BackgroundMenstruation is a normal physiological process occurring every month throughout the reproductive age of the females. However, significant variation in menstrual pattern is observed among adolescents. The objective of this study was to determine menstrual pattern among adolescent girls of Pokhara Valley.MethodA cross sectional study was conducted in seven schools of Pokhara Valley. A total of 260 adolescent girls were included in the study. Girls were requested to complete questionnaire containing 19 items. Selected girls voluntarily agreed to answer questionnaire under the supervision of the researcher and then the data was analyzed.ResultsMean age of the girls was 14.0 ± 1.3 years. Mean age at menarche was 12.2 ± 0.9 years. The mean cycle length of the subjects was 34.8 ± 11.8 days. It was observed that as many as 167(64.2%) girls had irregular menstrual cycle and significant association was found between regularity of menstruation and ethnicity. Seven (2.7%) girls had a menstrual cycle length shorter than 21 days, 60(23.1%) had cycle longer than 35 days and 193(74.2%) had a normal cycle length between 21 and 35 days. Majority 231(88.8%) had normal duration of menstruation. Dysmenorrhoea was reported by more than half of the girls and significant association was found between severity of dysmenorrhoea with school absenteeism and treatment needed.ConclusionDysmenorrhoea was the most common menstrual problem among adolescent girls. Girls’ school attendance was affected due to menstrual pain. Girls with severe dysmenorrhea needed medical treatment. Irregular menstruation was reported by more than half of the girls and significant association was found with the ethnicity.Electronic supplementary materialThe online version of this article (doi:10.1186/s12905-016-0354-y) contains supplementary material, which is available to authorized users.

Objectives: Refractive errors are the one of the most common visual disorders found worldwide in school going children and it is also one of the causes of blindness. It can easily be prevented, if timely proper measures are taken. In Kathmandu valley and Mechi Zone of Nepal, the distribution of refractive errors was found to be very high. No records are available from the Western part of Nepal. Considering the importance of the refractive errors the present study had been undertaken in Pokhara city. Materials and methods: Nine hundred and sixty four subjects (474 boys, 490 girls) were selected between age groups 10 to 19 years from six schools representing different region of Pokhara. After Preliminary examination: on acuity of vision with Snellen's and Jaeger's charts, the subjects were referred to the Manipal Teaching Hospital, Pokhara for con¿ rmation of the refractive errors. Results: Sixty two schools children (6.43%), out of 964 had refractive errors. Myopia was found to be most common (4.05%). The refractive errors were found more in Private school children (9.29%) than Government school children (4.23%), which is statistically signi¿ cant (P < 0.05). More boys (7.59%) were found to have suffered from refractive errors than girls (5.31%). Further, children with vegetarian diet (10.52%) had greater number of refractive errors than non-vegetarian diet children (6.17%). Conclusion:In the present study, percentage distribution of myopia was found to be higher (4.05%) than the hyperopia (1.24%) and astigmatism (1.14%). Interestingly, in the present study the refractive errors were found signi¿ cantly higher in Private schools children than Government schools because the children who read in Private schools have higher socioeconomic status; spend more time in home work, watching Television and Computer as compared to government schools children. These near activities of the eyes causes stress on eyes of the children and might be one of the causes of developing myopia.

Introduction: The cardiovascular system undergoes physiological changes during pregnancy. Electrocardiograms thereby play important role in understanding these physiological changes with the pathological one. The study has been carried out to study the electrocardiographic changes in pregnant women of third trimester and compare it with the non-pregnant women of same age group.Methods: Sixty third trimester pregnant women and sixty non-pregnant women of same age group attending Manipal Teaching Hospital were included. The 12 lead electrocardiograms of the participants were taken in supine position. The electrocardiograms were studied for various parameters like waves, intervals, segments and mean ventricular depolarization axis.Result: The result showed increase in heart rate in pregnant women when compared to control group. The decrease in PR interval associated with pregnancy was highly significant. The abnormalities in T wave associated with pregnancy, mostly in lead V1, V2, V3, V4, III and aVF were also highly significant. There was also increase occurrence of Q waves in pregnant women mostly in the bipolar leads. The QRS frontal axis compared to control showed increased tendency to shift towards left with advancing pregnancy. There was also significant increase in QT and QTc interval in third trimester pregnant women. The amplitude of various waves seemed to be decreased with pregnancy as well.Conclusion: This study shows that changes in electrocardiograms in third trimester pregnant women do occur. Therefore interpretation and evaluation of electrocardiograms in pregnancy should be done with caution.

Peak expiratory fl ow rate (PEFR) measurement is the easiest and cheapest method to evaluaterespiratory functions. So, the study was carried out to evaluate PEFR of healthy Nepalese adults andcompare their values with healthy Indian counterparts to know whether Indian prediction equationsfor PEFR can be used for Nepalese adult population or not.One hundred twenty-three healthy, young, non smoker adult Indian (64: 28 Males, 36 Females) andNepalese (59: 32 Males, 27 Females) medical students of 18 to 20 years of age participated in the study.The mean PEFR of Indian (male: 490.4 liter/min, female: 386.0 liter/min) and Nepalese (male: 485.9liter/min, Female: 365.2 liter/min) young adults were found to have no signifi cant differences.As there is no signifi cant difference in the mean PEFR of Indian and Nepalese young adults, predictionequations made for Indian adults can be used to predict PEFR of Nepalese subjects. Therefore, anattempt has been made to formulate a regression equation from the combined Indian and Nepalesesubjects. A stepwise, multiple, linear, regression analysis was performed for this purpose. The analysisshowed that height is the best predictor for PEFR in the present study. The regression equation basedon height for the combined Indian and Nepalese young adults is calculated as: PEFR = 5.687 × Height(cm) – 495.787. However, a stepwise, multiple, linear, regression equation with residual analysisfor the best fi t model was performed to formulate prediction equation for PEFR and this showed achange of the earlier regression equation to PEFR = 5.930 × Height (cm) – 536.131.Keywords: Peak expiratory fl ow rate, peak fl ow meter, prediction equation, spirometry, youngadults

The cardiovascular system undergoes physiological changes during pregnancy. These physiological changes in the heart can be understood by simple procedures like electrocardiography. With the objective of formulating basis of alterations in heart rate and impulse conductivity from atria to ventricles during pregnancy, the study was carried out in Manipal Teaching Hospital, Pokhara, Nepal between calendar year 2012 and 2013 by comparing electrocardiograms between pregnant and non-pregnant participants. The total number of participants in this study was 120: 50% was third trimester pregnant women as cases and the other 50% was non-pregnant women as controls. The statistically significant increase in heart rate and highly significant decrease in PR interval in electrocardiograms of cases conclude that the alterations in cardiac function do occur in pregnancies which all try to meet the growing demands of developing fetus. Thus, these changes neither should be misinterpreted as of pathological origin nor the latter one if present should be misdiagnosed by any health care providers.