Rheumatic Heart Disease (RHD) is still a major public health problem in developing countries such as India. Present study was conducted in urban population of district Srinagar of J&K state (India). A study had been conducted in the same population in 1983 & the prevalence at that time was 5.9 / 1000. The aim of the present study was to know the present status of Acute Rheumatic Fever (ARF) & RHD in the same population since we have observed a significant decline in the attendance of these patients in OPD & wards of Sheri-Kashmir Institute of Medical Sciences (SKIMS) Srinagar. A survey of school children aged between 6-16 years studying in randomly selected private and government schools of Srinagar-city was done. A total of 5661 school children were examined. Eleven school children were found to have heart disease. Of these 4 had RHD, confirmed on Echocardiography while 7 had congenital heart disease (CHD) and were excluded from the study. No case of ARF could be identified. As per our study the prevalence of RHD is 0.7/1000 school children. The results observed were lower than that reported in earlier studies from developing countries, but are comparable to large studies conducted in Christian Medical College Vellore in 2003 & Gorakhpur in 2005-2006. Therefore it is concluded that there has been a dramatic decline in prevalence of RHD over last two decades.

Objective: To define the correlation of clinical features with the angiographic findings in young patients (≤40 years) who presented to our institute with angina symptoms and also have an idea of disease burden in our community. Methods and results: A retrospective study was conducted over a 5 year period from 2010 to 2015. One hundred and twenty nine consecutive patients <40 years of age were admitted for evaluation and were reviewed. The mean age was 37.7 years (range 28-40), 76.7% (99) were males and 23.3% (30) were females. This was similar to the figures for more than 40 years cohort, 74.1% males and 25.9% females. Sixty two percent were urban and 13.2% were non-Kashmiri security forces. Predominant presentation was acute myocardial infarction (47.3%) followed by angina on effort (44.2%), atypical chest pain (7%), and unstable angina (1.6%). Among males 59.5% had angiographically documented coronary artery disease while only 23% of females had coronary artery disease documented. Three females presented with anterior wall myocardial infarction secondary to infective endocarditis, spontaneous left main coronary dissection and takotsubo cardiomyopathy respectively. Conclusion: The study focuses our attention on rising prevalence of coronary artery disease in young individuals from urban communities. Symptomatic males may need thorough early evaluation, young females presenting with myocardial infarction should be evaluated for non-atherosclerotic etiologies. Keywords: Myocardial infarction; young population; coronary artery disease

This study of 10 year review of pacing was undertaken to analyse the continuous rise in the incidence of pacing in this part of country. 532 patients implanted with permanent pacemakers were evaluated during this decade. The age of patients ranged from 6 to 85 years with majority of patients belonging to age group of 55 to 70 years and a male to female ratio of 2:1. The commonest presenting symptom was cardiac syncope seen in 76.50% followed by pre-syncope 31.50% .The indications for pacemaker implantation were complete heart block 48.12%, sick sinus syndrome 19.17%, symptomatic bifascicular block 12.96%, Mobitz type II 2 nd degree heart block 7.14%, permanent pacemaker dysfunction 5.85%, trifascicular block 5.63% and high degree AV block 1.13%. The commonest risk factors encountered in these patients were smoking 59.21%, followed by hypertension 26.32%, only 0.56% had no evidence of risk factor. The complications following pacemaker implantation were seen in 8.27%, 2.26% got lead displacement, 1.69% got wound infection, 1.69% got extrusion of generator. Other complications include lead fracture in 0.9%, premature battery failure 0.37% patients, high threshold in 0.19%, Pneumothorax in 0.19% and 0.5% got reimplantation because of generator expiry. Out of 532 patients paced permanently in the past decade, 458 patients followed regularly which revealed that majority of them were totally dependent upon the permanent pacemaker and had improved quality of Life.