Background: Ankylosing spondylitis can lead to heart disease, including aortic incompetence, conduction defects, mitral valve disease, cardiomyopathy, and pericarditis. Early detection of cardiac abnormalities is crucial for effective treatment and prognosis, as they increase with age, disease duration, and peripheral arthritis presence. Objectives: This study aimed to determine the type, prevalence, and extent of cardiac involvement in patients diagnosed with ankylosing spondylitis. Methods: The study were collected in the Department of Medicine and Rheumatology units of Bangabandhu Sheikh Mujib Medical University and Dhaka Medical College Hospital from January 2022 to December 2022. Diagnosis was established based on clinical features, physical examinations, and relevant laboratory and imaging studies. Patients with a history of rheumatic fever, syphilis, or those who declined participation were excluded from the study. Results: A total of 80 patients with ankylosing spondylitis underwent clinical examination, electrocardiography, and echocardiography to assess cardiac involvement. Among the participants, eight patients (10%) were found to have aortic insufficiency. Two patients had both aortic insufficiency and first-degree heart block, one had only first-degree heart block, and one had mitral insufficiency. Presents the cardiovascular manifestations detected in 12 patients (14%) with ankylosing spondylitis. Peripheral arthritis was present in 64% of the 12 patients with cardiovascular lesions, compared to only 34% of the 68 patients without such lesions. Conclusion: This hospital-based observational study investigated cardiac involvement in ankylosing spondylitis patients. Due to the small sample size, definitive conclusions were difficult to make, but the findings suggest that cardiac involvement is relatively common, emphasizing the need for early detection of cardiac abnormalities for effective treatment and prognosis.

Small bowel lymphoma associated with celiac disease is rare. The annual incidence varies from 0.5 to 1 per million inhabitants. We report two cases of small bowel lymphoma associated with celiac disease. The first case is a 50-year-old patient, treated for celiac disease since 2010 and whose tumor was revealed on abdominal CT as part of the etiological assessment of abdominal pain with an anemic syndrome. In the other case, it was a 52-year-old patient presenting the same symptomatology, in whom endoscopy revealed total villous atrophy, indicating the diagnosis of celiac disease, and CT showed a small bowel tumor. Both patients underwent segmental resection with single-stage anastomosis. The anatomopathological study concluded to a small lymphoma. Adjuvant chemotherapy was administered in both cases, and their evolution was favorable.

Ectopic spleen is a condition in which the spleen does not sit in the left hypochondrium but has an atypical, often pelvic, location. We report the case of a 35-year-old patient suffering from chronic abdominal pain for 11 years associated with an episode of hematemesis, pollakiuria and dysuria, with anemia and notion of multiple transfusions. Abdominal ultrasound found an ectopic spleen in the pelvic position, enlarged in size, with multiple collateral venous circulations and extensive partial thrombosis of the splenic vein. A total splenectomy by midline laparotomy was performed. Perioperative exploration found a bulky pelvic spleen with a long and tortuous splenic pedicle, involuted in 3 turns without splenic infarction. When the splenic artery is clamped, the colonic and gastric varicose veins lose half their diameter, so the decision is made to perform total splenectomy. Post-splenectomy antibiotic prophylaxis and vaccination was administered. The follow-up was favorable, with a follow-up of 4 years. The patient was then lost sight of.

Duodenal adenocarcinoma being the most common tumor of the small intestine: 33 to 48%, it remains very rare representing only 0.5% of malignant tumors of the digestive tract. Our retrospective study focused on four cases during the period 2017-2022 with an average age of 53.25 years and a sex ratio of 1M/3F. The clinical signs were varied with a predominance of cholestatic jaundice and a deterioration in general condition. The diagnosis was confirmed thanks to the endoscopy and the anatomopathological study of the biopsies carried out in all our patients. All our patients benefited from a surgical treatment, curative or palliative, which consisted of three cephalic pancreaticoduodenectomy and in one case a gastro-jejunal anastomosis. The post-operative follow-up was simple in two patients, one of our patients presented with gastroparesis which progressed well under medical treatment. In addition, we deplore a death which presented a hemoperitoneum related to a hemostasis disorder.

Hepatic teratoma is an extremely rare tumour. Since 1898 only 28 cases of hepatic teratoma have been reported in the literature, including 21 in pediatrics. The diagnosis is often confirmed by the anatomopathological study and the therapeutic approach is multidisciplinary based essentially on surgery. We report the case of a 45-year-old woman with a history of ductal carcinoma of the right breast for which she underwent surgery. The patient presented with pain in the right hypochondrium, a diagnosis of hydatid cyst of the liver was made based on a cystic image of the right liver on ultrasound. It showed a heterogeneous thin-walled cystic image in the right liver suggesting a type IV hydatid cyst. The MRI was in favor of a fluid lesion of the hepatic dome evoking a remodeled hydatid cyst. During surgery, the liver was found of normal size and segment VIII is the seat of an oval formation 70/60 mm in diameter. A resection of the cystic formation with a closed cyst was performed. Histological analysis concluded with the diagnosis of mature teratoma with no signs of malignancy. After a follow-up of 12 years, the patient is in good health and without recurrence.

Acute intestinal intussusception is a rare condition in adults. In the majority of cases, it is secondary to a tumor, which can be benign or malignant. Intestinal intussusception caused by a lipoma is exceptionally rare. We report a case of ileocolic intussusception caused by an ileal lipoma.

Tuberculosis (TB) has been a significant public health burden in Bangladesh, and to address this issue, the country has implemented the Directly Observed Treatment Short-Course (DOTS) intervention since 1993. The government has partnered with non-governmental organizations (NGOs) to implement community-based TB control programs. Research has shown that this approach has led to significant success in TB control, including a high case detection rate (> 81%), successful TB treatment (95%), and reduced TB mortality (27/100,000 population) over the past two decades. However, there are still significant concerns regarding the control of people living with HIV-TB (PLHIV-TB), multidrug-resistant TB (MDR-TB), and latent TB infection (LTBI). Additionally, the COVID-19 pandemic has slowed down the progress of TB control efforts. Challenges such as inadequate linkages with local NGOs, social stigma, gender discrimination in TB diagnosis, inadequate human resources, and poverty factors further exacerbate the situation. This study calls for a paradigm shift in TB control intervention towards a rights-based and need-based approach, considering gender, ethnicity, elderly people, and children. By addressing these challenges and implementing a comprehensive approach to TB control, Bangladesh is expected to achieve its goal of ending TB by 2035.

Background: Endoscopic ultrasound-guided biliary drainage (EUS-BD) is a relatively new therapeutic modality in the arsenal of endoscopists for attaining satisfactory biliary drainage when traditional ERC fails. The aim of our study is to describe the first Moroccan experience with EUS-BD in patients with malignant biliary obstruction after a failed or inaccessible ERCP. Methods: This is a retrospective study conducted at Ibn Sina Hospital, from Mars 2018 to July 2022, which include 27 patients with an inoperable or metastatic malignant biliary obstruction who underwent endoscopic ultrasonography-guided biliary drainage (EUS-BD) in case of endoscopic retrograde cholangiopancreatography (ERCP) failure. Results: From a total of 288 patients with malignant biliary obstruction,27 underwent EUS-BD (9,3%), 15 EUS-guided hepaticogastrostomy (55,5%) and 12 EUS-guided choledocoduodenostomy (44,4%) were performed. The mean age was 62.5 years (age range: 23-74 years), a male predominance of 59% was noted, cholestatic jaundice was present in 100% of patients and associated with pruritus in 92.59% of cases. The mean level of Total Bilirubin was 190 mg/l. The causes of biliary obstruction were: an inoperable pancreatic head mass in 13 patients(48,1%), a cholangiocarcinoma in 7 patients (25.9%), an ampullary mass in 4 patients(14,8%), a gallbladder cancer with hepatic and duodenal invasion in one patient (3,7%), a gastric antropyloric adenocarcinoma with pancreatic head invasion in one patient (3,7%) and Duodenal adenocarcinoma in one patient (3,7%).The leading causes of failed ERCP were secondary to tumor infiltration of the duodenal wall and critical duodenal stenosis in 11 cases (40,7%), in 9 cases due to a difficult cannulation (33.3%) and in 7 cases due to a failure to pass the stricture by ERCP (25.9%). In EUS-HG The technical and the clinical success rates were 86.6% (13/15) and 84.6% (11/13), respectively, the complication rate was 13.3% (2/15) including one case of stent migration complicated with bile leak and one case of cholangitis. In EUS-CD The technical and the clinical success rates were 91.6% (11/12) and 81.8% (9/11)), respectively, the complication rate was 16.6% (2/12) including two cases of cholangitis. The technical and the clinical success rates in all EUS-BD were 85.1% (24/27) and 83.3% (20/24), respectively. The complication rate was 14.8% (4/27). Conclusion: EUS-BD appears to be an effective and safe therapeutic option for biliary decompression in cases where ERCP fails.

Background: Worldwide, diabetes mellitus (DM) is a leading cause of death and disability. Iron overload is increasingly being connected to insulin resistance in patients with type 2 diabetes mellitus (T2DM). Free iron causes the assembly of reactive oxygen species that invariably steer the body’s homeostasis toward oxidative stress-mediated diabetic complications. We have very limited research-based data regarding the total iron binding capacities in type 2 diabetes mellitus patients. Aim of the study: The aim of the study was to compare the total iron binding capacities (TIBC) between type 2 diabetes mellitus patients and healthy individuals. Methods: This cross-sectional study was conducted in the Department of Biochemistry, Dhaka Medical College (DMC), Dhaka, Bangladesh from July 2015 to June 2016. In total 100 participants were enrolled in 2 groups as the study subjects. In group A, in total 50 diagnosed patients with type 2 diabetes mellitus (T2DM) were included. On the other hand, in group B, 50 age and sex-matched healthy individuals were included. Properly written consent was taken from all the participants before data collection. All the demographic and clinical information of the participants was recorded. All data were processed, analyzed and disseminated by using MS Excel and SPSS version 23.0 program as per necessity. Results: In this study, the mean serum iron in group A and group B were 112.7 μg/dl and 87.6 μg/dl respectively. The mean serum ferritin concentration in group A and group B were 199.3 μg/dl and 107.0 μg/dl respectively. There was a statistically significant increase in serum iron and serum ferritin concentrations in group A compared to group B. Both serum ferritin and serum iron levels showed strong positive correlations with HbA1C ((r=0.724, p<0.001, r=0.724, p<0.001) and FPG (r=0.724, p<0.001, r= 0.724, p<0.001). The mean TIBC level was found 184 μg/dl in group A and 318.8 μg/dl in group B. In analyzing the total iron binding capacities (TIBC) between the groups we observe that the TIBC (µg/dl) levels in group A and group B were 184.0±79.5 and 318.8 ± 14.0 µg/dl respectively. The TIBC levels were significantly lower in group A than in group B (<0.001). Conclusion: The total iron binding capacity level is significantly lower in type 2 diabetes mellitus (T2DM) patients than that in healthy individuals. Routine screening for iron status along with glycemic control in diabetic patients might help prevent complications in such patients.