Demographic and clinical profile of patients undergoing colonoscopy at a tertiary care center in Nepal: a retrospective cross-sectional study.

Background: Colonoscopy is widely used as a tool for diagnosis, screening and treatment of various pathologies in the rectum, colon, and terminal ileum. The aim of this study is to evaluate the demographic, clinical, and histological parameters of the records of patients undergoing colonoscopy at a tertiary care hospital in Nepal. Materials and methods: This retrospective cross-sectional study included the hospital records of all patients who underwent colonoscopy from 2015 to 2019 in a tertiary care centre in Nepal. Results: A total of 1255 records were included in the study. The mean and standard deviation of age were 43.8 and 19 years, respectively. Among the total study population, 61.9% were males and 38.1% were females. Common indications for colonoscopy included lower gastrointestinal bleeding (27.7%), altered bowel habit (26.9%) and persistent or recurrent abdominal pain (17.3%). Only 3% of the patients who underwent colonoscopy had inadequate bowel preparation. The overall diagnostic yield of colonoscopy was 57.5%. Findings during colonoscopy included colorectal polyp (19.4%), internal haemorrhoids (8.2%) and colitis (6.5%). Having an age of 50 or more years was significantly associated with the presence of colorectal adenocarcinoma (P=0.017, χ2 test) with an odds ratio of 2.35 (95% CI: 1.14, 4.89). Furthermore, having a female sex was found to be significantly associated with the presence of colorectal adenocarcinoma (P=0.012, χ2 test) with an odds ratio of 2.43 (95% CI: 1.19, 4.97). Conclusion: In the authors' study, a smaller proportion of the colonoscopies was aimed at screening for colorectal carcinoma (CRC), when compared to studies in developed countries. The sex predisposition of CRC in the authors' study is in contrast to the global trend. The authors recommend conducting studies to determine the risk factors and need for CRC screening in the Nepalese population.

Nonhealing oesophageal ulcer: a case report.

Esophageal tuberculosis is a rare presentation of a common infectious disease. It may occur as a primary infection of the esophagus or as a secondary spread mostly from caseating mediastinal lymph nodes. The clinical diagnosis of the condition is presumed to be complex, owing to nonspecific biopsy findings, failure of isolation of bacilli, and a lack of predisposing conditions in patients. This study aims to present a rare condition of esophageal tuberculosis secondary to mediastinal lymphadenitis and highlights a unique modality of diagnosis of the condition, especially in a resource strained setting. Case presentation: This case report presents the case of a 50-year-old male with dysphagia and a burning sensation at the epigastrium. Endoscopy and histopathological examination showed ulceration at the esophagus and granulomatous inflammation, respectively. Computed tomography showed enlargement of the prevascular and paratracheal group of lymph nodes. However, the acid-fast bacilli stain at the ulcer site was negative. The diagnosis could be confirmed only after 2 months of the antitubercular treatment trial, which significantly potentiated ulcer healing. Clinical discussion: Esophageal tuberculosis may result from a secondary infection caused by systemic dissemination following a pulmonary disease or as a primary infection. In this case, it likely resulted from lymphatic dissemination via prevascular and paratracheal lymph nodes manifested mainly as dysphagia. Conclusion: Tuberculosis should be considered as one of the differential diagnoses in areas of limited resources. Clinicians may have to rely on clinical judgement and/or the patient's response to standard antitubercular treatment to make a definitive diagnosis.

Myopia among Medical Undergraduates of a Medical College: A Descriptive Cross-sectional Study.

Introduction: Myopia is defined as a refractive error in which rays of light entering the eye parallel to the optic axis are brought to focus in front of the retina when accommodation is relaxed. Globally, myopia prevalence is on the rise for unknown reasons. The aim of the study was to find out the prevalence of myopia among undergraduates of a medical school. Methods: A descriptive cross-sectional study was conducted among medical undergraduates of a medical school between 2 May 2022 to 3 August 2022 after receiving ethical approval from the Institutional Review Committee of the same institute (Reference number: 21/20). A proforma was distributed among the medical undergraduates and data from known myopic students were collected. A convenience sampling method was used. Point estimate and 95% Confidence Interval were calculated. Results: Among 279 medical undergraduates, myopia was seen in 119 (42.65%) (36.85-48.45, 95% Confidence Interval). The mean age of the myopic undergraduates was 21±1.47 years. Conclusions: The prevalence of myopia among undergraduates was found to be lower than the other studies done in similar settings. Keywords: medical students; myopia; prevalence.

Klippel Trenaunay syndrome in a 3-year-old: A case report.

INTRODUCTION AND IMPORTANCE: Klippel-Trenaunay syndrome (KTS) is characterized by a triad of port-wine stain, varicose veins and soft tissue or bony hypertrophy of lower limb. Varicose veins in Klippel Trenaunay syndrome are mostly distributed in the lateral aspect of the lower limb. The exact etiology of KTS is not known, and the treatment usually starts with conservative management- limb elevation, compression stockings and physiotherapy. However, some cases are severe enough to warrant surgical management. CASE PRESENTATION: Here we present a case of a 3-year-old male child with clinical features suggestive of Klippel Trenaunay Syndrome managed successfully with sclerotherapy of persistent lateral marginal vein of servelle. At one month follow-up the vein was sclerosed and there was a significant reduction in varicosities of leg. CLINICAL DISCUSSION: Starting treatment of varicose veins in Klippel Trenaunay Syndrome in children is effective in preventing long-term complications in adults. Thus, treating venous malformation with sclerotherapy is warranted in early childhood to prevent venous hypertension and chronic venous insufficiency. CONCLUSION: Varicose veins in KT syndrome can be managed successfully by sclerotherapy of lateral marginal vein of servelle resulting in significant reduction in varicosities of leg.