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Background: Most of the bleeding in the lower gastrointestinal tract are usually located in the rectum, colon and terminal ileum. Colonoscopy is an invasive procedure used for both diagnostic and therapeutic purposes for detection of lower gastrointestinal (GI) tract pathologies and haemorrhage. Aims and Objective: The purpose of the study was to understand the clinical profile and colonoscopic findings in patients with lower gastrointestinal haemorrhage. Materials and Methods: Seventy-two patients presenting with lower GI haemorrhage were included in the study. All patients underwent colonoscopy after achieving hemodynamic stability and bowel preparation. Clinical profile and colonoscopic findings were studied. Results: The common aetiologies of lower GI haemorrhage were haemorrhoids followed by nonspecific colitis, colorectal polyp and carcinoma of colon. Rectum followed by sigmoid harbored majority of pathologies that presented with lower GI haemorrhage. Conclusions: The diagnosis of the pathological lesion and management of underlying cause not only prevents another episode of lower GI haemorrhage but also help in reducing morbidity and mortality. Colonoscopy or at least sigmoidoscopy is strongly recommended for evaluation, diagnosis and management of lower GI haemorrhage.

Background: Colonoscopy is an invasive procedure used for both diagnostic and therapeutic purpose for detection and management of the diseases of rectum, colon, and terminal ileum. This study was undertaken to assess the clinical profile and endoscopic findings in patients undergoing colonoscopy.    Methods: One hundred and sixty patients underwent colonoscopy from January 2018 till  December 2019.  Clinical profile, endoscopy and histological findings were studied from the hospital departmental records. Results: The commonest indications for performing colonoscopy were chronic diarrhea, altered bowel habits, chronic abdominal pain and bleeding per rectum. Colitis of unspecified etiology followed by ulcerative colitis and polyps were the common colonoscopy findings. Colorectal carcinoma were not uncommon. Conclusions: Colonoscopy is the gold standard modality for diagnosis of pathologies of lower gastro intestinal tract and should be an integral part of management. Screening colonoscopy is strongly recommended. Keywords: colitis; colonoscopy; colorectal disease  

Introduction: Green snakes found in hilly areas of Nepal cause significant morbidity in form of local swelling and bleeding manifestations. Polyvalent antivenoms are not indicated for the treatment. Specific management protocols are not endorsed for its bite. Conventionally, vitamin K and fresh frozen plasma are used to correct deranged coagulation in green snake bite.Objectives: The objective of this study was to evaluate the effectiveness of addition of tranexamic acid to the conventional method in green snake bite in western region of Nepal.Methodology: A hospital based, prospective comparative cross-sectional study was conducted at Department Medicine Manipal Teaching Hospital, Pokhara, Nepal from April 2014 to October 2017. It included 110 patients aged 15 to 76 years of both genders with confirmed history of green snake bite. Participants were alternately randomized into two groups; conventional group, tranexamic acid group. Duration of hospital stay was considered the primary outcome measure for this study while INR levels were considered the secondary outcome measure. Data were collected in a preformed pro forma and analyzed using SPSS version 16.0. Differences were considered significant if p-value is < 0.05.Results: The age (mean: 35.41; SD=17.23) of the study population ranged from 15 -76 years. The median duration of hospital stay in conventional group was 8 days (Inter Quartile Range = 7 to 8) and in tranexamic acid group was 6 days (Inter Quartile Range: 5 to 6). Mean INR was statistically significantly different at day 5 and day 6 in favor of tranexamic acid group (p<0.001)Conclusion: Treatment with tranexamic acid reduced the median duration of hospital stay by two days. Statistically significant differences in mean International Normalized Ratio levels were seen at day 5 and 6 of hospitalization (p<0.001). BJHS 2018;3(1)5 : 346-349