Mymensingh Medical Journal

Permanent URI for this collection

Browse

Recent Submissions

Now showing 1 - 20 of 367
  • Item
    What is known to us About Renal Function of our Retired Peoples?
    (2009-01-03) Khan, H U; Latif, S A
    Background: Bangladesh is one of the twenty countries in the world with the largest elderly populations, and by 2025, along with four other Asian countries, will account for 44% of world's total elderly population. This rapidly increasing population is a new and important group in terms of social and health policy in the country. As retired geriatric population is increasing day by day and there is a striking increase in their life expectancy and a decrease kidney function recognized as risk factor for morbidity and mortality in the elderly so evaluation of the renal function of retired persons are essential. Objective: To assess the renal function of retired geriatric population by estimation of creatinine clearance by Cockcroft-Gault formula. Design: This was a cross-sectional study. Participant: Retired persons aged 57 years and above without known hypertension, diabetes, renal diseases as study group and healthy adult aged 18-55 years as control group were included in this study. All were obtained from different areas of greater mymensingh districts. Intervention: Under strict aseptic precaution, venous blood was collected and serum creatinine of all were measured by deproteinization method and then calculation of creatinine clearance was done by using Cock-croft Gault formula. Outcome measures: Serum Creatinine, Creatinine clearance. Result: Significant decrease of creatinine clearance was found in the study group (57 years and above) in comparison to control group (p<0.001). There is progressive decrease of creatinine clearance values by age. Limitation: Calculation of Creatinine clearance by Cock-croft formula is not unambiguous and still not accepted unanimously globally. The other tests of renal function were not done. Conclusion: Though the mean creatinine clearance values were significantly decreased in 57 years and above which was progressively decreased by age, yet values were within normal physiological limits. So the retired geriatric population has good renal function in our setting.
  • Item
    Role of Micro-ESR and I/T Ratio in the Early Diagnosis of Neonatal Sepsis.
    (2009-01-03) Walliullah, S M; Islam, M N; Siddika, M; Hossain, M A; Chowdhury, A K
    This prospective study was undertaken in Dhaka Shishu Hospital from 15th March 2005 to 15th October 2006 to determine the role of micro-ESR and immature and total neutrophil (I/T) ratio in early diagnosis of neonatal septicaemia. Eighty suspected cases of septicaemia admitted in neonatal ward of Dhaka Shishu Hospital were included in this study. Patients those who had history of perinatal asphyxia, infant of diabetic mother, congenital cyanotic heart disease etc. were excluded from the study. Thirty neonates without sign symptoms of septicaemia admitted for other causes like jaundice, feeding problems etc. were taken as a control group. After taking informed consent data were collected in structured questionnaire. Following hematological investigations like total WBC count, differential count, absolute neutrophil count, band cell count, platelet count, CRP, blood culture were done. Micro-ESR was done as bed side test. I/T ratio detected from total neutrophil and band form count. Patients with positive blood culture were categorized as definite sepsis. Patients with negative blood culture but abnormal hematological report suggestive of sepsis were categorized as probable sepsis. Those who had no signs of sepsis were categorized as control group. Micro-ESR more than age of the patient in days + 3mm in 1st hour were considered significant for sepsis. I/T ratio more than 0.2 was considered positive for sepsis. Sensitivity and specificity of micro-ESR was 63.3% and 60% respectively. Sensitivity and specificity of I/T ratio was 70% and 56% respectively. Combination of micro-ESR and I/T ratio showed high sensitivity (80%) and specificity (70%).
  • Item
    Multifocal skeletal tuberculosis in children.
    (2009-01-03) Rahman, M A; Mutanabbi, M; Rahman, M H; Arefin, K E; Helal, M A
    Multifocal bone involvement is though rare but is reported from some countries where tuberculosis is endemic. Here we report a case of three years old boy was admitted in Bangabandhu Sheikh Mujib Medical University, Dhaka with the complaints of difficulty in walking ,low grade fever for six months, swelling over the back, elbow joint, knee joint and upper part of forearm and legs for two months. Family history of tuberculosis was positive. Mantoux test was 18mm, ESR 85mm in first hour, chest X-ray reveals right hilar lymphadenopathy, X-ray dorsolumber spine shows wedge shaped deformity in T11, L4 and with paravertebral collection from L2-L4. X-ray of legs, knee joint and forearms show multiple lytic lesions in shaft with periosteal reaction and cortical thickening. Ultrasonograph of whole abdomen shows psoas abscess. Culture of bone marrow aspirate reveals Mycobacterium tuberculosis. Patient was given an anti tubercular regimen with Rifampicin, Isoniazid, Pyrazinamide and Streptomycin for initial two months which to be followed by Rifampicin and Isoniazid for another 10 months.
  • Item
    Association between Morphological Changes of Nail and Nail Arsenic Level in Patients with Arsenicosis.
    (2009-01-03) Shafiquzzaman, M; Jahan, M K; Rahman, M M; Islam, M T; Miah, M A; Kamal, M; Islam, M M; Choudhury, A M; Chowdhury, S A; Mohammad, N
    This case-control type of analytical study was conducted in the Department of Dermatology and Venereology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh to find out the association between morphological changes of nail and nail arsenic level in arsenicosis patients. Majority of arsenicosis patients were male (56.67%). The mean age of the cases was 43.07+/-13.73 years. Nail changes were found in 26.67% of cases, most were nail dystrophy (23.33%) and rest were Mee's line (3.34%). There was significant difference between cases with or without nail changes and nail arsenic level. But cases with or with out nail changes had a significant difference between duration of intake of arsenic contaminated water. There was no correlation between nail changes and nail arsenic level for nail dystrophy and Mee's line. The study result failed to establish association between the morphological changes of nail and nail arsenic level.
  • Item
    Kartagener's Syndrome.
    (2009-01-03) Dhar, D K; Ganguly, K C; Alam, S; Hossain, A; Sarker, U K; Das, B K; Haque, M J
    Kartagener's Syndrome or Immotile Cilia Syndrome, a variant of Primary Ciliary Dyskinesia (PCD), is a rare autosomal recessive genetic disorder caused by defect in the tiny hair like structure, the cilia lining the respiratory tract (upper and lower), sinuses, eustachian tubes, middle ear and fallopian tubes. Here electron microscopy shows abnormal arrangement of ciliary tubules and patients with Kartagener's syndrome has an absence of dynein arms at the base of the cilia. The inability of cilia to move results in inadequate clearance of bacteria from the air passages, resulting in an increased risk of infection and causing bronchiectasis. Another result of ciliary immobility is infertility. A 60 years old lady was diagnosed as a case of Kartagener's syndrome. She had history of chronic cough for 20 years, irregular fever for 20 years and occasional shortness of breath for 5 years. Relevant investigations revealed dextrocardia, situs inversus, bilateral maxillary sinusitis with non pneumatised frontal sinus and bronchiectasis. She was treated with low concentration oxygen inhalation, antibiotic, bronchodilator, chest physiotherapy including postural drainage, vitamins and other supportive treatment.
  • Item
    Comparison between DOT EIA IgM and Widal Test as early Diagnosis of Typhoid Fever.
    (2009-01-03) Begum, Z; Hossain, M A; Musa, A K; Shamsuzzaman, A K; Mahmud, M C; Ahsan, M M; Sumona, A A; Ahmed, S; Jahan, N A; Alam, M; Begum, A
    A recently developed DOT enzyme immunoassay known as "Typhidot" for detecting IgM antibody against 50 KDa OMP antigen of Salmonella typhi, was evaluated on 100 clinically suspected typhoid fever cases and 40 age-sex matched controls, in the Department of Microbiology, Mymensingh Medical College during, the period from June 2006 to July 2007. Blood culture, Widal test, and DOT EIA for IgM test were performed in all patients. Among 100 clinically suspected typhoid fever cases, 35 were subsequently confirmed on the basis of positive blood culture for S. typhi and/or significant rising titre of Widal test. The DOT EIA IgM test could produce results within 1 hour. The result of the DOT EIA IgM test showed a good diagnostic value for typhoid fever. The sensitivity, specificity, positive and negative predictive value of the test was found as 91.42%, 90.00%, 88.88% and 92.30% respectively. On the other hand corresponding values for Widal test were of 42.85%, 85.00%, 71.42% and 62.96% respectively. Thus, The DOT EIA IgM seems to be a practical alternative to Widal test for early diagnosis of typhoid fever.
  • Item
    PCR for mecA Gene of Methicillin Resistant Staphylococcus Aureus.
    (2009-01-03) Zahan, N A; Hossain, M A; Musa, A K; Shamsuzzaman, A K; Mahamud, M C; Mamun, A A; Paul, S K; Ahmed, S; Sumona, A A; Begum, Z; Alam, M; Yusuf, M A; Uddin, M S
    The study was under taken to detect mecA gene of methicillin resistant Staphylococcus aureus (MRSA) by PCR. It was carried out in the department of Microbiology, Mymensingh Medical College in collaboration with the Department of Medicine under the Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh between the periods from July 2006 to June 2007. A total of 40 S. aureus strains were used in this study. Isolates of S. aureus were identified by standard microbiology technique and their antimicrobial susceptibility test was done by disk diffusion method according to NCCLS. Minimum inhibitory concentration (MIC) of oxacillin was determined for all isolates by standard agar plate dilution method. All strains were tested for mecA gene by PCR. Out of 40 S. aureus strains 15(37.5%) were detected as MRSA by disk diffusion and agar dilution method but 10(25%) yielded mecA gene by PCR. Detection rate of MRSA by disk diffusion and agar dilution test showed significant difference to that by PCR (p<0.001).
  • Item
    Bardet biedl syndrome.
    (2009-01-03) Habibullah, M; Mohiuddin, A A
    A young boy of 9 years hailing from Fulpur, Mymensingh was admitted in the department of Ophthalmology, Mymensingh Medical College Hospital, Mymensingh, Bangladesh on the 26th November, 2007 with the complaints of dimness of vision of both the eyes and night blindness since birth. The boy suffered poor mental performances with delayed mild stone development. He was apathetic looking and below average IQ with short stature. Visual acuity of this patient recorded 6/60 both the eyes with nystagmus. Fundus examination revealed waxy disc atrophy, arteriolar attenuation and retinal degeneration both the eyes. He had polydactilism, trunkal obesity, hypogenitalism. On the basis of history, clinical examination and relevant investigations the patient was diagnosed as Bardet-Biedl Syndrome.
  • Item
    Central nervous system tuberculosis and adjuvant corticosteroid therapy.
    (2009-01-03) Rahman, M L; Basher, A; Rashid, M; Islam, M; Kuddus, R; Arif, S M; Faiz, M A
    Tuberculous involvement of central nervous system is one of the important health issues causing high mortality and morbidity. Uncertainty and doubt dominate all aspects of CNS tuberculosis. Diagnosis is mainly based on clinical features, cerebrospinal fluid changes, and imaging characteristics. Few studies have shown that corticosteroids improve the clinical outcome, although the precise mechanism of action remains tentative. All the cases were selected on strong clinical suspicion of CNS tuberculosis. They were graded according to tuberculous meningitis (TM) severity grades. In this connection, we studied 13 patients in one medicine unit over 12 month's period to see the effect of corticosteroid as part of the outcome. Nine patients (69.23%) were in grade II, three (23.08%) patients were in grade III, and one (7.69%) was in grade I. Seven patients (53.85%) had tuberculous meningitis and six (46.15%) had tuberculoma (CT or MRI). Out of 13 cases 3 patients (23%) died in the hospital and 10 patients (77%) improved, of whom 2 patients (20%) recovered completely and 8 patients (80%) had residual neurological deficit. Our study suggests that the early detection of CNS tuberculosis is the most important prognostic factor. Timely started anti-Koch's treatment with adjuvant corticosteroid therapy has a direct bearing on patient outcome.
  • Item
    Quantitation of proteinuria in nephrotic syndrome by spot urine protein creatinine ratio estimation in children.
    (2009-01-03) Biswas, A; Kumar, R; Chaterjee, A; Ghosh, J K; Basu, K
    In Nephrotic Syndrome the amount of protein excretion is a reflection of activity of disease. Quantitative measurement of proteinuria by a 24-hour urine collection has been the accepted method of evaluation. Recent studies have shown that calculation of protein/creatinine ratio in a spot urine sample correlates well with the 24-hour urine protein (24-HUP) excretion. A study was conducted to compare the accuracy of a spot urinary protein/creatinine ratio (P/C ratio) and urinary dipstick with the 24-hour urine protein. Fifty two samples from 26 patients of nephrotic syndrome were collected. This included a 24-hour urine sample followed by the next voided random spot sample. The protein/creatinine ratio was calculated and dipstick was performed on the spot sample. This was compared with the 24-hour urine protein excretion. The correlation between the three samples was statistically highly significant (p<0.001) for all levels of proteinuria. The normal value of protein/creatinine ratio in Indian children was also estimated on 50 normal children admitted in the ward without any renal diseases calculated to be 0.053 (SE of mean +/-0.003).
  • Item
    Pattern of ocular trauma admitted in a tertiary hospital.
    (2009-01-03) Quayum, M A; Akhanda, A H
    Ocular trauma is an important cause of ocular morbidity. This prospective study was conducted to identify primarily the population at risk, sources of eye injuries and the common barriers for their early management. Cases were selected randomly during the period Aug/2006 to March/2008 among the patients admitted in the department of ophthalmology, Mymensingh Medical College Hospital, with the history of ocular injury. A total of 100 eyes in 97 patients were included in the study. Age ranges were 1.5 years to 75 years. Male were 78.35% (n=76) & female were 21.65% (n=21). 56.00% (n=56) injuries were accidental occupational injuries. Common sources of eye injury included sharp objects used in occupational activities 43% (n=43), blunt objects 23% (n=23), Chemicals 7% (n=7), Projectile objects 8%, (n=8), Bird-beak 5% (n=5), agricultural trauma 3% (n=3) and miscellaneous 11% (n=11). Young adult males engaged in industrial, mechanical, agricultural or domestic works are at particular risk for ophthalmic trauma. Poverty, ignorance, indigenous treatment, remote communications and lack of supervised and collaborative management seems to be the possible barriers for the early management of ocular injuries. Preventive measures are recommended to adopt not only in the workplaces but also in domestic, recreational, sports and transport settings.
  • Item
    Patient with bilateral breast enlargement and hypospadias.
    (2009-01-03) Ali, A A; Ahmed, T; Rashid, M M
    A 20 year old man was admitted in the surgical unit of Dhaka Medical College Hospital on August 2007 presented with Hypospadias & underdeveloped penis from childhood, gradual enlargement of both breasts for the last 10 years, absence of axillary and pubic hair from puberty & painful swelling of both testes for the last 3 years. The patient was regarded as a female upto the age of 10 years. He has got no voice change since puberty. On examination he had average body built, there was bilateral gynaecomastia, hypospadias, rudimentary penis & absence of pubic and axillary hair. His testosterone level, serum prolactin level, serum progesterone level, serum estradiol level was done. Cytology on buccal smear done and ultrasonography revealed no ovary and uterus. Ultimately patient was diagnosed as a case of androgen insensitivity syndrome (AIS). The case is reported for clinical awareness & to share our experience.
  • Item
    Effect of zinc on growth of preterm babies.
    (2009-01-03) Islam, M N; Chowdhury, A K; Siddika, M; Hossain, M A; Hossain, M K
    Zinc is being recognized increasingly as an important element in human growth, development and immunological function. It is probably the most intensely studied microelement in newborn nutrition. Zinc deficiency is common in young infants in the developing world and is associated with reduced immunocompetence and increased rates of serious disease. Preterm neonates are especially vulnerable because of preterm delivery and low birth weight. The preterm baby has very limited stored energy and needs an adequate supply of nutrient. Preterm infant have high zinc dietary requirements as 60% fetal zinc is acquired during third trimester of pregnancy. Low concentration of zinc was found in pre-term low birth weight babies in different studies. Studies showed that before supplementation serum zinc level in perterm low birth weight babies were 62+/-12.4mugm/dl, 65mugm/dl, 54+/-14.4mugm/dl and after supplementation serum zinc level were 105.8+/-16.6mugm/dl, 86.4+/-24.7mugm/dl respectively. At the same time mean weight & length of supplementation and without supplementation group were 6084 gm vs. 5280gm, 2779+/-638.7gm vs. 2474.6+/-441.8gm and length 23.7cm vs. 21.4cm, 46.49+/-2.6cm vs. 44.1+/-2.8cm respectively. So supplementation of zinc in preterm babies causes improved growth and development. Various reports showed beneficial effect of long supplement in early growth of pre-term babies. However long term follow up studies are needed to evaluate the beneficial effect of zinc supplementation on growth of preterm babies.
  • Item
    Evaluation of 100 cases of ascites.
    (2009-01-03) Mahmood, G; Debnath, C R; Mandal, A K
    This has been a descriptive cross sectional study on 100 consecutive adult cases of ascites. They were studied regarding the incidence of underlying causes, variable clinical presentations and the co-relation of investigations with clinical features during the period of September, 2006 to August, 2007 in Sher-e-Bangla Medical College Hospital, Barisal, Bangladesh. Diagnosis of ascites was based on history, clinical examination & USG examination. Among the 100 cases, male were 68 & female were 32, age range was 13-61years. Causes of ascites were cirrhosis of liver 68%, tubercular peritonitis 9%, hepatocellular carcinoma 8%, congestive cardiac failure 6%, malignancy 4%, nephrotic syndrome 3%, lymphoma 2% and others 4%. Cirrhosis of liver is the major cause of ascites in our study. Many of the patients with cirrhosis & hepatocellular carcinoma were positive for HBsAg & anti HCV implying that hepatitis B & C viruses play a positive role in this condition.
  • Item
    Outcome of pregnancy in women 35 years of age and above.
    (2009-01-03) Jahan, M K; Shafiquzzaman, M; Nahar, K; Rahman, M; Sultana, N; Rahman, M M; Begum, R
    Pregnancy outcome among women in the age group of 35 years and more are considered to be less favorable than those of younger women. To observe those, this case control study was conducted in the department of Obstetrics & Gynaecology, Mymensingh Medical College Hospital during the period of 1st June 2003 to 31st May 2004. The study includes 100 patients of 35 years of age or above and 100 controls of 20-30 years of age. Observed complications during the pregnancy and delivery were increased incidence of placenta previa, malpresentation, intrauterine death, preterm labour, obstructed labour ruptured uterus etc. Pregnancy related complications were found significantly high (p<0.001) in case group (80%) compared to control group (51%). Rate of caesarian section was also more among the cases. Post delivery maternal complications were more in case group (53%) compared to control (30%) (p<0.001). Perinatal morbidity and mortality was significantly high. Cause of late fetal death in older women include, failure of the uterine vasculature in older women to adapt sufficiently to the increase haemodynamic demands of pregnancy, reduced fetal oxygenation with maternal age and also a rise in the frequency of preexisting hypertension with age. Maternal age is an important and independent risk in pregnancy outcome.
  • Item
    A study to evaluate the efficacy and safety of oral fluconazole in the treatment of tinea versicolor.
    (2009-01-03) Muhammad, N; Kamal, M; Islam, T; Islam, N; Shafiquzzaman, M
    In our study of 6 month of pityriasis versicolor patient in skin department of Mymensingh Medical College Hospital outdoor, most of the patient was of age 16-25 years (63.33%), 20% was of age 26-35 years and 16.67% was of 36-45 years. Age distribution among male patient maximum (66.67%) was of 16-25 years and among females the maximum 50% was also of 16-25 years. Mostly was male (80%) and 20% was female only 20% of the patient has got the positive family history whereas 80% with no family history of the disease, which indicates that there is no hereditary predilection. Of the patient 66.67% was unmarried and 33.33% was married. Late adolescence & early adult age groups are predominantly affected. Small children & elderly adults are infected only in unusual circumstances, such as prolonged occlusion or immunosuppresion. Prevalence reported to be as high as 50% in the humid, hot environment of Western Samoa & on low as 11.1% in the colder temperature of Sweden. About sex distribution of patients 20% were female. The study shows that majority of patients were male (20%).
  • Item
    Incretin Mimetics and DPP-4 Inhibitors: New Approach to Treatment of Type 2 Diabetes Mellitus.
    (2009-01-03) Siddiqui, N I
    Type 2 diabetes constitutes the main bulk (85-90%) of diabetic population. It is a chronic metabolic disorder with progressive ?beta-cell dysfunction, impaired insulin actions and various other abnormalities. Insulin response of beta-cell is more after oral glucose or following meal than intravenous infusion of glucose. Gut related peptides, the incretin hormones released after meal following activation of the enteroinsular axis plays an important role in glucose homeostasis by pancreatic and extrapancreatic glucoregulatory effects and helps in preservation of beta-cell function. In type 2 diabetes, there is progressive decline of these incretins level, glucagons like peptide-1 (GLP-1) and glucose dependent insulinotropic polypeptide (GIP) with loss of beta-cell mass, beta-cell function and glycemic deterioration. These peptides are rapidly degraded by endogenous proteases, dipeptidyl peptides-4 (DPP-4) giving a very short half life of 2-3 minutes. Currently available anti-diabetic drugs do not address these arms of glucoregulatory dysfunction of type 2 diabetes. Modern therapeutic strategy should be targeted at preservation of beta-cell mass and function by exploiting the incretin hormones and enteroinsular axis. DPP-4 resistant incretin analogues/mimetics (e.g. exenatide, liraglutide) that have been developed by modifications/ substitutions in the polypeptide chain may be an effective alternative of the existing therapy of type-2 DM. DPP-4 inhibitors (e.g. sitagliptin, vindagliptin) prevent the degradation of endogenous GLP-1 and GIP, thereby potentiate their actions and help in glycemic control. Distinctive features of incretin mimetics are: their action is glucose dependent, do not produce hypoglycemia, help in preservation of beta-cell mass and function, help in weight reduction. DPP-4 inhibitors are weight neutral. Ongoing studies will reveal newer avenues and long term outcome of these molecules.
  • Item
    Kikuchi-fujimoto disease.
    (2009-01-03) Parveen, R; Rahman, S H; Yasmin, R; Quadir, M S; Muazzam, N; Alam, M N
    A 14 year-old Bangladeshi girl presented with high fever, painful swellings in the neck, anorexia, weight loss and night sweating. On examination she had multiple enlarged and tender cervical lymph nodes. Other systems were normal. Laboratory investigations for sepsis and autoimmune diseases were negative. Initial fine needle aspiration and cytology of affected lymph node was suggestive of tubercular lymphdenitis. But she did not respond to anti-tubercular treatment. Kikuchi-Fujimoto disease was diagnosed from the histopathological appearance of excised lymph node. She completely recovered with symptomatic treatment. Kikuchi-Fujimoto disease, also called Kikuchi's disease or histiocytic necrotizing lymphadenitis is a rare, benign but enigmatic disease of unknown aetiology. The disease is self-limited and has an excellent prognosis. Its recognition is crucial because it can be mistaken for systemic lupus erythematosus, malignant lymphoma, tubercular lymphadenitis or even, for metastatic adenocarcinoma. Clinicians' and pathologists' awareness of this disease may help prevent misdiagnosis and inappropriate treatment.
  • Item
    Anti H.pylori IgM in Symptomatic and Asymptomatic Population.
    (2009-01-03) Sumona, A A; Hossain, M A; Musa, A K; Shamsuzzaman, A K; Mahmud, M C; Khan, M S; Ahmed, S; Begum, Z; Zahan, N A; Ahmed, M U; Debnath, C R; Anne, R A
    To evaluate the usefulness of specific IgM in the diagnosis of Helicobacter pylori infection, a cross sectional study was carried out in the Department of Microbiology, Mymensingh Medical College between July 2006 to June 2007. A total of 45 patients having upper gastrointestinal symptoms underwent endoscopy and were subsequently diagnosed as patients with gastritis, peptic ulcer (PU) and non-ulcer dyspepsia (NUD) and another 45 asymptomatic individuals aged 18-65 years, were included in the study. The serum samples of participants were tested for presence of anti-H pylori IgM by using ELISA method. The ELISA for anti H. pylori IgM provided sensitivity and specificity of 73.33%, 93.33% respectively.
  • Item
    Upper abdominal mass with diagnostic dilemma.
    (2009-01-03) Ali, M O; Rashid, M M; Saifullah, M; Ahmed, T
    A 32 years old gentleman presented with a lump occupying the epigastric, left hypochondriac and umbilical region for the last 3 months which gradually increased in size & dull aching pain. He also complained of low grade fever and early satiety. On examination, he had a lump on upper abdomen which was irregular, firm, mildly tender, lobulated surface, restricted mobility, dull on percussion. USG examination of HBS revealed hepatomegaly and SOL in liver. CT abdomen revealed soft tissue mass in left upper abdomen. FNA revealed cells of mesenchymal origin. Per operatively a large lobulated, myxomatous highly vascular mass arising from the fundal part of the stomach was found and removed. Histopathology report comments about two differential diagnosis-leiomyosarcoma and gastrointestinal stromal tumour. CD117 immunostaining confirmed it was gastrointestinal stromal tumor (GIST). Post operatively patient was treated by Imatinib and is now under regular follow up.