Journal of Kathmandu Medical College

Adverse events following immunization of BCG vaccine among term and preterm infants in a tertiary care center

Smriti Mathema, Sagar Kafle, Raj Kishor Gupta, Samichhya Khanal — Tue, 29 Sep 2026 00:00:00 +0545

Introduction: Immunization is a highly effective public health strategy that protects against vaccine-preventable diseases; however, adverse events following immunization (AEFI) may occur. As AEFIs after BCG vaccination are not uncommon and immune responses in preterm infants differ from those born at term.
Objectives: This study aimed to evaluate AEFIs following BCG in term and preterm neonates.
Methodology: Hospital based observational study was conducted in a tertiary care center from July-December 2025. Babies of either sex, under the age of 3 months visiting the hospital’s immunization center for BCG Vaccine as per the National Immunization Program (NIP) were included in the study. A total of 120 babies were enrolled using purposive sampling and were divided into two groups with 60 in each term and preterm group. Parents were contacted at various time points via telephone / whatsApp / viber for questioning about post vaccination adverse events.
Results: Majority of the respondents were male (61.7%) in term group and female (51.7%) in the preterm group. The mean birth weight for preterm infants was significantly lower compared with the term infants (1945 ± 470 grams vs 3134 ± 409 grams, p <0.001). Inoculation site, ulceration, redness, and scar formation were commonly found among the babies in both groups within 20 weeks. No adverse effect of BCG vaccination was noticed except one preterm infant (1.7%) developing an abscess.
Conclusion: AEFI following BCG vaccination were rare and comparable between term and preterm infants, suggesting a favorable safety profile of the vaccine in both groups.

Assessment of Vitamin B12 deficiency in diabetic patients on metformin attending a tertiary care center

Tue, 29 Sep 2026 00:00:00 +0545

Introduction: Diabetes mellitus is one of the most encountered diseases. Vitamin B12 deficiency is highly prevalent among the adult individuals with diabetes mellitus under the Metformin therapy.
Objective: Objective of this study is to assess the prevalence of Vitamin B12 deficiency among the diabetic individuals under Metformin therapy.
Methodology: A descriptive cross-sectional study was conducted at the department of Biochemistry, Nepalese Army Institute of Health Sciences (NAIHS), Sanobharyang from January 2024 to January 2025. A total of 255 diabetic patients under Metformin therapy were included in this study. Data collected included their age, glycated hemoglobin (HbA1c) level and Vitamin B12 level. Chi square test was used to find the association of different variables.
Results: Among the total 255 participants in this study, 150 (58%) are female. Mean age group of participants was 55.14 years and mean value of HbA1c was 6.18. In this study 156 (61%) of participants have Vitamin B12 deficiency. The highest prevalence of Vitamin B12 deficiency was seen among the age group >60 years i.e., 55 (64.7%). Also the deficiency was highest among the female 95 (63.3%) than in male 61 (58.1%). Comparing with HbA1c, Vitamin B12 deficiency is higher i.e., 78.6% among the poor control group and least deficiency were seen among the good control group i.e., 59.9%.
Conclusion: This study concludes that in diabetic patients, Metformin therapy could be a major factor related to Vitamin B12 deficiency. It increases with age and poor control of diabetes as well. Screenings of Vitamin B12 deficiency or supplementation in such individuals were recommended.

Human papilloma virus vaccine hesitancy among female undergraduates at a medical college, Kathmandu

Narayani Paudel, Nikita Shrestha — Tue, 29 Sep 2026 00:00:00 +0545

Introduction: About 70% of cervical cancer occurrences globally are caused by Human Papilloma Virus strains 16 and 18. The prevalence of cervical cancer can be decreased by Human papilloma virus vaccines that protect against Human papilloma virus 16 and 18 infections. The World Health Organization had identified vaccine hesitancy as one of the top 10 threats to global health in 2019. A study conducted in China shows that 62.36% medical students reported having Human papilloma virus vaccine hesitancy.
Objectives: To assess the Human papilloma virus vaccine hesitancy among female undergraduate students in a medical college of Kathmandu, Nepal.
Methodology: A descriptive cross-sectional study was conducted among 428 female undergraduate students studying at a Medical College, Kathmandu. Data was collected by self-administered questionnaire using google form and analyzed by using Statistical Package for Social Science version 27.
Results: Out of 428 respondents, 377 (88.1%) had Human papilloma vaccination hesitancy. Convenience was pointed out as the major domain with highest hesitancy against the Human Papilloma vaccine. Among all the reasons, the expensive cost of Human Papilloma vaccine was the main reasons for respondent's hesitancy against Human Papilloma vaccine.
Conclusion: The findings of the study showed very high hesitancy regarding Human papilloma virus vaccine. Educating students about the advantages of the Human Papilloma vaccine and making it more affordable will help lower vaccine hesitancy and increase Human Papilloma vaccine vaccination rates, eventually reduce the prevalence of cervical cancer.

Pregnancy outcomes in women presenting with first trimester vaginal bleeding: A descriptive longitudinal study

Lakpa Dolma Lama, Meena Thapa — Tue, 29 Sep 2026 00:00:00 +0545

Introduction: Pregnancy is a significant event in a woman’s life, and emotional attachment to the pregnancy and developing foetus may begin early in the first trimester. Bleeding during first trimester is a source of stress and anxiety to mothers because of the uncertainty of the outcome, lack of preventive measures and emotional significance of early pregnancy loss.
Objective: To determine pregnancy outcomes among women presenting with first trimester vaginal bleeding.
Methodology: This hospital-based descriptive longitudinal study was conducted at Kathmandu Medical College Teaching Hospital over a period of one year. Pregnant women presenting with vaginal bleeding within the first trimester (≤13 weeks) were enrolled. Maternal characteristics, pregnancy viability, obstetric complications, mode of delivery, and perinatal outcomes were analyzed using SPSS.
Results: Out of 220 women included, 136 (61.8%) had non-viable pregnancies and 84 (38.2%) had viable pregnancies. The mean maternal age was 28.89 ± 5.1 years and the mean gestational age at presentation was 8.44 ± 2.08 weeks. Among viable pregnancies, 40 (47.7%) delivered at term, 31 (36.9%) had preterm delivery, and 13 ( 15.4%) had mid-trimester abortion. Obstetric complications occurred in 55 (77.5%) of viable pregnancies, with prelabour rupture of membranes being the most common 34 (61.8%). Among 70 live births, 16 (22.5%) required NICU admission and there were four perinatal deaths.
Conclusion: First trimester vaginal bleeding is frequently associated with pregnancy loss and adverse maternal and perinatal outcomes. Even in viable pregnancies, close antenatal surveillance is warranted.

Age estimation based on Pulp-Tooth Area Ratio of maxillary canine using Cone Beam Computed Tomography

Tue, 29 Sep 2026 00:00:00 +0545

Introduction: Dental age estimation based on the Pulp Tooth area ratio (PTR) of the maxillary canines obtained from Cone Beam Computed Tomography (CBCT) image may be a reliable method for age estimation in living or deceased individuals.
Objectives: To determine the age estimation based on PTR of the maxillary canines in three planes (sagittal, coronal and axial) with the help of CBCT images in Nepalese population.
Methodology: CBCT images were used for the age estimation by determining the PTR of maxillary canines. For each tooth, midsagittal, midcoronal, and three axial sections at cementoenamel junction (CEJ), onefourth root level from CEJ, and midroot were assessed. The radiographic images were saved as JPEG file and processed using Image J software. PTR were calculated and data obtained were subjected to regression analysis; their correlation to chronologic age as well as the standard error of the estimate (SEE) were derived.
Results: Our study included, 43 (57.33%) males and 32 (42.66%) females with mean age of 30.25 years. The mean of PTR for maxillary canines were 0.053797 at CEJ, 0.067992 at onefourth root level from CEJ and 0.053794 at midroot in axial section, 0.138715 at midsagittal plane and 0.108110 at midcoronal plane respectively. The PTR for maxillary canine was found to be statistically significant at mid coronal plane (p<0.05).
Conclusion: This study showed that PTR calculation of maxillary canines is a reliable parameter with a significant correlation for human age estimation and concluded that CBCT can be used as a conservative approach with reasonable accuracy.

Assessment of maternal knowledge on neonatal danger signs in a tertiary level hospital: a cross-sectional study

Pratibha Manandhar, Sunil Raja Manandhar — Tue, 29 Sep 2026 00:00:00 +0545

Introduction: Identification of neonatal danger signs is crucial for providing timely management on neonatal care and reducing neonatal morbidity and mortality.
Objective: To assess mother's knowledge on neonatal danger signs and its contributing factors in a tertiary level hospital.
Methodology: A cross-sectional study was conducted from 9th December 2025 to 8th January 2026 among 385 mothers of neonates aged 0–30 days at Kathmandu Medical College Teaching Hospital, Kathmandu, with ethical approval obtained (Ref: 03122025/07). Data on socio-demographic characteristics, maternal knowledge of WHO-defined neonatal danger signs, and associated factors were collected using a structured questionnaire and analyzed in SPSS version 26 using descriptive statistics and logistic regression.
Results: Overall, 94% of mothers demonstrated good knowledge on neonatal danger signs, with particularly high recognition of respiratory distress, jaundice, persistent vomiting, umbilical infection, and hypothermia. However, notable gaps were evident, with a proportion of mothers reporting “don’t know” for signs such as poor feeding, skin/eye infections, fever, and lethargy. Institutional delivery was significantly associated with better maternal knowledge compared to home delivery (aOR = 0.13; 95% CI: 0.02–0.80; p = 0.029).
Conclusion: Maternal knowledge on neonatal danger signs was high overall. However, gaps persisted in recognizing poor feeding, skin/eye infections, and lethargy. Institutional delivery was significantly associated with maternal knowledge, although the small number of home deliveries limits the strength and generalizability of this finding.

Contraceptive acceptance among post-abortion clients attending a tertiary care center: A descriptive cross-sectional study

Rupa Bajagain, Anjana Bohaju, Sarjan KC — Tue, 29 Sep 2026 00:00:00 +0545

Introduction: Abortion is one of the major causes of maternal mortality in a developing country like Nepal. About 13% of maternal deaths is due to abortion related complications. Post abortion contraception plays a crucial role in reducing unintended pregnancies and preventing repeat abortions, contributing to improved maternal health.
Objectives: The aim of this study was to find out the post abortion contraceptive acceptance rate among post abortion clients attending the Department of Obstetrics and Gynaecology of a tertiary care center.
Methodology: A descriptive cross-sectional study was conducted in the Department of Obstetrics and Gynecology of a tertiary care center from 1st February 2025 to 30th July 2025 after obtaining ethical approval from the Institutional Review Committee (Reference no- 25122024/06). Convenience sampling method was used .Data was collected by the authors by using a pre-tested proforma. All women coming for abortion during the first and second trimester (n=96) were enrolled. Demographic and clinical data was collected. Point estimate and 95% confidence interval were calculated.
Results: Among 96 patients, the prevalence of acceptance for post-abortion contraceptive was found to be 78 (81.25%) [95% Confidence Interval (CI):73.44-89.06]. A total of 18 (18.75%) women did not accept the post-abortion contraceptives. The most commonly accepted contraceptive method was the oral contraceptive pill in 29 (37.18%) women followed by barrier methods (male condom).
Conclusion: This study highlights a substantial acceptance rate of post abortion contraception among women attending a tertiary care setting.

Determinants of hypertension among middle-aged and elderly populations of Kavrepalanchowk district

Tue, 29 Sep 2026 00:00:00 +0545

Introduction: Hypertension is a significant contributing factor for the morbidity and mortality in the world. The global prevalence of hypertension is in the increasing trend and reached 1.4 billion in 2024.
Objective: The objective of the study is to find the prevalence of hypertension and the determinants of hypertension.
Methodology: The study was conducted using cross-sectional study design in Panauti Municipality. The data was collected during Aug/Sept, 2025 and 352 samples were selected using the systematic random sampling. Data for anthropometric measurements and perceived stress level were collected and analysed using SPSS. Chi square test was used to find association between categorical variables with hypertension.
Results: The prevalence of hypertension was found to be 57.7%. Among the total hypertensive participants, 164(80.8%) were known hypertensive and 104(51.2%) had family history of hypertension. Among the total respondents, 76(21.6%) were known diabetes. The variables age group, education status, smoking, BMI, waist circumference, diabetes were found to be significant association with the hypertension.
Conclusions: The prevalence of hypertension is high in the study area. It also revealed that higher age group, low level of education, smoking, BMI, waist circumference, and known diabetes are significant factors for the hypertension.