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Organ transplantation after brain death is challenging in Nepal due to cultural beliefs, legal frameworks, and ethical considerations. The Human Body Organ Transplantation (Regulation and Prohibition) Act (HBOTA) has not met with substantial success after its amendment. This review critically appraises the current state of brain death and organ transplantation in Nepal. It explores challenges, evaluates progress, and provides recommendations. Literature review of databases was conducted to find articles on brain death, organ donation, and transplantation in Nepal. Analysis of cultural, legal, ethical, and practical factors influencing implementation. Key challenges include limited awareness, religious beliefs, infrastructure gaps, and family consent barriers. HBOTA amendments in 2016 enabled brain death donations, however, donation rates remain low. Strategies are needed to improve public education, resources, personnel training, and collaboration. Cultural sensitivity and stakeholder engagement are crucial. A multifaceted approach addressing cultural, legal, ethical and practical dimensions is essential to improve organ donation rates in Nepal. Despite progress, substantial challenges persist requiring evidence-based strategies focused on awareness, capacity building, policy improvements, and culturally appropriate community engagement.

Background Teamwork and collaboration among students are essential for successful problem-based learning (PBL) implementation; however, many medical colleges in Nepal face obstacles to implementing successful PBL sessions. This action research explored elements affecting teamwork during PBL sessions at Lumbini Medical College in Nepal and developed interventions that could readily be applied to enhance student collaboration. Methods The study employed qualitative methods, collecting data through online open-ended questionnaires from second-year and first-year medical students. Initial data from second-year students identified teamwork challenges, while feedback from first-year students evaluated interventions. Specific interventions were implemented with first-year students, including improved internet connectivity, systematic textbook availability in PBL rooms, structured presentation formats (PechaKucha), and clear role assignments, as second-year students had completed their preclinical phase. The effectiveness of these interventions was evaluated through first-year students’ feedback. Results Thematic analysis revealed three key challenges: communication barriers (including language and technical issues), discrepancies in participation, and differing levels of preparation. Positive feedback from first-year students confirmed that the implemented interventions were successful in improving team dynamics, facilitating more active participation, and enhancing resource utilization. Conclusions Successful implementation of PBL necessitates not only infrastructural support (internet and access to the resources needed to learn) but also pedagogical structure (e.g. clearly defined roles within groups, systematic structures of participation). These findings offer practical guidance for medical educators seeking to enhance PBL effectiveness, particularly in resource-limited settings. Clinical trial number Not applicable.

Aims: To evaluate the prevalence and risk factors of type 2 diabetes mellitus (T2DM) from 2000-2020 in various parts of Nepal.  Methods: PubMed, Embase, Scopus, and Google Scholar were searched using the appropriate keywords. All Nepalese studies mentioning the prevalence of T2DM and/or details such as risk factors were included. Studies were screened using Covidence. Two reviewers independently selected studies based on the inclusion criteria. Meta-analysis was conducted using Comprehensive Meta-Analysis Software v.3.  Results: A total of 15 studies met the inclusion criteria. The prevalence of T2DM, pre-diabetes, and impaired glucose tolerance in Nepal in the last two decades was 10% (CI, 7.1%- 13.9%), 19.4% (CI, 11.2%- 31.3%), and 11.0% (CI, 4.3%- 25.4%) respectively. The prevalence of T2DM in the year 2010-15 was 7.75% (CI, 3.67-15.61), and it increased to 11.24% between 2015-2020 (CI, 7.89-15.77). There were 2.19 times higher odds of having T2DM if the body mass index was ≥24.9 kg/m 2. Analysis showed normal waist circumference, normal blood pressure, and no history of T2DM in a family has 64.1%, 62.1%, and 67.3% lower odds of having T2DM, respectively.  Conclusion: The prevalence of T2DM, pre-diabetes, and impaired glucose tolerance in Nepal was estimated to be 10%, 19.4%, and 11% respectively.

[...]SBA training has been undergone robustly. To establish a direct correlation between decreased MMR and SBA attended deliveries, assessment of the quality of care is vital rather than the number of institutional deliveries. Like many low and middle-income Southeast Asian countries, Nepal has evolved with reproductive health gains from unattended home deliveries to deliveries attended by TBAs to Female Community Health Volunteers to SBAs.

Background: Abortion is an essential service, the need for which has increased during the coronavirus disease 2019 (COVID-19) pandemic. Because of the lockdowns at several periods, these services were hampered. This study analyzed the pattern of Safe Abortion Services (SAS) at a tertiary healthcare center during the first six months of the COVID-19 pandemic in Nepal. Methods: This is a cross-sectional analytical study. We compared the pattern of safe abortion services between the first three months of the pandemic when a lockdown was implemented and the second three months when the lockdown was eased. Demographic and obstetric profile of women, their abortion choices, method of termination, difficulty in accessibility, and level of psychological distress were studied. Results: A total of 52 women were provided SAS during the study period. The number of women coming for SAS during lockdown was 47.1% less than that after easing of the lockdown. During the lockdown, women came at a later period of gestation with a mean of 9.5 weeks compared to 7.5 weeks in the later three months. Because of fear of COVID-19, 19.2% (n=10) women opted for termination of pregnancy. Increased need of contraception was felt but 40% (n=12) had problems of accessibility. More women had probable serious mental illness during the lockdown period (p=0.008). Conclusion: Lockdown during the pandemic decreased the number of women coming for SAS due to barriers in accessibility. Contraceptive needs are also increased but access is difficult. The need for safe abortion services and contraception has increased during the pandemic but the lockdown caused inaccessibility. Psychological distress is prevalent, and fear of COVID-19 has become a common reason for termination of pregnancy. This pandemic can be taken as an opportunity to provide and improve contraception and abortion accessibility, and quality with integration of mental health support.

Background: Facebook addiction is said to occur when an individual spends an excessive amount of time on Facebook, disrupting one's daily activities and social life. The present study aimed to find out the level of Facebook addiction in the Nepalese context and briefly discuss the issues associated with its unintended use. Methods: A descriptive cross-sectional study was conducted in the Department of Forensic Medicine of Lumbini Medical College. The study instrument was the Bergen Facebook Addiction Scale typed into a Google Form and sent randomly to Facebook contacts of the authors. The responses were downloaded in a Microsoft Excel spreadsheet and analyzed using Statistical Package for Social Sciences version 16. Results: The study consisted of 103 Nepalese participants, of which 54 (52.42%) were males and 49 females (47.58%). There were 11 participants (10.68%) who had more than one Facebook account. It was observed that 8.73% (n=9) to 39.80% (n=41) were addicted to Facebook. Conclusion: When used properly Facebook has its own advantages. Excessive use is linked with health hazards including addiction and dependency. Students who engage more on Facebook may have less time studying, leading to poor academic performance. People need to be made aware of the issues associated with the misuse of Facebook.

Possession state is a disorder of consciousness with substitution of the personality, which is claimed to be a spirit, a deity, a dead person or some other power. In rural Nepal these experiences are normalised and Hindu communities often attribute psychological conditions to a supernatural cause. We report the case of a 30-year-old woman who presented with acute-onset symptoms characterised by episodes of altered consciousness, vocalisations suggestive of religious chants, and deity-associated behaviour, probably influenced by local suggestions of divine possession. Additional notable features included similar presentations among a family member and seeking help from traditional healers prior to psychiatric consultation. Medical examinations and investigations were normal. Specific cultural and religious manifestations posed challenges to clinical interpretation. The patient responded well to combined pharmacotherapy and supportive psychotherapy during her brief hospital stay, with cessation of possession episodes. This case report highlights the importance of cultural competence in Nepalese forensic psychiatric evaluations, particularly in the context of possession states, while examining the application of mental health legislation in traditional cultural settings.

Background: Male genital injuries are urological emergencies which if not promptly treated with correct therapeutic intervention may lead to chances of loss of fertility due to infections and anatomical disruption of normalcy. This study highlights the clinical scenarios, etiology and outcome of male genital injury cases that were managed at a tertiary care center in Nepal. Such injuries are not frequently encountered as lack of reporting by patients means cases are rare. The present study is the first from Nepal which depicts a comprehensive report on male genital injuries.   Methods: A retrospective analysis of discharge summaries was carried out and the cases of male genital injuries were reviewed during June 2020. All the treated cases during the two-year period from April 2018 to April 2020 at Lumbini Medical College, Nepal were included in the study.  Results: There were eight cases of genital trauma admitted and treated during the study period. All the patients were males and age ranged from six to 71 years with a mean age of 33 ± 21.45 years. Fall injury and road traffic accidents (RTA) were observed to be the primary cause in the majority of cases.  Conclusion: Superficial injuries to the penis and scrotum do not require surgical exploration and could be managed conservatively. However, deeper and complicated injuries, testicular preservation, the functionality of the part and cosmetic issues are taken into consideration which might require a multi-disciplinary approach. Apart from the medical issues pertaining to genital injuries, there are legal and psychological aspects of such events too which should not be ignored.

Key Clinical Message Early intervention is imperative for potentially fatal dermatologic diseases such as pemphigus vulgaris. In rural Nepal, limited public awareness, home remedies, and delays in healthcare access lead to poor outcomes. Although biopsy confirms the diagnosis, experienced dermatologists can make an accurate clinical diagnosis when characteristic skin lesions are present.

Background and Aims Healthcare students are expected to lead healthy lives yet they may engage in health risk behaviors (HRBs) like physical inactivity, poor diet, and substance use. These behaviors can have negative consequences for both the individual's health and well‐being, as well as their ability to perform their future roles as healthcare providers. This study aimed to assess the prevalence of HRBs and associated factors among medical and nursing students at Lumbini Medical College, Nepal. Methods A cross‐sectional study was conducted among 412 undergraduate healthcare students using a self‐administered questionnaire. HRBs across various domains were assessed. Validated scales screened for anxiety and depression. Regression analyses determined associations between mental health and HRBs. Results Low physical activity was prevalent, with only 10.7% exercising ≥5 times/week. Inadequate fruit/vegetable intake (1–2 servings/day) was reported by 79.9% students. Short sleep duration (5–6 h) on weeknights (51.2%) was common. More than three quarter (76.5%) of students met the screening cutoff score for HRBs. The study highlighted that students with addiction, depression and anxiety are more likely to exhibit HRBs (p < 0.01). Conclusion Multiple HRBs were highly prevalent among the students. A considerable proportion demonstrated a clustering of risky lifestyle factors, which were linked to poor mental health. Interventions should address academic burden, promote positive health behaviors, and target mental well‐being in this vulnerable group.