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Introduction Temporary transvenous pacemaker insertion is an emergency lifesaving procedure for patients with hemodynamically unstable and life-threatening bradyarrythmias. The aim of this study was to analyze demographics, indications, route of insertion and complications in patients undergoing temporary transvenous pacemaker implantation. Methods This was a retrospective observational study conducted at a tertiary-care center in Nepal. The hospital records of patients who had undergone temporary transvenous pacemaker implantation between July 2015 and June 2019 were reviewed. Results A total of 343 patients with mean age of 65.52±16.09 years received temporary transvenous pacing. Out of these 205 (59.8%) were males. Greater proportion of patients were between the age group of 70-80 years (n=76, 22.2%). Hypertension (n=97, 28.3%) was the most common comorbidity noted. The most common indication for temporary pacing was symptomatic complete heart block 165 (59.6%). Total of 288 (84%) patients received permanent pacemakers while 55(16%) had reversible cause so TPI was removed. Right Femoral vein was the most common (99%) venous access site. Among the 343 patients, complications were observed in 29 (8.4%) of cases during and after the temporary transvenous pacemaker insertion. The overall mortality stood low at 2% (n=7). Conclusion Temporary transvenous pacemaker insertion is required in elderly population presenting with bradyarrythmias and occasionally in acute myocardial infarction presenting with bradyarrythmias as complication. Temporary pacemaker insertion was overall a safe procedure with infrequent serious complications; however, strategies to avoid and alleviate such complications (RV perforation) should be sought and implemented. [ABSTRACT FROM AUTHOR]

Background: Studies emphasizing the prevalence of coronary artery disease (CAD) and the diversity of coronary lesions among asymptomatic renal transplant recipients (RTRs) are few and far between in Nepal. Methods: In this cross-sectional observational study, a cohort of potential RTRs who were subjected to coronary angiography (CAG) as a part of both routine pre-op evaluation and therapeutic modality were enrolled and the spectrum of coronary angiographic lesions was reported. Significant CAD was defined by angiography as ≥ 70% stenosis. Percutaneous coronary intervention (PCI) was done for significant lesions. Results: A total of 60 patients (mean age: 53.7 ± 7.2 years, 43 males and 17 females) formed the subjects of the study. Diabetes was the commonest cause of ESRD (61.7%) with the mean duration of ESRD being 4.3 ± 2.2 years. Of the patients, 86.7% were routinely subjected to CAG and the remaining 13.3% presented with acute coronary syndrome. The right femoral artery was the most common access vessel (81.7%). CAD was present in 30/60 patients (50%). The left anterior descending artery was the most common culprit vessel (46.7%), followed by the left circumflex artery (38.3%). Among the routine CAG group, 42.3% had some form of CAD, the highest proportion of which was triple vessel disease (23.3%). Both double vessel disease and triple vessel disease were found to be highly prevalent in patients with hyperlipidemia, diabetes, and in smokers. The angiographic lesions were predominantly of discrete (41%), diffuse (35.9%), and eccentric (46.2%) types, had tandem arrangement (58.9%) with moderate angulation (56.4%), and were irregular (58.9%) in contour. A total of 3 ostial (7.7%) and 9 calcified (23.1%) lesions were found to be present. Chronic total occlusion and bifurcation lesions were observed in 4 (10.3%) and 5 (12.8%) cases, respectively. Six (15.4%) patients had well-developed collaterals. Twenty-one (53.8%) patients underwent PCI and 3 (7.7%) patients underwent coronary artery bypass surgery. Type B2 was the most common lesion (46.2%). Conclusion: Asymptomatic ESRD patients on the renal transplant list were found to have a high prevalence of CAD. CAG can be an efficient screening alternative for the detection of significant CAD among these patients. [ABSTRACT FROM AUTHOR]

This paper explores the impact of globalization in Nepalese women. The changes on the women's way of life due to globalization can be seen directly in the economy, media, IT sectors, various parts of society and ultimately in the culture. When the Nepalese women entered into the globalization process the Hindu norms and values of the society (where more than 82 percent are Hindu) has creolized with the global way of life. The women are becoming more selfreliant and empowered due to globalization but at the same time they are entering more risky markets to fulfill the desires that floated by the globalization. Similarly, globalization has offered various employment opportunities and exposure in international arena, but it also creates mental anxiety, depression and sexual abuse for those remaining in or outside the country. As there is very limited research and study on the impact of globalization in the Nepalese society, it is too early to conclude the impact of globalization as good or bad on Nepalese women. [ABSTRACT FROM AUTHOR]

Background: Cervical cancer is the most common cancer among Nepalese women. Cervical cancer screening plays a vital role in reducing the morbidity and mortality of the disease. In this study, we assessed the prevalence of precancerous lesions of cervical cancer from community-based screening programs in Nepal., Methods: In this cross-sectional study involving record review, data were drawn from community-based screening programs in 14 districts by B.P. Koirala Memorial Cancer Hospital in Nepal. All women who underwent cervical cancer screening using visual inspection with acetic acid between June 2017 to December 2018 were included., Results: A total of 7,270 women were screened during the study period with the prevalence of cervical precancerous lesions among 153 (2.1%; 95% Confidence Interval 1.8-2.5) participants. Of which, the highest positivity rate was observed in the age group 30 years and below (46, 3%). The majority (4453, 61%) of the total women screened, were married at age below 20 years and 188 (3%) reported a history of cancer in their families. The most common presenting complaints were low abdominal pain (1236, 17%), low back pain (1152, 16%), itching in the anogenital region (828, 11%), and per vaginal discharge (818, 11%). Cervical cancer was suspected in 25 (0.3%) women., Conclusions: The prevalence of precancerous lesions of cervical cancer is low but with high existing risk factors among Nepalese women of selected districts. The government should implement effective and sustained cervical cancer awareness and population-based screening programs along with a continuum of care. The national criteria for screening should also include young women with known risk factors.