INTRODUCTION: Colonoscopy remains the gold standard in diagnosing lower gastrointestinal pathologies. Colonoscopy is also helpful in preventing colorectal carcinoma by removing adenomatous polyp, however, colonoscopy is a difficult skill to master. Though Upper GI Endoscopy is widely available, colonoscopy facilities are relatively rare in developing world. In this field, the vast majority of reported data come from developed countries, and data from a developing country like Nepal is relatively scarce. With this background, present study was aimed to see clinical profile of patients presented for colonoscopy at a colonoscopy centre from western Nepal. MATERIAL AND METHODS: It was a cross sectional study which was carried out in Endoscopy Centre, Edmond City Hospital, Butwal, Nepal from 1 October 2010 to 31 September 2012. Study was approved by the hospital authorities. All the patients for colonoscopy at our centre were evaluated as per predesigned Pro-forma. Colonoscopy was done in all the patients under intravenous sedation after bowel preparation. Colonoscopic abnormalities were noted and biopsied if indicated and sent for histopathological examination. RESULTS: Sixty patients underwent colonoscopy in our centre during study period, among them 33 (55%) were male and 27 (45%) were female. The mean age was 45.23 ± 15.30 years (range 1678 years). Procedure was completed in 54 (90%) patients. Altered bowel habit, chronic diarrhoea and bloody diarrhoea were the three most common indications for colonoscopy. Significant lesions were seen in 35 (56.67%) patients. Among the patients with significant lesions anal canal or rectum or sigmoid colon were involved in 34 (97.14%) patients. The most common finding in colonoscopy was nonspecific colitis involving rectum and sigmoid, seen in 8 (13.33%) cases. Other findings include ulcerative colitis 6 (10%), anal fissure 6 (10%), haemorrhoids 5 (8.33%), ca colon 4 (6.67%), colonic polyp 4 (6.67%), ca rectum 1 (1.67%) and solitary rectal ulcer 1 (1.67%) patients.CONCLUSION: In present study altered bowel habit, chronic diarrhoea and bloody diarrhoea were the three most common indications for colonoscopy. Anal canal, rectum, sigmoid colon involvement were seen 97.14% patients. There is an urgent need to strengthen Lower GI Endoscopy facilities in resource poor setting. Flexible sigmoidoscopy may be a cheaper and easier initial screening tool for evaluating colorectal diseases.DOI: http://dx.doi.org/10.3126/jucms.v1i3.8761Journal of Universal College of Medical Sciences Vol.1(3) 2013: 28-32

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.

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Background: Alcohol is widely consumed socially accepted recreational beverage, that is toxic and affects directly or indirectly almost every organ. Spectrum of alcoholic liver disease ranges from fatty liver to cirrhosis. One of the complications of the later spectrum is portal hypertension, around 50% develops varices and bleeding depends on the size of the varices. Predicting varices without endoscopic is difficult but few non-invasive parameters are available. Materials and Methods: It was a prospective cross-sectional study done in Nobel Medical College Teaching Hospital, Biratnagar, Nepal from September 2018 to August 2019. Approval was acquired from Institutional Review Committee. Patients with chronic ethanol ingestion and features suggestive of chronic liver disease clinically and investigation wise were enrolled in the study. History, physical examinations along with platelet count, prothrombin time was taken and ultrasonography abdomen and upper gastrointestinal endoscopy was done to see the splenic diameter, and varices. Results: Esophageal varices were present in 53%. Mean platelet count with variceswas 122566 ± 36024.8 /mm3, splenic diameter was 133.1 ± 21.3 mm, prothrombintime (PT) time was 19.3 ± 5.0 sec andratio of platelet per spleen diameter was 930.2 ± 259.4 /mm3/mm.Platelet count < 163500/mm3 has sensitivity and specificity 83.0% and 83.0% respectively. Ratio of platelet per splenic diameter ratio cutoff 1293.7 has 88.7% sensitivity and 85.1% specificity for predicting varices. Conclusion: In chronic alcoholic liver disease patients low platelet count, increased splenicdiameter, low platelet per splenic diameter ratio are useful in predicting presence of esophageal varices.

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