Introduction: Endoscopic retrograde cholangiopancreatography (ERCP) requires effective sedation and analgesia. Ketamine–propofol and ketamine–midazolam is commonly used, but comparative data in ERCP are limited. Objective: To compare the effectiveness and safety of ketamine–propofol (KP) versus ketamine–midazolam (KM) for procedural sedation during ERCP. Methods: This prospective observational study included 50 ASA I–II patients aged 18–70 years undergoing ERCP, equally allocated to two groups. The KP group received ketamine–propofol 1:1 (0.5 mg/kg loading dose, 2–3 mg/kg/h infusion). The KM group received ketamine 0.5 mg/kg plus midazolam 0.02 mg/kg, with supplemental doses as required. Sedation was targeted to a Ramsay score of 5. Time to achieve targeted Ramsey Sedation Score after induction, patient needing rescue sedation, hemodynamic variables, recovery time, and adverse events were recorded. Data were analyzed using t-tests and chi-square tests, with P < 0.05 considered significant. Results: Group KP achieved faster sedation than Group KM (184.80 ± 48.74 vs. 314.40 ± 92.11 seconds; P value < 0.001) and shorter recovery time (7.92 ± 1.89 vs. 9.48 ± 2.25 min; P value < 0.05). Discharge time was similar between groups. Hemodynamic parameters were lower in the KP group after induction. Desaturation and airway maneuvers were more frequent with KP while post procedure nausea and vomiting and recovery agitation were more common with KM group, though not statistically significant. Conclusion: Both regimens were effective for ERCP sedation. Ketamine–propofol provided faster onset, quicker recovery and better hemodynamic control, but with more respiratory adverse events.
Introduction: Melasma is a common acquired hyperpigmentary disorder primarily affecting sun-exposed areas, predominantly in women of reproductive age. Thyroid dysfunction has been proposed as a potential endocrine trigger; however, data from Nepalese populations remain limited. Objectives: This study aimed to determine the prevalence of thyroid dysfunction in melasma patients compared to matched controls, and to assess its association with clinical parameters of melasma. Methods: A 1:1 frequency-matched case-control study was conducted at Nepalgunj Medical College and Teaching Hospital, Kohalpur, Nepal (65 melasma cases, 65 controls). Serum TSH was measured by ECLIA. Analyses included Fisher’s exact test, Mann-Whitney U test, Kruskal-Wallis test, and Spearman’s rank correlation. Results: The groups were comparable in age (median 30 years; p = 0.883) and sex (p = 1.000). Thyroid dysfunction was detected in 17/65 cases (26.2%) versus 4/65 controls (6.2%); OR 5.40 (95% CI 1.71–17.11; p = 0.003). Hypothyroidism accounted for 94.1% of cases with thyroid dysfunction. Median serum TSH was 2.97 mIU/L in cases versus 2.59 mIU/L in controls (p = 0.095). Centrofacial and malar distributions each comprised 44.6% of cases. Thyroid dysfunction was exclusive to female cases (17/56, 30.4%; p = 0.098). No significant correlation was identified between serum TSH and melasma duration (r = −0.077, p = 0.543). Conclusions: Thyroid dysfunction was significantly more prevalent in melasma patients versus controls (OR 5.40; 95% CI 1.71–17.11; p = 0.003), with hypothyroidism predominating (94.1%). These findings highlight thyroid dysfunction as a relevant systemic co-morbidity in melasma, warranting further multicentre studies.
Introduction: Cysticercosis, a parasitic disease endemic to developing countries, is caused by the larval stage of Taenia solium. While neurocysticercosis is common, isolated myocysticercosis, especially of the sternocleidomastoid (SCM) muscle, is exceedingly rare, particularly in pediatric patients. Case presentation: We report the case of a 9-year-old strictly vegetarian female child presenting with painless left-sided neck swelling. Ultrasonography revealed a well-defined cyst with a central echogenic focus, suggestive of a scolex. Fine-needle aspiration cytology (FNAC) confirmed the diagnosis of cysticercosis. Computed tomography ruled out a neuro-ocular involvement. The patient was treated conservatively with albendazole, corticosteroids, and antihistamines, which led to complete resolution within three months and no residual disease or recurrence after six months. Conclusion: This case highlights the importance of considering myocysticercosis in the differential diagnosis of neck swelling in children, even among vegetarians. Early diagnosis using noninvasive modalities and conservative management can ensure excellent outcomes while avoiding unnecessary surgical interventions in endemic regions.
Communication is fundamental to the practice of medicine. While advances in biomedical science and technology continue to transform healthcare, the ability of healthcare professionals to communicate effectively with patients, families, and colleagues remains one of the most powerful determinants of quality care. Skilled communication is not merely an interpersonal attribute; it is a core clinical competency that influences diagnostic accuracy, patient safety, therapeutic relationships, health outcomes and healthcare professionals job satisfaction This issue highlights the importance of skilled communication as the backbone of medical practice, the reason of its lacking and different methods for its improvement. By strengthening our communication skills, we strengthen therapeutic relationships, enhance patient safety, foster professional collaboration, and ultimately uphold the highest standards of compassionate, evidence-based care. Investing in communication is, therefore, an investment in better medicine for every patient, every encounter, and every healthcare setting.
Introduction: Intravesical prostatic protrusion (IPP) reflects the degree of prostatic protrusion into the bladder and may serve as a non-invasive marker of obstruction in benign prostatic enlargement (BPE). We tend to evaluate the association of IPP with lower urinary tract symptoms (LUTS) and compare predictive performance with prostate size for obstruction-related outcome in patients. Methods: Hospital-based prospective study was conducted from August to December 2025 and included 380 men aged >50 years presenting with LUTS attributed to BPE. IPP and prostate size were measured on trans abdominal ultrasound. Symptoms were assessed using the International Prostate Symptom Score (IPSS), quality-of-life (QoL) score, Peak flow rate (Qmax) and post-void residual urine (PVR). A bladder outlet obstruction (BOO) surrogate outcome was defined as Qmax <=10 mL/s and/or PVR >=100 mL. Results: Mean age and prostate size was 65.04 years and 43.6 g respectively. Mean IPP was 6.3 ± 4.2 mm. IPP was positively correlated with IPSS (rho=0.366, p<0.001), QoL (rho=0.315, p<0.001), and PVR (rho=0.270, p<0.001), and inversely correlated with Qmax (rho=-0.301, p<0.001). Mean IPSS increased across IPP grades (9.4, 12.5, and 16.2 for grades 1-3). BOO surrogate was present in 121/380 (31.8%) and increased across IPP grades (23.3%, 33.6%, 46.2%). IPP demonstrated higher discrimination for BOO surrogate than prostate size (AUC 0.621 vs 0.578). Conclusion: Higher IPP correlates significantly with greater LUTS, poorer QoL, lower urinary flow rate and larger residual urine. Hence, it is a better predictor of LUTS and BOO than prostate volume in men with BPE.
Introduction: Dry Eye Disease is one of the most common ocular diseases worldwide. This study aimed to determine the prevalence of Dry Eye Disease and its relationship with age group and gender among depression patients in a tertiary care teaching hospital. Methods: This was a cross-sectional study conducted among 84 patients of depression from June 2025 to November 2025. Standard proforma was used to collect socio-demographic variables. Ocular Surface Disease Index questionnaire was administered to assess the dry eye symptoms. Dry Eye Disease was diagnosed if the Ocular Surface Disease Index score was ≥ 13 and was further classified as mild (13-22), moderate (23-32) and severe (33-100). The statistical methods used were mean, frequency and percentage. Chi-square test was used to test the association between dry eye disease with age group and gender. Results: The mean age of the study sample was 43.79 (SD±14.19) years. Females 63(75%) were predominant. The prevalence of Dry Eye Disease among depression patients was 29.76% (95% Confidence Interval: 20.27% - 40.73%). Among patients of Dry Eye Disease, mild 13(15.48%) was most prevalent, followed by moderate 10(11.9%) and severe 2(2.38%). Dry Eye Disease was significantly associated with gender but not with age group in depression patients.
Introduction: Neonatal chest radiography is essential but carries risks due to high radiation sensitivity and recurrent requirement for imaging. This study identifies optimal exposure parameters for visualizing stipulated pathologies—pneumothorax and hyaline membrane disease—using Gammex 610 phantom to balance image quality and exposure factors. Methods: The study was conducted using the Gammex 610 neonatal chest phantom, which included inserts simulating normal lung, pneumothorax, and hyaline membrane disease (HMD). A total of 16 radiographs were acquired using different combinations of kVp (45, 50, 55) and mAs (6.3, 4.0, 3.2, 2.5, 2.0, 1.6, 1.3, 1.0). Objective metrics were assessed by calculating signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) using ImageJ. Subjective image quality: visual grade analysis (VGA) was evaluated by five radiologists using a 4-point Likert scale. The inter-rater agreement was measured using Fleiss’ Kappa. Results: The higher exposure settings yielded superior mean CNR and SNR; they also increased radiation burden. The 45 kVp / 2 mAs setting provided acceptable image quality, with a mean CNR of 5.86 and SNR of 26.75. Furthermore, radiologist-assessed VGA scores (3.61) at this level were comparable to those achieved at higher exposure settings (>50 kVp / 1.6 mAs). Conclusion: This phantom-based experimentation demonstrates that exposure parameter (kVp and mAs) reduction is possible while maintaining image quality. Based on CNR, SNR and VGA scores and in alignment with the ALARA principle, the authors recommend 45 kVp /2.0 mAs as the most appropriate exposure factors for the institutional settings.
Introduction: Tuberculosis is a global health problem. A rapid and accurate diagnostic technique is necessary for effective management. The primary method for detection of Mycobacterium Tuberculosis (MTB) is sputum smear microscopy, using Ziehl-Neelsen (ZN) stain which has limitations. However, Auramine Rhodamine (AR) staining provides similar specificity but increased sensitivity. This study was conducted for comparison of ZN and AR staining in the detection of Mycobacterium Tuberculosis (MTB). Methods: This study was conducted between March to July, 2025 . Ethical approval was taken from Institutional Review Committee (Ref. No. MTH/001/2025). Written consents were taken from patients. Early morning sputum samples were collected and processed for ZN and Auramine staining. Data were analyzed using SPSS software. Results: Out of 100 samples, 13 (13%) were positive for Mycobacterium tuberculosis. Eight of these were positives by AR staining only and 5 were positive by both ZN and AR staining. There were no cases that were negative with AR but positive with ZN method. There was no association between demographic and other factors such as age (χ²=1.705; p=0.636), sex (χ²=0.048; p=0.826), smoking (χ²=0.088; p=0.766) and diabetes (χ²=1.076; p = 0.300) with the detection of MTB. However, a significant association was observed between family history of TB (χ² =13.613; p < 0.001) and patient’s occupation (χ² = 7.696; p = 0.006). Conclusion: Auramine rhodamine staining was found superior to ZN for the detection of MTB. Our results suggest that house hold contacts of TB and high risk groups especially farmers should be investigated on a priority basis.
Introduction: Community acquired pneumonia is an important cause of morbidity and mortality in the pediatric population, especially in the under-5 age group. It is essential to identify parameters for early diagnosis and prognostication. Conventionally used markers such as CRP and procalcitonin are expensive and often unavailable in low-resource settings. This mandates the use of novel and ubiquitous investigations such as complete hemogram. The present study aimed at evaluating the role of novel systemic inflammatory indices (NLR, MLR, PLR, SII, SIRI) in predicting disease severity in children with community acquired pneumonia. Methods: This prospective observational study, conducted at a tertiary care center of North India, included 130 children aged 1 month–14 years admitted to the Paediatrics ward with a diagnosis of community acquired pneumonia. The relevant clinical features and complete hemogram of the child were recorded and defined indices calculated. The role of these indices in predicting the need for ICU admission, vasopressor use, and development of complications including mortality was evaluated using ROC curves. Results: NLR was found to have the highest sensitivity in predicting disease severity. It could predict the need for ICU admission with a sensitivity of 78.5% and specificity of 50% (p=0.0174). It might be an important marker in predicting mortality in children with community acquired pneumonia. MLR also demonstrated high specificity in predicting complications. Conclusion: NLR derived from routine hemogram can be used as a simple and non-expensive screening tool for predicting the development of severe illness and complications in children hospitalized with community acquired pneumonia.
Introduction: Chest pain is one of the symptoms which bring patient to the Emergency Department. Myocardial infarction is the most significant clinical presentation of Acute Coronary Syndrome and cause of morbidity and mortality among the global population. This study aims to identify the occurrence of Myocardial Infarction and investigate its relationships with demographic and cardiac risk factors, and characteristics of chest pain. Methods: A prospective cross-sectional study was carried out among 113 patients in the Emergency Department of Manipal Teaching Hospital, Nepal. For categorical variables, descriptive statistics, including frequency and percentage, were presented. The Chi-square test, Independent Samples Test were employed for inferential analysis. A p-value of less than 0.05 was considered to be as significant. Results: Among 113 patients who attended with chest pain, 31 patients had a myocardial infarction. Age, gender and occupation showed no significant association in Myocardial Infarction Troponin-positive patients also had a higher prevalence of smoking and dyslipidemia, although it was not statistically significant in our study. Nonetheless, cardiovascular disease was of significant association with myocardial infarction (p=0.004). ECG results showed a close correlation with MI where 62.9 % of troponin-positive patients reported STEMI (p<0.0001). The most common abnormality in NON-STEMI patients was T-wave inversion (61.5%). Conclusions: Myocardial infarction was frequent occurrence in patients who reported chest pain in this tertiary care unit. The study indicates that combining clinical history, risk factor evaluation, ECG interpretation, and cardiac biomarkers are significant in early diagnosis and management of MI
Introduction: Accurate diagnosis of intra-articular knee injuries is essential to guide management and prevent long-term complications. Arthroscopy is the diagnostic gold standard but is invasive, whereas Magnetic Resonance Imaging (MRI) offers a non-invasive alternative. The objective of this study is to assess the diagnostic accuracy of MRI in detecting ligamentous, meniscal, and chondral injuries of the knee by correlating findings with arthroscopy. Methods: Paramilitary personnel with clinically suspected knee injuries who underwent both MRI and arthroscopy were included. MRI findings were compared with arthroscopy, the reference standard, and diagnostic performance indices were calculated. Results: MRI demonstrated high sensitivity and specificity for anterior cruciate ligament, posterior cruciate ligament, and meniscal tears, with relatively lower accuracy for chondral injuries. Conclusions: MRI is a reliable, non-invasive tool for diagnosing major intra-articular knee injuries. Correlation with arthroscopy highlights its strengths and limitations, supporting its role in preoperative evaluation and surgical planning.
Introduction: Doppler ultrasound provides hemodynamic information about thyroid vascularity. Establishing normative values for inferior thyroid artery parameters is essential for differentiating physiological from pathological conditions. This study aimed to determine normative Doppler parameters of the inferior thyroid artery in clinically euthyroid adults in Nepal. Methods: A cross-sectional study was conducted with 122 clinically euthyroid adults aged 18 years and above at a tertiary care hospital from January 1st to March 31st, 2024. Doppler parameters including Peak Systolic Velocity (PSV), Resistive Index (RI), and Pulsatility Index (PI) were measured using high-resolution ultrasound. Descriptive statistics, independent t-tests, one-way ANOVA, and Pearson correlation analyses were performed using SPSS version 25.0. Results: The mean PSV was 17.66 cm/s (SD ± 2.82), RI was 0.50 (SD ± 0.06), and PI was 0.72 (SD ± 0.08). Mean thyroid volume was 8.01 mL (SD ± 2.48) for the overall cohort, with males showing 8.20 mL (SD ± 2.95) and females 7.83 mL (SD ± 1.93). No significant gender differences were observed in PSV (p=0.41), RI (p=0.08), PI (p=0.18), or thyroid volume (p=0.52). Weak correlations were found between PSV and age (r=-0.15) and between Peak Systolic Velocity and thyroid volume (r= -0.02). Conclusions: This study provides baseline normative data for inferior thyroid artery Doppler parameters in euthyroid Nepali adults. The findings demonstrate stable hemodynamics across genders and age groups, serving as reference values for clinical practice
Many bladder stones develop over time around foreign bodies. These may include fragments of Foley catheters, forgotten DJ stents, broken guidewires or endoscopic instruments, encrusted sutures, surgical staples, or objects self-introduced by patients with psychiatric disorders. Herein, we report the case of an 80-year-old male who was evaluated for obstructive and irritative lower urinary tract symptoms (LUTS). Imaging suggested a bladder calculus; however, endoscopic intervention revealed and facilitated the removal of an iatrogenically introduced plastic foreign body forming the nidus at the core of the calculus. Although several case reports have described various iatrogenic materials introduced into the urinary bladder masquerading as urinary bladder stones, we have not found a similar case in the available literature.
Introduction: Sex determination is one of the important parts of forensic investigation other than race, age and stature especially when mutilated, decomposed and skeletonized human remains are encountered. Studies in various populations have shown hand dimensions to be useful in sex differentiation. Present study aims at determining sex from hand dimensions in Nepalese medical students. Methods: This was cross sectional study was conducted from February 2024 to August 2025 in Nobel Medical College Teaching Hospital, Nepal, including 412 Nepalese medical students (182 males and 230 females). Hand length and hand breadth were measured and hand index calculated. Data was analyzed using SPSS (Ver.20) software. Male and female parameters were compared using independent sample t-test. P value < 0.05 was considered significant. The average value of male and female was set as sectioning point for each parameter to calculate the diagnostic accuracy of sex determination. Results: Males had significantly greater hand length, hand breadth and hand index (P < 0.001) with sectioning points calculated as 17.84cm, 7.96cm and 44.59 respectively for sex differentiation. Discriminant analysis showed diagnostic accuracy of hand breadth, hand index and hand length to be 89.6%, 81.3% and 79.1% for females and 78%, 74.7% and 72% for males respectively in determining sex. Conclusions: Sex differentiation by sectioning point analysis of hand dimensions is reasonably accurate in Nepalese medical students. Hand breadth is the most accurate followed by hand index and hand length. Diagnostic accuracy is greater in females than males
Introduction: Visceral Leishmaniasis (VL) is one of the major public health problems of Nepal and is almost a fatal disease if not managed timely. VL cases have been reported in Nepal since 1980. The Government of Nepal is committed to reducing VL morbidity and mortality and to eliminating this disease through early case detection and treatment via effective diagnostic and treatment facilities at hospitals and health facilities through various trainings on revised national guidelines and treatment protocol, review meetings, disease surveillance, indoor residual spraying in priority affected areas by 2026. The study was conducted to investigate the current challenges and evolving trends in the epidemiology, clinical presentation, diagnosis, and management of visceral leishmaniasis at Nepal, with the goal of informing improved healthcare strategies and control measures. Methods: This prospective hospital-based study was conducted in the Department of Medicine, Bheri Hospital, Nepal, from July 2016 to June 2018. Data were entered in Excel and analyzed using SPSS 18th version. Descriptive data were presented in a pie chart and table with frequency and percentages. Results: A total of 60 patients were diagnosed with VL during the study period. Males comprised 52 (87%) and females 8 (13%) patients. Eighty-eight percent (53) of patients were above 15 years of age and twelve percent (7) were below 15 years. The median age was found to be 28 years. Twenty (33%) patients belonged to hilly regions, 31 (52%) were from Terai and 9 (15%) patients belonged to mountains. Our result shows that VL is not only found in the South and East but also prevalent in the North and West, it is not only seen in the Terai region but also found in hills and mountain regions. Relapse after treatment with liposomal amphotericin B was seen in 10 (16.7%) cases. Conclusions: VL is a chronic protozoal infection requiring specific and expensive treatment, having near 100% mortality if not treated in time. Relapses made the disease further challenging. Reporting cases from so-called nonendemic areas has made this disease more challenging. Urgent revision of treatment protocol is needed for appropriate management of visceral leishmaniasis and to prevent relapse and expansion of dedicated kala-azar elimination program in a new emerging geographical area is demanding
Introduction: Ventilator-associated pneumonia (VAP) is a prevalent hospital-acquired infection in mechanically ventilated patients, leading to increased morbidity, mortality, and antimicrobial resistance. Early identification and understanding of microbiological patterns and antibiotic susceptibility are crucial to optimizing treatment strategies. Methods:A cross-sectional study was conducted in the ICU of Manipal College of Medical Sciences, Pokhara, from March 5, 2024, to March 6, 2025. Patients on mechanical ventilation for >72 hours exhibiting signs of infection were included. Endotracheal aspirates were obtained and cultured. Pathogens were identified, and antibiotic susceptibility testing was performed. Data were analyzed using SPSS to determine the prevalence, microbiological profile, and antibiotic resistance patterns. Results: Of 107 patients, 75 (70.1%) had culture-positive tracheal aspirates. The predominant organisms were Gram-negative bacteria (62.5%), notably Acinetobacter baumannii, Klebsiella pneumoniae, and Pseudomonas aeruginosa. A. baumannii showed complete resistance to first-line antibiotics and 92.6% resistance to carbapenems, while all isolates remained sensitive to polymyxin B, colistimethate, and tigecycline. K. pneumoniae demonstrated 60–93.3% resistance to cephalosporins and aminoglycosides. P. aeruginosa was moderately resistant to beta-lactams but susceptible to carbapenems and aminoglycosides. Fungal isolates (Candida spp.) accounted for 4.7%, and Staphylococcus aureus for 2.8%. Conclusions:This study underscores a high burden of VAP in ICU patients, predominantly caused by multidrug-resistant Gram-negative pathogens. The alarming resistance to first-line antibiotics necessitates robust infection control measures and prudent antibiotic use. Targeted empirical therapy guided by local microbiological trends is vital to improving patient outcomes in mechanically ventilated populations.
Low grade appendiceal mucinous neoplasm (LAMN) is a rare malignancy of the gastrointestinal tract, the most common site being the appendix. Late diagnosed neoplasms may not be differentiated from adnexal masses even by advanced imaging methods and other diagnostic procedures. This might lead to fatal condition. These tumors are often discovered incidentally, either during a survey or at the time of surgery for other causes. We, hereby, present three cases of LAMNs found incidentally during various surgeries in our centre. We conclude that early histopathological diagnosis is mandatory for the timely treatment.
Introduction: Problem-Based Learning (PBL) is a student-centered instructional method that enhances critical thinking, teamwork, and knowledge retention. At Manipal College of Medical Sciences (MCOMS), PBL has been integrated into the pre-clinical sciences curriculum. Understanding faculty perceptions of this pedagogical method is essential for optimizing its implementation. This study aimed to assess the perceptions of pre-clinical science faculty members at MCOMS regarding the effectiveness and challenges of PBL in medical education. Methods: A descriptive cross-sectional study was conducted among 30 faculty members from seven pre-clinical departments at MCOMS. Data were collected using a structured questionnaire containing 30 perception items rated on a five-point Likert scale. Responses were analyzed using SPSS version 20, and Kruskal-Wallis tests were employed to explore associations with faculty characteristics. Results: Faculty perceptions toward PBL were generally favorable. More than 85% agreed that PBL improves knowledge retention, student engagement, communication skills, teamwork, and critical thinking. However, significant concerns were reported about inadequate faculty training, lack of assessment clarity, and unsuitable classroom infrastructure. A statistically significant difference in perception was observed among the oldest age group (p=0.020), but not with other demographic variables. Conclusion: Faculty members value PBL for its educational benefits but identified gaps in training and institutional support. To maximize the impact of PBL, structured faculty development programs and logistical improvements are recommended.
Introduction: The aortic arches consist of three main branches. And these branches supply the upper limb, head, neck and brain. The knowledge of these anatomical variations is significant for diagnostic, surgical, and interventional surgeries of the thorax and neck. Thus, this study aims to know the anatomical variation in the branching patterns of aortic arches among Nepalese population. Methods: This descriptive study was carried out in the Department of Radiology of KMCTH between 15 November 2024 to 16 February 2025 after getting the ethical clearance from the Institutional Review Committee (reference no. KMC-IRC 16102024/03). The total collection in these three months was 200 after taking the consent verbally. The Convenient sampling was done. The study was done in CT scan contrast. In this, the variation of the aortic arches were studied under the different types I- Types VII. The data was analyzed with Statistical Package for the Social Sciences 20 version. Results: In this study, the maximum distribution of sample was between 56-65 years and 108 (54%) were male and 92 (46%) were female and the most common variation of the aortic arches were the normal i.e aortic arches giving rise to the three main branches. However, it was followed by type II aortic arch second common among distribution in both genders. In this study the type III and Type IV was seen in both the gender. But there is no data in TypeV-TypeVII. Conclusions: The variation in the branches of aorta is crucial in emergency during cardiothoracic surgery. The identification of variation may achieve desired objectives and avoid complications during vascular and intervention surgery.
Curriculum is one of the most frequently used terminology in the context of education. It is a vital part of education. It can be conceptualized as a well-organized plan for conducting educational activities in a school, college, university or in a specific course or program which helps the students learn effectively and efficiently. The process of curriculum development incorporates four major processes: need assessment, planning and design, implementation and evaluation. Curriculum implementation is the phase of putting the prescribed curriculum in action in the classrooms. The availability of adequate and trained human and material resources are the essence for the successful implementation of curricula. As curriculum is an ever-changing and ever-evolving process it needs to be evaluated time and again to ensure it meets academic standards, societal needs, and evolving educational trends. Even though teachers are the major implementers of curriculum however most of the teachers are not familiar with the process of curriculum development. The aim of this editorial is to clarify the concept of curriculum, to understand various strategies that has to be considered while designing a curriculum, steps involved in curriculum implementation and importance of curriculum evaluation.
