Introductions:Patients with chronic kidney disease have a high burden of somatic symptoms which may be due to depression. This study analyses occurrence of depression in patients with chronic kidney disease (CKD) undergoing hemodialysis (HD) at a tertiary care center in Kathmandu, Nepal.  Methods: This is a retrospective study done at Patan Hospital, a tertiary care teaching hospital of Patan Academy of Health sciences, Lalitpur, Nepal. Translated in Nepali language and validated Beck Depression Inventory (BDI) was used. A cut-off of 16/17 was used to define depression.   Results: Altogether 56 patients were included, mean age 54.375±17.87 years, time on HD 25.06±21.58 months, BDI score 19.18±10.16. The prevalence of depression was 51.8%. There was no significant differences of BDI score and rate of depression in genders, housing status, education level, alcohol intake, presence of co-morbidity and shift of HD. However, there was a significant association of BDI score and the employment status, p=0.026 and the affordability of erythropoiesis stimulating agent, p=0.033.  Conclusions: Depression was common in patients undergoing hemodialysis treatment and the rate of depression was significantly lower in the patients who were employed and used of erythropoiesis stimulating agent.

Introductions: Hepatitis C virus (HCV) infection is common in the patients undergoing hemodialysis (HD). The quality of life and survival of patients with hepatitis C infected end-stage renal disease is less than that of the noninfected ones. This study aims to determine the prevalence of HCV in patients undergoing HD and the risk of transmission. Methods: This was a retrospective study of charts of the chronic kidney disease patients who underwent dialysis at Patan Hospital from March 2011 to July 2017. Those patients who were positive for HIV, HBsAg and HCV before the initiation of dialysis were excluded. Pearson Chi square test and Fisher’s Exact test were used to determine the significance of the results. Results: Out of 173 patients, 12 (6.9%) seroconverted to HCV: five (41.66%) in first year, four (33.33%) in second year, and three (25%) in third year (Fisher’s Exact test p=0.26). Out of 173 patients, 137 (79.2%) received blood transfusion, 27 (15.6%) received erythropoiesis stimulating agent (ESA), 9 (5.2%) received both blood transfusion and ESA. The HCV seropositivity were 9 (75%), 2 (16.66%), and 1 (8.33%) respectively in them, Fisher’s Exact test p value was 0.65. There was no significant association between the seroconversions in in-center versus multicenter HD and the number of dialyses per week. Conclusions: Hepatitis C infection was common (6.9%) in HD patients. There was no significant association of transmission in regards to duration of HD, transfusion or single vs multicentre HD.

Introductions: Dasatinib is indicated as a first line, second line and third line tyrosine kinase inhibitor (TKI) in chronic myeloid leukemia (CML). In our center it is used as a second line or third line therapy in BCR-ABL gene positive CML. Methods: It is a retrospective observational therapy done from June 2015 to May 2018. The purpose of the study is to see the response rates using the second line and third line dasatinib after failing or not tolerating imatinib alone or following a sequential therapy with imatinib and nilotinib. Results: A total of 31 (male 56.3%) patients were included in our study. In eighteen patients it was used as a second line TKI and in 13 a third line TKI. Complete Hematologic Response (CHR) was achieved in 93.55%. Best optimal responses were 46.66% and 61.53% in second and third line dasatinib respectively. Major Molecular Response (MMR) was achieved in 35.71% (26.66% and 46.14% in second line and third line dasatinib respectively). For both the groups, the overall survival was 92% and 94 % at 20 months and the event free survival was 70% at 10 months. Conclusions: Dasatinib is effective in achieving MMR and inducing survival benefit in the patients who failed imatinib alone and imatinib and nilotinib.