Background & Objectives: Acute cor onar y syndr ome (ACS) is an emerging cardiac problem in the young population in Asia and Nepalese population is not an exception to this. Early ACS in young age imparts huge familial and social economic burden. Early identification and proper management strategy is still a challenging problem in developing countries like Nepal where there are limited coronary intervention centers. The study was conducted with objective to study the clinical spectrum, etiologies, coronary angiographic characteristics and their clinical outcomes. Materials & Methods: This is a cross-sectional study carried out in a tertiary hospital in central Nepal. Forty patients with acute coronary syndrome with age less than 40 years were enrolled in the study. Results: Majority of the patients were males with male: female=1.8:1. Twenty six (65%) patients were having ST segment elevation myocardial infarction followed by non-ST elevation myocardial infarction in nine (22.50%) patients and unstable angina in five (12.50%). patients. The most common risk factors were smoking, systemic hypertension, diabetes mellitus and dyslipidemia. Majority were having single vessel disease. Twenty (50%) patients had undergone primary angioplasty followed by thrombolysis in seven patients and the rest were managed medically because of late presentation. In-hospital major adverse cardiac events and mortality were higher among STEMI than NSTEMI and unstable angina. Conclusion: Acute coronary syndrome in the young is increasing in the Nepalese population. This group of population should be well educated and made aware of the potential coronary risk factors and their modification.

Staphylococcus pseudintermedius is a common cause of zoonotic infections in dogs and cats. Recently, there has been an increasing number of infections being reported in humans caused by this organism. We report a case of complicated urinary tract infection in an elderly patient with recent bilateral ureteral stent placement caused by this organism with associated persistent high-grade bacteraemia.

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Background & Objectives: The cardiovascular complications including morbidity and mortality remains alarmingly high in all stages of chronic kidney disease. Although patients with chronic kidney disease share many of the similar risk factors for cardiovascular disease as the general population, there are a number of uremia related risk factors, such as anemia and alterations in calcium/phosphorus metabolism that also play a role in promoting cardiovascular disease. The objective of the study was to study the cardiovascular complications in end stage renal disease patients on maintenance hemodialysis.Materials & Methods: It is a hospital based cross-sectional observational study conducted at College of Medical Science - teaching Hospital. Hundred patients (n=100) with a diagnosis of end stage renal disease (irrespective of the underlying cause), and those who were on hemodialysis support were studied over a period of one year.Results: One hundred end stage renal disease patients were analyzed. Cardiovascular disease was present in 74% (n=74). the mean age of the patient who had cardiovascular disease was 59.36+14.337 years. The three major causes of end stage renal disease in the study population were hypertension (35%) followed by diabetes(31%) and chronic glomerulonephritis (14%). On electrocardiogram, left ventricular hypertrophy was a major finding 64% (n=64) followed by arrhythmias 30% (n=30). On echocardiography, left ventricular hypertrophy was found in 49% (n=49) followed by left ventricular diastolic dysfunction 38% (n=38). On subgroup analysis, left ventricular hypertrophy was found statistically significant with calcium and phosphorus product > 55 mg2/dl2 (p=0.01). Similarly left ventricular systolic dysfunction, regional wall motion abnormalities and st-t changes was found statistically significant with anemia; p=0.006, p=0.0004 and p=0.02 respectively.Conclusion: Prevalence of cardiovascular complications were common in end stage renal disease patients receiving maintenance hemodialysis. Anemia, calcium and phosphorus product > 55 mg2/dl2 were their independent risk factors.