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OBJECTIVE: To determine etiology and outcome of children with lower gastrointestinal bleeding (LGIB). METHODS: This was a prospective study conducted at the Department of Pediatric Gastroenterology and Hepatology, Children's Hospital and The Institute of Child's Heath, Multan, Pakistan, from July 2019 to March 2020. A total of 148 cases presented with bleeding per rectum and underwent colonoscopy, were included. Children of both genders and aged three month to 15 years were included. Detailed history, clinical examination, laboratory studies, colonoscopy and histopathology were done in all cases. Study information like demographics, complaints, general clinical examination, colonoscopy and histopathological findings were recorded. RESULTS: Overall, mean age was noted to be 7.20±1.83 years. Abdominal pain was reported in 41 (27.7%), diarrhea 36 (24.3%), fever 12 (8.1%) and constipation in 4 (2.7%). Pallor was noted among 68 (45.9%), weight loss 39 (26.3%) and tachycardia 31 (20.9%). Colonoscopy revealed juvenile colonic / rectal polyps, infectious colitis and solitary rectal ulcer (SRU) as the most common etiologies found among 58 (39.2%), 20 (13.5%) and 19 (12.8%) cases respectively. Juvenile polyps and non-specific colitis were the commonest histopathological findings seen in 55 (37.2%) and 20 (13.5%) cases respectively. Colonoscopic polypectomy was used to remove all juvenile polyps. CONCLUSION: LGIB is presentation of various underlying causes. Children with LGIB commonly present with abdominal pain. Juvenile polyps were the most frequent cause of LGIB among children flowed by non-specific colitis. Most of the children having LGIB were diagnosed and treated successfully, few are in remission and very few were found resistant to treatment.
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BACKGROUND AND OBJECTIVE: Parathormone (PTH) and serum Vitamin D3 (VD3) share a complex interplay where increased VD3 leads to a negative response on parathormone level. Our objective was to determine the correlation of parathormone (PTH) and Vitamin D3 (VD3) levels in nursing mothers and infants 1-6 months' age from South Punjab, Pakistan. METHODS: This study is a secondary data analysis of previously conducted cross sectional study which was conducted at the Department of Pediatric Medicine, Nishtar Medical University, Multan, during August 2010 to June 2011. Study included 67 infants 1-6 months of age and 60 nursing mothers. A venous blood sample was drawn for estimation of VD3, calcium, phosphate, alkaline phosphatase, parathormone and albumin. Spearman correlation coefficient was calculated to determine the inverse correlation between PTH and VD3 levels. RESULTS: Mean age (in days) of the infants was 83±53.7 days whereas maternal mean age was 25.53 ± 4.12 years. Median VD3 level in infants was 20.90 ng/ml (IQR - 49.5). Median serum PTH levels were 20.90 pg/ml (IQR - 26.17). Median VD3 level in nursing mothers was 21.0 ng/ml (IQR 7.2- 43.8). Median maternal serum PTH levels were 20.89 pg/ml (IQR 2.9 - 232.4). Substantial negative relation between VD3 and parathormone in infants and mothers was not evident (r = - 0.027, p-value 0.83) and (r = 0.156, p-value 0.23) respectively. A significant positive association between infant and maternal VD3 was observed (rs -0.55, p-value < 0.001). CONCLUSION: Our study affirms that the customary negative correlation between VD3 and parathormone levels does not exist.