No abstract

At present, cardiovascular diseases are global health problems responsible for 17.3 million deaths per year and adding extra burden in developing countries like Nepal. Studies show that serum uric acid (SUA) can result in endothelial dysfunction which can lead to vascular disease like stroke. In this study, we determined serum uric acid levels in patients with acute coronary syndrome (ACS) and assess its risk factors. A cross sectional study was conducted in 82 patients with ACS who fulfilled the inclusion criteria included in the study and their serum uric acid level were investigated. It was found that 51 (62.2%) were males and 31 (37.8%) were females. Mean age in study population was 60.26 ± 11.34 years. Majority of the population belongs to 56-65 years age group. The mean uric acid level of our study population was 6.03 ± 1.50 mg/dl (male = 5.92 ± 1.72, female = 6.64 ± 1.53). SUA ≥ 7 mg/dl was maximum in 56-65 years age group and there was no association between age and SUA (P value = 0.146). Over half of the study population were hypertensive i.e. 42 (51.21%) and smoker i.e. 43 (52.43%). It showed association between SUA and ACS (P value = 0.003). Among those having diabetes, maximum have SUA ≥ 7 mg/dl i.e. 17 (47.22%). Among those having high cholesterol level, male have higher incidence than female with no association between T. Cholesterol and gender (P value = 0.49). The mean value of T. Cholesterol was 189.83 ± 46.81 mg/dl (male = 198.78 ± 55.19 mg/dl, female = 202.30 ± 54.92 mg/dl) with (P value = 0.52). In conclusion, the mean age of ACS patients was 60.26 years, with the peak incidence at the age of 56-65 years. The ACS had male predominance. The potential risk factors of ACS were: Age >56 years (65.83%), male sex (62.2%), dyslipidemia (35.36%, hypertension (51.2%), diabetes mellitus (43.9%), smoking (52.4%) and alcohol consumption (39%). Among these SUA significantly associated with risk factors were-Sex, Diabetes Mellitus, T. Cholesterol. There was association between serum uric acid level and ACS patients. Hypertension and smoking constitutes one of the major risk factor for ACS in study population.

Background: Humla is one of the remote districts located in the north-west of Nepal and located at an altitude between 1500 and 7300 meters. Poor health-care services, less health-care professional, seasonal outbreak of diseases, food deficit in winter, and traditional beliefs in the curative service have caused health-care problems, hindrance, and challenges in the proper health-care delivery in Humla. Objectives: This study aims to provide information on the health problems and describes the difficulties and challenges to the health-care system in Humla district. Materials and Methods: A retrospective cross-sectional survey was conducted at the District Hospital Humla regarding medical treatment and disease prevalent from June 2017 to April 2018. Microsoft and SPSS version 18 were used to analyze the data. Results: It showed that the majority of the patients visiting at hospital show gastritis (30%), followed by pelvic inflammatory disease (20%), chronic obstructive pulmonary disease (12%), trauma (from landslide injury and fall injury) (8%), and alcoholic liver disease (10%). In addition, 35% of Humli people follow the traditional belief of witch doctor, 15% do home remedy, and 50% of people go to see a medical doctor and do modern treatment. Conclusions: Humli people face several difficulties in the health care, such as less number of hospitals, less number of doctors and health-care personals, few specialists, and less medical equipment. Among medical problems, gastritis and pelvic inflammatory disease were the most common medical problems in Humla.