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Case History: A 61-year-old male patient presented in the outpatient department of medicine in Capital Hospital Islamabad, complaining of severe epigastric pain that had been increased in intensity since last 15 days. The onset of pain was sudden, burning and pinching in character, aggravated by intake of food and relieved by strong painkillers and pain radiated to back. The patient also had low-grade fever since last 10 days and generalized weakness. Pain starts a few minutes after taking a meal. There was no history of dysphagia, melena, shortness of breath, cough, chest pain or discomfort, food regurgitation, vomiting, hematemesis, altered bowel habits and burning or difficult micturition. There was no significant past medical or surgical history. The patient was a non-smoker, had decreased appetite and sleep disturbance. There was no history of Diabetes mellitus , hypertension, heart diseases , asthma or cancer in the family. On examination, his pulse rate was 76 and blood ...

Stomach cancer usually presents with the symptoms of indigestion, abdominal fullness, burping, loss of appetite and heart burn. Late symptoms include, hemoptysis, melena, weight loss, weakness or fatigue, and pain after eating. Obstruction of gastric outlet, gastro-esophageal junction and pleural effusion are also late symptoms. Usually it is difficult to catch the gastric cancer in its early stages because patients of gastric cancer usually present with the similar symptoms as those of Peptic Ulcer Disease . So patients keep on getting treatment of peptic ulcer disease while cancer continue to grow. At the time of diagnosis, usually cancer has already been reached to advance stages.   In Capital Hospital Islamabad, a 61 year old male patient presented in emergency department complaining of difficulty in swallowing, unable to eat any thing, food regurgitation, vomiting, nausea, lack of appetite, epigastric pain, easy fatigability and significant weight loss. Sometime he also notice...

Lutembacher syndrome is a rare form of a cardiovascular syndrome characterized by the presence of Mitral Stenosis and Atrial Septal Defect at the same time. In simple words, if a patient has both atrial septal defect and mitral stenosis at the same time then you can label such patient as a case of Lutembacher syndrome. Pathophysiology or Mechanism of Lutembacher syndrome Lutembacher syndrome is the name of the presence of both atrial septal defect and mitral stenosis in the same patient and at the same time. The cause these two conditions that is, atrial septal defect and mitral stenosis can be anything. It doesn’t matter what causes these two conditions, if these two conditions are present in a patient at the same time then this is a case of Lutembacher syndrome. The most common cause of mitral stenosis is valvular heart disease or rheumatic heart disease . Rheumatic heart disease may lead to mitral stenosis or MS can be congenital. On the other hand, the atrial septal defect c...