Background: Acute upper GI bleeding is a common medical emergency with a hospital mortality of approximately 10%. Higher mortality rate is associated with re-bleedinging. Complete Rockall scoring system identifies patients at higher risk of re-bleeding and mortality. Materials and Methods: This is a descriptive hospital based study conducted in Gastroenterology unit of College of Medical Sciences and Teaching Hospital, Bharatpur, Nepal from January 2012 to December 2014. It included 200 patients at random presenting with manifestations of UGI bleed. Complete Rockall score was calculated in each patient and its correlation with mortality and re-bleeding was determined. Scores of >5 has been considered as one category as it comprises of patients with very high risks and scores of 0-4 as another category of low or lesser risks for the purpose of comparison of different risk factors. Results: Males were predominant (71%). Age ranged from 14 to 90 years, mean being 50.43+17.75 years. At presentation 110 patients (55%) had both hematemesis and malena, 56 patients (28%) had only malena and 34 patients (17%) had only hematemesis. Shock was detected in 21%, severe anemia and high blood urea were found in 31% and 41% respectively. Median hospital stay was 6.5+3.10 days. Comorbidities were present in 83.3%. Complete Rockall score ranged from 0 to 9, mean being 4.30+2.19. One hundred and thirteen (56.5%) had complete Rockall score <4 and 87 (43.5%) >5. Re-bleeding was found in 16 (8%) patients. One hundred and eighty eight patients (94%) recovered and discharged from the hospital and 12 patients (6%) expired. The correlations between high Rockall scores (>5) and the occurrence of re-bleeding (p=0.001) and mortality (p=0.001) were statistically significant. Conclusions: Acute Upper GI bleeding is a medical emergency. Predictors of mortality in this series were high complete Rockall score >5, esophageal varices with Child Pugh score C, massive initial bleed as well as re-bleed and multiple co-morbidities.

Introduction: Colonoscopy is one of the useful diagnostic tool to evaluate lower gastrointestinal tract. Theaim of this study was to evaluate patient characteristics, common symptoms, colonoscopicfindings and histopathology findings by reviewing colonoscopy procedures. Methods: This was a retrospective study conducted at College of Medical Sciences and teaching hospital, Bharatpur, Nepal over a period of three years (1st January 2017 – 31st December 2019). Census sampling method was used to retrieve the data. Patients characteristics, indications, duration of symptoms and findings were retrieved from the endoscopy record register and histopathology finding of those patients whose biopsy were taken were retrieved from the pathology department record file.  Results: Over a three years period 324 colonoscopy were reviewed.The mean age of the study populationwas 48.77+/-17.35 years. Male to female ratio was 1.38:1. The most common indication forcolonoscopy was pain abdomen with mucus in stool in 25.3% patients followed by bleedingper rectum in 21.3% patients. Other than normal colonoscopy the most common findings wereHaemorrhoids in 20.1% patients and inflammatory or ulcerative lesions in 17.6% patients.Colorectal malignancy was seen in 6.48% patients. Colonoscopic biopsy was done in 114patients. The common biopsy findings were ulcerative colitis in 12.7%, adenomatous polypin 6.8%, adenocarcinoma in 6.5% of the total study patients.Poorly differentiated carcinomawas found more in the younger age group and males were more commonly affected withcolorectal cancers than females.Conclusions: The most common indication for colonoscopy was pain abdomen with mucus in stool in25.3% patients. The common findings were Haemorrhoids in 20.1% patients and inflammatoryor ulcerative lesions in 17.6% patients. Colorectal malignancy was seen in 6.48% patients.The common biopsy findings were ulcerative colitis in 12.7%, adenomatous polyp in 6.8%,adenocarcinoma in 6.5% of the total study patients. Males were more commonly affected withcolorectal cancers than females.Keywords: Colonoscopy, lower gastrointestinal tract, colorectal cancer, ulcerative colitis,haemorrhoids.