential that could benefit both MSP and Dagala communities. It is feasible to establish an alternative medicinal plants collection center in Dagala Gewog.
Background: Wegener's granulomatosis (WG), Churg Strauss syndrome (CSS) and microscopic polyangii... more Background: Wegener's granulomatosis (WG), Churg Strauss syndrome (CSS) and microscopic polyangiitis (MPA) are primary systemic vasculitides (PSV), the clinical features of which have been described from tertiary centres. Aim: To provide the first clinical description of MPA from a general hospital and compare clinical features with WG and CSS. Design: Retrospective analysis of patient records. Methods: Records of 99 PSV patients attending a single hospital, from 1988 to 2000, were reviewed for: clinical features, date/age at diagnosis, sex, duration of illness, anti-neutrophil cytoplasmic antibodies (ANCA), treatment, comorbidity and deaths. Cases were classified using ACR, CHCC and Lanham criteria/definitions. Birmingham vasculitis activity scores (BVAS) and damage index (VDI) were calculated. Survival was assessed using Cox proportional hazards model and standardized mortality ratios (SMRs). Results: Compared to previous reports there was more ENT (29%) and respiratory (29%) but less renal (92%) involvement in MPA, and less ENT involvement in WG (81%). CSS showed high neurological (72%), cardiovascular (28%) and gastrointestinal (17%) involvement and the highest median (range) VDI (p ¼ 0.01 vs. WG; p ¼ 0.001 vs. MPA). BVAS1 was significantly lower in MPA than in WG [median (range) 15 (4-29) vs. 21 (6-39), (p ¼ 0.001)] but not in CSS [20 (7-28), p ¼ 0.08]. SMR (95%CI) for PSV was 4.8 (3.0-6.6); 5-year survival was 45.1% for MPA, 75.9% for WG and 68.1% for CSS. Age was a significant risk, but only to the same extent as in the reference population. When age was adjusted for, no other significant factor was found. Discussion: The clinical characteristics seen here are similar to those in previous series. There are difficulties in using the MPA CHCC definitions in classification. There is a high proportion of neurological involvement in CSS, causing permanent damage. MPA may have a poorer prognosis than WG or CSS.
The Tibetan plateau of China is one of the world's major pastoral areas, in which rangeland m... more The Tibetan plateau of China is one of the world's major pastoral areas, in which rangeland management underwent fundamental changes in the twentieth century. This article reviews the rangeland privatisation process in the Tibetan plateau over the last ten years, examining cases from Hongyuan, Zoige and Maqu Counties in the eastern part of the plateau, Nyima County in the northwestern part and Dingri County in the southwestern part.Rangelands have been allocated to individual households or 'the least contracting unit' starting from 1996, but the process of rangeland privatisation was diverse and is still ongoing in the western part of the Tibetan plateau.Rangeland privatisation has some significant impacts on local people and their environment. First, many rangelands are inequitably allocated due to their highly variable topography, productivity and availability of water resources. Secondly, access to social and economic services has been made more difficult for some, wh...
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