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Mean Brain Weight among Autopsy Cases at the Department of Forensic Medicine of a Tertiary Care Centre: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2022) Kandel, Jwala; Pokharel, Dikshanta
Abstract Introduction: Weight of the brain is an important diagnostic criterion during autopsy. Normal variations in brain weight among various population demands for population-specific study. The aim of this study was to find the mean brain weight among autopsy cases at a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among autopsy cases in the Department of Forensic Medicine of a tertiary care hospital from July 2019 to July 2021. The approval for the study was obtained from the Institutional Review Committee (Reference number: 550/2019). Convenience sampling was done. Brain was dissected following standard autopsy technique and weight was measured by an electronic digital weighing scale (5 kg/0.01 gm). Statistical Package for the Social Sciences version 20.0 was used for data analysis. Point estimate at 95% Confidence Interval and descriptive statistics were used to express results in frequency, mean, standard deviation, range, and percentage. Results: The mean brain weight for 394 autopsy cases was 1272.38±144.07 grams (1258.15-1286.60 at 95% Confidence Interval). For male and female it was 1322.47±140.22 grams and 1221.27±129.55 grams respectively. Maximum attainment of brain weight was found at 21 to 30 years age group for both sexes. Out of 394 cases, 199 (50.50%) were males and 195 (49.50%) were females. In all the age groups, male brain weight was greater than that of female. Conclusions: The mean weight of the brain derived from the present study is found to have variable values in comparison to other studies done under similar settings.
Poor Glycemic Control in Type 2 Diabetes Mellitus Patients in Two Tertiary Care Centers during COVID-19 Lockdown: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2022) Oli, Jagatkiran; Pant, Ved Prakash; Niraula, Apeksha; Lamsal, Madhab
Abstract Introduction: Lockdown enforced to control the rapid transmission of novel coronavirus has resulted in the confinement of people in the home and restrictions of movement. This may have altered the lifestyle and glycemic control of type 2 diabetes mellitus patients. This study aimed to find the prevalence of poor glycemic control in type 2 diabetes mellitus patients in two tertiary care centres during COVID-19 lockdown. Methods: A descriptive cross-sectional study was conducted among 259 type 2 diabetes mellitus patients in selected hospitals from 1st September to 30th September 2020 after receiving ethical approval from the Departmental Research Unit, Biochemistry under Institutional Review Committee (Reference number: DRU/01/2020). A convenience sampling method was used. Data analysis was done by using Statistical Package for the Social Sciences version 26.0. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Among 259 patients with type 2 Diabetes Mellitus, 183 (70.65%) (65.10-76.20 at 95% Confidence Interval) had poor glycemic control during the lockdown period. Mean fasting and post-prandial blood glucose among these patients were 164.16±49.30 mg/dl and 246.76±69.86 mg/dl respectively. Conclusions: Our study depicts that the majority of the type 2 diabetes mellitus patients had poor glycemic control during the lockdown period which was similar when compared to other studies.
Potential Drug-drug Interaction among the Patients Admitted in Intensive Care Units of a Tertiary Care Centre: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2022) Ghimire, Rakesh; Prasad, Pravin; Parajuli, Subigya; Basnet, Rabin; Lamichhane, Pratik; Poudel, Nirmal; Shrestha, Pramesh Sunder; Kharel, Shristi; Pokharel, Akritee; Mudvari, Anish
Abstract Introduction: Drug interactions are one of the major contributors to increase hospital stay, inflate health care expenses, and cause serious adverse events and end-organ damage. Patients admitted to the intensive care unit are already critically sick and are at greater risk of these adverse outcomes. The study aimed to find out the prevalence of potential drug-drug interactions in the Intensive Care Units of a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among the patients admitted in the Intensive Care Unit of a tertiary care hospital from April-June 2019. Ethical approval was taken from the Institutional Review Board at the institute (Reference number: 399). Convenience sampling method was used. Data was collected using proforma and potential drug-drug interactions were identified using Lexicomp® drug-interactions version 1.1 (Wolters Kluwer). All the drug interactions identified were classified and the severity scale of interactions was also defined. Statistical Package for the Social Sciences version 17.0 was used for data analysis. Point estimate at 95% Confidence Interval was calculated along with frequency, percentage, mean, standard deviation, and mode. Results: Out of 101 patients, the prevalence of the drug-drug interaction was found to be 90 (89.11%) (83.04-95.18 at 95% Confidence Interval). A total of 490 drug-drug interactions were identified. In severity scale, it was seen that 311 (63.46%) were of moderate severity and 303 (61.83%) of drug interactions were categorised as category C in risk rating. Conclusions: Prevalence of potential drug-drug interactions was higher compared to similar published literature. The most common drug with potential interaction was fentanyl and among pairs was fentanyl plus paracetamol.
Palliative Care and Pain Management in a Resource-Limited Setting
(Kathmandu University, 2025) Gautam, A; Gautam, A; Johnson, S; Rahman, FA
ABSTRACT Palliative care is a vital component of healthcare that aims to alleviate the suffering of patients with life-threatening conditions. This specialized medical care focuses on managing symptoms, addressing social, emotional, and physical needs, and enhancing the quality of life for patients and their families. Palliative care addresses the patient’s medical, psychological, and spiritual requirements, and can be used as the primary focus of care or in conjunction with curative therapies. Pain management is a crucial aspect of palliative care, involving the control or reduction of pain through medication, therapy, and other treatments. However, pain is a subjective sensation, making quantification and effective relief challenging. This review highlights the complex issues associated with pain management in palliative care, emphasizing the need for improved training and accessible pain management techniques, such as the widely recognized “Wong-Baker Face Pain Scale”, particularly in resource-constrained environments like Nepal. The complex nature of pain management in palliative care compromises patients’ quality of life, influenced by factors like chemotherapy and terminal illness. Addressing this issue is imperative, especially in areas like Nepal where there is a shortage of appropriate training among medical personnel. Encouragingly, initiatives like mobile health teams, smartphone apps, and the establishment of a Palliative Care Training Center demonstrate progress in improving end-of-life care. KEY WORDS Health personnel, Nepal, Pain management, Palliative care
The G.R.A.P.E. Checklist for Students of Healthcare to Finetune and Safeguard their Scholarly Manuscripts
(Kathmandu University, 2025) Shukla, B; Panda, A
ABSTRACT Structured scientific writing in medicine is seldom a part of curricula especially in non-native English-speaking countries. However, with the right tools and strategies, young researchers and academicians can be assured of artful dissemination of their research. The aim of this study is to propose a checklist that can help authors in structuring a polished scholarly manuscript. In order to achieve this, the authors carried out a literature search across prominent databases like PubMed, MEDLINE and Global Index Medicus to investigate the common reasons for retraction or rejection of manuscripts between 2020 to 2023. The inclusion criteria were as follows: reviews, observational studies, commentaries and editorials published in English since 2020 in the field of healthcare. A total of 32 results were identified, eight of which met the inclusion criteria. The eight included studies were from the field of dentistry, cardiology, neurology, spine surgery, anaesthesiology, nursing, and medically assisted reproduction. The most common reasons for article rejection or retraction were academic misconduct, designing errors, unintentional errors and data fraud. In order to overcome these flaws, the G.R.A.P.E. (Grammar, Reference Management, Archiving, Plagiarism, Equator-Network) checklist is proposed. Satisfying this checklist can result in a well-knit manuscript. The common reasons for article rejection/retraction can be avoided should students and academicians use the recommended strategies and tools as per the proposed checklist. KEY WORDS Academic publishing, Academic writing, Learning tool, Open educational resources, Research misconduct
Raised D-dimer Level among COVID-19 Patients in a Tertiary Care Hospital: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2022) Rizal, Shikha; Joshi, Bishal Raj; Regmi, Sunil
Abstract Introduction: Serum D-dimer is a protein fragment generated during the final phase of clot formation. Increased serum D-dimer levels indicate the hemostatic change in patients, likely related to the prothrombotic switch. As the world is battling with the damaging effect of coronavirus disease, it is very important to find out the early and effective predictors of prognosis to improve the management of COVID-19 patients. Thus, our study aims to find out the prevalence of increased D-dimer levels in coronavirus disease patients. Methods: A descriptive cross-sectional study was conducted on a total of 235 patients admitted in the COVID ward and COVID Intensive Care Units at a tertiary care hospital from July 2020 to August 2021 after getting ethical approval (Reference number: 401/2020) from the Institutional Review Committee. A convenience sampling method was used for sample collection. The highest recorded values for D-dimer during the hospital stay were taken for data collection. The data were entered in Microsoft Excel 2013 and analyzed using Statistical Package for the Social Sciences version 16.0. Point estimate at 95% Confidence Interval was calculated along with frequency, proportion, mean and standard deviation. Results: Among 235 patients, elevated D- dimer level was in 175 (74.46%) (68.88-80.04 at 95% Confidence Interval). Majority of the patients were males 136 (77.71%) whereas 39 (22.28%) of the patients were females. Conclusions: The prevalence of raised D-dimer levels was quite higher in our studies compared to other studies done in different parts of the world. Thus, serum D-dimer level may serve as an early marker in improving the management of patients with coronavirus disease.
“SNOT RACE”: Dhulikhel Hospital Protocol for Analysis of Computed Tomography of Nose, Paranasal Sinuses
(Kathmandu University, 2025) K.C., AK; Shrestha, BL; Dhakal, A
ABSTRACT The anatomy of nose and paranasal sinuses is highly complicated and is most often characterised by considerable anatomical variations. These variations have often been linked to the aetiopathogenesis of inflammatory sinonasal pathology. Also apart from diagnostic value, these variations also predispose the surrounding critical structures to iatrogenic trauma during functional endoscopic sinus surgery (FESS). Some of these variations also have a role in recurrence of disease. Computed tomography (CT) is the mainstay of diagnosis and surgical planning for sinonasal diseases, and a structured checklist to assess possible anatomic variants helps to reduce the risk of surgical complications. Hence, we developed a checklist at our centre with the mnemonic “SNOT RACE”. KEY WORDS Anatomical variations, Computed tomography, Functional endoscopic sinus surgery, Paranasal sinuses
Laparoscopic Adrenalectomy for Adrenal Mass
(Kathmandu University, 2025) Adhikari, MB; Yadav, DK; Maharjan, B; Gautam, RK; Mishra, P; Basnet, B; Khadga, A
ABSTRACT Adrenal gland tumors, including both benign and malignant forms, are increasingly detected due to advancements in imaging techniques. This prospective study, conducted at Nepal Mediciti Hospital evaluated thirteen patients diagnosed with adrenal masses, all confirmed benign via contrast-enhanced computed tomography. Functional assessment, preoperative endocrinological and anesthesiological evaluations and pharmacological preparations were conducted as needed. All patients underwent successful lateral transperitoneal laparoscopic adrenalectomy, performed by a single surgeon. The study population had a female predominance (9 females, 4 males), with tumor sizes ranging from 2 to 9 cm. No surgeries required conversion to open procedures, and postoperative outcomes were favorable, with no mortality or re-operations. Complications were minimal, including transient blood pressure elevation in one pheochromocytoma case and one postoperative chest infection. Histopathological findings included aldosterone-producing adenomas, cortisol-producing adenomas, and pheochromocytomas. The study supports the continued use of laparoscopic adrenalectomy as the preferred surgical method for adrenal tumors. KEY WORDS Adrenal gland, Adrenal tumor, Laparoscopic surgery
Sputum Eosinophil Level among Healthy Individuals Visiting Medicine Outpatient Department of a Tertiary Care Centre: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2022) Pant, Subash; Shrestha, Prinsa; Acharya, Rajat; Gurung, Pranita; Neopane, Arpana
Abstract Introduction: Sputum differential is the most comprehensive, and non-invasive investigation for evaluating airway inflammation because of its reliability, reproducibility and responsiveness. The interpretation of the results of induced sputum examination depends on knowledge of normal values from a healthy population. So far, the reference values of sputum differential cells in Nepalese population are not reported. Neutrophil and eosinophil are used to assess the inflammatory response of the airway. The aim of our study was to detect the eosinophil level in the sputum of healthy individuals with normal pulmonary function. Methods: A descriptive cross-sectional study was conducted in a tertiary care hospital, from November 1, 2021 to December 31, 2021 after taking ethical clearance from Institutional Review Board (Reference number: 1507202106). Convenience sampling was done. Collected data was entered and analysed using Statistical Package for the Social Sciences version 24.0. Point estimate at 95% was calculated along with mean and standard deviation for continuous data. Results: Among 139 induced sputum samples, 7 (5.03%) had eosinophils present in their sputum (1.40 to 8.67 at 95% Confidence Interval). The age range of the participants was 18 years to 79 years with mean age of 39.5 ± 15.06. Prevalence of eosinophilia (percentage of eosinophil ≥3) was 4 (2.88%). Conclusions: The prevalence of eosinophilia in our study was found to be similar to published literature. The results of the present study show that there is a paucity of eosinophils with predominance of neutrophils, macrophages and lymphocytes in induced sputum samples of healthy non-smoker adults with normal pulmonary function test.
Posterior Microphthalmos with Papillomacular Retinal Folds and Pseudo Disc Edema
(Kathmandu University, 2025) Shrestha, R; Shah, RK; Joshi, P
ABSTRACT We report a rare case of posterior microphthalmos with prominent papillomacular folds, pseudo disc edema and high hyperopia in a 12 year old child with no systemic anomalies. The patient was diagnosed as high hyperopia two years ago but the posterior findings were missed. The anterior segment of the eye was normal on slit lamp examination but the appropriate diagnosis was missed. Hence detailed evaluation of every hyperopic child should be done for the timely management. This case report highlights the importance of detailed fundus and biometric evaluation to avoid missing the diagnosis of posterior microphthalmos in a high hyperopic child with no systemic anomalies. KEY WORDS Hyperopia, Microphthalmos, Papillomacular folds, Pseudo disc edema
GeneXpert Based Confirmed Cases among Suspected Cases of Tuberculosis in a Tertiary Care Centre: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2022) Pant, Prabesh; Gurung, Kishor; Shrestha, Nitesh; Basnet, Subhechhya
Abstract Introduction: Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis mostly affecting the lungs. Due to the low sensitivity of conventional microscopy and time-consuming culture method, Nucleic acid Amplification Assay Technique is preferred because of its rapidity and sensitivity. This test also helps in finding drug resistance to Rifampicin and also curtails the transmission of disease. The study is aimed to find the prevalence of GeneXpert confirmed cases among suspected cases of tuberculosis in a tertiary care centre. Methods: A descriptive cross-sectional study in 104 patients was conducted in a tertiary care centre from 30th Dec 2021 to 3rd Feb 2022. Ethical clearance was taken from the Institutional Review Committee (Reference number: 464/078/079). Sputum samples were collected from patients and were processed for GeneXpert under biological safety standards. GeneXpert Mycobacterium tuberculosis/rifampicin assay, sample processing, deoxyribonucleic acid extraction, and deoxyribonucleic acid amplification occurred in a fully automated cartridge-based real-time Polymerase chain reaction. A convenience sampling method was done. Collected data were coded as per variables and entered in Statistical Package for the Social Sciences version 25. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage for binary data. Results: In all 104 patients, GeneXpert detected 10 (9.62%) (3.94-15.26 at 95% Confidence Interval) positive tuberculosis cases. Out of total positive cases, there were 6 (60%) males and 4 (40%) females and there was 1 (10%) rifampicin-resistant case. Conclusions: The prevalence of pulmonary tuberculosis among presumptive cases in our study was found to be similar to reported literature.
Soft Tissue Ridge Augmentation for Pontic Site Preparation: A Perio-Prostho Synergy
(Kathmandu University, 2025) Marattha, P; Humagain, M; Lamichhane, S; Rijal, AH; Shrestha, A; Timilsina, S
ABSTRACT The reconstruction of a lost alveolar housing is important to achieve a harmonious balance between biology, function, and aesthetics for a prosthesis’s successful outcome. Soft tissue ridge augmentation is a periodontal surgical procedure designed to correct mild to moderate horizontal alveolar ridge deformities alongside fixed partial prosthesis, mostly preferred for their aesthetic benefits and less invasive nature as compare to hard tissue augmentation. Moreover, the increase in keratinized tissue and the improved soft tissue profile reduces the risk of future complications and is essential for hygiene maintainance. The purpose of this case report was to present the successful periodontics-prosthodontics synergistic approach to treat a seibert class I moderate type ridge defect with additional vestibular depth and keratinized tissue insufficiency issues in an edentulous molar pontic site using a free gingival onlay graft. KEY WORDS Alveolar ridge augmentation, Autograft, Esthetics, Pontic site preparation
Tympanic Membrane Perforation among Patients Presenting to Department of Otorhinolaryngology of a Tertiary Care Hospital: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2022) Ghimire, Bibek; Basnet, Meenakshi; Aryal, Gyan Raj; Shrestha, Nischal
Abstract Introduction: Intact tympanic membrane acts as a partition between the external ear and middle ear. Tympanic membrane perforation is one of the commonest causes of conductive hearing loss. Perforation size is the most important determination of hearing loss. The aim of this study was to find out the prevalence of tympanic membrane perforation among patients presenting to the otorhinolaryngology department of a tertiary care hospital. Methods: A descriptive cross-sectional study was carried out in the Department of Otorhinolaryngology and Head Neck Surgery of a tertiary care hospital from March 2021 to August 2021. Ethical approval was taken from Institutional Review Committee (Reference number: 57112021). Convenience sampling was done and data was collected from 414 patients presenting to the department. Collected data were entered, analyzed in Statistical Package for the Social Sciences version 21.0 and documented for study. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage for binary data. Results: Among 414 patients, tympanic membrane perforation was seen in 100 (24.15%) (20.02-28.27 at 95% Confidence Interval). Among 100 patients with a total of 153 perforated eardrums, mild hearing loss was seen in the majority of the cases. Posterior perforation had a mean hearing loss of 40.41±5.96 dB, central had 39.09±3.13 dB, and anterior had 35.15±5.88 dB. Conclusions: Our study showed the prevalence of tympanic membrane perforation to be high when compared to other similar studies. Hearing loss was observed in all cases; the majority with mild hearing loss. The degree of hearing loss was more in larger and posterior perforation.
Thyroid Angiosarcoma : An unusual and challenging case report at B.P. Koirala Institute of Health Sciences
(Kathmandu University, 2025) Lamichhane, U; Paudyal, P; Karki, S; Pradhan, A; Dahal, M; Shah, SP
ABSTRACT Angiosarcoma is an uncommon malignant vascular tumor of endothelial origin and commonly described in soft tissue. Thyroid is an uncommon site for angiosarcoma and is a very aggressive tumor commonly occurring in elderly female, characterized by its prevalence in Alpine regions of central Europe. The main aim of this case report is to provide an insight on thyroid angiosarcoma (TAS) occurring in non- Alpine region, to know the major diagnostic features of thyroid angiosarcoma and distinguish it from anaplastic thyroid carcinoma with angiomatoid features. Due to its overlapping microscopic features diagnosis of primary thyroid angiosarcoma (TAS) was challenging. However, the combination of thorough microscopic findings and immunohistochemical studies (CD 31, Vimentin, Thyroglobulin and Thyroid Transcription Factor-1) are vitally important in differentiating these two tumors to achieve at a final diagnosis. This significantly helps to decide the best treatment option and predict the behaviour. KEY WORDS Anaplastic carcinoma, Angiosarcoma, Thyroid gland
Neurophysiology of Mindfulness Meditation: A Narrative Review Based on Buddhist Perspective
(Kathmandu University, 2025) Joshi, B; Jha, JP; Karn, A; Shrestha, L
ABSTRACT Meditation, an inward journey to explore profound levels of consciousness rooted in Buddhism, has significant physical and psychological benefits, including enhanced well-being, improved concentration, emotional stability, and positive cognitive shifts. This narrative review consolidates past two decades of research on the neurophysiological effects of Buddhist mindfulness meditation based on neuroimaging findings, and aims to examine the Buddhist view of mindfulness meditation in relation to the structural and functional changes in the brain areas in health and diseases. Meditation practices, such as Vipassana in Buddhism, emphasize mindfulness and non-judgmental awareness of oneself and surrounding. Neuroimaging studies have revealed its significant impact on brain regions including structural changes involving anterior cingulate cortex (ACC), temporal lobe, insula, hippocampus, amygdala, thalamus and other areas. Four fundamental mechanisms summarize the mindfulness meditation: attention regulation, body awareness, emotion regulation, and a transformed self- perspective. The scientific explanation of effects of meditation is challenging, and we are only beginning to understand in neurophysiological terms. Previous research on mindfulness meditation has employed diverse methodological approaches, including self-reported measures, behavioral tasks and neuroimaging techniques; but there lacks a standardization, making it difficult to compare the findings. However, the cognitive processes are thought to underlie the potential benefits of mindfulness meditation in promoting mental well-being on an individual and societal level. This review highlights the mechanisms of mindfulness meditation to improve cognitive flexibility and promote mental well-being, in relation to Buddhist philosophy, with implications for individual and societal benefits. KEY WORDS Buddhism, Cognition, Consciousness, Meditation, Mindfulness, Neurophysiology
Exploring the Job Satisfaction among Workforce Working in Four Medical Colleges in Nepal: a cross-sectional study
(Kathmandu University, 2025) Dahal, DP; Gupta, N
ABSTRACT Background Job satisfaction is a critical factor influencing healthcare quality, patient’s outcomes and overall wellbeing in medical profession. Job satisfaction is an important component of improving job performance and maintaining overall quality of work in any organization. The result of job satisfaction will have an impact not only at the individual level but also in the institutional, societal, and national level. Objective To explore overall job satisfaction among the workforce of four different medical colleges in Nepal, as well as the factors associated with it. Method A cross-sectional study was conducted from August to December 2024 among medical, nursing, and administrative staff who had at least one year of teaching or working experience in their respective institutions. A 36-items job satisfaction questionnaire with 6-point Likert type responses was administered in-person. Data analysis was carried out with STATA version 18 software. Categorical variables were presented as frequencies and percentages, whereas continuous variables were described using means, standard deviations, medians, and ranges. Inferential statistical analyses comprised independent t-tests for comparisons between two groups and analysis of variance (ANOVA) for comparisons among multiple groups. A multivariable linear regression model was used to identify the significant factors associated with health workforce job satisfaction. Statistical significance was defined as p < 0.05, with results reported at a 95% confidence interval. Result This study analyzed job satisfaction among 533 health workers in four medical colleges. The average overall job satisfaction score was 122.24 (±15.17). Multivariable linear regression identified several significant determinants of overall job satisfaction among health workers in Nepal’s teaching hospitals. Employees in Nursing (adjusted mean difference [AMD]: 5.35, 95% CI: 2.46 to 8.26) and Administration (AMD: 5.45, 95% CI: 2.20 to 8.71) departments reported higher OJS compared to those in the medical department. Contract staff had significantly lower job satisfaction (AMD: -4.23, 95% CI: -7.19 to -1.28), while differences for daily wage and other positions were not significant. Unexpectedly, employees without chronic diseases reported lower OJS (AMD: -2.66, 95% CI: -5.86 to -0.55). Higher organizational input factors were significantly associated with lower OJS (AMD: -0.37, 95% CI: -0.55 to -0.19). Conclusion This study revealed that health workforces had positive attitude towards their job however are dissatisfied with the benefits offered to them and the operating condition of their institutions. Expanding the teaching learning resources, continuing career opportunities through participation in professional development and regular promotion and increment of salary would be helpful in improving job satisfaction among health workforce in Nepal. KEY WORDS Health workforce, Medical colleges, Organizational characteristics, Satisfaction
Status of Hypertension and Its Associated Factors Among Undergraduate Medical Students of a Private Medical College in Lalitpur District
(Kathmandu University, 2025) Sah, SK; Singh, N; Pandey, S; Sherpa (Lama), AT; Panta, PP; Shah, S; Ghising, K; Rai, N
ABSTRACT Background Hypertension, a significant global health concern, warrants exploration within the unique context of medical student populations. Hypertension is a silent killer and is a leading cause of premature morbidity and mortality particularly in developing countries including Nepal. Medical students are prone to stress, long working hours, unsteady and unhealthy lifestyles such as lack of exercise, eating unhealthy food which are high risk factors contributing to hypertension. Objective To assess the prevalence of hypertension and its associated risk factors among undergraduate medical students. Method A Cross-sectional study was conducted between August to November 2023 among the undergraduate medical students from first-year to final-year and interns at a teaching hospital after obtaining ethical approval from the Institutional Review Committee. A total enumeration sampling technique was used. Chi square test was used to determine the association between variable and P value less than 0.05 was fixed for statistically significant. Result Out of 500 participants, 234 (46.80%) were reported to have hypertension according to the classification of the American Heart Association, 2023. Among them, 169 (72.22%) were male and 65 (27.78%) were female, with a male-to-female ratio of 2.6:1. Male participants had significantly higher odds of developing hypertension compared to females, with a crude odds ratio (COR) of 3.116 (95% CI: 2.144–4.53, p < 0.001) and an adjusted odds ratio (AOR) of 2.815 (95% CI: 1.914–4.139, p < 0.001). Participants categorized as “Obese” also had significantly higher odds of developing hypertension compared to “Non-obese” individuals, with a COR of 1.862 (95% CI: 1.189–2.916, p = 0.006) and an AOR of 1.636 (95% CI: 1.026–2.607, p = 0.039). Conclusion The high frequency of hypertension in this study could indicate a hidden epidemic among medical students. The results suggest that effective health screening and routine examinations are necessary, in addition to measures that support healthy lifestyles. KEY WORDS Alcohol consumption, Blood pressure, Hypertension, Obesity, Sex, Smoking habit
Body Mass Index in Patients with Degenerative Spondylolisthesis: A descriptive cross-sectional study
(Kathmandu University, 2025) Kafle, KR; Lakhey, RB; Ghimire, N; Paudel, S; Paudel, S; Kafle, D
ABSTRACT Background Low back pain is a leading cause of disability globally. Obesity, a product of modern lifestyle, is a well-established risk factor for many diseases including spine pathologies. Degenerative lumbar spondylolisthesis is a significant cause of low back pain in the middle-aged and elderly population. However, the literature on relationship between high body mass index and degenerative spondylolisthesis is inconsistent. Objective To investigate prevalence of obesity among the patients with degenerative spondylolisthesis. Method This cross-sectional study was conducted at Tribhuvan University Teaching Hospital, Nepal, involving 81 patients aged ≥ 40 diagnosed with degenerative spondylolisthesis at various lumbar vertebral levels and grades. Anthropometric measurements were obtained and analyzed using an Independent t-test to compare the mean age, height, weight, and body mass index across different levels, grades, and between sexes. Result Among the 81 patients, 59 were female, and 22 were male. The mean age and, BMI were 59.41 ± 10.97 years, and 26.04 ± 4.41 kg/m2, respectively. A notable 59.3% of patients had Body Mass Index ≥ 25. Patients with grade II spondylolisthesis exhibited significantly higher weight and Body Mass Index compared to those with grade I spondylolisthesis (p = 0.031, 0.013), particularly in female population (p = 0.003, 0.007) and at L4-L5 level (p = 0.003, 0.004). Conclusion Body mass index and weight were significantly higher in patients with grade II spondylolisthesis compared to grade I. This finding underscores the need for further research to understand the relationship between obesity and degenerative spondylolisthesis. KEY WORDS Body mass index, Epidemiology, Obesity, Spondylolisthesis
Epidemiological, Clinical Profile and Outcome of Hospitalized COVID Patients in a Tertiary Hospital in Nepal during the Second Wave
(Kathmandu University, 2025) Dhungana, D; Acharya, RR; Banstola, B; Tiwari, R; Dawadi, V
ABSTRACT Background COVID-19 caused a global pandemic. It caused significant morbidity and mortality worldwide. The cases peaked at different intervals. The second wave, worldwide, was caused by delta variant. Majority of cases occurred from April 2021 to November 2021. Nepal was also affected during this period, causing a shortage of intensive care unit beds, oxygen supplies, and trained healthcare professionals. Objective To assess the clinical profile and outcome of patients admitted to a tertiary hospital in Nepal. Method An observational study was conducted with data collected from the medical records department after obtaining permission from the hospital authority and ethical clearance from the institutional review board. Sociodemographic variables, clinical profiles including symptoms on presentation, laboratory and imaging reports, duration of hospital stay, and outcome were obtained. Data were entered into SPSS and analysed. Result Among 307 patients,. mean age of the patients was 58.73 years (S.D=17.77). Most common reported symptoms were breathlessness in 59.6% (53.9, 65.1), fever in 58.6% (52.9, 64.2) and cough in 44.3% (38.6, 50.1) cases. The mortality rate was found to be 38.8% (33.2%, 44.5%). Breathlessness on presentation was associated with increased odds of mortality (adjusted odds ratio: 3.24, 95% CI 1.88, 5.60). Males were found to be at 1.77 (95% CI 1.01, 3.11) times risk of death as compared to females. Conclusion Nearly two-third of admitted patients had at least one or more comorbidities. Variability in symptoms on presentation may predict possible patient outcomes. The government should prioritize infectious diseases and plan for disease outbreaks at the national, provincial, and local levels. KEY WORDS COVID-19, Comorbidities, Coronavirus, Pandemic, Mortality
Utilization and Completeness of World Health Organization Surgical Safety Checklist in a Tertiary Hospital in Nepal
(Kathmandu University, 2025) Shrestha, U; Ghimire, P; Khatri, G
ABSTRACT Background The World Health Organization Surgical Safety Checklist (WHO-SSC) reduces surgical complications and morbidity; however, its utilization remains low in low- and middle- income countries. Objective To assess the utilization and completeness of a modified WHO Surgical Safety Checklist at a tertiary hospital in Nepal. Method A descriptive, observational cross-sectional study was conducted in 300 surgeries at Kathmandu Medical College Teaching Hospital (February to May 2024) following ethical clearance. Utilization and completeness of the modified WHO Surgical Safety Checklist (Pre-procedure check, Sign-in, Time-out, Sign-out) were observed passively. Data were analyzed using Microsoft Excel and SPSS v 20. Data were presented in numbers and percentages and Chi-square/ Fisher’s exact test used for categorical variables. A p-value of < 0.05 was considered significant. Result WHO Surgical Safety Checklist was utilized in 48.7% of cases, with full compliance in only 8.7%. Utilization rate was seen to be 63% in the Pre-procedure check, while Sign-out was the least performed (29.3%). Highest utilization was seen in the General Surgery department, while the highest completion rate was seen in Neurosurgery (100%). Verbal confirmation (70.2%) was done more than written documentation. Conclusion Despite proven benefits, adherence to WHO Surgical Safety Checklist remains suboptimal. Targeted training and regular audits are essential to improve compliance and patient safety in resource-limited settings. KEY WORDS Completeness, Compliance, Utilization, WHO surgical safety checklist

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