RESUMEN
Objective: to evaluate the role of colonoscopy in the diagnosis and management of bleeding per rectum in children
Material and Methods: it was descriptive type of study conducted at Department of Pediatrics, Services Hospital, and Lahore including 50 patients of either sex with age range of 5-15 years in whom colonoscopy was performed for bleeding PR. The patients with acute dysentery, melena and rectal prolapse were excluded from study. Gut preparation was started forty-eight hours before procedure. The children were given clear liquids without any milk and fiber containing diet. Liquid paraffin was given orally as laxative and two doses of kleen enema were given, 12 hours and 1 hour before procedure. Colonoscopy was performed under deep sedation [Midazolam 0.25-0.5mg/kg] using fiber optic pediatric colonoscopy in Medical Unit-1 of Services Hospital, Lahore. Polypectomy was done in patient with pedunculated polyps and colonic biopsy was taken where indicated. The samples were sent for histopathology in the Department of Pathology of the same hospital. After procedure all patients were kept under observation for4-6 hours in pediatric ward
Results: colorectal polyps were the most common cause of bleeding per rectum [56%] followed by ulcerative colitis [12%], solitary rectal ulcer [8%], non-specific colitis [8%] and hemorrhoids in 2%. There was suspicion of malignancy in 2 children on colonoscopy. Biopsy was taken and it was confirmed as adenocarcinoma on histopathology in one child. Among patients with polyps [n=28], 22 [78.6%] have single polyp and 6 [21.4%] have more than one. Main site of polyps was rectum [20 patients] while it was sigmoid/recto sigmoid junction in 5 and descending colon in 2 children. Polypectomy was performed in 21 children while it was not possible in 7 due to sessile polyps in 6 and polyp size larger than snare in 1 child
Conclusion: colons-copy is safe and very useful tool in the diagnosis and management of bleeding per rectum in pediatric patients and juvenile polyps are the commonest cause of bleeding per rectum in this age group
RESUMEN
To evaluate and see the relationship of maternal nutritional status with that of the newborns. Design: This was a prospective observational study. Place and Duration of Study: The research was carried out on mothers between the age of 20 to 40 years in the Lady Willingdon and Ittefaq Hospital. Patients and The study was carried out on 30 mothers, divided in two groups, comprising 15 in each. 15 mothers belonging to the low socio-economic class whose income was < Rs 6000/month, and 15 to those belonging high socio-economic class with an average monthly income Rs > 20000 / month. Anthropometrics indexes of the infants from Lady Willingdon Hospital indicated that all the infants were of low birth weight [<2500gm]. Low hemoglobin [<10gm/dl] were found in many women though the ferritin stores were satisfactory. Similarly half of the infants had low hemoglobin levels [11-13 gm/dl] with an adequate ferritin stores. It was also found that high maternal hemoglobin levels [>11 gm/dl] were positively correlated with higher infant hemoglobin, serum ferritin, weight, height and head circumference measures. It was thus concluded that maternal nutritional status is directly related with that of newborn