Journal of Kathmandu Medical College

Sexual dysfunction among perimenopausal women attending a tertiary care centre: A descriptive cross-sectional Study

Shreyashi Aryal, Kristina Shakya, Jiya Acharya — Sun, 26 Oct 2025 00:00:00 +0545

Introduction: The perimenopausal phase involves declining estrogen and ovarian function, causing changes like weakened pelvic muscles and vaginal thinning that often result in sexual dysfunction. The Female Sexual Function Index-6 is a validated tool commonly used to assess these female sexual function issues for early identification and management.
Objectives: This study aimed to determine the prevalence of sexual dysfunction using the Female Sexual Function Index-6 among perimenopausal women attending the Obstetrics and Gynaecology outpatient department.
Methodology: A descriptive cross-sectional study was conducted among perimenopausal women visiting the Obstetrics and Gynaecology outpatient department in a tertiary care centre. Ethical approval was obtained from the Institutional Review Committee. Women with incomplete questionnaires, those with diagnosed psychiatric disorders, unable to provide consent to participate, women with cervical pathology like cervical polyp or carcinoma, malignancies or pelvic surgery, women under hormone replacement therapy and those with surgical menopause were excluded. A convenience sampling technique was used. Point estimate and confidence interval were calculated for binary data.
Results: Among 60 perimenopausal women, the mean total Female Sexual Function Index score was 11.77±6.44, indicating a high prevalence of sexual dysfunction across all six domains. Sexual function was poorer among women whose partners worked abroad, with only 25.21% of the FSFI score. The orgasm domain was the most impaired (1.25±1.22), followed by desire (1.43±0.74) and arousal (1.45±1.08).
Conclusion: It was found that a larger number of perimenopausal women had sexual dysfunction, with the lowest score in orgasm and desire.

Clinical profile, severity, and outcomes of acute pancreatitis among patients visiting a tertiary care center in Eastern Nepal

Khushboo Priya, Rishab Shrestha, Dipak Kumar Sah, Rajan kumar Thadhiya — Sun, 26 Oct 2025 00:00:00 +0545

Introduction: Acute pancreatitis (AP) is a common gastrointestinal emergency with variable clinical presentation and outcomes. Severity indices such as the Modified CT Severity Index are important tools for predicting complications and outcomes.
Objective: To evaluate the clinical profile, severity and outcomes of patients with acute pancreatitis at a tertiary care center in Eastern Nepal.
Methodology: A descriptive cross-sectional study was conducted at Nobel Medical College Teaching Hospital, Biratnagar over a period of one year among 90 patients using consecutive sampling. Patients aged ≥18 years fulfilling at least two of these criteria: typical abdominal pain, ≥3 times elevated serum amylase/lipase, or imaging features of acute pancreatitis were included. Data were analyzed using IBM SPSS Statistics for Windows version 25 with descriptive statistics to summarise baseline characteristics and chi-square or Fisher’s exact tests to see the associations between disease severity and outcomes.
Results: The mean age of patient was 44.8 ± 15.9 years, with a male predominance 51 (57%). Alcohol 39 (43%) and gallstones 30 (33%) were the leading causes. Based on the Modified CT Severity Index, 13 (20%) of cases were mild, 38 (58%) moderate, and 15 (23%) severe. Complications occurred in 42 (47%) of patients more than half those were peripancreatic fluid collection. Overall mortality was 5 (6%,) all within the severe group. Disease severity showed a significant association with mortality (p < 0.001).
Conclusion: Acute pancreatitis in Eastern Nepal predominantly affects middle-aged males. A substantial proportion present with moderate-to-severe disease and notable mortality, underscoring the need for early severity assessment and improved critical care facilities.

Readiness for Self-Directed Learning among Undergraduate Nursing Students

Poojan Sharma — Sun, 26 Oct 2025 00:00:00 +0545

Introduction: Self-directed learning is a type of instructional strategy and plays an important role in nursing education, associated with academic achievement, communication self-efficacy, assertiveness, responsibility, and students’ clinical competencies.
Objective: To identify the level of readiness among undergraduate nursing students.
Methodology: Descriptive cross-sectional study was conducted among the undergraduate nursing students of Manmohan Memorial Institute of Health Sciences from October 2023 to April 2024. All the nursing students of Bachelor of Nursing Science and Bachelor of Science in Nursing program were included in the study. Total enumerative sampling technique was used with total sample size of 202. Self-Directed Learning Readiness Scale was used to identify the students’ readiness. Data were collected using self-administered questionnaire. Bivariate logistic regression analysis was carried out. Ethical approval obtained from Nepal Health Care Cooperative Institutional Review Committee.
Results: The mean ± SD age of the participants was 22.7 ±2.9. The mean score of self-directed learning readiness was 112.6. More than half 104(51.48%) of them had low level of readiness for self-directed learning. A significant positive correlation was found between self-management and desire for leaning (r=0.46, p value <0.001); self-management and self-control (r=0.46, p value <0.001) and desire for learning and self-control (r=0.48, p value <0.001). None of the students’ characteristics were significantly associated with the readiness of Self-directed learning.
Conclusion: More than half of the students have low level of readiness for Self-directed learning. No any students’ sociodemographic and academic characteristics were significantly associated with the readiness for Self-directed learning.

Prevalence and risk factors of retinopathy of prematurity among neonates in Bharatpur, Chitawan, Nepal

Manisha Shrestha — Sun, 26 Oct 2025 00:00:00 +0545

Introduction: Retinopathy of prematurity (ROP) is an important cause of preventable blindness in prematurely born children. With the advancement of neonatal care for these children, the rate of their survival is increasing, so is the probability of development of ROP among them.
Objectives: To assess the prevalence and risk factors of retinopathy of prematurity among infants.
Methodology: A retrospective observational study was conducted at the Department of Paediatric ophthalmology, Bharapur Eye Hospital. Records from 1st July 2022 to 31st Dec 2023 were analyzed. It included preterm babies with a gestational age of ≤ 34 weeks and/or a birth weight of ≤1750 g and older children on oxygen therapy referred for ocular examination. maternal and neonatal risk factors were noted. Chi-square test and independent t-tests were used to analyze data with p- value ≤ 0.05 as significant.
Results: A total of 141 neonates were screened, 68 (48.23%) male and 73 (51.77%) female. Mean delivery age was 33.007±2.38 weeks (range: 26-40 weeks), and mean birth weight was 1638.16±464.58 g (range: 840-3180 g). Normal vaginal deliveries were 35 (24.82%), and C-sections were 106 (75.18%). ROP incidence was 20 (14.18%) out of which 8 (40%) neonates with ROP were referred to higher centre, while the rest resolved spontaneously. Premature rupture of the membrane 44 (31.31%) was the major maternal risk factor, and respiratory distress syndrome was noted in 21 (14.89%) neonates.
Conclusion: ROP screening should be performed in all preterm low birth weight infants. Reducing childhood blindness from ROP requires combined efforts from neonatologists, obstetricians, and ophthalmologists.

Association between level of physical activity and risk of fall among community-dwelling elderly living in Dhulikhel: A cross-sectional study

Umesh Adhikari, Aarju Bhattarai, Rajan Shrestha — Sun, 26 Oct 2025 00:00:00 +0545

Introduction: Falls are a major public health concern among older adults, contributing to significant mortality, morbidity, and disability. Physical activity has been shown to improve balance, strength, and overall physical function, which can help reduce fall risk.
Objectives: To explore the association between physical activity levels and fall risk among community-dwelling elders.
Methodology: A cross-sectional study was conducted in Dhulikhel municipality from 10 May, 2024, to 12 March, 2025. A total of 128 elderly individuals (aged ≥65 years) were selected using cluster random sampling. Data were collected through face-to-face interviews using a structured questionnaire, and the Global Physical Activity Questionnaire was used to assess physical activity. Risk of fall was assessed using the Timed Up and Go test. Descriptive statistics were used to describe socio-demographic characteristics, and a chi-square test was used to examine the association between physical activity levels and fall risk.
Results: Among 128 participants, 45.3% were at risk of falls. The prevalence of falls increased with age, particularly in individuals aged ≥75 years (p-value <0.001). A significant association was found between physical activity levels and fall risk,( p-value <0.001). Participants with low physical activity were more likely to be at risk of falling compared to those with moderate to high physical activity.
Conclusion: The study highlights the protective role of physical activity in reducing fall risk among the elderly. Tailored interventions promoting regular physical activity may help reduce fall-related injuries and improve overall health in elderly populations.

Occurrence of ESKAPEE pathogens in blood samples of patients with bloodstream infections and their antimicrobial resistance patterns.

Sun, 26 Oct 2025 00:00:00 +0545

Introduction: Some of the most threatening drug-resistant microbes are the members of ESKAPEE group, an acronym for Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter spp., and Escherichia coli which are posing a constant risk with increasing treatment challenges worldwide.
Objectives: To determine the occurrence of ESKAPEE pathogens in blood samples of patients attending and determine their antimicrobial resistance pattern.
Methodology: This hospital based cross-sectional study was conducted in the Department of Microbiology, KIST Medical College Teaching Hospital retrospectively. The records were obtained from culture and sensitivity test performed on all the blood samples received in the Microbiology Laboratory from July 2023- June 2024. The data was entered and analyzed in WHONET 2024 program.
Results: Out of 4180 blood samples received, pathogenic bacteria were isolated from 108 samples. ESKAPEE pathogens constituted 68.5% of total bacterial isolates. Five (6.75%) Enterococcus spp, 33 (44.59%) Staphylococcus aureus, 10 (13.5%) Klebsiella pneumoniae, 9 (12.16%) Acinetobacter spp., 3 (4.05%) Pseudomonas aeruginosa, 1 (1.35%) Enterobacter spp and 13 (17.56%) Escherichia coli were isolated. Sixty three percent Staphylococcus aureus were Methicillin resistant. Twenty percent Klebsiella pneumonaie and 23% Escherichia coli were Extended-Spectrum Beta-Lactamases producers. Sixty percent of Klebsiella pneumonaie and 22.22% Acinetobacter spp. showed carbapenem resistance.
Conclusion: Our study shows increased prevalence of ESKAPEE pathogens resistant to commonly used antibiotics. Judicious use of antimicrobials, active infection control practices, stringent antibiotic policy and regular surveillance is the need of the hour for preventing antimicrobial resistance.

Prevalence of cusp of Carabelli among medical and dental students of a medical college of Nepal: A descriptive crosssectional study

Sun, 26 Oct 2025 00:00:00 +0545

Introduction: Carabelli's trait has been used as an ethnic indicator for decades because of its ease of observation in living and skeleton specimens. It has importance in forensic, anthropological, and ethnic studies.
Objectives: The present study aimed to determine the prevalence and degree of expression of the cusp of Carabelli in the maxillary first molar among medical and dental students.
Methodology: This cross-sectional descriptive study was conducted from February 2024 to August 2024 among 221 medical and dental students using convenience sampling after obtaining institutional ethical approval. The palatal surfaces of mesiolingual cusp of permanent maxillary first molars were examined using a sterile mouth mirror and probe. The Carabelli trait was graded according to the classification given by Goose and Lee. The SPSS v.26 was used for statistical analysis. Descriptive statistics were presented as percent and frequency for categorical data.
Results: The Cusp of Carabelli was prevalent in 160 (72.40%). The Grade II pattern was the highest (136, 30.77%), and the Grade IV pattern was the lowest (32, 7.24%). Among males, 104 (73.24%) and among females 56 (70.89%) had the Carabelli trait present. The bilateral cusp of Carabelli was observed in 117 (73.13%) participants. Brahmins had the highest (77, 78.57%) and Muslims had the lowest (3, 42.86%) prevalence of cusp of Carabelli.
Conclusion: The prevalence of cusp of Carabelli in Maxillary first molar in Nepali Medical and dental students was higher compared to other populations. However full expression of a well-developed cusp was quite low in the present study

Association of nonalcoholic fatty liver disease to early carotid atherosclerosis in a tertiary care center: A cross-sectional study

Piyush Shrestha, Suman Paudel, Prerana Singh Rokaha — Sun, 26 Oct 2025 00:00:00 +0545

Introduction: Nonalcoholic fatty liver disease (NAFLD) encompasses conditions ranging from simple hepatosteatosis to severe liver cirrhosis. It is strongly correlated with components of metabolic syndrome such as insulin resistance, dyslipidemia, and obesity. As NAFLD patients have higher cardiovascular risk, ultrasonography assessed carotid artery intima-media thickness (CIMT) provides a non-invasive measure of evaluating atherosclerosis.
Objective: To evaluate CIMT among NAFLD patients by using B-mode ultrasonography to assess NAFLD as an independent risk factor for atherosclerosis.
Methodology: This descriptive cross-sectional study was conducted among NAFLD patients aged 18–80 years undergoing ultrasound at Kathmandu Medical College. Patients with alcohol consumption >30g/day or other comorbidities such as chronic liver disease and cardiovascular disease were excluded. Calculated sample size was 196 and convenience sampling technique was used. CIMT and hepatic echogenicity were assessed by B-mode ultrasonography. Data were collected via a proforma, and descriptive statistics like frequency percentage, mean±SD was calculated to see the distribution and Analysis of variance (ANOVA) test was done to evaluate the difference in CIMT. Ethical clearance was obtained from the Institutional Review Committee of Kathmandu Medical College Teaching Hospital (Ref:199012024/07).
Results: Among 196 patients, 120 (61.2%) patients had Grade I fatty liver, 71 (36.2%) had Grade II fatty changes and 5 (2.6 %) had Grade III fatty liver respectively. The mean right and left CIMT were 0.65mm and 0.67mm respectively. CIMT increased significantly with the severity of fatty liver (p=0.001).
Conclusion: NAFLD is significantly associated with early carotid atherosclerosis, supporting its role as an independent cardiovascular risk factor.