It is one of commonest presentation in medical outpatient department. It necessitates initial endoscopy in the presence of warning symptoms including Age [greater than or equal to]50 years3, family history of upper GI malignancy in a first-degree relative, unintended weight loss, bleeding or iron deficiency anemia, dysphagia, odynophagia, persistent vomiting, abnormal imaging suggesting organic disease4.

A 47-year-old female presented to the medical outpatient department with a 2-year history of fatigue and generalised cramps.

CASE REPORT: A 50 year old post-menopausal woman from a near-by tribal village was admitted in the medical outpatient department in our hospital with a history of decreased urinary output since 1 week, fever since 1 week, abdominal pain 1 month, difficulty in passing urine since 1 month and white discharge since 1 month.

When the specialist from Al Amal Hospital, which is under the Ministry of Health (MoH), is not present, some patients are turned away while some are issued prescriptions by General Practitioner's in the medical outpatient department (OPD), hospital 
 sources and patients said.

A Washington, D.C., physician made it clear that "a significant aspect of the Karen Quinlan case is the fact that it is in court at all." The month before the court reached its decision, the director of the Medical Outpatient Department at Boston's Children's Hospital Center coolly offered a clinician's perspective in the pages of the Hastings Center Report:

Likewise, there were no significant differences between the proportions being visited by a district nurse (34%, 29%), being admitted to hospital (28%, 27%) and attending medical outpatient departments (31%, 37%) ([x.sup.2], p > 0.05 for all comparisons).