Submissions

Author Guidelines

Manuscripts must be prepared in accordance with "Uniform requirements for Manuscripts submitted to Biomedical Journals" developed by the ICMJE-International Committee of Medical Journal Editors. The uniform requirements and specific requirement of JPAHS are summarized below. Before sending a manuscript, authors must complete the checklist as per JPAHS requirements, also available from the JPAHS website (www.jpahs.edu.np).

Types of Manuscript and word limits

• Original Article:Randomised controlled trials, interventional studies, studies of screening and diagnostic tests, outcome studies, cost-effectiveness analyses, case-control series, and surveys with high response rates. Word count of the main text (introduction up to 250 words, methods, results, discussions, conclusions) should be 2000 to 4000 words (excludes structured abstract of up to 250 words; references ≥20 to 50, acknowledgments, COI, author contribution, funding). Up to six tables/figures (either of these or in combination). Journal may allow vitiations on justified request.
• Review Article:Systematic review or narrative review, critical assessments of literature and data sources. The Word count of the main text (introduction up to 400 words, methods, results, discussions, conclusions, etc.) should be 4000-6000 words (excluding references ≥50; unstructured abstract up to 250 words). Up to six photographs/tables (either of these or in combination). Journal may allow vitiations on justified request.
• Medical education: related to medical/health science education with abstract and references, word limit and structure may vary according to types of manuscript.
• Rural Health: related to rural health services, word limit and structure may vary according to type of manuscripts.
• Students Section: related to various aspects and written by health science students, word limit and structure may vary according to types of manuscript.
• Nursing Section: related to nursing and midwifery, word limit and structure may vary according to types of manuscript.
• Journalology: related to scientific journal writing, publishing, editing word limit and structure may vary according to types of manuscript.
• Case Report with Review of Literature: new/interesting/rare cases with clinical significance or implications. Up to 1000 words excluding references (up to 10) and unstructured abstract (up to 100), up to three photographs/tables (either of these or in combination total three).
• Viewpoint/Perspective: personal views to express your own point of view on any issues relevant to health, including controversial subjects. Up to 1000 words excluding reference (up to 10).
• Letter to the Editor: Should be short, decisive observation. They should not be preliminary observations that need a later paper for validation. Up to 1000 words excluding reference (up to10).
• Limits for number of images and tables: for all the above-mentioned categories the number of images and tables should be approximately one per 500 words. When there is gross variation, justify.

MANUSCRIPT SUBMISSION
Please submit manuscript through our online submission system or via email to:

The Chief Editor
Journal of Patan Academy of Health Sciences (JPAHS)
Lagankhel-5, Lalitpur
GPO Box 26500
Kathmandu, Nepal.
Email: editor.jpahs@pahs.edu.np
Web: www.jpahs.edu.np

MANUSCRIPT PREPARATION
Manuscripts must be submitted in clear, concise English language, either in British or American, do not mix. Please refer to sample of 'Forwarding, Authorship and Declaration letter' available in our website. Please provide proof of ethical approval of the research. Authors may be required to submit three sets of original figures for clarity. Please submit manuscript through our online submission system or via email.

The manuscript must be single-spaced in A4 size, Calibri 12 points. Normal margins of 25 mm. Number each page. The pages should be numbered consecutively, beginning with the title page. Each section of the manuscript should commence on a new page in the following sequence, do not number (here number is provided for your convenience): 1. title page with full name of authors and their affiliations, corresponding author’s detail contact, running title, word count of each section and full article, numbers of tables and figures, 2. abstract structured or unstructured as per the type of manuscript, keywords, 3. introductions, 4. methods, 5. results, 6. discussions, 7. conclusions, 8. acknowledgements, 9. conflict of interests, 10. references, 11. tables and figures numbered and list of title/legend. 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 example “&” for “and” or “@” 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.

TITLE PAGE

The title page should carry

1. Type of manuscript (e.g. Original article, Case Report)
2. The title of the article should be concise, informative include sufficient detail to appreciate what the paper is about. It should include key words and phrases for indexing purposes. Title normally does not exceed two to three lines in print i.e. around 20 words. Do not include numbers, acronyms, abbreviations, proprietary names etc.
3. Running title or short title not more than 50 characters including spaces;
4. Authors’ name as it appears in your culture/society (e.g. Jay Narayan Shah, do NOT format to Shah JN or Shah Jay Narayan). You may mention which is first name, middle name and last name), with highest academic degree(s) for record and institutional affiliation.
5. The name of the department(s) and institution(s) to which the work should be attributed;
6. The name, address, phone numbers, facsimile numbers and e-mail address of the contributor responsible for correspondence about the manuscript;
7. The total number of pages, total number of photographs and word counts separately for abstract and for the text (excluding the references and abstract);
8. Source(s) of support in the form of grants, equipment, drugs, or all of these;
9. Acknowledgement to individual or institute for significant contribution who do not qualify for authorship for example general support by a departmental chair, or staff-
   
   • Acknowledgments of technical help.
   • Acknowledgments of financial and material support, which should specify the nature of the support.
10. If the manuscript was presented as part at a meeting, the organization, place, and exact date on which it was read.
11. Registration number of clinical trials.
12. Conflict of interest.

ABSTRACT
Provide full tile on abstract page. The abstract up to 250words should be structured for original articles- Introductions, Methods, Results and Conclusions. State the context (background), aims, settings and design, material and methods, statistical analysis used, results and conclusions. Below the abstract should provide 3 to 8 keywords arranged alphabetically, separated by coma, all small case. The abstract should not be structured for a review article and case report. Do not include references in abstract. Avoid use of abbreviations unless absolutely necessary.

INTRODUCTION
Provide a context or background for the study, the nature of the problem and its significance in up to 200 words limit. Starting from global view, regional then local, it should be written in ‘inverted triangle’ in three paragraphs ideally, to end with the rationale and relevancy of the study. 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 pre-specified subgroup analyses should be described. Provide only directly pertinent references, and do not include data or conclusions from the work being reported.  

METHODS
Include detail information on materials and methods; the details of where, when, how, who, why etc, with elaborate process so as the study can be ‘reproduced’.

Describe the study population in detail including controls. Describe the methods and procedures, so that other workers can reproduce the results. If the methods used are new or substantially modified, describe them and state their limitations. When reporting research on human beings, the authors must include an assurance that the work was approved by a medical ethics committee and that the subjects gave their informed consent to participate. The Methods section should include only information that was available at the time the plan or protocol for the study was written; all information obtained during the conduct of the study belongs in the Results section. Selection and Description of Participants Describe your selection of the observational or experimental participants (patients or laboratory animals, including controls) clearly, including eligibility and exclusion criteria and a description of the source population. Because the relevance of such variables as age and sex to the object of research is not always clear, authors should explain their use when they are included in a study report; for example, authors should explain why only subjects of certain ages were included or why women were excluded. 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. Authors submitting review manuscripts should include a section describing the methods used for locating, selecting, extracting, and synthesizing data. These methods should also be summarized in the abstract.

Selection and description of participants Describe selection of the observational or experimental participants (patients or laboratory animals, including controls) clearly, inclusion and exclusion criteria and a description of the source population. Relevance of variables such as, age and sex, authors should explain why only certain age group or genders were included. 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. Provide working definition of your study, for example when it is about ‘elderly’ mention specifically what you mean by elderly with specific age/group.

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 study. Give references to established methods, including statistical methods; 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.

Ethics Mention whether ethical approval was obtained. Indicate whether the procedures followed were in accordance with the ethical standards (Helsinki Declaration). Do not use patients’ names, initials, or hospital numbers, identifiable illustration/images. When reporting experiments on animals, indicate whether the institution’s or a national research council’s guideline, or any national law on the care and use of laboratory animals was followed.

The ‘evidence’ for approval by a local Ethics Committee should be supplied by the authors when required. Animal experimental procedures should be as humane as possible and the details of anaesthetics and analgesics used should be clearly stated. The journal will not consider any paper which is deemed unethical. A statement on ethics committee permission and ethical practices must be included in ‘Methods’ section.

Statistics Describe statistical methods with enough detail on study design, sampling technique, sample size etc, 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 the use of P values, which fails 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.

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 (http://www.consort-statement.org). 
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 

RESULTS
Present your results in logical sequence in the text, tables, and illustrations, giving the main or most important findings first, based on your objective of the study. Do not repeat all the data in the tables or illustrations, 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, 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, for example ‘xx% (xx/xx)’. Use graphs as an alternative to tables with many entries; do not duplicate data in graphs and tables.

Illustrations, table, graph and figures must be ‘cited’ appropriately, and not merely elaborate them, for e.g. do not write ‘Table xx shows that xxx’, instead write ‘we found xxx (Table xx)’.Title of the table (placed on top), and legend of the figure (placed at bottom)should be self-explanatory so as reader do not need to refer to the main document to understand what the table is about. Follow the format ‘Table x.xxx  xxx’(not Tab or Table: etc). Provide full form of any abbreviation used in table or figures, as ‘Note’ below the table or figure. Table should not exceed one A4 size.

Tables: Tables should be self-explanatory, with appropriately constructed title which has similar importance as the title of the manuscript, and should not duplicate textual material. Tables with more than 10 columns and 25 rows, or which do not fit in one page are not acceptable. Number tables, in Arabic numerals, consecutively in the order of their first citation in the text and supply a brief title for each. Type or print each table with double spacing on a separate sheet of paper. Number tables consecutively in the order of their first citation in the text and supply a brief title for each. Do not use internal horizontal or vertical lines. Give each column a short or an abbreviated heading. Authors should place explanatory matter in footnotes, not in the heading. Explain all nonstandard abbreviations in footnotes, and use the following symbols, in sequence: *, †, ‡, §, ||, ¶, ** , †† ,‡‡

Identify statistical measures of variations, such as standard deviation and standard error of the mean.

If you use data from another published or unpublished source, obtain permission and acknowledge that source fully. Submit such tables for consideration with the paper so that they will be available to the peer reviewers.

Illustrations (Figures): 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.

Legends for Illustrations (Figures): 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. [Back]

DISCUSSION
Emphasize and start discussion with the new and important findings of ‘your study’ and the conclusions that follow from them to support your study objective. Do not repeat in detail data or other information given in the ‘Introduction or the Results section’. Begin by summarizing briefly the main findings, then explore possible mechanisms or explanations for these findings, compare and contrast with relevant literature, state the limitations of the study, and explore the implications of the findings for future research and for clinical practice. Discussion should be written in ‘triangle’ form ‘starting from your study to the regional and global’, opposite to the structure of ‘introduction’.

Link the conclusions with the goals of the study but avoid unqualified statements and conclusions not adequately supported by the data. Do not make statements on economic benefits and costs unless the manuscript includes the data and analyses. Avoid claiming priority or alluding to work that has not been completed. State new hypotheses when warranted.

Conflict of interests (COI) 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.

Acknowledgements and funding
Acknowledge person or institute who have helped in the study, in short and do not add praise or literature in this section. Mention about fundings and its details.

REFERENCES
References should be numbered consecutively in the order in which they are first mentioned in the text (not in alphabetic order). Identify references in text, tables, and legends by Arabic numerals in superscript after the punctuation marks. References cited only in tables or figure legends should be numbered in accordance with the sequence established by the first identification in the text of the particular table or figure. Avoid using abstracts as references. Information from manuscripts submitted but not accepted should be cited in the text as "unpublished observations" with written permission from the source. References to papers accepted but not yet published should be designated as “in press” or “forthcoming”; authors should obtain written permission to cite such papers as well as verification that they have been accepted for publication.

We sometime check the accuracy of references, avoid citing retracted articles.

Currently most citation systems developed in west tend to change the cited name as “surname name (initial) middle name (initial)”. As increasing trend of more contributions from the Asian countries, for e.g. Chinese, Japanese etc in their daily use they write “surname” first followed by “name” unlike other cultures, which becomes just opposite when modified by the system. Provide full name of the authors below title of the manuscript in author by-line as it appears in respective society/culture without attempt to modify for surname name. The full name appears below title of the manuscript in author by-line.

For more details please see the recent publication on the JPAHS website. To minimize confusion, the current practice increasingly uses abbreviated name followed by surname (as shown in example 2 below, please open the DOI link and go through references, unlike traditional Vancouver system of using surname followed by initials of name). We prefer style number 1. and least preferred is 3 (which is best modified as 2.).

Provide link for Crossref (DOI), PubMed (PMID), Google Scholar, Article (HTML, PDF), etc.

1. Shanta Bir Maharjan, Shailendra Shah, Romi Dahal, Rajan Gurung, Jay N Shah. Elective surgery patients walk to operating room instead of wheeled in on trolley: patient centered care. Journal of Patan Academy of Health Sciences. 2018;5(1):35-9.
2. JN Shah, SB Maharjan, S Paudyal. Routine use of antibiotic prophylaxis in low-risk laparoscopic cholecystectomy is unnecessary: a randomized clinical trial. Asian Journal of Surgery. 2012;35:136-9. PubMedDOI
3. Shah JN, Maharjan S, Gurung R. Shortened Preoperative Fasting Time to Allow Oral Rehydration Solution Clear Liquid up to Two Hours before Elective Major Surgery in Adults. Journal of the College of Physicians and Surgeons--Pakistan: JCPSP. 2018 May1;28(5):348-51. PubMed, DOI

The JPAHS uses modified Vancouver referencing style, in accordance with the ICMJE guideline (http://www.icmje.org  or http://www.nlm.nih.gov/bsd/uniform_requirements.html).For in-depth details on referencing, please visit website of ‘Citation Medicine, The NLM Style Guide for Authors, Editors, and Publishers’(http://www.ncbi.nlm.hig.gov/books/NBK7256/) for details of referencing style for journals, books, internet, media etc.

Do not use software’s facility of automatic referencing, footnotes, headers, footers, etc. Remove the automatic formatting in submission.

Units of Measurement
Measurements of length, height, weight, and volume should be reported in metric units (meter, kilogram, or litre) or their decimal multiples.

Temperatures should be in degrees Celsius. Blood pressures should be in millimetres 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.

Abbreviations and Symbols
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.

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. Do not use software’s facility of automatic referencing, footnotes, headers, footers, etc.

Copyright transfer and author agreement
Submission of the manuscript means that the authors agree to assign exclusive copyright to JPAHS. All authors must sign a Copyright Transfer and Author Agreement form upon submission of the manuscript to the Journal. The work shall not be published elsewhere in any language without the written consent of JPAHS. The articles published in this journal are protected by copyright which covers translation rights and the exclusive rights to reproduce and distribute all of the articles printed in the journal.

Authorship (details on JPAHS website)
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, all four criteria suggested by ICMJE modified in 2014, (a) Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; AND (b) Drafting the work or revising it critically for important intellectual content; AND (c) Final approval of the version to be published; AND (d) Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Dual Publication
If material in a submitted article has been published previously or is to appear in part or whole in another publication, the Chief Editor 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 JPAHS and future articles of the author will be rejected automatically.

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 corresponding author should notify change of address, if any, on time.

Declaration
A declaration letter 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.

Sending a revised manuscript
While submitting a revised manuscript, contributors are requested to include, a copy of the revised manuscript copy in ‘review track change mode’ with point to point clarification to each comment, along with a copy of the final revised manuscript with the changes underlined in red. The manuscript number should be written on each of these documents.

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

CHECK LIST

While submitting your manuscript to JPAHS please make sure you have submitted following documents:

1. Forwarding Letter
2. Authorship
3. Declaration
4. Manuscript
5. Ethical Approval Letter

Forwarding letter

• Document filled in, printed, signed, scanned and ready to send
• Signed by all contributors
• Previous publication / presentations mentioned
• Source of funding mentioned
• Conflicts of interest disclosed

Authors

• Complete author information
• Author for correspondence, with e-mail and tel. no.
• Identity not revealed in paper except title page (e.g. name of the institute in material and methods, citing previous study as ‘our study’, names on figure labels, name of institute in photographs, etc.)

Presentation and format

• Single spacing
• Margins 2.5 cm from all four sides
• Title page contains all the desired information (vide supra)
• Title is not more than 100 characters (including spaces)
• Title is in sentence case
• Running title provided (not more than 50 characters)
• Abstract page contains the full title of the manuscript
• Plain language summary (up to 100 words)
• Abstract provided (not more than 100 words for case reports and 250 words for original articles)
• Structured abstract provided for an original article
• Key words provided (three or more in alphabetical order, each word in small case, separated by comma and no full stop at the end)
• Introduction of 100-250 words as per types of manuscript
• References cited in superscript in the text without brackets
• References 5-100 according to the journal’s instructions

Language and grammar

• Uniformly American English (mention if you use (or British but do not mix up)
• Abbreviations spelt out in full for the first time
• Numerals from 1 to 10 spelt out
• Numerals at the beginning of the sentence spelt out

Tables and figures

• Number within specified limits.
• No repetition of data in tables/graphs and in text
• Figures necessary and of good quality (colour)
• Table and figure numbers in Arabic letters (not Roman)
• Figure legends provided (not more than 40 words)
• Patients’ privacy maintained (if not, written permission enclosed)
• Credit note for borrowed figures/tables provided

JPAHS Guidelines and Checklists:

• JPAHS Author Guidelines
• JPAHS Manuscript Preparation Guidelines
• JPAHS Checklist

Submission Documents Templates:

• JPAHS Template Forwarding Letter
• JPAHS Template Authorship
• JPAHS Template for Author’s Contribution
• JPAHS Template Declaration

Manuscript Templates:

• JPAHS Template for Original Article
• JPAHS Template for Case Report
• JPAHS Template for Review Article
• JPAHS Template for Perspective
• JPAHS Template for letter to the Editor