INTRODUCTION The lower gastrointestinal bleeding (LGIB) is an alarming symptom and common disease with annual admission of 0.15% with mortality rate of 5-10%. LGIB is caused by neoplastic and non-neoplastic lesions. For accurate diagnosis of various colorectal lesions, colonoscopy is gold standard, convenient and cost effective procedure. It is the investigation of choice in LGIB and helps in early diagnosis of colorectal carcinoma. This study was aimed to scrutinize the clinical and colonoscopic findings in patients with LGIB in UCMS.   MATERIAL AND METHODS This was a hospital based prospective observational study conducted after taking permission from institutional review committee in January 2017 at UCMS-TH from 15th January 2017 to 15th January 2018. All patients presenting with LGIB who fulfilled inclusion and exclusion criteria and gave written consent were included.   RESULTS Total 88 patients were included in the study. The mean age of our patients was 48 ±17 years with age range from 17-81 years. Majority were in the age group 50-60 years (25%) (n=22). Colonoscopy detected abnormality in 73.8% cases. The common non-neoplastic were haemorrhoids and non-specific colitis (14.5% each) followed by 12.5% of neoplastic cases. The higher frequency of colorectal lesions was observed in males comprising 72.7% (n=64) patients. The most commonly diagnosed etiologies of LGIB were haemorrhoid and nonspecific colitis respectively.   CONCLUSION Colonoscopy detected abnormality in 75% of cases. The common causes of LGIB were haemorrhoids and non-specific colitis followed by neoplastic lesion. A careful history, physical and colonoscopic examination with or without biopsy makes significant impact for early diagnosis and treatment.

Introduction: Acute upper gastrointestinal    (UGI) bleeding   is a common   medical   emergency   which   is associated   with significant morbidity and mortality.  The annual incidence of UGI bleeding varies from 48 to 160 cases per 100,000 populations   in the United States of America (USA), with a mortality rate of 7% to 10%. The aetiology and outcome of UGI bleeding varies significantly in different geographic regions depending on the demographic   and socioeconomic characteristics   of the local population.   This  study  was  done  to  evaluate   the clinical  profile  and  outcome   of patients  presenting   with  acute  UGI bleeding  at a tertiary care centre in Lumbini  zone of Nepal.Material and Methods: This was a hospital based prospective   observational   study. All the patients  who presented  with  acute UGI bleeding  and fulfilled  the inclusion  criteria  from  1st  August  2013 to 31st  July 2014 were included  in the study. The study was cleared by the ethical review committee of the institute and written informed consent was taken from all the patients.Results: During the study period, 70 patients fulfilled the inclusion criteria   and were subjected to statistical analysis.  The mean age of patients in the present study was 55.11 ± 19.93 years. The majority of patients (30, 43%) were elder, belonging to the age group of more than 60 years.  There were 55 (79%) male and 15 (21 %) female.  The patients were mostly farmers by occupation   accounting   29 (41 %) cases.  Ethnically, 26 (3 7%) patients of UGI bleeding were from janajati group where majority of them had esophageal varices.  Overall, the peptic ulcer disease was the leading cause of UGI bleeding seen in 26 (37%) patients followed by esophageal   varices seen in 23 (33%) patients.  0 positive was the commonest   blood group which was found in 28 (40%) of our patients.  In our study 44 (63%) patients  were alcohol  consumers  and 37 (53%)  had coexisting   comorbidities   that  added  for the UGI  bleeding  related  complications.   During admission,   7 patients expired causing 10% mortality.Conclusion: Acute UGI bleeding was commonly seen in older age group patients with male preponderance.   Peptic ulcer disease was the leading cause of the UGI bleeding.   The mortality   rate was found to be 10%. The mortality   also increased   with increasing age and patients with pre-existing co morbidities. Journal of Universal College of Medical ScienceVol. 6, No. 1, 2018, Page: 3-7

INTRODUCTIONOrganophosphorous poisoning is a prevalent emergency care problem found in Nepal. Nepal being agricultural country and pesticide being easily available, organophorous poisoning is most common cause of poison related morbidity and mortality in Nepal. Main objective of the study is to evaluate the clinical profile and outcome of patients on the basis of demographic profile, type of compound, presenting symptoms and outcome. MATERIAL AND METHODSOur study included 80 patients with organophosphorous ingestion, admitted in ICU and wards of Universal College of Medical Sciences Teaching Hospital (UCMS-TH), Bhairahawa, Rupendehi, Nepal from1th July, 2019 AD to 30th July 2020 AD. Ethical clearance was obtained along with consent from patient. Data was collected from patient’s visitor. RESULTSFemales (63%) were more common than males (37%). Age group 21-30 was most likely to ingest OP compound for suicidal attempts.Chlorpyriphos (80%) was most common compound ingested.41% cases consumed alcohol, 10% cases were smokers, 11% cases had diabetes and 22% cases had hypertension. Vomiting (90% cases) was most common symptom. 54% cases had hospital stay of less than 5 days and 43% cases had hospital stay of 5-10 days.Based on POP scoring 24 cases of  moderate severity 1 case died where as 3 cases out of 8 severe cases died.74% had uneventful recovery,11%  developed intermediate symptoms,10% needed ventillatory support and 5% died due to poisoning.  CONCLUSIONOrganophosphorous poisoning was the most common acute poisoning in young female population.Strict policies against the free availability and sale of insecticides is required to control organophosphorus poisoning.

INTRODUCTION Covid-19 is a debilitating disorder which affects the lungs with multiple organs involvement. The biochemical variables play important role in the management of the Covid-19 patients who are with different clinical profile, socio-demographic, and co-morbid conditions like diabetes and hypertension. MATERIAL AND METHODS This cross sectional study was conducted in the Covid-19 hospitalized cases at UCMS, Bhairahawa. Total of 150 patients were enrolled in the study period from May 2021 and October 2021 whose clinical profile, sociodemographic and biochemical variables were assessed. RESULTS The gender wise distribution shows the male dominancy with M:F ratio 1:0.85. The maximum age group vulnerable to Covid-19 in our study was found to be 41-60 years with median age of 47 years. There were constellations of symptom with shortness of breath 70% becoming first followed by cough 67.3% and fever 54%. The frequency of diabetes and hypertension was 19.3% and 24% showing co-morbidity associated changes in biochemical parameters. The male to female differences in biochemical changes have been associated with Covid-19 patients, however age wise distribution do not show any difference in biochemical parameters. CONCLUSION COVID 19 patients have a high prevalence of diabetes and hypertension, which is a common morbidity. A few biochemical indices (D-dimer, LDH, CRP, and ALT) change significantly between males and females. All biochemical parameters, on the other hand, are unaffected by age.

INTRODUCTIONCorona virus disease 2019 (COVID-19) has become a global public health issue with unpredictable progression to ARDS. Therapy timing of anti-inflammatory agents and immune-suppressing medication is of utmost importance. Previous studies have consistently found elevated levels of C-Reactive Protein with disease severity. In this study, we aimed to investigate the relationship between C-Reactive Protein and severe SARS-COV-2 pneumonia. MATERIAL AND METHODSOur study included 55 patients with COVID-19, admitted in COVID Unit of Universal College of Medical Sciences Teaching Hospital (UCMS-TH), Bhairahawa, Rupendehi, Nepal from 16th June 2021 to 15th September 2021. We included COVID-19 cases confirmed by a RT-PCR test  with severe pneumonia based on W.H.O criteria and those undergoing C-Reactive Protein levels. RESULTSMales (56%) were more compared to females (44%). Age group 41-60 years were likely to develop severe COVID-19 pneumonia. Cough (44%), dyspnea (42%) and fever (40%) were most common symptom. Hypertension (34%) and diabetis (24%) were common comorbidities present. Patients with severe COVID-19 pneumonia had average CRP value of 59.6 mg/l. CONCLUSIONElevated CRP level was associated with COVID-19 severity.