Background

Background: The upper gastrointestinal bleeding (UGIB) is defi ned as bleeding within the intraluminal gastrointestinal tract from any location between the upper oesophagus to the duodenum at the ligament of Treitz. It is one of the important medical emergencies worldwide. Objective: The objective of this study is to study the aetiology of upper gastrointestinal bleeding based on endoscopic examination fi ndings in patients of various demographic characteristics. Materials and methods: This is a retrospective observational study. The endoscopic record book from 2007 January to 2009 October was reviewed for all the cases who underwent oesophago-gastro-duodenoscopic examination for upper GI bleeding. The clinico-epidemiological data of all the patients was reviewed and analyzed in concert with the aetiology of bleeding. Results: A total of 90 patients (58 males, 32 females; mean age 45.32+ 18.47 years) of upper gastrointestinal bleeding was studied and analyzed in terms of aetiology of bleeding and demographic profi le. Among the ethnic groups, Aryan 46 (51%) was the most common ethnic group to have upper GI bleeding followed by Newars 24 (27%), Mongolians 16 (18%), Dalits 3 (3%) and others 1 (1%). Out of 90 patients, 47( 52.2%) cases was less than 45 years of age, 30(33.3%) of 46 to 65 age ; and 13(14.4 %) more than 65 years of age. Gastric ulcer 23(25.6%) was the most common endoscopic fi nding, followed by oesophageal varices 14 (15.6%), acute erosive/haemorrhagic gastropathy 11 (12.2%), duodenal ulcer 9(10%), growth 7(7.8%), vascular lesions 3(3.3%), Mallory-Weiss tear 1(1.1%), fundal varices 1(1.1%) and, no cause was identifi ed in 21(23.3%) cases. The peptic ulcer bleeding was the most common fi nding in Aryan 22(47.9%), whereas oesophageal varices and growth were more common in Newar 7(29.2%) and 3 (12.5%) respectively. Conclusion: Peptic ulcer disease is the most common cause of upper GI bleeding which was most commonly found in Aryan population; followed by oesophageal varices and growth as second and third most common causes and were more prevalent in Newar and Mongolian people.

Hypertension is one of the major cardiovascular problems in middle and low income countries. There are few studies conducted in Nepal which shows significant number of hypertensive popu­lation in suburban area. Systematic random sampling from voter lists of all the members more than 18 years of age of Dhulikhel Municipality was done. 796 among 1150 sampled population were interviewed and their blood pressure was measured twice using mercury sphygmomanom­eter in standard method in their home. The average blood pressure was taken for study. Hyper­tension was defined as systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg, and/or on antihypertensive treatment. Total number of study population was 796. Among them 490 (61.6%) were female and 306 (38.4%) were male with age ranging from 18 years to 88 years (mean 48.41±17.38). Overall prevalence of hypertension was 28.9% (male 28.8%, female 29%). The prevalence was increasing with age (11.1% in <30 years to 44.8% in >70 years). Ac­cording to JNC 7, 29.1% were in Pre-hypertensive group. This study shows that Hypertension is significant in suburban area of Nepal. Nepalese Heart Journal | Volume 7 | No.1 | November 2010 (special issue) | Page 35-39 DOI: http://dx.doi.org/10.3126/njh.v7i1.8500