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Background Health financing is a major domain of health system building blocks. With the epidemiological transition and increasing trend of Cardiovascular diseases (CVDs), it is crucial to assess the status of health financing to address the gap of prevention, control, and treatment of CVDs in Nepal. Objective This paper aims to assess the situation of healthcare financing on Cardiovascular diseases in Nepal. We framed three key functions of health system financing: (a) revenue collection, (b) pooling of resources, and (c) purchasing of services for this study. Method We used sequential explanatory mixed-method research design. We conducted desk reviews, analyzed secondary data on health financing followed by Key-Informant Interviews with five relevant policymakers and experts between February and September 2019. We obtained the Ethical clearance from the Nepal Health Research Council. Result Out of pocket (OOP) expenditure remains the highest source (52%) of total health care expenditure in Nepal, and two third of it is made for NCDs. Out of total current health expenditure on outpatient and inpatient services for fiscal year 2015/16, only 7% of total NCDs was spent on CVDs. Hypertension is the third-most utilized insurance service out of 36 CVD related services provided by the Health Insurance Board. The existing health related social service schemes covers the high costs associated with treatment, and streamlining these services including provider payment mechanisms with the health insurance program could open up opportunities to expand quality CVD services and make it accessible to the marginalized population. Conclusion Health Financing is the integral part of the health system. With the rising burden of cardiovascular diseases and its impact on impoverishment due to high OOP, integrated health care services, budget specification based on the evidence-based burden of disease such as CVD needs to be prioritized by the government.

Background: Plantar fasciitis is a self limiting disease, with only 10% of patient developing chronic condition even after ten months. We hypothesized that patient with chronic plantar fasciitis who are treated with standard plantar fascia stretching program can have a better functional outcome than those treated with Achilles tendon-stretching exercise.Method: Forty patients who had chronic plantar fasciitis for duration of at least ten months were randomized into one of two groups. Group A received plantar stretching exercise and Group B had Achilles tendon stretching program. All patients completed the pain subscale of Foot Function Index and a subject relevant outcome survey that incorporated generic and condition-specific outcome measures related to pain, function and satisfaction with treatment outcome.Result: The pain subscale scores of the Foot Function Index showed significantly better results at eight weeks for the patients managed with plantar fascia stretching program respect to item 1 (worst pain; p = 0.004) and item 2 (first steps in the morning; p =0.001). Similarly at ten months follow up, pain subscale score comparison was statistically significant for item 1 (p = 0.018) and item 2 (p =0.003).Conclusions: A treatment method of non-weight-bearing stretching exercises specific to plantar fascia is superior to the conventional method of weight-bearing Achilles tendon-stretching exercises for treating patients with chronic plantar fasciitis.Nepal Journal of Medical Sciences Vol.3(2) 2014: 84-88

Failures of glacial lake dams can cause outburst floods and represents a serious hazard. The potential danger of outburst floods depends on various factors like the lake's area and volume, glacier change, morphometry of the glacier and its surrounding moraines and valley, and glacier velocity. Remote sensing offers an efficient tool for displacement calculations and risk assessment of the identification of potentially dangerous glacial lakes (PDGLs) and is especially helpful for remote mountainous areas. Not all important parameters can, however, be obtained using spaceborne imagery. Additional interpretation by an expert is required. ASTER data has a suitable accuracy to calculate surface velocity. Ikonos data offers more detail but requires more effort for rectification. All investigated debris-covered glacier tongues show areas with no or very slow movement rates. From 1962 to 2003 the number and area of glacial lakes increased, dominated by the occurrence and almost linear areal expansion of the moraine-dammed lakes, like the Imja Lake. Although the Imja Lake will probably still grow in the near future, the risk of an outburst flood (GLOF) is considered not higher than for other glacial lakes in the area. Potentially dangerous lakes and areas of lake development are identified. There is a high probability of further lake development at Khumbu Glacier, but a low one at Lhotse Glacier.

Ice volume estimates are crucial for assessing water reserves stored in glaciers. Due to its large glacier coverage, such estimates are of particular interest for the Himalayan–Karakoram (HK) region. In this study, different existing methodologies are used to estimate the ice reserves: three area–volume relations, one slope-dependent volume estimation method, and two ice-thickness distribution models are applied to a recent, detailed, and complete glacier inventory of the HK region, spanning over the period 2000–2010 and revealing an ice coverage of 40 775 km2. An uncertainty and sensitivity assessment is performed to investigate the influence of the observed glacier area and important model parameters on the resulting total ice volume. Results of the two ice-thickness distribution models are validated with local ice-thickness measurements at six glaciers. The resulting ice volumes for the entire HK region range from 2955 to 4737 km3, depending on the approach. This range is lower than most previous estimates. Results from the ice thickness distribution models and the slope-dependent thickness estimations agree well with measured local ice thicknesses. However, total volume estimates from area-related relations are larger than those from other approaches. The study provides evidence on the significant effect of the selected method on results and underlines the importance of a careful and critical evaluation.

The Randolph Glacier Inventory (RGI) is a globally complete collection of digital outlines of glaciers, excluding the ice sheets, developed to meet the needs of the Fifth Assessment of the Intergovernmental Panel on Climate Change for estimates of past and future mass balance. The RGI was created with limited resources in a short period. Priority was given to completeness of coverage, but a limited, uniform set of attributes is attached to each of the ~198 000 glaciers in its latest version, 3.2. Satellite imagery from 1999–2010 provided most of the outlines. Their total extent is estimated as 726 800 ± 34 000 km2. The uncertainty, about ±5%, is derived from careful single-glacier and basin-scale uncertainty estimates and comparisons with inventories that were not sources for the RGI. The main contributors to uncertainty are probably misinterpretation of seasonal snow cover and debris cover. These errors appear not to be normally distributed, and quantifying them reliably is an unsolved problem. Combined with digital elevation models, the RGI glacier outlines yield hypsometries that can be combined with atmospheric data or model outputs for analysis of the impacts of climatic change on glaciers. The RGI has already proved its value in the generation of significantly improved aggregate estimates of glacier mass changes and total volume, and thus actual and potential contributions to sea-level rise.