Kathmandu Medical College Teaching Hospital

Acute pancreatitis (AP) is a gastrointestinal disorder frequently associated with gallstones, hypertriglyceridemia, and alcohol use. Drug-induced pancreatitis has been documented in the medical literature, with various medications implicated as potential triggers. We report a case of a 31-year-old man with hypertension who presented with severe upper abdominal pain and was diagnosed with AP. Extensive diagnostic evaluation excluded common causes, pointing towards losartan. Symptomatic management and cessation of losartan led to improvement. This is a rare instance of losartan-induced AP. The patient experienced symptoms after a year of use, suggesting that pancreatitis can occur at any time during therapy. The underlying mechanisms are unclear; however, they might include decreased bradykinin breakdown leading to localized pancreatic duct angioedema. This highlights the importance of differentiating drug-induced pancreatitis from idiopathic causes. This case highlights the importance of considering pancreatitis in differential diagnosis, particularly in patients lacking typical risk factors.

Acute lupus pneumonitis is a rare but potentially life-threatening pulmonary manifestation of systemic lupus erythematosus, often presenting with nonspecific respiratory symptoms. We report a case of a 48-year-old female who presented with fever, dyspnea, and pleuritic chest pain. High-resolution computed tomography of the chest revealed bilateral pleural effusions. Autoimmune serologic testing showed strongly positive antinuclear antibody and anti-double-stranded DNA antibodies. After exclusion of infectious and alternative autoimmune etiologies, a diagnosis of acute lupus pneumonitis was made. The patient showed marked clinical improvement following systemic corticosteroid therapy. This case emphasizes the importance of early recognition and prompt immunosuppressive treatment to improve clinical outcomes.

Education is the process of the facilitation, learning or the gaining of knowledge, skill values beliefs and habits. Education plays a vital role in the shaping individual, societies, and nations. So, Adult education is important those who dropout the education in different levels. Different motivational factors motive them to rejoin the school in different levels. This research explores the challenges faced by the adult students in re-entering formal education and to analyze the key motivational factors motivating adult students to pursue further education. This study is based on qualitative method. In-depth interview was conducted with 8 participants who are studying in different grades. Interpretative research paradigm and exploratory research design are used to collect the information. This study highlights the intrinsic motivational factors like Desire for personal growth and development, Self-fulfillment and achievement, Family encouragement, and Self-Efficacy and Confidence to enroll in the school in various levels.

Unintentional home injuries are a leading cause of morbidity and mortality among children under five in Nepal, particularly in rural areas. Despite this burden, culturally appropriate community-based prevention strategies remain limited. This study explored community perspectives to inform the design and delivery of a parental education intervention for childhood home injury prevention. A qualitative study was conducted in Sunkoshi Rural Municipality, Sindhupalchok District, in December 2024. Seven focus group discussions were held with 56 mothers of preschool-aged children, and 11 key informant interviews were conducted with Female Community Health Volunteers (FCHVs), health-facility in-charges, a school health nurse, and local government officials. Data were analysed thematically using NVivo 14, guided by the Health Belief Model. Five major themes were identified: (1) Perceived household hazards and common child injuries, (2) Behaviours leading to child injuries, (3) Barriers and facilitators for prevention, (4) Prevention and control practices, and (5) Design and delivery of Information, Education and Communication (IEC) materials. Burns and falls were the most frequently reported injuries, often resulting from unsafe cooking areas, open fires, and poor supervision. Barriers to prevention included limited parental awareness, competing household priorities, and unsafe home environments, whereas community cooperation and FCHV support acted as facilitators. Participants favoured simple, visual, and low-cost educational materials, such as posters, flipcharts, and videos, delivered through participatory group discussions led by FCHVs. Parents and community stakeholders demonstrated strong interest in home injury prevention education. Embedding culturally tailored parental education within existing community health platforms, particularly FCHVs and mothers' groups, represents a feasible, scalable, and sustainable approach to reducing childhood injuries in rural Nepal.

Influenza's clinical profile in children has changed post-COVID, with increased respiratory failure and a shift to older affected age groups, while mortality and severe cardiovascular complications remain stable. This study is the first to systematically compare pediatric influenza outcomes, including all major complications and mortality, pre- and post-COVID-19, revealing specific shifts in disease presentation and demographics. Informs clinical vigilance, diagnostic strategies, and public health planning for pediatric influenza by highlighting shifts in hospitalization patterns and complications observed during the post-mitigation period. Findings support preparedness efforts recognizing temporal disruptions surrounding the pandemic.

Introduction Stroke remains a leading cause of death and disability worldwide, with a high burden in low-resource settings like Nepal. Timely administration of intravenous thrombolysis is critical for improving outcomes in patients with acute ischemic stroke. However, delays in receiving thrombolysis can significantly reduce its effectiveness and impact recovery. This study aimed to explore and understand the reasons contributing to delays in thrombolysis among stroke patients in emergency departments within low-resource settings through a qualitative approach. Methods A qualitative study was conducted at Tribhuvan University Teaching Hospital, Kathmandu, Nepal. Eighteen participants, including ten stroke patients and eight witnesses, were interviewed using a semi-structured guide. Data were analyzed using thematic analysis to identify common themes regarding treatment delays. Results The study identified four primary reasons contributing to delays in thrombolysis treatment: (a) failure of patients and witnesses to recognize stroke symptoms early, (b) limited availability of thrombolysis services in the hospitals, (c) financial barriers to seeking care, and (d) delayed diagnosis or misdiagnosis by healthcare professionals. Conclusion This study highlights the significant barriers to thrombolysis delays in Nepal. Key interventions, such as improving public awareness of stroke symptoms, increasing access to thrombolysis services, and reducing financial barriers, are necessary to improve outcomes in stroke patients.

The gastronomy, or culinary practice cover various meanings across different cultures and contexts. As food reflects culture internally, it becomes more challenging to communicate precise meanings and cultural insights through food discussions when the audience share a distinct cultural background. However, Upendra Subba’s movie Jaari portrays Limbu cultural practices and rituals, using food as a narrative tool to exhibit the Limbu culture and identity. In this regard, the paper explores gastronomy as a narrative technique and cultural commentary in Limbu socio cultural praxis to address three specific research questions: What aspects of Limbu food culture are woven into the socio-cultural fabric of the Limbu community? How does the practice of food consumption serve as a narrative device to depict Limbu culture and identity? Why does food culture, as a narrative approach, play a crucial role in shaping and expressing Limbu socio-cultural identity? In order to answer the questions, the paper has employed Mary Douglas’s concept of food as communication system and categorization and Roland Barthes’s ideas of food as social semiotics. The answers and the analysis based on the interrogation reveal that food functions as a metaphor in socio-cultural spaces, carrying multiple meanings, with its metaphoric significance potentially revealing the most authentic way of life. It argues that food not only serves as semiotic system but as a storytelling device to communicate the Indigenous aesthetics of the Limbu community and connect deep cultural meanings with people’s everyday life and actions.

Green synthesis, which creates nanoparticles from natural sources such as microorganisms or plant extracts, is a sustainable alternative to traditional chemical methods since it employs less hazardous chemicals and has fewer negative environmental consequences. In this study, the antioxidant, antibacterial, and toxicological properties of ZnO nanoparticles were investigated by synthesizing them using an aqueous extract of Catunaregam spinosa (C. spinosa) leaves. X-ray Powder Diffraction (XRD), Field Emission Scanning Electron Microscopy (FE-SEM), Energy Dispersive X-ray Analysis (EDX), Fourier Transform Infrared Spectroscopy (FTIR), and UV-vis spectroscopy were used to confirm the formation and properties of ZnO-NPs. FE-SEM investigation indicated a nearly spherical form, and XRD computed an average crystallite size of 12.39 ± 3.84 nm. The UV-vis spectrum showed a high absorption peak at 366 nm. FTIR indicated the existence of bioactive functional groups, which are important for nanoparticle capping and stability. ZnO-NPs showed antibacterial efficacy against Escherichia coli, Shigella sonnei, Klebsiella pneumoniae, and Staphylococcus aureus at 50 μg/mL. The inhibition zones were 9 mm, 13 mm, 16 mm, and 15 mm, respectively. Klebsiella pneumoniae and Staphylococcus aureus had the same minimum inhibitory concentration (MIC) of 6.25 mg/mL. Nanoparticles also demonstrated significant antioxidant activity in the DPPH experiment. Toxicity evaluation against Artemia salina yielded an LC50 of 55.20 ± 16.19 μg/mL, indicating dose-dependent effects. Overall, this study found that ZnO-NPs generated with Catunaregam spinosa leaf extract have promising antibacterial, antioxidant, and toxic characteristics, indicating potential biological applications.