Introduction: Many college students suffer from sleep disorders, including insomnia, and sleep deprivation, resulting in a poor sleep quality. Students are at risk for sleep disorders, and those at risk may also be at risk for academic failure. The main aim of the study is to assess the level of sleep quality among college students in Kathmandu, Nepal. Methods: A cross-sectional study was conducted with 504 students of class 11 and 12 of any faculties among selected colleges of Kathmandu. Simple random sampling was used for selection of colleges. Ethical approval was taken before data collection. Participants with chronic medical illness and mental disorders were excluded from the study. A semi-structured questionnaire was used to collect the information related to socio-demography, and Pittsburgh sleep quality index was used to assess the sleep quality in college students. All data extracted from questionnaires were entered and analyzed using SPSS version 20. Results: Out of 504 students, 40.9% were found to have good sleep quality, whereas, 59.1% were found to have poor sleep quality. 55.21% of male students and 65.78% of female students had poor sleep quality. 58.30% of science students and 59.85 % of management students had poor sleep quality. Conclusions: The quality of sleep among Nepalese college students was found to be poor. Many colleges are unaware of the risks or issues to the students.

Background: Early and late introduction of complementary feeding is associated with increased morbidity and nutritional deficiencies in children. In 2016, the under 5 mortality rate of Nepal was 39 deaths per 1000 live births and around 1 million under 5 children had suffered from chronic malnutrition. The main aim of this study was to identify the level of knowledge and practice regarding complementary feeding among the mothers of children aged group 6 to 24 months in Bhanu Municipality, Tanahu District, Nepal.Methods: A descriptive cross-sectional study was conducted with 158 mothers of children age group 6 to 24 months from ward number 1 and 2 in Bhanu Municipality, Tanahu District, Nepal. Data collection was done after taking ethical approvalby using a semi-structured questionnaire via face-to-face interviews. Collected data were entered and descriptive analysis was carriedout in Statistical Package for the Social Services version 20. Categorical variables were presented using frequency and percentage. Clopper-pearson method was used to determine 95% confidence interval.Results: Out of 158 respondents, 26.6% (95%CI:19.9,34.2) had inadequate knowledge, whereas 73.4% (95%CI:65.8, 80.1) had adequate knowledge on complementary feeding. Likewise, the study revealed that 51.9%(95%CI: 43.8, 59.9) did the right practice, while 48.1%(95%CI: 40.1,56.2) were involved in the wrong practice on complementary feeding. Only 39 % mothers gained the knowledge about complementary feeding from the health workers. 2.5% of mother had exclusively breastfed their child up to just 3 months. Conclusions: Despite the good level of knowledge about complementary feeding, the wrong practice was prevalent in about half of the mothers. As a result, enhancing existing strategies and developing new intervention measures including capacity building of healthworkers to improve child feeding practices must be mandatory actions for the government and policymakers.Keywords: Complementary feeding; knowledge; Nepal; practice

Background: Sleep is an important lifestyle factor to be addressed in patients having chronic non-communicable diseases. Data revealing prevalence of insomnia in chronic medical illnesses (CMIs) in Indian population are lacking. Yoga has been found effective in improving sleep quality in patients with chronic medical illnesses (CMIs). Aim: To find the prevalence of insomnia in major chronic medical illnesses and to assess the effect of Integrated Approach of Yoga Therapy (IAYT) on them. Methods and Material: From the outpatients and inpatients of our integrative therapy clinics, 200 patients (116 males; 84 females) in the age range 49.57 ± 11.71 years, who satisfied the inclusion criteria and were diagnosed by the physician with any of the four major categories of CMIs: cardio-pulmonary, diabetes, musculoskeletal, and psychiatric were screened for insomnia using Insomnia Severity Index (ISI) scale. Those found suffering from clinically significant insomnia (ISI score > 14) were admitted and a residential IAYT intervention was given for a week. Before and after the intervention, ISI and Pittsburg insomnia rating scale (PIRS) were administered to assess extent of insomnia. Data was analyzed before and after the intervention using paired t-test. Results: Taking all patients of CMIs together, we found that 35% suffered from clinical insomnia, out of which, 12.5% had severe and 22.5% had moderate insomnia. We also found that prevalence of clinical insomnia was highest among those suffering from psychiatric illnesses (62.07%) and minimum in those having musculoskeletal disorders (28.05%). Those suffering from diabetes mellitus and cardio-pulmonary disorders reported prevalence of 32.25% and 31.94% respectively. After IAYT intervention of one week, extent of clinical insomnia reduced from 35% at the baseline to 8.5% in all patients of CMIs taken together. Following changes were observed in percentage of patients suffering from clinical insomnia in different CMIs before and after one week of IAYT intervenHow to cite this paper:

Objectives Substance use disorder is a pattern of recurrent use of illicit substances that leads to severe psychosocial imbalance and recurrent relapse. The study was to evaluate the efficacy of a yoga-based intervention as an add-on in enhancing psychological wellbeing, compared with physical exercise among substance abusers. Methods In this randomized controlled study, 96 male participants with substance use disorder from a residential rehabilitation treatment center, Kathmandu, Nepal, were randomly allocated into two groups namely the yoga group (n=48, mean age ± SD=25.18 ± 6.43) and the physical exercise group (n=48, mean age ± SD=25.02 ± 5.02). The participants in the yoga group attended the 90 min yoga sessions for 12 weeks (six days per week) whereas the physical exercise group attended exercise sessions for the same duration. Above mentioned interventions were in addition to standard rehabilitation treatment. The study measured the Self-Control, Anxiety, Depression, Sleep parameters, and Mindfulness at the baseline and after 12 weeks of intervention. Results A significant enhancement in self-control was observed in both the yoga (p<0.033, d=0.33) and the exercise group (p<0.038, d=0.32). Yoga group showed significant improvement in mindfulness score (p<0.017, d=0.37), whereas exercise group did not show any significant changes in mindfulness (p<0.169, d=0.21). The depression and anxiety scores reduced significantly in both yoga (p<0.044, d=0.31; p<0.025, d=0.35 resp.) and exercise (p<0.032, d=0.34. p<0.039, d=0.32. resp.) group. Furthermore, significant reduction was seen in sleep disturbance after yoga (p<0.001, d=0.52) and exercise (p<0.001, d=0.78) intervention. The sleep – somnolence score reduced significantly only in yoga group (p<0.020, d=0.36). The magnitude of improvement was higher in the yoga group than physical exercise group on self-control, mindfulness, depression, anxiety and some sleep parameters, however the between group differences could not reach to the level of significance. Conclusions The 12 week yoga intervention did not appear to be significantly more effective than the 12 week physical exercise program on psychological wellbeing in male participants with substance use disorder. However, greater improvement in psychological wellbeing was observed within the yoga group. In future, a multi-centric study with robust design, larger sample size and longer follow-up is required to conform the present results and to find out the difference between the impacts of yoga and physical exercise on psychological wellbeing in substance abusers.

Introduction and importance: Kartagener’s syndrome is a rare, ciliopathic autosomal recessive genetic disorder that comprises a triad of situs inversus, chronic sinusitis, and bronchiectasis leading to recurrent respiratory infections due to ciliary dyskinesia and thereby progressive deterioration of lung function. Additional clinical features of infertility, otitis media, and rhinitis are also seen in patients. Case presentation: The authors hereby present a case of Kartagener’s syndrome in a 40-year-old male with a repeated respiratory infection and bronchial asthma. He was received at the emergency room with symptoms of hemoptysis, shortness of breath, and chest pain. Diagnosis of cystic bronchiectasis with superadded infection was made based on clinical examinations and radiological assessments. He was treated in high-dependency unit. After 5 days of relieving therapeutic interventions in the hospital, he was discharged without further complication. Clinical discussions: Early diagnosis of Kartagener’s syndrome is likely to be beneficial as it helps delay deterioration of lung function to prevent complications and improve the quality of life of patients but the diagnosis of this syndrome is usually delayed as it is a rare disease, especially in countries with lack of complex diagnostic facilities. So, assessment for this syndrome has to be done in patients presenting with chronic and recurrent respiratory infections for correct timely diagnosis to have a good patient-centric healthcare facility.

Organophosphorous poisoning is a very common poisoning. Intermediate syndrome with respiratory failure is a highly fatal complication. We report a case of 20 year old male who developed intermediate syndrome despite adequate atropinisation . Early clinical recognition of the syndrome and institution of mechanical ventilation along with ongoing atropine therapy was instrumental in saving the patient’s life. Patient was discharged on day 10 after successful treatment.

Meditation is generally described as being in the present moment or being alert in the present moment, instead of constantly struggling to change or to become. Meditation is an essential part of Yoga philosophy and the seventh limb of Astanga Yoga described by sage Patanjali in the ancient text Patanjali Yoga Sutra. Yoga including meditation, is an ancient technique invented to unite the individual consciousness with the universal consciousness, however, scientific studies have demonstrated the vast health advantages associated with it. Mindfulness as a non-judgmental awareness of the present-moment is also a part of yoga philosophy, however, most of the mindfulness practices those are being practiced in modern days are also rooted in Buddhist philosophy. Some well-known meditation techniques are Buddhist meditations, Hindu meditations, Chinese meditations, Christian meditation, Islamic meditations, Guided meditations etc. Meditation influences brain systems involved in attention, awareness, memory, sensory integration, emotion regulation, and higher-order cognitive functions. Meditation has also been found to be very effective in relieving stress, regulating emotions and promoting mental health. A significant increase in grey matter volume was found in the meditators as compared to non-meditators. The larger grey matter volume overall, and with regional enlargement in several right hemispheric cortical and subcortical brain regions are associated with sustained attention, self-control, compassion and interoceptive perception. Several functional neuroimaging studies showed that some brain regions are recruited consistently across different meditation techniques including insula, pre/supplementary motor cortices, dorsal anterior cingulate cortex, and frontopolar cortex.

Introduction: Chronic low back pain (CLBP) is two and a half times more prevalent in the working population than in nonworking population. The 1-year prevalence of low back pain (LBP) in working population ranges from 23% to 38%. However, the 1-year prevalence in computer professionals was found to be 31%–54%. Studies have demonstrated the vast mental and physiological health advantages associated with yoga. Objective: We planned to investigate the effect of yoga and mindfulness meditation in computer users with CLBP. Methods: Eighty computer users (42.6 ± 8.45 years of age; suffering from CLBP for 5.20 ± 3.01 years; 51 males and 29 females) were recruited from Bengaluru, Karnataka, India. Subjects were randomized into two groups; yoga and mindfulness meditation/YM group (n = 40) and physical exercise/PE group (n = 40). YM group practiced an integrated module comprising yoga practices and mindfulness meditation, while PE group practiced physical exercises designed for LBP (1 h per day, 3 days per week for 16 weeks). Assessments were done at baseline, after 8 weeks, and after 16 weeks. Results: Seventy-seven participants (39 in YM and 38 in PE) completed the study. Oswestry Disability Index (ODI) scores and Numerical Rating Scale (NRS) scores decreased significantly, and the Sit and Reach Test (SRT) scores improved significantly in both groups after intervention (p < 0.001). Between-group analyses demonstrated that there was a significant difference in ODI scores (YM = 7.28 ± 5.68, PE = 15.53 ± 8.13, P < 0.001), NRS scores (YM = 1.00 ± 0.89, PE = 1.82 ± 0.73, P < 0.001), and SRT scores (YM = 26.41 ± 5.03, PE = 22.82 ± 4.96, P = 0.002) between the YM group and PE group at 16 weeks, favoring the YM group. Conclusion: A 16-week yoga & mindfulness meditation program appeared to be effective in reducing pain and functional disability, and in improving spinal flexibility in computer users with CLBP.