, Sanjay N. Khanal2, Steven M. Thygerson3, William S. Carter4, James D. Johnston3, Sunil K. Joshi5 1Department of Community Medicine, Kathmandu University School of Medical Sciences, Dhulikhel Hospital, Dhulikhel, Kavre Nepal JFIF d d Ducky d qhttp://ns.adobe.com/xap/1.0/