According to the global cancer observatory (GLOBOCAN), there were 16,485 new cases of pancreatic cancer in Southeast Asia in 2020, with men (9458 cases) having the highest incidence compare to woman (8320 cases). The death rate from 16,485 cases was 16,167 cases (98%). A person's chance of developing pancreatic cancer in addition to other cancers is between 1% to 20%. In this study, we reported a case of pancreatic tumor with lung tumor. A 68 years old woman presented with right quadrant abdominal pain since 1 month ago. The pain occurs randomly, but mostly occur during night. The pain didn’t occur after eat fatty food and during exercise. The pain didn’t relieve by rest. The patient also experienced nausea and vomit. The vomit consist of food and blood. She complains black colored stools and dark yellow urine. She also lost weight from 62 kg to 47 kg. There was history of gastric bleeding in 4 month ago. She was passive smoker. We then did several tests such as complete blood count, blood chemistry, serology, chest x-ray and abdominal CT-scan. The test showed pancreatic tumor with suggestive primary lung tumor. Patient with multiple primary tumor are an extremely rare type of cancer, which need comprehensive approach to both diagnosis and treatment of these numerous primary tumors.

Background and Purpose: Diabetes Mellitus is one of the commonest chronic metabolic diseases which has been increasing significantly, linked to obesity and advanced age, with high morbidity and mortality caused by its complication. On the other hand, vitamin D deficiency is also serious public health problem. In a recent year, vitamin D supplementation is recognised to have several roles on metabolic and glucose control, so are immune system. The aim of this study is focus on correlation between diabetes mellitus and vitamin D, especially in elderly population, in the midst of global pandemic due to COVID-19. Method: The design of this study is literature review. A literature searching was carried out by using key term ‘Diabetes Mellitus Type 2’, ‘Elderly Population’, ‘Vitamin D Supplementation’, and ‘COVID-19’ from four database, including NCBI, PubMed, Science Direct, and Google Scholar. Result: Administering vitamin D supplementation in elderly population with diabetes mellitus type 2 could have several benefits for improving HbA1c, insulin resistance, metabolic profile, and blood glucose level. Moreover, vitamin D supplementation might help elderly patients with type 2 diabetes for having immunity to prevent infection, including COVID-19 infection. Conclusion: Vitamin D supplementation can be considered as a simple and beneficial adjuvant therapy along with other treatment for diabetes mellitus in elderly population especially in this COVID-19 era. Keywords: Diabetes Mellitus Type 2, Elderly, Vitamin D, Covid-19.

Acute cholecystitis needs to be rapidly diagnosed and treated correctly. The classic patient characteristics were obese, increasing age, and being female. In a few cases, cholecystitis can occured in an atypical patient, such as in young age. Here, we report a 25-year-old obese female patient that came with right upper abdominal pain which was associated with nausea and vomiting. From imaging studies, we found that she had distended gallbladder with multiple stones. Open cholecystectomy was done and patient did well postoperatively. Acute cholecystitis had to be suspected in all age, especially in patient with another risk factor like obesity in our case. Keywords: acute cholecystitis, gallstone, cholecystectomy