Menstrual pattern among adolescent girls of Pokhara Valley: a cross sectional study.

BACKGROUND: Menstruation 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. METHOD: A 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. RESULTS: Mean 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. CONCLUSION: Dysmenorrhoea 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.

The incidence of color blindness among some school children of Pokhara, Western Nepal.

The incidence of color blindness varies from race to race and different in different geographical area. Since, there is no such report about the prevalence of color blindness in the western part of Nepal, the present study had been conducted to find out the incidence of color blindness among school children of Pokhara city, western Nepal. Participant's (n=964, 474 boys, 490 girls, age group 10 to 19 years) color vision was tested by using Ishihara chart (38 plates). Among 474 boys, 18 boys were color blind with the prevalence of 3.8%. None of girls were found to be color blind. Out of 18 color blind boys, nine, six and three boys were the victims of deuteranopia, deuteranomaly and protanomaly respectively. The incidence of color blindness were more amongst the Darji (14.3%) and Newar (9.1%) ethnic groups.

Age at menarche of subpopulation of Nepalese girls.

The present study was carried out to explore the mean age at menarche of school going girls of Western Nepal, Pokhara and to determine the factors influencing age at menarche. The data was collected from five schools located within the Pokhara Valley of Western Nepal. Only the students who had experienced menarche were included in the study. Verbal consent was obtained after explaining the objectives of the study; the students were interviewed for personal and family details and information obtained was recorded. The age at menarche was found to be 12.69 +/- 0.95 years. The mean age at menarche of those attending community schools was significantly higher than that of those attending private schools (12.85 +/- 0.87 vs 12.41 +/- 0.99 years). The mean age at menarche was found to be delayed with increase in number of family members and more siblings. The mean age at menarche of the vegetarians was higher than that of non-vegetarians (12.82. +/- 0.81 vs 12.68 +/- 0.95 years).

Study on the refractive errors of school going children of Pokhara city in Nepal.

OBJECTIVES: Refractive errors are the one of the most common visual disorders found worldwide in school going children and also it is 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: 964 subjects (474 boys, 490 girls) were selected between age groups 10 to 19 years from 6 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 confirmation of the refractive errors. RESULTS: Sixty two schools children (6.43%), out of 964 had refractive errors. The 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 significant (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 significantly 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.

A comparative study of the peak expiratory flow rate of Indian and Nepalese young adults in a teaching institute.

Peak expiratory flow rate (PEFR) measurement is the easiest and cheapest method to evaluate respiratory functions. So, the study was carried out to evaluate PEFR of healthy Nepalese adults and compare their values with healthy Indian counterparts to know whether Indian prediction equations for 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) and Nepalese (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: 485.9 liter/min, Female: 365.2 liter/min) young adults were found to have no significant differences. As there is no significant difference in the mean PEFR of Indian and Nepalese young adults, prediction equations made for Indian adults can be used to predict PEFR of Nepalese subjects. Therefore, an attempt has been made to formulate a regression equation from the combined Indian and Nepalese subjects. A stepwise, multiple, linear, regression analysis was performed for this purpose. The analysis showed that height is the best predictor for PEFR in the present study. The regression equation based on height for the combined Indian and Nepalese young adults is calculated as: PEFR = 5.687 x Height (cm) - 495.787. However, a stepwise, multiple, linear, regression equation with residual analysis for the best fit model was performed to formulate prediction equation for PEFR and this showed a change of the earlier regression equation to PEFR = 5.930 x Height (cm) - 536.131.

A comparative study of body mass index (BMI) in diabetic and non-diabetic individuals in Nepalese population.

INTRODUCTION AND OBJECTIVES: Diabetes Mellitus (DM) is the most common endocrine disorder world-wide. The prevalence of diabetes mellitus is increasing. In the present study an attempt has been made (i) to examine the relation between obesity and diabetes mellitus in Nepalese people, (ii) to find out whether BMI cut-off points for determining over weight and obesity as per WHO criteria are applicable in Nepalese study population. MATERIALS AND METHODS: The present study was carried out in Manipal College of Medical Sciences (MCOMS) and Manipal Teaching Hospital (MTH), Pokhara. The Diabetic patients of Pokhara and surroundings who attended the 'Diabetic Clinic' and Out Patient Department (OPD) during August 2004 to November 2004 at Manipal Teaching Hospital were included in the present study. The number of diabetic patients was two hundred (200), out of which, one hundred and fourteen (114) were male and eighty six (86) were female. In addition one hundred (100) non-diabetic subjects who attended the OPD at MTH were taken for comparison with the diabetic patients, of which, forty seven (47) were male and fifty three (53) were female. Age, height and weight were recorded for every subject. BMI was calculated by the standard formula. In the present study, body mass index (BMI) of the diabetic subjects was found to be more than that of non-diabetic subjects. BMI of non-diabetic males and females were found to be around 22 kg/m2 which is within normal range as per WHO recommendations. On the other hand, diabetic subjects' BMI were found to be around 25 kg/m2, which denotes borderline obesity. It is clear from the present study that 51.5% of the diabetic subjects were within the normal range (BMI 18.5-24.9 kg/m2). More diabetic subjects were found in over-weight (25-29.9) category than non-diabetic subjects. As per WHO criteria 56% of the non-diabetic subjects were within the normal BMI range (BMI 18.5-24.9 kg/m2). It is also evident that when BMI in the range of 25.0-29.9 kg/m2 is considered as over-weight, only 33% were found to be over-weight in diabetic subjects. But when BMI > or =23 kg/m2 (as recommended for Asians) is taken as the determining factor for overweight, 64% of overweight male subjects and 72.09% of overweight female subjects were found to be diabetic. CONCLUSION: According to the observations of the present study on Nepalese it can be concluded that BMI cut-off points for determining over-weight and obesity should be lowered to 23 kg/m2 or less which can provide an adequate basis of taking action on risks related to overweight and obesity in Nepal.