Journal of Chitwan Medical College (JCMC) is official journal of the Chitwan Medical College (CMC), Bharatpur, Nepal. It is meant to provide academic platform for all the medicos and also to ensure their scientific involvement in different areas health sciences. JCMC is an open access, peer reviewed, quarterly, multidisciplinary biomedical journal devoted to Health Sciences. JCMC was started since 2010 as yearly publication and from January 2014 onward, it is being published quarterly. This is as open access journal which means all the content are freely available to the users and institutions without any charge. Authors do not have to pay for submission, processing or publication of articles in JCMC.

Users are allowed to read, download, copy, distribute, print, search, or link to their full texts of articles. Articles published in this journal can be accessed through free of cost. This is according to guidelines of BOAI definition of open access and under the terms of Creative Commons Attribution License. JCMC is included in INASP and our work is licenses under a Creative Commons Attribution-Non Commercial 3.0 Unported License.

The JCMC [ISSN 2091-2412(Print), 2091-2889(Online)], welcomes scientific research articles, unique cases and reviews of general interest to medical researchers or medical educationists from the field of biomedical sciences.

It publishes articles on the following category: Original Article, Review Article, Case Report/ Series, images in clinical sciences, Editorials, Viewpoint, Book Reviews, Medical Education, Book Reviews, Specially Invited Articles and Letter to the Editor. All manuscripts should be submitted as email attachment to and should be in English. The results and ideas contained therein should be original and should be of high scientific value. The journal gives preference to good quality research papers with new findings, clinically oriented studies over experimental and animal studies. JCMC gives special attention to the articles providing immediate impact to the health and policy will get preferences through fast track review, as well.


An important decision made by the Editorial Board prior to launch was that the journal must be for the many and not just for a few who are engaged in clinical research. All of us, whether we are doctors, nurses, physiotherapists, dentists or in any other field of health care, must take a greater responsibility for managing and solving the many unique health issues and problems. We must engage in research and voice our opinions by publishing them in this, our journal. To ensure wide readership, the journal will carry a variety of articles of general interest, as well as scientific articles, based on topics relevant to our region. With so many categories, JCMC is sure that that researcher will be able to make regular contributions to this journal. JCMC encourages the new generation of medical doctors and allied health professionals to create and publish new research data in this journal and adopt critical thinking habits to address current health problems. This journal should also encourage international research collaborations that result in joint publications of high international standards.


The manuscripts will be reviewed for possible publication with the understanding that they are being submitted to one journal at a time and have not been published, simultaneously submitted, or already accepted for publication elsewhere.

The Editors review all submitted manuscripts initially. Manuscripts with insufficient originality, serious scientific and technical flaws, or lack of a significant message are rejected or if good article are written poorly then author are requested to re-submit after the revision according to NJOG format. All manuscripts received are duly acknowledged.

Editors review new submissions according to its guidelines, when they meet all criteria, they will be sent to the two peer reviewers. If the decision conflicts between two, it will be send to third peer reviewer. The typical review will take minimum 4-6 weeks, which includes 2 weeks for peer review and remaining weeks for peer review handling process. However, this may take little longer due to unseen workloads.

When the article is received from peer reviewer there will be one of the following outcome and the decision choices include:

Accept Submission: The submission will be accepted without revisions.

Revisions Required: The submission will be accepted after minor changes have been made according to the reviewer’s comment.

Resubmit for Review: The submission needs to be re-worked, but with significant changes, may be accepted. It will require a second round of review, however.

Resubmit elsewhere: When the submissions do not meet the focus and scope of NJOG.

Decline Submission: The submission will not be published with the journal

All comments received from the reviewers will be passed on to the authors within 4-6 weeks of receival. Regardless of whether or not the submission is accepted for publication, it is essential that appropriate feedback be provided to the concerned.

JCMC respects the views, opinion, comments and decision of the reviewer, however the right for acceptance and rejection of the manuscript is reserved with the Editor-in-Chief, on the basis of maintaining the integrity of the science, following the guideline of ICJME, WAME, COPE.

The editors will be responsible for directing the manuscripts to the appropriate reviewers who have knowledge and/or expertise in the requisite fields. Each manuscript will be accepted (sometimes on a conditional basis pending suggested changes) or declined based on the reviewers’ comments, and other factors by Editor-in-Chief’s decisions. In the case of a controversial ground breaking article that could have far-reaching impact on the field, further reviews may be sought. The decision ultimately rests with the Editor-in-Chief.

Peer Reviewers will be provided with Review Guidelines, once they accept to review the submission. NJOG will rate reviewers on a five-point quality scale after each review.

If the manuscript is accepted for publication and published, the paper or the portion there of, will not be published elsewhere unless the consent is obtained in writing from editor-in-chief of NJOG.

After receiving back from author, the manuscript will go through editorial process including proof reading, formatting, and page proof will be prepared which will be sent back to the corresponding author, which has to be returned within three days. Non response to proof copy may delay the publication of the same article, may publish proof copy article as same or may even get rejected from the JCMC.

Publication Frequency
Quarterly Publication (Jan-March, Apr-June, July-September, October-December)

Open Access Policy
Articles published in this journal are freely available online free of cost in electric form at Authors do not have to pay for submission, processing or publication of articles in JCMC. The aim of JCMC is to increase the visibility and ease of use of open access scientific and scholarly articles thereby promoting their increased usage and impact. Hence, JCMC grants the permission to read, download, copy, distribute, print, search, or link to the full texts of these articles which is available online ( ) freely. We follow the guideline of and also


Manuscript must be prepared in accordance with “Uniform requirements for Manuscripts submitted to Biomedical Journals” developed by the International Committee of Medical Journal Editors ( The uniform requirements and specific requirement of JCMC are summarized below. Before sending a manuscript authors are requested to check for the latest instructions available. Instructions are also available from the website of the journal. (

Types of manuscript and word limits

Original Article: Randomized controlled trials, interventional studied, studies of screening and diagnostic test, outcome studies, cost effectiveness analyses, case-control series and surveys with high response rate. Up to 2500 words excluding references (up to 30) and abstract (up to 250).

Review Article: Systemic critical assessments of literature and data sources. Up to 3000 words excluding references (up to >50 but < 100) and abstract (up to 250).

Medical Education: Any article related to medical education with abstract and references, word limit may vary.

Case Report: new/interesting/very rare cases with clinical significance or implications can be reported. Up to 1000 words excluding references (up to 10) and abstract (up to 100), up to three photographs.

Viewpoint: These articles are personal views and allow you to express your own point of view on any issues relevant to health. We like these to include controversial subjects. Up to 800 words excluding reference (up to 5-8) Letter to the Editor: Should be short, decisive observation. They should not be preliminary observations that need a later paper for validation. Up to 400 words and 5 references. Limits for number of images and tables: for all the above-mentioned categories the number of images and tables should not be more than one per 500 words.


Manuscripts must be submitted in clear, concise English language. Please submit one original and two photocopies of the manuscript and three sets of the original figures along with a Forwarding, Authorship and Declaration letter, sample is available in the JCMC Forum. Authors also have to include a diskette (preferably CD) along with hard copies. All authors must give signed consent to publication in a letter sent with the manuscript. Note: An electronic copy of the article is mandatory through email. Authors should send their manuscripts to:

Editor in Chief
Journal of Chitwan Medical College
Chitwan Medical College, P.O. Box: 42
Bharatpur-10, Chitwan, Nepal.


The manuscript must be typed double-spaced on one side only on A4 size white paper with Times New Roman Font, size of 12 points. Margins should be a minimum of 25 mm. The pages should be numbered consecutively, beginning with the title page and should be in bottom left. Each section of the manuscript should commence on a new page in the following sequence: title page and running head, structured abstract, key words, introduction, materials and methods, result, discussion, conclusion, acknowledgement, references, tables and figures with caption list. Particular attention should be taken to ensure the manuscript adheres to the style of the journal in all respects. Please do not use any signs for e.g. “and” for “&” or “@” signs for “at the rate” and related signs; however, you can use abbreviations used in standard text books, provided the full form has been given when it first appears in the text. The text of original articles should be divided into sections with the headings: Abstract, Key words, Introduction, Methods, Results, Discussion, References, Tables and Figure legends. For case report: Abstract, Key words, Introduction, Case Report, Discussion, Reference, Tables and Figure Legends.

1.    FORMAT: The whole text including references should be typed in double spacing using 12 fonts (Times New Roman) with margins of one inch.

2.    MANUSCRIPT: should be arranged in the following order;
a. Cover Letter

b. Title and Author information including address, email and phone number of corresponding author. Author’s name should begin with first name.

c. Abstract (structured except for case report and review article) and keywords (In alphabetical order)

d. Text (Introduction, Methods, Results, Discussion and Conclusions)

e. References

f. Tables: Each table in one page as annex document

g. Figures: Each figure as a separate attachment

h. Legends for all the figures in one page as a separate attachment

3.    COVER LETTER: It should confirm that the submission made has not been published, accepted or considered for publication elsewhere.

4.    TITLE PAGE: The title page should carry

a. Type of manuscript (e.g. Original article, Case Report, Review Article etc)

b. The title of the article, which should be concise, but informative;

c. Running title or short title not more than 50 characters;

d. The name by which each contributor is known (First name, Middle name and Last name), with his or her highest academic degree(s) for record and institutional affiliation;

e. The name of the department(s) and institution(s) to which the work should be attributed;

f. The name, address, phone numbers, facsimile numbers and e-mail address of the contributor responsible for correspondence about the manuscript;

g. The total number of pages, total number of photographs and word counts separately for abstract and for the text (excluding the references and abstract);

h. Source(s) of support in the form of grants, equipment, drugs, or all of these;

i. Acknowledgement, if any; one or more statements should specify
   i.   contributions that need acknowledging but do not justify authorship, such as general support by a departmental chair;
   ii.  acknowledgments of technical help; and
   iii. acknowledgments of financial and material support, which should specify the nature of the support. This should be included in the title page of the manuscript and not in the main article file.

j. If the manuscript was presented as part at a meeting, the organization, place, and exact date on which it was read.

k. Registration number of clinical trials.


The second page should carry the full title of the manuscript and an abstract. The abstract should be structured for original articles as: Background, Method, Result and Conclusion. State the context, aims, settings and design, Materials and Methods, statistical analysis used, results and conclusions. Below the abstract should provide 3 to 8 keywords arranged alphabetically. The abstract should not be structured for a review article and case report. Do not include references in abstract.

a. Provide a context or background for the study (that is, the nature of the problem and its significance). State the specific purpose or research objective of, or hypothesis tested by, the study or observation; the research objective is often more sharply focused when stated as a question. Both the main and secondary objectives should be clear, and any prespecified subgroup analyses should be described. Provide only directly pertinent references, and do not include data or conclusions from the work being reported.

The Methods section should be in sufficient detail and should contain study design, ethical approval, duration and place of study, inclusion and exclusion criteria, informed consent, statistical analysis and software used. It should only include information that was available at the time the study being planned or protocol being written; all information obtained during the conduct of the study belongs to the results section.

Relevance of study design and selection of participants should be mentioned. The guiding principle should be clarity about how and why a study was done in a particular way. When authors use variables such as race or ethnicity, they should define how they measured the variables and justify their relevance. Technical information: Identify the methods, apparatus (give the manufacturer’s name and address in parentheses), and procedures in sufficient detail to allow other workers to reproduce the results.

Give references to established methods, including statistical methods (see below); provide references and brief descriptions for methods that have been published but are not well known; describe new or substantially modified methods, give reasons for using them, and evaluate their limitations. Identify precisely all drugs and chemicals used, including generic name(s), dose(s), and route(s) of administration. Reports of randomized clinical trials should present information on all major study elements, including the protocol, assignment of interventions (methods of randomization, concealment of allocation to treatment groups), and the method of masking (blinding), based on the CONSORT Statement (

Note: Authors submitting review article should include a section describing the methods used for locating, selecting, extracting, and synthesizing data. These methods should also be summarized in the abstract.

Describe statistical methods with enough detail to enable a knowledgeable reader with access to the original data to verify the reported results. When possible, quantify findings and present them with appropriate indicators of measurement error or uncertainty (such as confidence intervals). Avoid relying solely on statistical hypothesis testing, such as P values, which fail to convey important information about effect size. References for the design of the study and statistical methods should be to standard works when possible (with pages stated). Define statistical terms, abbreviations, and most symbols. Specify the computer software used.

Present your results in logical sequence in the text, tables, and illustrations, giving the main or most important findings first. Do not repeat all the data in the tables or illustrations in the text; emphasize or summarize only the most important observations. Extra or supplementary materials and technical detail can be placed in an appendix where they will be accessible but will not interrupt the flow of the text, or they can be published solely in the electronic version of the journal. When data are summarized in the Results section, give numeric results not only as derivatives (for example, percentages) but also as the absolute numbers from which the derivatives were calculated, and specify the statistical methods used to analyze them. Restrict tables and figures to those needed to explain the argument of the paper and to assess supporting data. Use graphs as an alternative to tables with many entries; do not duplicate data in graphs and tables. Avoid nontechnical uses of technical terms in statistics, such as “random” (which implies a randomizing device), “normal,” “significant,” “correlations,” and “sample.”

It is useful to begin the discussion by summarizing briefly the main findings, then explore possible mechanisms or explanations for these findings, compare and contrast the results with other relevant studies, state the limitations of the study, and explore the implications of the findings for future research and for clinical practice. Do not repeat in detail data or other information given in the Introduction or the Results section.

Link the conclusions with the goals of the study but avoid unqualified statements and conclusions not adequately supported by the data. In particular, avoid making statements on economic benefits and costs unless the manuscript includes the appropriate economic data and analyses. Avoid claiming priority or alluding to work that has not been completed. State new hypotheses when warranted, but label them clearly as such.

Reference should be in vancouver system of referencing. The references should be cited using superscript in Arabic numerals in the text and should be in order. In the reference list, the references should be numbered and listed in order of appearance as in the text.

Tables should be self-explanatory and should not duplicate textual material. Tables with more than 10 columns and 25 rows are not acceptable. Tables should not be submitted as photographs. Tables should be numbered by ‘Arabic numerals’ consecutively in the order of their first citation in the text and should be supplied with a brief self-explanatory title that matches column width. Type each table with double spacing on a separate sheet of paper. Do not use internal horizontal or vertical lines.  Authors should place explanatory matter in footnotes. Explain all nonstandard abbreviations in footnotes, and use the following symbols, in sequence:

*, †, ‡, §, ||, ¶, ** , †† ,‡‡
Mention statistical measures of variations, such as standard deviation and standard error of the mean. P value. Be sure that each table is cited in the text.

i. FIGURES (Illustrations):
Graphs, charts, diagrams or pen drawings must be drawn by professional hands in Indian ink (black) on white drawing paper. In case of x-ray, miniature photo prints should be supplied. Photographs should be supplied in high quality glossy paper not larger than 203 mm x 254 mm (8” x 10”). In case of microphotographs, stains used and magnification should be mentioned. Each illustration should bear on its back the figure number and an arrow indicating the top. All illustrations should be black and white and should be submitted in triplicate with suitable legends. We accept electronic versions of illustrations, which should have a resolution of 300 dpi, and the dimension of 640 x 480 to 800 x 600 pixels dimension and picture format should be JPEG (*.jpg, *.jpeg) or TIFF (*.tif, *.tiff). Pictures will be published in B/W free of charge. But, if you want to publish your picture in color, please contact the editorial board for the cost and payment procedure. For x-ray films, scans, and other diagnostic images, as well as pictures of pathology specimens or photomicrographs, send sharp, glossy, black-and-white or color photographic prints, usually 127 x 173 mm (5 x 7 inches). Letters, numbers, and symbols on figures should therefore be clear and consistent throughout and large enough to remain legible when the figure is reduced for publication. Photomicrographs should have internal scale markers. Symbols, arrows, or letters used in photomicrographs should contrast with the background.

Photographs of potentially identifiable people must be accompanied by written permission to use the photograph.

Figures should be numbered consecutively according to the order in which they have been cited in the text. If a figure has been published previously, acknowledge the original source and submit written permission from the copyright holder to reproduce the figure. Permission is required irrespective of authorship or publisher except for documents in the public domain.

Type or print out legends for illustrations using double spacing, starting on a separate page, with Arabic numerals corresponding to the illustrations. When symbols, arrows, numbers, or letters are used to identify parts of the illustrations, identify and explain each one clearly in the legend. Explain the internal scale and identify the method of staining in photomicrographs.

Measurements of length, height, weight, and volume should be reported in metric units (meter, kilogram, or liter) or their decimal multiples.
Temperatures should be in degrees Celsius. Blood pressures should be in millimeters of mercury, unless other units are specifically required by the journal.
Journals vary in the units they use for reporting hematologic, clinical chemistry, and other measurements. Authors must consult the Information for Authors of the particular journal and should report laboratory information in both local and International System of Units (SI). Editors may request that authors add alternative or non-SI units, since SI units are not universally used. Drug concentrations may be reported in either SI or mass units, but the alternative should be provided in parentheses where appropriate.

Use only standard abbreviations; use of nonstandard abbreviations can be confusing to readers. Avoid abbreviations in the title of the manuscript. The spelled-out abbreviation followed by the abbreviation in parenthesis should be used on first mention unless the abbreviation is a standard unit of measurement.

7.  Copyright :
© Authors retain the copyright.
Authors grant the journal right of first publication with the work simultanously licensed under a Creative Commons Attribution 4.0 International License (CC-BY 4.0). This license permits use, distribution and reproduction in any medium, provided the original work is properly cited.

8.    Authorship:

All persons designated as authors should qualify for authorship. Authorship credit should be based only on significant contribution. The first author named must accept the responsibility for ensuring that both versions of the paper submitted and the corrected proofs have the approval of all co-authors. Submission of a manuscript will also be taken to imply that all authors have obtained permission from their employers or institution to publish, if they are obliged to do so and that relevant ethical approval has been obtained for clinical studies. However, authorship credit should be based only on significant contribution to (a) conception and design, or analysis and interpretation of data, to (b) drafting the article or revising it critically for important intellectual content and on (c) final approval of the version to be published. Authors may include explanation of each author’s contribution separately.

9.    Dual publication:
If material in a submitted article has been published previously or is to appear in part or whole in another publication, the Editor in Chief must be informed. If the same paper appears simultaneously elsewhere or has previously been published or appears in a future publication, then the author will be black-listed for the JCMC and future articles of the author will be rejected automatically.

10.  Forwarding letter:
The covering letter accompanying the article should contain the name and complete postal address of one author as correspondent and must be signed by all authors. The correspondent author should notify change of address, if any, on time.

11.  Declaration:
A declaration should be submitted stating that the manuscript represents valid work and that neither this manuscript nor one with substantially similar content under the present authorship has been published or is being considered for publication elsewhere and the authorship of this article will not be contested by anyone whose name(s) is/are not listed here, and that the order of authorship as placed in the manuscript is final and accepted by the co-authors. Declarations should be signed by all the authors in the order in which they are mentioned in the original manuscript.

12.  Electronic version of manuscripts
Do not use ‘oh’ (O) for ‘zero’ (0), ‘el’ (l) for one (1). Do not use space bar for indentation. Do not break words at the end of lines.

Do not insert a tab, indent, or extra spaces before beginning of a paragraph.

13.  Sending a revised manuscript
While submitting a revised manuscript, contributors are requested to include, along with single copy of the final revised manuscript, a photocopy of the revised manuscript with the changes underlined in red and with the point to point clarification to each comment. The manuscript number should be written on each of these documents.

If the manuscript is submitted online, the contributors’ form and copyright transfer form has to be submitted in original with the signatures of all the contributors’ within two weeks from submission.
Hard copies of the images, for the articles submitted online, should be sent to the journal office at the time of submission of a revised manuscript.

14. Conflict of Interest Notification Page:
To prevent the information on potential conflicts of interest from being overlooked or misplaced, it needs to be part of the manuscript.
However, it should also be included on a separate page or pages immediately following the title page. JCMC do not send information on conflicts of interest to reviewers.

When reporting studies on human, indicate whether the procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional or regional) and with the Helsinki Declaration of 1975, as revised in 2000 (available at Do not use patients’ names, initials, or hospital numbers, especially in illustrative material. When reporting experiments on animals, indicate whether the institutions or a national research council’s guide for, or any national law on the care and use of laboratory animals was followed. Evidence for approval by a local Ethics Committee (for both human as well as animal studies) must be supplied by the authors on demand. Animal experimental procedures should be as humane as possible and the details of anesthetics and analgesics used should be clearly stated. The ethical standards of experiments must be in accordance with the guidelines provided by the CPCSEA (animal) and ICMR (human). The journal will not consider any paper which is ethically unacceptable. A statement on ethics committee permission and ethical practices must be included in all research articles under the ‘Materials and Methods’ section.

REPORTING guidelines for specific study designs


Type of study



Randomized controlled trials


Studies of diagnostics accuracy


Systematic reveiws and metaanalysis


Observational studies in epidemiology


Meta-analyses of observational studies in epidemiology


All the authors should take ethical approval from the institution where the research is carried out and the letter should be submitted to JCMC. Similarly, informed consent should be taken from the study subjects or participants and this should be mentioned during submission of the manuscript.


While submitting your manuscript to JCMC please make sure you have submitted following documents:
1. Forwarding Letter
2. Authorship
3. Declaration
4. Manuscript
Forwarding letter
• Signed by all contributors
• Previous publication / presentations mentioned
• Source of funding mentioned
• Conflicts of interest disclosed
• Complete author information
• Author for correspondence, with e-mail and telephone numbers
• Identity not revealed in paper except title page (e.g. name of the institute in Materials and Methods, citing previous study as ‘our study’, names on figure labels, name of institute in photographs, etc.)
Presentation and format
• Manuscript with Double spacing
• Margins 2.5 cm from all four sides
• Title page contains all the desired information (vide supra)
• Running title provided (not more than 50 characters)
• Abstract page contains the full title of the manuscript
• Abstract provided (not more than 150 words for case reports and 250 words for original articles)
• Structured abstract provided for an original article
• Key words provided (three or more)
• Introduction of 75-100 words
• Headings in title case (not ALL CAPITALS, not underlined)
• References cited in superscript in the text without brackets
• References according to the journal’s instructions.
• Use correct grammar, punctuation and word synthesis
• Abbreviations spelt out in full for the first time
• Spell out - single-digit numbers (1-9) except when beginning a sentence and use numerals for all others
Tables and Figures
• Number within specified limits.
• No repetition of data in tables/graphs and in text
• Actual numbers from which graphs drawn, provided
• Figures necessary and of good quality (colour)
• Table and figure numbers in Arabic letters (not Roman)
• Labels pasted on back of the photographs (no names written)
• Figure legends provided (not more than 40 words)
• Patients’ privacy maintained (if not, written permission enclosed)
• Credit note for borrowed figures/tables provided
• Manuscript provided on a floppy (with single spacing)

Ahead of Print

Published Ahead of Print

The editors of this journal are pleased to offer electronic publication of accepted papers prior to print publication. Any final changes in manuscripts will be made at the time of print publication and will be reflected in the final electronic version of the issue.


Articles appearing in this Published Ahead-of-Print section have been peer-reviewed and accepted for publication in this journal and posted online before print publication. Articles appearing here may contain statements, opinions, and information that have errors in facts, figures, or interpretation. Neither the editorial board nor the publisher accept responsibility for the views of the authors expressed in their contributions.

Contact us


Chitwan Medical College 
Bharatpur-13 Chitwan, Nepal 
P.O.Box No. :- 42

Tell: + 056-592366 
Fax: + 056-592364



Chitwan Medical College Teaching Hospital. 
Bharatpur-10 Chitwan, Nepal
P.O.Box No. :- 42

Tell: + 056-532933 
Fax: + 056-532937



Chitwan Medical College 
Lazimpat, Kathmandu (In front of British Embassy)
Tell: + 977-1-4005042 
Fax: + 977-1-4005041



Chitwan Medical College
Bharatpur-13 Chitwan, Nepal
P.O.Box No. :- 42
Tell: + 056-592366
Fax: + 056-592364


Chitwan Medical College
Bharatpur-10 Chitwan, Nepal
P.O.Box No. :- 42
Tell: + 056-532933
Fax: + 056-532937


Chitwan Medical College
Lazimpat, Kathmandu (In front of British Embassy)
Tell: + 977-1-4005042
Fax: + 977-1-4005041

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