Background: Colonoscopy is an invasive procedure used both diagnostically and therapeutically. Direct visualization and real-time image of entire large colon and distal terminal ileum makes it superior. Patients are unable to undergo colonoscopy because of the limitation in the developing country. Moreover, limited studies are available in our country regarding the colonic diseases. Materials and Methods: It was a descriptive cross-sectional study done in Nobel Medical College Teaching Hospital, Biratnagar, Nepal from January 2018 to December 2018. Approval was acquired from Institutional Review Committee. All patients undergoing colonoscopy in the hospital was included. After taking proper consent, bowel preparation, premedications, colonoscopy was performed, findings noted in pro-forma. Results: Of the total 176 patients 119 (67.60%) were male and 57 (32.40%) were female; mean age 46.98 ± 17.13 years. Indication for performing colonoscopy was chronic diarrhea in 58(33.0%), chronic abdominal pain in 47(26.70%). Significant lesion observed in 142 patients (80.68%); colitis with unspecified etiology in 69 (39.20%), ulcerative colitis in 28 (15.90%), crohn’s disease in 13(7.38%).Colitis was more in male 46(66.67%) and involving rectum was common. Pan-ulcerative colitis was common seen in 11patients (39.28%). Conclusion: Chronic diarrhoea and chronic abdominal pain were two common indications. Male patients were in higher prevalence opting for colonoscopy. Colitis of unspecified etiology of rectum and ileo-cecal region was most common finding. Ulcerative colitis involving whole of colon and younger age group was predominantly affected.

Background : Physician knew for centuries that primary cardiac disorders leads to stroke, but it is recent realization that strokes may produce cardiac abnormalities. It is essential to distinguish whether cardiopulmonary abnormalities are caused by the stroke or unrelated. It is very difficult to distinguish because pre-existing cardiac abnormalities are highly prevalent in stroke. This study is designed to see ECG changes in stroke that can help for further evaluation and management.Methods and Materials: This descriptive Cross-Sectional hospital-based study was conducted to describe the ECG changes, character of ECG abnormalities in patients with stroke. All the patients admitted in the Nobel Medical College in one-year meeting inclusion criteria and residing in Eastern part of Nepal were included. Both Ischaemic and Haemorrhagic stroke were taken. ECG changes includes QTc-prolonged, AF (Atrial Fibrillation), T inversion, QRS prolonged, PR prolonged, ST elevation, ST depression, Hyperacute T wave in different types of stroke was evaluated on the basis of age, sex, smoker, HTN and DM.Result : The total participants were 100. Out of which 65 were male and 35 were female and 72.0% were 60 years and above and 28.0% below 60 years with Mean Age in year ± Standard deviation of male and female was (64.74 ± 12.62) and (63.69 ± 13.53) respectively. Ischemic and Haemorrhagic stroke was 87.0% and 13.0% respectively. ECG changes were found in 84.0%.Conclusion:  Ischaemic stroke (87.0%) was more common than Haemorrhagic stroke (13.0%). ECG changes were in 84.0% and QTc-prolonged (29.0%) was the most common followed by AF (27.0%).Journal of Nobel Medical CollegeVolume 6, Number 2, Issue 11 (July-December, 2017) Page: 42-47

BackgroundIn Gastroenterology practice, worldwide, the most common cause of dyspepsia is functional. Functional or non-ulcer dyspepsia is established by gastroduodenoscopy which rules out structural disorders in dyspeptic patients. Helicobacter pylori, a gram-negative bacterium in gastric mucosa is associated with non-ulcer dyspepsia, chronic gastritis, gastriculcer and cancer. Worldwide prevalence of Helicobacter pylori infection is higher but its association with non-ulcer dyspepsia is less clear. Material and MethodsThe aim of this study was to see the prevalence of H. pylori infection in non-ulcer dyspepsia. A cross-sectional study of 340 patients presented at Nobel Teaching Hospital in one year with dyspeptic symptoms underwent clerking, physical examination, gastroduodenoscopy and RUT. Symptomatic patients without any structural lesions were designated as functional dyspepsia. RUT when turned red indicated positive for H. pylori infection. Result Out of 340 patients, 180 (52.9%) were female and 160(47.1%) were male. Mean age of male and female patients was 35.88 ± 11.8 and 38.11 ± 11.7 respectively. Amongst all participants 150 (44.11%) were housewives and 69(20.3%) were students. Endoscopic findings showed gastritis 205(60.29%) and duodenitis 15(4.42%). RUT was found positive in 62% of gastritis and 86.7% of duodenitis patients (p value=0.001). Conclusion High prevalence of H pylori infection in present study may be one of the causative factors in producing symptomatic non-ulcer dyspepsia. Hence, early detection and complete eradication of H.pylori infection is mandatory. It will reduce usage of PPIs and also improve quality of life.

Background: Many of the patients with coronary heart disease require lifelong statin administration. Patients usually discontinue the medicine either due to side effects like myalgia, hepatotoxicity or due to the cost of the medicine.  The aim of this study is to see the scope of adjustment of the regimen to alternate-day dosing as an option to be considered in patients for whom adverse effects or cost are issues. Materials and Methods: A comparative, prospective, parallel group and open study was performed on forty- two patients of both genders with dyslipidaemia within the age group of 30 to 60 years attending the out – patients department of Medicine of Nobel Medical College and Teaching Hospital from February 2020 to March 2020. Mean reductions in different lipid fractions in the two treatment groups over the eight-week study period was calculated and then compared. Frequencies of patients developing different side effects was also calculated and compared between the two groups. Results: Baseline characters of both the groups were well balanced. Low density lipoprorein-C was reduced by 33.8 % in once-daily group and 31.3 % in alternate-day group, respectively. Changes were also recorded for the other lipid parameters. Such changes were found to be of no significant difference when compared between the two groups (p>0.05). Conclusion: An alternate-day regimen of statin in patients of hyperlipidaemia showed similar effect on the lipid panel compared to daily regimen.