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Objective: To determine etiology and outcome of children with lower gastrointestinal bleeding (LGIB). Methods: This was a prospective study conducted at the Department of Pediatric Gastroenterology and Hepatology, Children’s Hospital and The Institute of Child’s Heath, Multan, Pakistan, from July 2019 to March 2020. A total of 148 cases presented with bleeding per rectum and underwent colonoscopy, were included. Children of both genders and aged three month to 15 years were included. Detailed history, clinical examination, laboratory studies, colonoscopy and histopathology were done in all cases. Study information like demographics, complaints, general clinical examination, colonoscopy and histopathological findings were recorded. Results: Overall, mean age was noted to be 7.20±1.83 years. Abdominal pain was reported in 41 (27.7%), diarrhea 36 (24.3%), fever 12 (8.1%) and constipation in 4 (2.7%). Pallor was noted among 68 (45.9%), weight loss 39 (26.3%) and tachycardia 31 (20.9%). Colonoscopy revealed juvenile colonic / rectal polyps, infectious colitis and solitary rectal ulcer (SRU) as the most common etiologies found among 58 (39.2%), 20 (13.5%) and 19 (12.8%) cases respectively. Juvenile polyps and non-specific colitis were the commonest histopathological findings seen in 55 (37.2%) and 20 (13.5%) cases respectively. Colonoscopic polypectomy was used to remove all juvenile polyps. Conclusion: LGIB is presentation of various underlying causes. Children with LGIB commonly present with abdominal pain. Juvenile polyps were the most frequent cause of LGIB among children flowed by non-specific colitis. Most of the children having LGIB were diagnosed and treated successfully, few are in remission and very few were found resistant to treatment. doi: https://doi.org/10.12669/pjms.37.2.2676 How to cite this:Talib MA, Aziz MT, Suleman H, Khosa GK, Joya SJ, Hussain I. Etiologies and outcome of lower gastrointestinal bleeding in patients presenting to a tertiary care Children’s Hospital. Pak J Med Sci. 2021;37(2):---------. doi: https://doi.org/10.12669/pjms.37.2.2676 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Objectives: Tetanus is an avoidable disease. Significant reduction in the incidence of tetanus is observed around the globe but in Pakistan, its incidence is still high. The objective of current study was to determine the demographic, clinical features, outcome and complications of tetanus patients admitted in Pediatric Intensive Care Unit (PICU). Study Design: This Descriptive-observational study. Setting: At PICU of The Children Hospital & ICH Multan Pakistan. Periods: 1st January 2013 to 31st December 2017. Material and Methods: A total of 77 tetanus cases admit through the study period in PICU. Clinical features, complications, duration of stay and outcome of 77 tetanus cases during study period were noted. Results: Amongst a total of 77 cases, 62 were male (80.6%) and 15(19.4%) female. Most (57.1%) were between 2 to 7 years. Twenty five (32.4%) were unvaccinated, 52 (67.6%) partially vaccinated. According to the grade of severity (Ablett classification), majority (40) were of grade-III. Regarding the outcome, 15 (19.5%) expired. Conclusion: Tetanus is a fatal disease with high mortality rate. Vaccination and right management of the disease are the best options to minimize the load of tetanus in our country.

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