immunoproliferative small intestinal disease is considered as a rare condition and has endemicity inMediterranean countries and often associated with campylobacter jejuni infection. This conditionvaries in severity from benign to frankly malignant. Prolonged remission can be obtained with longterm antibiotic therapy but chemotherapy is required for those who have aggressive disease. Bangladeshidata on IPSID is sparse. Here our patient 21 years old male presented with chronic diarrhoea, occasionalvomiting, severe weakness and significant unintentional weight loss. He had cachectic body built,bipedal edema, easy bruising, glossitis with angular stomatitis. His upper GI endoscopy showed multiplenodular lesion in the duodenum. Biopsy was taken from nodular lesion and sent for histopathology,geneXpert and culture. Histopathology revealed IPSID. He was treated with tetracycline and improvedclinically. J MEDICINE 2022; 23: 84-86

Background: Bone marrow aspiration is assessed for cytology and trephine biopsy provides overall cellularity, detection of focal lesion and infiltration. Bone marrow study plays a crucial role in identifying cause of aplastic anaemia in clinical practice. This study was carried out to see the etiological and clinical spectrum of pancytopenia based on bone marrow examination. Materials and Methods: This descriptive study was conducted in the Department of Medicine, Dhaka medical college Hospital, Dhaka, Bangladesh over a 2-year period (August 2016 to July 2018). A total 80 cases of pancytopenia were included in the study. Patients were diagnosed by hemoglobin less than 10 gm/ dL, total leukocyte count less than 4000/Cumm and platelet count less than 150000/cumm. Results: Maximum number of cases were seen in age group of 16-30 years (31.25%) and male to female ratio is 1.1:1. The commonest presenting complaint was fever in 40% (32/80) of the cases. Pallor was present in all the patients, Splenomegaly was seen in 20% (16/80) and hepatomegaly in 12.5% of the cases (10/80). Petechial hemorrhages were present in 5% (4/80). The commonest cause of pancytopenia was megaloblastic anemia (35%) and followed by aplastic anemia (32.5%). Conclusion: Pancytopenia is a common clinical problem encountered in clinical practice and the major differential diagnostic considerations of pancytopenia are aplastic anemia, megaloblastic anemia and hematological malignancies. J MEDICINE JUL 2019; 20 (2) : 68-71

Background: Serum tumor markers are convenient, non-invasive, acceptable to patients and play an important role as an ancillary tumor diagnostic tool. CA 19-9 has become a common tumor marker, specific for digestive system tumors. The study was carried out to determine the value of CA 19-9 as a tumor screening marker among healthy individuals. Materials and Methods: This study had been carried in Dhaka Medical college Hospital from January 2016 to January 2018. The serum CA 19-9 level was detected using a microsome luminescence method. Individuals with high CA 19-9 levels underwent further examination, including routine fecal testing, thoracic and abdominal computed tomography (CT) scan, gastroscopy, and colonoscopy. These individuals had regular follow-up examinations. Results: Over a 3-year period, the serum CA19-9 levels of 960 healthy individuals were estimated. The CA 19-9 level of 15 individuals was positive (positive rate: 1.56%), including 7 men (7/699; 1.001%) and 8 women (8/261; 3.06%). There was a significant difference between males and females (p<0.01), The overall tumor detection rate was 0.72% (7/960) including 6/699 men (0.85%) and 1/261 women (0.38%). Conclusion: Therefore, elevated CA 19-9 level can be used to assist in the diagnosis malignancy. J MEDICINE JUL 2019; 20 (2) : 92-94

This prospective cross sectional study was conducted in Dhaka Medical College Hospital, Dhaka during July, 2013 to December, 2013. Hundred patients were included in this study. Peptic ulcer disease, presented as upper abdominal pain is one of the common disease with a number of underlying causes. Prospective analyses of 100 patients with upper abdominal pain were studied at medicine units of Dhaka Medical College Hospital, Dhaka. Of these 36 patients belonged to peptic ulcer, 20 patients to irritable bowel syndrome and 22 patients to non-ulcer dyspepsia. Next in order were helminthiasis (5 patients), cholelithiasis (4 patients), gastric carcinoma (4 patients), liver abscess (5 patients) chronic pancreatitis (3 patients) and acute pancreatitis (1 patient). Mean age incidence in this series was 39.47 years. Male and female ratio was 1.54:1. Forty patients were smoker with male and female ratio of 3.44:1.All patients had presenting feature of upper abdominal pain. Commonest site of pain was in the epigastrium in 48.08% of cases.Pain was burning in 43.27% cases, periodic pain in 24.03%, and nocturnal hunger pain in 33.65% of cases.Relief of pain after taking food were observed in 38.46%. Epigastric tenderness was present in 56.73% patients.The diagnosis of peptic ulcer disease, irritable bowel syndrome and non-ulcer dyspepsia, the three leading causes of upper abdominal pain, were suspected by history and physical examination but it was difficult to interpret these on clinical ground alone .Some routine and some selected investigation were done for confirmatory diagnosis.In this series, significant disparity detected between clinically diagnosed peptic ulcer diseases 90.38% and endoscopically confirmed peptic ulcer disease, 34.62% cases. As a consequence of wrong diagnosis of PUD, there are huge misuses of ulcer healing drugs and a great economic burden on patients (300 taka per month) and on the nation.DOI: http://dx.doi.org/10.3329/jom.v16i1.22386 J MEDICINE 2015; 16 : 27-34

Bangladesh Journal of Medicine, Vol 23 No 2, 2012, Page 67-75 DOI: http://dx.doi.org/10.3329/bjmed.v23i2.14989