This cross sectional study was carried out in the department of gastroenterology, BIRDEM, Dhaka from

On a worldwide basis, cancer of esophagus is the sixth most common malignancy. In developing countries it ranks third in frequency and has one of the worst prognoses of any neoplasm of the human body. It is essential to detect the malignancy early and to determine the extent of the disease to ensure the best option for a cure. The aim of this study was to evaluate the frequency and pattern of Oesophageal carcinoma with respect to age and sex groups and to determine the trends of histology, site distribution and risk factors of Oesophageal carcinoma. A prospective study was carried out in 102 patents with Oesophageal carcinoma between May 2007 and April 2010 in Laxmipur, Feni & Kushtia district. The data were recorded in prestructured proforma and analyzed later on. The site of tumor was classified as upper, mid & lower esophagus. A high frequency of cancer was seen in males with a total of 79 (77.5%) cases as compared to 23 (22.5%) females with male to female ratio of 3.43:1. Maximum number of the patients of Oesophageal carcinoma was seen in 5th and 6th decades of life. Dysphagia was the main presenting complain in 94.11 % of patients. Tobacco & betel nut chewing are strong risk factors for Oesophageal cancer. Squamous cell carcinoma was the most common malignancy seen in (97) 95.1% of patients. The remaining (5) 4.9% had Adenocarcinoma. Most of the Oesophageal carcinoma 49 (48.04%) were located in the lower third of esophagus followed by middle third 41 (40.19%). Key words: Oesophageal carcinoma; Risk factors; Trends of disease. DOI: 10.3329/jdmc.v19i1.6248 J Dhaka Med. Coll. 2010; 19(1) : 29-32.

Double balloon enteroscopy (DBE) is a newly developed endoscopic modality for diagnosis and treatment of small bowel disorders. The aim of this study was to evaluate the diagnostic and therapeutic impact of DBE in patient with suspected small bowel disease. This was a prospective study. Sixty one double balloon enteroscopy procedures (30 antegrade 31 retrograde) were done in thirty six patients(20M/16F, mean age 40±12.5 range 16-65 years ) at gastroenterology department, Sir Salimullah Medical College, Dhaka between October 2011 and September 2012. Indications for DBE included chronic abdominal pain 14(38.9%), obscure GI bleeding 11(30.56%), Small bowel obstruction 05(13.89%), and chronic diarrhea 06(16.67%). The morphologic findings were ulcerations 13(36.11%), growth 03(8.33%), vascular ectasia 03(8.33%) and polyp 01(2.78%). Therapeutic interventions were performed in one patient only. No serious complications were observed. Diagnostic yields in case of chronic abdominal pain, chronic diarrhea, obscure GI bleeding and small bowel obstruction were 50%, 66%, 63% and 40% respectively. The findings were adenocarcinoma 04(11%), lymphoma 03(8.4%), tuberculosis 03(8.4%), non specific findings 05(13.9%), IPSID 01(2.8%), crohn's disease 01(2.8%), vascular ectasia 03(8.33%) and normal 16(44.44%). DBE is well tolerated, feasible and useful technique for the diagnosis as well as treatment of small intestinal disorders.

Consecutive fifty subjects having fever with altered consciousness admitted into medical wards in Rangpur Medical College Hospital, Rangpur were selected to find out the aetiology and its correlation with laboratory findings of the subjects. Subjects having prolonged fever, (more than 21 days) pregnancy, trauma, drug intoxication, cerebrovascular disease and metabolic causes including liver diseases were excluded from the study. Study revealed that majority of the study subjects were below 39 years (76%) of age and most of them were male (80%). Predominant cases were found to be pyogenic meningitis (44%), followed by encephalitis (32%), cerebral malaria (20%) and tubercular meningitis (4%). Neutrophilic leucocytosis, high cerebrospinal fluid protein, very high cell count and low sugar were a common observation in pyogenic meningitis while very high erythrocytic sedimentation rate was the main findings in tubercular meningitis and high lymphocytic count was observed in encephalitis as compared to other. So it is concluded that subjects suffering from fever with altered consciousness are 1. Predominantly male of young age group. 2. pyogenic meningitis is a predominant cause. 3. Cerebrospinal fluid findings were observed to have usual findings in disease of pyogenic meningitis, encephalitis and tubercular meningitis.

-Chiari syndrome (BCS) is a rare disease in population characterized by hepatic venous outflow obstruction at a site that may vary from the level of the small hepatic veins up to the junction of the inferior vena cava with the right atrium . Here we presented a case of 35 year old male who presented with abdominal pain, abdominal distension and leg oedema . Subsequent physical examination, laboratory data, abdominal ultrasonography and duplex study all confirmed the diagnosis of BCS with Protein C , protein S , and antithrombin III deficiency . But we were unable to detect whether these factor deficiency were primary or secondary. Genetic study may be used to elucidate the cause. Whether primary or secondary, standard protocol should be used to treat Budd Chiari syndrome with these factor deficiency.(J Banagladesh Coll Phys Surg 2013; 31: 223-226)