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7%) and competent lips (98.6%). Crowding was present in 35.4%, midline discrepancy in 11.3%, crossbite in 7.2%, scissor bite in 0.6% and open bite in 2.1% of the children examined.

Most of the occlusal characteristics were desirable but with the existence of some malocclusion traits, necessitating timely recognition and correction through early screening. Gender and racial influences were also observed and it emphasizes the need for treatment plan based on them.

Most of the occlusal characteristics were desirable but with the existence of some malocclusion traits, necessitating timely recognition and correction through early screening. Gender and racial influences were also observed and it emphasizes the need for treatment plan based on them.

Sleep is important in maintenance of proper functioning of both mental and physical functions of human body. Studies have shown there is impact on the sleep parameters with the use of caffeine, cigarette and alcohol. As there is little availability of similar studies here in Nepal, we made an attempt to know the relation of consumption of such substances with the sleep quality and sleep parameters as per Pittsburgh Sleep Quality Index scale. Methods A cross sectional study was conducted among the undergraduate students at BP Koirala Institute of Health Sciences, Dharan. Students were asked to complete a self- administered questionnaire to give information about demographic variables and habit of consumption of caffeinated beverages, cigarette and alcohol. The Pittsburgh Sleep Quality Index was utilized after the permission from authority to evaluate sleep quality.

Out of 350, almost half of the students (44.6%) had poor sleep quality. 40.8% students reported sleeping six hours or less per night and 10.1% used medications to sleep. 96% reported consuming caffeinated beverages, 20% consumed cigarettes and 38.3% consumed alcoholic beverages. There was significant association of poor sleep quality with the increased consumption caffeine, cigarette and alcohol (p<0.05).

Poor sleep is prevalent among the undergraduate students of B P Koirala Institute of Health Sciences and the consumption of caffeine, cigarette and alcohol is associated with increment in poor sleep quality among them.

Poor sleep is prevalent among the undergraduate students of B P Koirala Institute of Health Sciences and the consumption of caffeine, cigarette and alcohol is associated with increment in poor sleep quality among them.

Psychiatric comorbidities are common in thyroid disorder patients and complicate patients’ life quality as well as disease management. We aimed to explore prevalence of anxiety and depression and identify associated characteristics among patients with thyroid function disorder.

A descriptive, cross-sectional study was conducted on 129 thyroid disorder patients aged ?20 years. A semi-structured questionnaire, Beck Anxiety Inventory, and Beck Depression Inventory were used for sociodemographic characteristics, anxiety, and depression respectively. Group differences were compared (Chi square) or correlations were determined (Pearson’s correlation coefficient).

Patients’ mean age was 38.09±12.68 years; most were females (102, 79.1%) and hypothyroid (90, 69.8%). Overall prevalence of anxiety and depression were 50.4% and 42.6% respectively. Anxiety was more prevalent in females (54.9% vs 33.3% in males, p=0.046), low economic status (73.9% vs 35.5% in higher status, p=0.019), and hyperthyroid (64.1% vs 44.4%ning of the groups with higher prevalence is advisable.

The use of radial access for percutaneous coronary intervention is increasing in Nepal. However, there is limited study on the comparison of radial and femoral access in Nepal. This is the study comparing net adverse clinical events of radial with femoral access for intervention.

This prospective study was conducted at Shahid Gangalal National Heart Center from January 2014 to June 2015 among 849 participations who underwent percutaneous coronary interventions, and 418 radial interventions were compared with 418 femoral interventions. A comparison was done in terms of 30- day rate of net adverse clinical events defined as the composite of death, myocardial infarction, stroke, target lesion revascularization and major bleeding.

Incidence of net adverse clinical events was significantly lower in radial compared to femoral approach 18(4.30%) vs. 51 (12.2%), p= <0.001). Mortality observed in the radial approach was significantly lower (p=<0.001) compared to femoral. Procedure success was not significantly different p=0.629. The trans-radial approach had significantly higher crossover rate (p=0.001). Observed vascular access site complications (p=0.026) and hospital stay (p=<0.0001) were lower in the radial group. Radiation exposure measured by fluoroscopy exposure time was not significantly different between the two groups (p=0.290).

Radial access is associated with a lower rate of net adverse clinical events at 30 days compared to femoral access. Radial access is safer and equally effective compared to femoral access in the context of Nepal.

Radial access is associated with a lower rate of net adverse clinical events at 30 days compared to femoral access. Radial access is safer and equally effective compared to femoral access in the context of Nepal.

Methotrexate is considered as the anchor drug for the treatment of rheumatoid arthritis. However, various adverse effects limit its use leading to frequent discontinuation of treatment. This study aimed to evaluate the common adverse effects of methotrexate in patients with rheumatoid arthritis.

A prospective observational study was conducted at National Center for Rheumatic Diseases from June 2018 to May 2019 among patients with rheumatoid arthritis using methotrexate monotherapy. Laboratory tests like liver function tests, renal function tests, complete blood count, C-reactive protein, erythrocyte sedimentation rate were done at baseline and every 3 months. check details Data on patients’ comorbidities, disease activity and side effects of drug were collected on every follow- up. Statistical analysis was carried out with the help of SPSS 23.0.

Out of 232 patients experiencing at least one adverse effect while on methotrexate monotherapy, 87.5% were female and mean age was 46.9±10.8 years. The mean dose of methotrexate was 16.