Shocking images show destruction after the earthquake in Nepal

An injured woman and her daughter receive medical treatment after arriving at Dhading hospital, in the aftermath of the earthquake, in Dhading Besi

A massive earthquake in Nepal measuring 7.8 on the Richter scale has killed almost 4,000 people across four countries and triggered a deadly avalanche on Mount Everest.

The quake, which struck just before noon on 25 April, about 50 miles from Kathmandu in the valley region, is the worst to hit the poverty-stricken Himalayan nation in 81 years.

The government has declared a state of emergency in affected areas. Extensive destruction was reported across the country.

A Nepalese man and woman hold each other in Kathmandu's Durbar Square

Local people gather at the top of large mound where once stood a temple to view the scene of devastation in Kathmandu

A helicopter prepares to rescue people from camp 1 and 2 at Everest Base Camp, Nepal

An elderly woman mourns in front of her destroyed home in the Kumalpur village

Members of a rescue team from China huddle while planning their operation at the site of earthquake in Kathmandu

Earthquake victims collect belongings and salvage food items from a destroyed building

People pray before cremating the body of a victim of the earthquake

An injured boy sleeps on the ground outside the overcrowded Dhading hospital in Dhading Besi

Nepalese victims of the earthquake lie inside an Indian air force helicopter as they are evacuated from Trishuli Bazar to Kathmandu airport in Nepal

A Nepalese girl injured in the earthquake holds the hand of her mother inside an Indian air force helicopter

Indian resident Santosh (2L) is met by relatives after being evacuated following an earthquake in Nepal at the railway station in Amritsar

Nepalese soldiers carry a wounded man on a makeshift stretcher to a waiting Indian air force helicopter

An Indian Air Force person carries a Nepalese child

An Indian Air Force person walks carrying a Nepalese child, wounded in the earthquake, to a waiting ambulance as the mother follows

Many houses, buildings and temples were destroyed during the earthquake, leaving thousands dead or trapped under the debris (Getty)

Family members break down during the cremation of an earthquake victim in Bhaktapur (AP)

At least 17 people died on Everest after an avalanche struck, triggered by the earthquake

Mount Everest base camp after the avalanche (AP)

People were trapped under rubble after the powerful earthquake struck

A man cries as he walks on the street while passing through a damaged statue of Lord Buddha a day after the earthquake in Bhaktapur (Reuters)

The Dharahara tower after the earthquake (EPA)

Nepal's worst earthquake for 81 years has so far left more almost 4,000 dead, and is expected to rise sharply (EPA)

People try to free a living man from the rubble of a destroyed building (EPA)

People free a man from the rubble of a destroyed building (EPA)

A man struggles to free himself from under the rubble of a destroyed building (EPA)

People carry a woman from the rubble of a destroyed building (EPA)

An injured child lies on the ground outside the Medicare Hospital in Kathmandu (AP)

Health workers take care of injured people outside the Manmohan Memorial Community Hospital (EPA)

People search for survivors stuck under the rubble of a destroyed building (EPA)

Nepalese health workers carry injured people into an open area following the earthquake (AFP/Getty Images)

Nepalese rescue members and onlookers gather at the collapsed Darahara Tower in Kathmandu (AFP/Getty Images)

Indian bystanders look at a collapsed house following an earthquake, in Siliguri (AFP/Getty Images)