Background Cardiovascular diseases (CVDs) are the leading cause of deaths and disability in Nepal. Health systems can improve CVD health outcomes even in resource-limited settings by directing efforts to meet critical system gaps. This study aimed to identify Nepal’s health systems gaps to prevent and manage CVDs. Methods We formed a task force composed of the government and non-government representatives and assessed health system performance across six building blocks: governance, service delivery, human resources, medical products, information system, and financing in terms of equity, access, coverage, efficiency, quality, safety and sustainability. We reviewed 125 national health policies, plans, strategies, guidelines, reports and websites and conducted 52 key informant interviews. We grouped notes from desk review and transcripts’ codes into equity, access, coverage, efficiency, quality, safety and sustainability of the health system. Results National health insurance covers less than 10% of the population; and more than 50% of the health spending is out of pocket. The efficiency of CVDs prevention and management programs in Nepal is affected by the shortage of human resources, weak monitoring and supervision, and inadequate engagement of stakeholders. There are policies and strategies in place to ensure quality of care, however their implementation and supervision is weak. The total budget on health has been increasing over the past five years. However, the funding on CVDs is negligible. Conclusion Governments at the federal, provincial and local levels should prioritize CVDs care and partner with non-government organizations to improve preventive and curative CVDs services.

Trees Outside Forest (TOF) are considered important from an environmental, economic and social perspective.Due to its spatial heterogeneity and distribution patterns, the assessment of TOF and its importance is largely absent. The current study was carried out to assess the major TOFs, carbon stocks contained and socio-economic contribution of TOFs in Banepa Municipality. A stratified random sampling method was used for the collection of data (i.e. agriculture land, settlement area and other than agriculture and settlement). Circular plots of 1,000 m 2 having a radius of 17.84 m were laid out randomly in all three strata. A questionnaire survey and field observation was done to explore the socio-economic contribution of TOF. During the study, a total of 28 tree species were recorded. Socio-economic contribution of TOF were converted and presented in terms of monetary value per household per year (NRs/hh/yr), i.e. firewood (960 NRs/hh/yr), fruits (820 NRs/hh/yr), selling whole tree (5500 NRs/hh/yr), timber (25500 NRs/hh/yr) and fodder (4543 NRs/hh/yr). About 23% of the TOF are mostly used for fodder collection and the other 23% of TOF for fruit collection. The total carbon stock was calculated to be 5.76 ton/ha (1.39ton/ha in agriculture land, 2.09ton/ha in the settlement area, and 2.27 ton/ha in other than agriculture or settlement) in the study area and the average carbon stock was calculated to be 1.92 ton/ha. Species-wise carbon stock was calculated where Prunus cerasoides and Alnus nepalensis were found to have a higher contribution in carbon storage. Hence, there is a visible impact of TOF in carbon storage and socio-economic improvement of local people.

Introduction: Prehypertension is an early indicator of hypertension and subsequently the increased risk factor for cardiovascular diseases in later years of life. Prevalence of prehypertension and hypertension was found to be higher among adults in Nepal. However it is not much explored among the young population focusing on gender, hence requiring more studies to control it efficiently. Thus, this study aims to determine the prevalence of prehypertension and its associated risk factors among nursing students. Materials and methods: A cross-sectional study was conducted among the nursing students of Nepalgunj Nursing Campus, Banke, Nepal. Blood pressure measurement and anthropometric measurement was done for data collection. Descriptive analysis, Pearson correlation and chi square test was done using SPSS v20. Results: Total 189 female nursing students participated whose mean age was 22.06±3.42 years. Only 21 participants (11.1%) had prehypertension. Out of total, 36 (19%) were overweight and 11 (5.8%) were obese; 56 (29.6%) had a high waist hip ratio and 75 (39.7%) of the participants had family history of hypertension. There was no significant association of prehypertension with body mass index, waist hip ratio and family history of hypertension. However, the systolic blood pressure was moderately and positively correlated with waist circumference (r=0.215, p=0.003), hip circumference (r=0.222, p=0.002) and body mass index (r=0.237, p=0.001) but not with waist-hip ratio. Similarly, the diastolic blood pressure was also moderately and positively correlated with waist circumference (r=0.309, p<0.001), hip circumference (r=0.269, p<0.001), body mass index (r=0.269, p<0.001) and waist hip ratio (r=0.178, p=0.014). Conclusions: Although the prevalence of prehypertension among nursing students is low and there are no significantly associated risk factors, blood pressure is still correlated with the anthropometric measurements.

Background and Objectives: Survival after cardiopulmonary arrest depends on early and effective cardiopulmonary resuscitation (CPR). Demand for courses of basic life support (BLS)/CPR is increasing worldwide. Till date, there have been little reports regarding CPR knowledge and attitude among the Nepalese dental health personnel. This study aimed to assess the knowledge and attitude towards CPR among undergraduate dental students, interns and postgraduate residents studying at Kantipur Dental College and Teaching Hospital (KDCH), Kathmandu, Nepal. Material and Methods: A descriptive cross-sectional study was conducted among 243 dental students studying at KDCH. Data was collected through a self -administered semi-structured questionnaire. Collected data was organized, recorded, coded and then analyzed using Statistical Package of Social Science (SPSS) version 16. Descriptive statistics was used to compute mean, percentile, standard deviation and one way ANOVA test was done to compare the mean knowledge score between different academic levels of the students at 95% level of significance. Results: The mean knowledge and attitude score towards CPR among the dental students was 8.05±2.85 and 4.63±0.51 respectively. Out of total students, only few (5.8%) had adequate knowledge whereas all (100%) had a positive attitude towards CPR. The mean score for the pre-clinical students (7.26 ±2.38) was significantly (p=0.001) lower than clinical students (8.44 ±3.23), interns and residents (8.85 ±2.54). Conclusion: The present study showed inadequate knowledge regarding CPR among dental students of different academic levels but they have a positive attitude towards it. The integration of CPR in the early year of the curriculum along with regular training of CPR in succeeding years will enhance their knowledge.

Background Cardiopulmonary fitness in terms of maximum aerobic capacity (VO2 max) reflects the total physical fitness of a person. Nursing students, who are the future health care workers and a role model, are more likely to encourage their patients to adopt healthy habits. However, there is a gap of evidence about nursing student’s physical fitness. Thus, this study aimed to assess the cardiopulmonary fitness in terms of VO2 max among the nursing students of Nepalgunj Nursing campus, Banke, Nepal. Methods A cross sectional study was conducted to assess the cardiopulmonary fitness among the nursing students enrolled in Nepalgunj Nursing Campus using a non-probability purposive sampling technique. Queen’s College Step test was conducted along with anthropometric measurements. Descriptive analysis, and chi square test was done using SPSS v20. Ethical approval was taken from the Institutional Review Committee, Institute of Medicine, Tribhuvan University (Ref-99(6-11) 077/078). Results Total 189 female nursing students participated whose mean age was 21.06±3.41 years. Thirty-six (19%) were overweight and 11 (5.8%) were obese. Out of total, 56 (29.6%) had a high-risk waist hip ratio. Almost half (42.9%) of the respondents had superior level of VO2 max with mean VO2 max value of 43.605±10.686. There was a significant association between VO2 max and BMI (X2 =18.856, p=0.016). Conclusion There is superior level of cardiopulmonary fitness among the young nursing adults. Since BMI is associated with VO2 max, one should be aware of maintaining a normal BMI.