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The historic first open heart surgery by the all-Nepalese team was performed at Tribhuvan University Teaching Hospital (TUTH) on 20 February 1997. Since then with-in three years period 132 cases of Open Heart Surgeries were performed. Retrospective study of those cases and problems faced in continuing the service is presented here.

Motivation: There is an ongoing debate in development economics about whether resources aiming to improve household welfare should be allocated to general development programmes, such as providing education, or to specific income enhancing programmes, such as promoting certain commodities or practices. Purpose: This article contributes to this debate by analysing income levels and income diversification strategies of households that were engaged in growing organic coffee in the hills of Nepal. Engaging in organic coffee production is hypothesized to be an important income enhancing activity for asset-poor subsistence farmers. Approach and Methods: We conducted a structured household survey of 441 coffee growers from Gulmi and Lalitpur districts in Nepal with a focus on the sources of income. The household income diversification was measured using the mean of the household share of each type of income and the share of a given source of income over a given group of households. We modelled the determinants of household income using Ordinary Least Squares and Tobit regressions. Findings: We found that most households derive a higher proportion of income from off-farm sources. The main finding is that education increases household off-farm income by improving access to domestic and international labour markets, and this reduces dependence on farming. Lowincome households have a higher proportion of income from farming. Across all households, non-certified coffee production is financially more attractive to farmers than organic production. Policy Implications: Our findings suggest that investing in general development, especially education, is more effective than a scheme to promote cash crops as it allows asset-poor subsistence farmers to engage in regional and international labour markets.

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With an increasing human population and vehicles, air pollution in Thimphu City is growing and causing a risk to human health, properties, and ecosystems. The population of Thimphu was 79,185 in 2005 but in 2017 it surged up to 114,551. An increase in the human population has also led to the rising demands for vehicles and thus increased the vehicular emissions in the area. Additionally, the use of traditional fuels, burning of waste and agriculture residues, forest fire, and transboundary pollutants are other sources resulting in poor air quality in Thimphu City. Air pollution data from journal articles, government documents, reports from national and international organizations, and books were reviewed. Concentrations of PM10, PM2.5, SO2, NO2 were increasing over the decades. The annual average PM10 recorded in Thimphu was 28 µg/m3 in 2005, 47 µg/m3 in 2010, 43 µg/m3 in 2014, and 42 µg/m3 in 2015. Winter months were found to have higher PM10 and PM2.5 concentrations. The 24-hourly average concentrations of SO2 ranged from 0.0 to 6.9 µg/m3 and NO2 8.2-26.6 µg/m3. There is a need for comprehensive studies to identify spatial and temporal variations in the ambient concentration of the pollutants in the area. Strict enforcement of the legal frameworks is essential for the mitigation of air pollution in Thimphu City.