<p class="abstract"><strong>Background:</strong> The incidence of usage of over-the-counter drugs is drastically increasing day by day. Over-the-counter (OTC) drugs are medicines sold directly to consumer without a prescription from health care personnel. In many countries, OTC drugs are selected by a regulatory agency to ensure that they are safe and effective when used without physician’s care. Taking OTC medicines still has risk. Some interact with other medicines, supplements, food and drinks and some causes problem for people with certain medical conditions.</p><p class="abstract"><strong>Methods:</strong> A descriptive cross sectional was conducted from 1st February - 15th August 2016 among 110 among adults of age group 20 and above residing in Chapapani-12, Pokhara. A pre-tested structured questionnaire were used and data were analyzed using Statistical Package for Social Science (SPSS) for windows version 18.0. Frequency, percentage, chi-square and correlation were performed.  </p><p class="abstract"><strong>Results:</strong> Nearly 1/3^rd of the respondents (33.6%) were of age group 20-29 years and more than half (60.9%) were female. More than half of the respondents (54%) had good knowledge and less than half (47%) had good practice of OTC. There was significant association of knowledge with age, marital status, education and monthly family income. There was significant association of practice with education of respondents. There was weak positive correlation between knowledge and practice (r =0.211).</p><strong>Conclusions:</strong> This showed that the knowledge hadn’t been fully practiced into action by the community people and still they are lacking the concept of over-the-counter drugs and its safe use in daily living.

INTRODUCTION:  Cardiomyopathy is a disease  of the heart  muscle  that  leads  to deterioration of myocardial functioning.  It has different morphological variation with  dilated cardiomyopathy being the most common  form  comprising over 90% of all cases. Heart  failure  (HF)  is the  most  common  clinical  presentation of dilated  cardiomyopathy.   Various  electrocardiographic changes  are common in these patients.  The most common  cause of sudden death in these patients is arrhythmia.  This study aimed at characterizing different  electrocardiographic changes  in patients of dilated cardiomyopathy admitted  for heart failure.MATERIAL AND METHODS: A retrospective analysis of records of admitted  patients  from l" January 2015 to 30th April 2018 was conducted.  Study was conducted  after obtaining ethical clearance  from institutional review  board. Data was collected in a preformed proforma and analyzed using SPSS 20.0 version.RESULTS: Consecutive  400 cases of dilated  cardiomyopathy with systolic dysfunction (LVEF<40%) were taken  for the study. Two hundred and fifty two (63 %) were male. The mean age of patients was 59.33 (± 15.76) years. The most common  risk factors in our patients  were smoking (66%)  followed by systemic hypertension (49%), IHD (32%), and diabetes  mellitus (33%) respectively. Out of 400 patients, abnormal ECG were found in 82.5%. The most common abnormality  was LVH (30.7%) followed by LBBB (22.5%) and AF (20.5%).CONCLUSION: The percentage   of abnormal  electrocardiographic findings was high in our study. All patients of dilated cardiomyopathy should undergo electrocardiography screening for risk stratification and to prevent serious  consequences with early necessary intervention.Journal of Universal College of Medical SciencesVol. 6, No. 1, 2018, Page: 40-45

Background: It is estimated that, on an average about 35% of infants 0 - 6 months old are exclusively breastfed around the world. Optimal breastfeeding and complementary feeding practices can save the lives of 1.5 million children under five every year. The condition is further worse in slum areas where vulnerable group of people resides. So, this study aims to assess prevalence on initiation of breastfeeding, exclusive breastfeeding and complementary feeding practices. Methods: A cross sectional study was conducted from November 2017 - February 2018 among 400 married women having child between 6 - 24 months. A pre-tested structured questionnaire comprising of socio-demographic characteristics, exclusive breastfeeding and complementary feeding practice were used. Data was analyzed using Statistical Package for Social Sciences (SPSS) 18.0 version. Results: About 55% of the mothers had initiated breastfeeding within an hour (<1 hour). About half (50.5%) had practiced exclusive breastfeeding to their children. More than fifty percentages (51.5%)of the mothers introduced complementary foods at 6 months. Age at pregnancy, mode of delivery, family size and colostrum feeding is associated with early initiation of breastfeeding at 95% CI i.e. p value <0.05. Whereas, age of mother, ethnicity, mode of delivery and initiation of breastfeeding were significantly associated with exclusive breastfeeding at 95% CI i.e. p value <0.05. Conclusions: The breastfeeding and complementary feeding practice in slum area is not optimal. Health awareness program focusing on early initiation of breastfeeding, exclusive breastfeeding practices and timely introduction of complementary foods in these vulnerable groups of population is needed o prevent its untoward effects. Keywords: complementary feeding; exclusive breastfeeding; initiation; malnutrition.  

<p class="abstract"><strong>Background:</strong> Globally, an estimated 300,000 maternal deaths occur annually owing to causes associated with pregnancy, of which nearly 75% were preventable. Each year, modern contraceptives help women prevent 215,000 pregnancy-related deaths (including 66,000 from unsafe abortions), 2.7 million infant deaths and the loss of 60 million years of healthy life. Vaccination is one of the most cost-effective health interventions available, saving millions of children from illness, disability and death each year. The burden of infectious diseases has been reduced primary due to immunization.</p><p class="abstract"><strong>Methods:</strong> A cross-sectional study regarding knowledge and practice of family planning and immunization was conducted in a Maternal and Child health (MCH) clinic of Western Regional Hospital, Pokhara. The sample consists of 100 married women of reproductive age group (15-49) years having under five children coming to the clinic using purposive sampling technique.  </p><p class="abstract"><strong>Results:</strong> Knowledge regarding family planning methods were oral contraceptive pills/depot/implant (84%) followed by intrauterine contraceptive device (77%), condom (65%), natural methods (80%), permanent method (92%). Condom was most commonly used among temporary methods. More than 4/5^th of the respondents were aware about vaccines as per schedule of Nepal. But 5% of the respondents had neither given any vaccine to their baby and nor taken any dose of tetanus toxoid vaccine during their previous pregnancy.</p><strong>Conclusions:</strong> Still 14% of the respondents were not aware about any methods of family planning and 19% does not know about the vaccines as per schedule of Nepal. So there is a need to increase awareness about the different types of family planning methods and immunization.

Introduction: Cardiovascular disease remains the main cause of death in the world, and myocardial infarction represents the main contributor to this mortality. Timely restoration of myocardial blood flow with reperfusion therapy is crucial. Pre-hospital delay is a major obstacle for early reperfusion therapy and has negative impact on mortality and left ventricle function. Methods: A prospective study was carried in cardiology unit of a medical college from August 2013 to December 2017. Cases of acute ST segment elevation myocardial infarction that have undergone thrombolysis were recruited. Results: Out of 450 patients with ST Elevation Myocardial Infection (STEMI), delayed presentation was seen in 288 (64%) for >6 hrs and 108 (24%) patients for >12 hrs. The duration from onset of symptoms to the presentation in the emergency room (pre-hospital delay) was 12.66 hrs (SD=14.19, range = 30 min to 72 hrs). The door to needle time was 54 min (SD=24) The major factors for pre-hospital delay were misinterpretation of symptoms (59%) and transportation problems (31%). Conclusion: Misinterpretation of symptoms remain the most common cause of delayed presentation. Health education for public awareness can reduce the delay. Extension of thrombolytic therapy to district hospital and primary health center level after basic training for medical officer with checklist and collaboration in form of telemedicine with referral cardiac center may have major impact on morbidity and mortality reduction in acute STEMI patients with early reperfusion therapy.