Journal of Kathmandu Medical College

Assessment of mother’s knowledge on growth monitoring of under five children in a tertiary level hospital

Pratibha Manandhar, Sunil Raja Manandhar, Sunil Kumar Joshi — Mon, 25 May 2026 00:00:00 +0545

Introduction: Growth monitoring is an essential child health intervention for the early detection of growth faltering and under-nutrition. Mother’s knowledge plays a crucial role in the effective utilization of growth monitoring services.
Objectives: To assess mother’s knowledge of growth monitoring and identify associated factors among mothers of under-five children.
Methodology: A hospital-based cross-sectional study was conducted at Kathmandu Medical College Teaching Hospital (KMCTH), Nepal from 9th December 2025 to 8th January 2026. A total of 384 mothers of children aged 0–59 months attending Paediatric outpatient and immunization clinics were recruited using consecutive sampling. Ethical clearance was obtained from Institutional Review Committee KMCTH (Ref no.03122025/06). Data were collected using structured questionnaire. Data were entered in Excel sheet and data analysis was done in SPSS version 26. Binary logistic regression analysis was performed to identify factors associated with good knowledge of growth monitoring and results were expressed as adjusted odds ratios (AOR) with 95% confidence intervals (CI) followed by p- value 0.05 as statistically significant.
Results: Only 18% of mothers had good knowledge on growth monitoring of children. Mothers from joint families were more likely to have good knowledge compared to those from nuclear families (AOR=2.05; 95%CI:1.18–3.57). Higher monthly family income was also significantly associated with good knowledge (AOR=4.18;95% CI:1.95–8.93). Maternal age, education and occupation were not significantly associated after adjustment.
Conclusion: Knowledge of growth monitoring among mothers were sub-optimal. Family structure and household income were key determinants, highlighting the need for strengthened counseling and targeted educational interventions.

Pain assessment in cerebral palsy children during stretching session of hamstring muscle

Smita K.C, Manisha Lakhey — Mon, 25 May 2026 00:00:00 +0545

Introduction: Pain is defined as disturbed sensation that causes suffering or distress. Repeated and prolonged experience to pain can alter future responses to painful stimuli. Pain is common in children with cerebral palsy which may be unrecognized and not managed on time. children with cerebral palsy have difficulty in communicating their own pain experience. Pain related to stretching is one of the most salient negative memories in childhood, as pain has negative impact on health outcomes.
Objective: To assess the pain during stretching session of hamstring muscle among children with cerebral palsy.
Methodology: A cross-sectional study design was carried out among 35 children with cerebral palsy aged 3 to 18 years using purposive sampling technique. Children were assessed for pain during stretching of hamstring muscles in both passive stretching and positioning stretching using Non-Communicating Children’s Pain Checklist-Post-operative Version scale at Bhaktapur Community Rehabilitation Center, Patan Community Rehabilitation Center and Special Education and Rehabilitation Center. Data collection was done from April to July 2018. Data analysis was done using SPSS Inc. SPSS Statistics for Windows Version 16.0. Chicago, IL: SPSS Inc.; 2007. Frequency and percentage were used to interpret descriptive findings and Chi-square test was used to find out the association.
Results: In passive stretching 5.71% children experienced mild pain and 94.29% experienced moderate/severe pain. In positional stretching 17.14% experienced mild pain and 82.86% experienced moderate/severe pain.
Conclusion: Children with cerebral palsy experienced more pain in positional stretching than passive stretching ,there was no association between pain and severity level of cerebral palsy.

Outcome of laparoscopic cholecystectomy in elderly patients at a tertiary care centre: A descriptive study

Sujan Regmee, Manoj Adhikari, Romi Dahal, Uttam Laudari; Sneha Raut — Mon, 25 May 2026 00:00:00 +0545

Introduction: Gallstone disease is increasingly prevalent in the elderly population and often requires surgical intervention. Laparoscopic cholecystectomy (LC) is the standard treatment; however, concerns persist regarding perioperative risk in elderly patients due to comorbidities and reduced physiological reserve.
Objectives: This study aimed to evaluate the perioperative outcomes of Laparoscopic Cholecystectomy in elderly patients.
Methodology: A prospective observational descriptive study was conducted between January 2021 and July 2023 at a tertiary care centre. Patients aged ≥65 years undergoing elective or emergency Laparoscopic Cholecystectomy were included. Data on demographics, comorbidities, American Society of Anesthesiologists classification, indications for surgery, postoperative complications graded using the Clavien–Dindo system, length of hospital stay, readmissions, and histopathological findings were collected and analysed.
Results: A total of 334 elderly patients were included, with a mean age of 68.9 ± 4.7 years. Most patients were classified as ASA grade I–II 322 (96.41%). Uncomplicated cholelithiasis was the most common indication for surgery 233 (69.76%). Postoperative complications occurred in 44 (13.17%) of patients. Complications ranged from Clavien–Dindo Grade I to Grade IIIb, with no Grade IV or V complications and no mortality. Fourteen patients (4.19%) required readmission. The mean duration of total hospital stay was 3.57 ± 2.05 days.
Conclusion: Laparoscopic cholecystectomy in elderly patients demonstrated perioperative outcomes and complication profiles comparable within the range reported in the literature for younger populations. These findings support the continued use of laparoscopic cholecystectomy in elderly patients when guided by appropriate patient selection, perioperative optimization, and routine histopathological assessment.

Nutritional risk screening of hospitalized children based on STRONGkids tool at a tertiary care center

Mon, 25 May 2026 00:00:00 +0545

Introduction: Malnutrition is a common but often under-recognized problem among hospitalized children, associated
with adverse clinical outcomes and prolonged hospital stays. Early identification of nutritional risk using validated
screening tools is essential for timely intervention.
Objectives: To determine the nutritional risk status of hospitalized children in Nepal using the STRONGkids tool and to
correlate risk scores with anthropometric status and length of hospital stay.
Methodology: A prospective hospital-based cross-sectional study was conducted from March 2024 to March 2025 among
211 children aged ≥ one month to 16 years admitted to pediatric and pediatric surgery wards at Kathmandu Medical
College. Nutritional risk was assessed using the STRONGkids tool within 24 hours of admission, and anthropometric
evaluation was performed using WHO growth standards.
Results: Among the study population, 16 (7.6%) children were at high risk, 89 (42.2%) at moderate risk, and 106 (50.2%)
at low risk of malnutrition. Anthropometric assessment showed 27 (12.8%) were stunted, 24 (11.4%) wasted, 23 (10.9%)
underweight. A significantly positive correlation was found between STRONGkids score and hospital stay (Pearson’s r =
0.181, p value = 0.008).
Conclusion: The STRONGkids tool is effective in detecting both acute and chronic nutritional risks in hospitalized
Nepalese children. Routine use of this tool may enable early identification and timely intervention, potentially reducing
the burden of malnutrition in hospitalized children.

Menstrual pattern among schoolgirls in Bhaktapur District, Nepal: A cross-sectional study

Ahana Shrestha, Ram Krishna Chandyo, Christina Seefeldt Stæhr, Samip Shrestha — Mon, 25 May 2026 00:00:00 +0545

Introduction: Menarche is a physiological milestone in adolescent development, with timing influenced by genetic,
nutritional, and socioeconomic factors. Understanding menstrual patterns and knowledge among schoolgirls is vital for
developing targeted public health planning and clinical care in Nepal.
Objectives: This study aimed to synthesize current evidence on menstrual patterns, including age at menarche, cycle
regularity, common menstruation problems, hygiene practices and associated factors among school-going adolescent
girls in Bhaktapur district, Nepal.
Methodology: A descriptive cross-sectional study was conducted among 375 adolescent girls (10-19 years) from public
and private schools, selected via stratified random sampling. Data were collected through self-administered questionnaire
using a pre-tested structured questionnaire and anthropometric measurements. Statistical analysis included descriptive
statistics, Pearson’s correlation, Chi-square tests, and ordinal logistic regression analysis.
Results: The mean age at menarche was 12.08 ± 1.12 years, with 310 (82.7%) attaining menarche between 11-13 years.
Most participants 248 (66.1%) reported regular menstrual cycles (21-35 days). Dysmenorrhea was highly prevalent 335
(89.3%), with 208 (62.1%) reporting moderate-to-severe pain; however, only 34 (10.1%) used analgesics. Lower physical
activity was significantly associated with increased severity of dysmenorrhea (p=0.012). Commercial sanitary pads were
used by 339 (90.4%) of participants, and 151 (40.3%) reported school absenteeism due to menstruation.
Conclusion: The mean menarcheal age in this population is consistent with regional trends. The high prevalence
of dysmenorrhea and its significant impact on school attendance, coupled with low healthcare-seeking behavior,
underscores the need for targeted adolescent health education and accessible pain management strategies.

Cerebrovascular accident and its clinico-radiological presentation in a tertiary care center

Mon, 25 May 2026 00:00:00 +0545

Introduction: Stroke is a leading cause of death and disability worldwide. Accurate correlation of clinical symptoms with
imaging findings is essential for prompt diagnosis and management.
Objective: To determine the incidence of ischemic and hemorrhagic stroke among admitted patients and evaluate the
clinico-radiological correlation.
Methodology: A prospective observational study was conducted at the Department of Radiodiagnosis, Bir Hospital,
NAMS, Kathmandu, from December 2024 to June 2025. A total of 150 patients with a clinical diagnosis of stroke who
underwent CT imaging were included in the study. Clinical presentations, demographics, and imaging findings were
analyzed and correlated.
Results: Among the 150 patients, 116 (77.3%) had ischemic stroke and 34 (22.7%) had hemorrhagic stroke. Hemiparesis
was significantly more prevalent in ischemic stroke patients (92.2%) compared to hemorrhagic stroke patients (32.4%, p
< 0.001). Altered sensorium (50.0% vs. 3.4%, p < 0.001), headache (50.0% vs. 8.6%, p < 0.001), vomiting (32.4% vs. 1.7%, p
< 0.001), seizures (11.8% vs. 0.9%, p = 0.02), and loss of consciousness (58.8% vs. 3.4%, p < 0.001) were significantly more
common in hemorrhagic stroke patients. The NIH Stroke Score >10 was high in both groups with no significant difference
(97.4% ischemic vs. 100% hemorrhagic, p = 0.48).
Conclusion: The study highlights distinct clinical and radiological differences between ischemic and hemorrhagic
strokes. Hemiparesis is predominantly associated with ischemic strokes, while altered sensorium, headache, vomiting,
seizures, and loss of consciousness are more common in hemorrhagic strokes. Early clinical assessment combined with
CT imaging remains vital.

Reproductive Techniques in the Mahabharata: A Review Article

Khagendra Neupane — Mon, 25 May 2026 00:00:00 +0545

Introduction: This study highlights how the Mahabharata, a narrative epic, describes reproductive methods that
presage contemporary reproductive procedures and familial connections. These include extracorporal gestation, niyoga
(surrogate reproduction), divine conception, ayonija birth (non-womb birth, embryo splitting, proto-epigenetics, and
social constructions found within the Mahabharata.
This research seeks to explore how the Mahabharata, an epic, presents reproductive techniques, foreshadowing modern
procreative practices and kinship arrangements. It unveils extracorporeal gestation (development outside the body),
niyoga (proxy reproduction), divine conception (non-human genetic agency), ayonija birth (non-womb birth), embryo
division, proto-epigenetics and socially constructed practices used in the epic.
Objectives: This review aims to explore the reproductive concepts in theMahabharataand meaningfully relate to modern
reproductive technologies, especially with ethical complexity, kinship, and the separation of biological, gestational, and
social roles.
Methodology: This study will use a qualitative methodology to study a chosen set of reproductive stories from the
Mahabharata through a medical humanities perspective by drawing parallels between ancient and contemporary
reproduction practices.
Results: The Mahabharata presents multiple reproductive models. Niyoga and divine conception employ mediated
reproduction. These forms separate biological, social, and gestational parenthood. In Kunti’s case, selective reproduction
is evident. Ambika and Ambalika experience psychological influence in childbirth. In the case of the Kauravas,
extracorporeal development is observed.
Conclusion: These observations suggest that reproductive themes from the Mahabharat have a significant connection
with modern reproductive technology in terms of ethics, kinship ties, and dissociation between biological, gestational,
and social aspects.