Diagnostic Evaluation of Patients Presenting with Rectal Bleeding by Colonoscopy

2020 ◽  
Vol 42 (1) ◽  
pp. 36-39
Author(s):  
Bala R Malla ◽  
Suyog Simkhada
Keyword(s):  
Rectal Bleeding ◽  
Diagnostic Yield ◽  
Adult Population ◽  
Common Finding ◽  
Common Causes ◽  
Optic Colonoscopy ◽  
The Common ◽  
Gastro Intestinal Tract ◽  
Histopathologic Findings ◽  
Malignant Mass

Introduction Rectal bleeding indicates the bleeding from lower gastro-intestinal tract occurring distal to ligaments of Treitz. Annual incidence of per rectal bleeding has been estimated to be 20% . Colonoscopy is the examination of choice for investigation. The objective of this study is to know the diagnostic yield of colonoscopy in cases with per rectal bleeding and to know the common causes of per rectal bleeding in adults MethodsOne hundred and twenty-nine adult patients, age more than 18years, who presented to Surgical OPD and ward of Dhulikhel Hospital during the year 2018 and 2019 were taken for the study irrespective of their sex. All the patients were subjected to fibre-optic colonoscopy after necessary preparation and the findings were recorded. Diagnosis was based on colonoscopic and histopathologic findings. ResultsA total of 129 (77 male and 52 female )patients with per rectal bleeding were evaluated with colonoscopy. The age ranged from 18 years to 79 years with the mean age 42.25 (SD+/- 15.29). Colonoscopy showed abnormalities in 102 patients (79.06%). The most common finding was hemorrhoids in 36 patients (27.90%) followed by colorectal malignant mass in 20 patients (15.50%). Polyps were diagnosed as the cause of rectal bleeding in 14 patients (10.84%). ConclusionColonoscopy has good diagnostic yield at evaluating cases with per rectal bleeding. Hemorrhoids, colorectal malignant mass and polyps are the common causes producing PR bleeding in Nepalese adult population.

scholarly journals Solitary Rectal Ulcer Syndrome: Uncommon Cause of Rectal Bleeding in Children

2008 ◽  
Vol 47 (172) ◽  
Author(s):  
Sudhamshu KC ◽  
D Sharma ◽  
B Bashnet ◽  
AK Mishra
Keyword(s):  
Rectal Bleeding ◽  
Adult Population ◽  
Rectal Polyp ◽  
Rectal Ulcer ◽  
Pediatric Age ◽  
Proctoscopic Examination ◽  
Solitary Rectal Ulcer ◽  
Solitary Rectal Ulcer Syndrome ◽  
Common Causes ◽  
Bleeding Per Rectum

Rectal polyp and hemorrhoids are common causes of bleeding per rectum in pediatric age group.However, there are some other causes which should be considered in differential diagnosis. We haveacquainted a case of rectal bleeding due to solitary rectal ulcer in a child of 10 year. Colonoscopicexamination was required for diagnosis as proctoscopic examination and digital rectal examinationmissed the diagnosis, probably due to poor co-operation by the patient and rare nature of the disease.Although well recognized in the adult population, the pediatric experience with this condition islimited.Key word: children, rectal bleeding, solitary rectal ulcer

Rectal bleeding

2018 ◽  
Vol 11 (3) ◽  
pp. 143-146
Author(s):  
Rodrick Babakhanlou
Keyword(s):  
Primary Care ◽  
Rectal Bleeding ◽  
Secondary Care ◽  
Common Presentation ◽  
Common Causes ◽  
Bleeding Per Rectum ◽  
The Common

Bleeding per rectum is defined as the passage of blood from the anus. It is a common presentation in adults of all ages and the majority of cases can be managed in primary care. This article will focus on the common causes of rectal bleeding, its assessment and management, including guidance for referral pathways to secondary care.

scholarly journals Assessment of Gastrointestinal Autonomic Dysfunction: Present and Future Perspectives

2021 ◽  
Vol 10 (7) ◽  
pp. 1392
Author(s):  
Ditte S. Kornum ◽  
Astrid J. Terkelsen ◽  
Davide Bertoli ◽  
Mette W. Klinge ◽  
Katrine L. Høyer ◽  
...  
Keyword(s):  
Gastrointestinal Tract ◽  
Autonomic Dysfunction ◽  
Physiological Function ◽  
Clinical Performance ◽  
Data Interpretation ◽  
Assessment Methods ◽  
Common Finding ◽  
Colonic Manometry ◽  
Target Organs ◽  
Common Causes

The autonomic nervous system delicately regulates the function of several target organs, including the gastrointestinal tract. Thus, nerve lesions or other nerve pathologies may cause autonomic dysfunction (AD). Some of the most common causes of AD are diabetes mellitus and α-synucleinopathies such as Parkinson’s disease. Widespread dysmotility throughout the gastrointestinal tract is a common finding in AD, but no commercially available method exists for direct verification of enteric dysfunction. Thus, assessing segmental enteric physiological function is recommended to aid diagnostics and guide treatment. Several established assessment methods exist, but disadvantages such as lack of standardization, exposure to radiation, advanced data interpretation, or high cost, limit their utility. Emerging methods, including high-resolution colonic manometry, 3D-transit, advanced imaging methods, analysis of gut biopsies, and microbiota, may all assist in the evaluation of gastroenteropathy related to AD. This review provides an overview of established and emerging assessment methods of physiological function within the gut and assessment methods of autonomic neuropathy outside the gut, especially in regards to clinical performance, strengths, and limitations for each method.

scholarly journals From “Technical Newbies” to “Optimistic Politicians”

2019 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
James Prater ◽  
Konstantinos Kirytopoulos ◽  
Tony Ma
Keyword(s):  
Information Technology ◽  
Quantitative Research ◽  
Valuable Insight ◽  
Scheduling Problems ◽  
Information Technology Projects ◽  
Content Type ◽  
Common Causes ◽  
The Common ◽  
Project Estimation ◽  
Engineering Projects

Purpose Despite the advent of sophisticated control methods, there are still significant issues regarding late delivery of information technology projects. The purpose of this paper is to investigate the common causes of scheduling problems specifically in the information technology projects context. Design/methodology/approach Through a quantitative research, the importance of those causes, as well as the underpinning factors driving them, is explored. The causes are ranked according to their relative important index, and exploratory factor analysis is employed to reveal underlying dimensions (factors) of these causes. Findings From the analysis, four factors were extracted, namely, “Dataless Newbie,” “Technical Newbie,” “Pragmatic Futurist” and “Optimistic Politician.” These factors explain the different latent conditions that lead to scheduling problems in information technology projects. Practical implications The key contribution of this research is that it enlightens the latent conditions underpinning scheduling problems. Also, the evidence provides that schedule development for information technology projects is impacted by the same causes that impact engineering projects, and that applying a number of mitigation techniques widely used within the engineering area, such as reference class, would, no doubt, not only improve information technology schedules but also reduce the political pressures on the project manager. Originality/value This research provides a valuable insight into understanding the underlying factors for poor project estimation.

scholarly journals Promising Novel Biomarkers in Cardiovascular Diseases

2021 ◽  
Vol 11 (8) ◽  
pp. 3654
Author(s):  
Brigitte Sipos ◽  
Peter Jirak ◽  
Vera Paar ◽  
Richard Rezar ◽  
Moritz Mirna ◽  
...  
Keyword(s):  
Cardiovascular Diseases ◽  
Diagnostic Yield ◽  
Accurate Estimate ◽  
World Health ◽  
Current Status ◽  
Fatty Acid Binding ◽  
Type Plasminogen Activator ◽  
Common Causes ◽  
Novel Biomarkers ◽  
Health Organization

Cardiovascular diseases remain the most common causes of death globally, according to the World Health Organization. In recent years, a great number of biomarkers have been investigated, whereas only some have gained value in the diagnosis, prognosis, and risk stratification of different cardiovascular illnesses. As numerous studies have investigated the diagnostic yield of novel biomarkers in various disease entities every year, this review aims to provide an overview of the current status of four promising representatives. In particular, this manuscript refers to soluble suppression of tumorigenicity 2 (sST2), heart-type fatty acid binding protein (H-FABP), growth differentiation factor (GDF-15) and soluble urokinase-type plasminogen activator receptor (suPAR). These markers are of special interest as they are thought to provide an accurate estimate of cardiovascular risk in certain patient populations, especially those with pre-existing diseases, such as obesity or diabetes mellitus. We sought to give an overview of their function, individual diagnostic and predictive value and determination in the laboratory. A review of the literature regarding the aforementioned cardiovascular biomarkers yielded manifold results with respect to their individual diagnostic and prognostic value. Yet, the clinical relevance of these findings remains unclear, warranting further studies to identify their optimal use in clinical routine.

scholarly journals Thyroid and Molecular Testing. Advances in Thyroid Molecular Cytopathology

2021 ◽  
Vol 2 (2) ◽  
pp. 77-92
Author(s):  
Esther Diana Rossi ◽  
Philippe Vielh
Keyword(s):  
Thyroid Nodules ◽  
Adult Population ◽  
Needle Aspiration ◽  
Common Finding ◽  
Molecular Testing ◽  
Additional Tool ◽  
Thyroid Cytology ◽  
Hürthle Cell ◽  
Cell Neoplasm ◽  
Undetermined Significance

Thyroid nodules are a common finding in the adult population including the fact that more than 50% of individuals, over the age of 60, have thyroid nodules. The majority have been mostly detected with ultrasonography and 10% by palpation. The majority of these nodules are benign, whereas 5–15% of them are malignant. The pre-operative diagnosis of cancer is a critical challenge in order to ensure that each patient can be treated with the best tailored management with a reduction of unnecessary surgery for benign lesions. Fine needle aspiration cytology (FNAC) represents the first and most important diagnostic tool for the evaluation of thyroid lesions. According to the literature, FNAC is able to render a conclusive diagnosis in up to 70–80% of all cases. For the remaining 20–30% of nodules, cytological diagnoses fall into the category of indeterminate lesions mostly due to the lack of specific morphological features. According to the Bethesda system for reporting thyroid cytopathology (TBSRTC), indeterminate lesions can be sub-stratified into three different subcategories including “atypia of undetermined significance/follicular lesion of undetermined significance-AUS/FLUS”; “follicular or Hürthle cell neoplasm/suspicious for follicular or Hürthle cell neoplasm-FN/SFN”; and “suspicious for malignancy-SFM”. Many of these indeterminate lesions undergo repetition or diagnostic lobectomy. Nonetheless, the majority of these cases will have a benign diagnosis due to the fact that the rate of cancer ranges between 6 and 30%. It stands to reason that the application of ancillary technique, mostly molecular testing, emerged as a critical additional tool for those thyroid indeterminate lesions. Since the early 1990s, material collected from cytological samples yields sufficient and adequate cells for the detection of point mutation or gene fusions. Nonetheless, the further availability of new sequencing technologies such as next-generation sequencing (NGS) has led to more comprehensive molecular applications adopted now in clinical use. The current review investigates the multiple advances in the field of molecular testing applied in thyroid cytology.

scholarly journals A NEW METHOD OF EPISTAXIS MANAGEMENT USING NASAL GEL: A SINGLE CENTER, RANDOMIZED CLINICAL TRIAL

2018 ◽  
Vol 11 (3) ◽  
pp. 104 ◽  
Author(s):  
Mehdi Torabi ◽  
Ava Roughani Esfahani ◽  
Shiva Moeinaddini ◽  
Mohammad Reza Baneshi
Keyword(s):  
Clinical Trial ◽  
Side Effects ◽  
Randomized Clinical Trial ◽  
Patients Satisfaction ◽  
Stop Time ◽  
Common Causes ◽  
Procedural Time ◽  
Nasal Bleeding ◽  
The Common ◽  
Discharge Length

 Objective: Epistaxis is one of the common causes of patients’ referral to the emergency departments. In the majority of cases, epistaxis is managed by traditional methods. We investigated the efficacy of nasal gel (NG) in comparison to anterior nasal packing (ANP) to stop mild-to-moderate anterior nasal bleeding.Methods: In this prospective, randomized clinical trial, patients were divided into two groups of ANP (n=60) and NG (n=40). We determined and compared the efficacy of treatment (bleeding stop time and recurrence), patients’ satisfaction at discharge (length of stay in the hospital, pain during the procedure, and procedural time), and safety (less side effects) in both groups.Results: The procedural time ≤2 min was observed in 90% and 58.33 % of NG group and ANP group, respectively (p<0.001). Pain score during procedure ≤4 and patients’ satisfaction ≥7 were, respectively, seen in 87.5% and 65% of NG group, but it was 43.33% and 41.7% in ANP group, respectively (p<0.001, p=0.02). The side effects in ANP group were 35%; however, no side effects were observed in NG group.Conclusion: In the management of mild-to-moderate anterior nasal bleeding although NG efficacy is equivalent to ANP, using NG may be more convenient and satisfactory for patients. In addition, the use of this gel may result in more safety and fewer side effects.

scholarly journals Clinicopathological study of patients with pancytopenia

2020 ◽  
Vol 9 (1) ◽  
pp. 169
Author(s):  
Y. Srinivas ◽  
Mohammed Elyas
Keyword(s):  
Bone Marrow ◽  
Blood Cells ◽  
Reticulocyte Count ◽  
Megaloblastic Anemia ◽  
Bone Marrow Failure ◽  
General Medicine ◽  
Large Sample Size ◽  
Age Group ◽  
Common Causes ◽  
The Common

Background: Pancytopenia is due to bone marrow failure characterized by anemia, leukopenia, and thrombocytopenia. It a common hematological disorder. Low blood counts in the bone marrow failure disease result from deficient hematopoiesis. Marrow damage and dysfunction also may be secondary to infection, inflammation, or cancer. Pancytopenia has an extensive differential diagnosis and it can result from damage to bone marrow destruction of preformed blood cells peripherally with increased reticulocyte count. Aim of the study were to study the different etiological conditions and clinical features of pancytopenia in rural medical college.Methods: This study has been conducted in the department of general medicine in association with the pathology department and between March 2019 to February 2020, 45 patients were included in this study. males were 27 and females were 18. The age group is between 20 years and 60 years. 2 ml of anticoagulant blood send for HB% total count, platelet count, packed cell volume, and RBC indices.Results: The total no. of patients included in this study were 45 among these 45 patients, males were 27, and females were 18. The common age group is between 20 and 60 years and the common causes of aplastic anemia in our study are megaloblastic anemia.Conclusions: Pancytopenia is a common hematological problem in India. In our study megaloblastic anemia is the most common cause of pancytopenia females are affected during pregnancy. So, periodical clinically examined and investigations may reduce the incidence. of further research with a large sample size and meticulous investigations required to replicate the finding of the study.

scholarly journals An unusual cause of edema in a child with congenital heart disease post Fontan procedure

2019 ◽  
Vol 7 (11) ◽  
pp. 4396
Author(s):  
Minal Wade ◽  
Shweta Shettiwar ◽  
Ankita Shah
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Rare Complication ◽  
Fontan Procedure ◽  
Protein Losing Enteropathy ◽  
Common Causes ◽  
Disease Protein ◽  
The Common ◽  
Fontan Palliation

Protein Losing Enteropathy Post Fontan procedure. Protein Losing Enteropathy (PLE) is an uncommon cause of edema in children with congenital heart disease. Protein-Losing Enteropathy may be defined as excessive loss of proteins across the intestinal mucosa and is due to either a primary gastrointestinal abnormality or secondary to cardiac disease. Protein-losing enteropathy (PLE) is a rare complication of the Fontan palliation for functional single-ventricle. Although PLE occurs in about 3.5% of patients post-Fontan, it confers marked morbidity and high mortality within 5 years of diagnosis. The pathogenesis of Fontan-related PLE is not completely understood, and it is unclear why it develops in some patients post-Fontan and not others. We describe a child with Double Inlet Right Ventricle who had undergone Fontan procedure, and presented to us with generalised oedema. The child had hypoproteinaemia, the common causes for which were ruled out and was diagnosed as Protein Losing Enteropathy (PLE) related to his surgical intervention. Though, not frequently encountered it should be kept in mind as one of the causes of anasarca.

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