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PubMed | Erasmus Medical Center, University of Dhaka, University of Queensland, Bangladesh University and 4 more.
Type: | Journal: BMC cancer | Year: 2016

Cancer burden among children and adolescents is largely unknown in Bangladesh. This study aims to provide a comprehensive overview on childhood and adolescent cancers and to contribute to the future strategies to deal with these diseases in Bangladesh.Data on malignant neoplasms in patients aged less than 20 years diagnosed between 2001 and 2014 (N = 3143) in Bangladesh was collected by the National Institute of Cancer Research and Hospital and ASHIC Foundation. The age pattern and distribution of cancer types were analysed and the incidence rates were calculated.The age-standardised incidence rate was 7.8 per million person-years for children (0-14 years) in the last time period (2011-2014). Retinoblastoma (25%) and leukaemia (18%) were the most common childhood cancers. For adolescents (15-19 years), the age-specific incidence rate was 2.1 per million person-years in the same time period. Most common adolescent cancers were malignant bone tumours (38%), germ cell and gonadal tumours (17%), and epithelial tumours (16%). There were more boys affected (M: F ratio 2.0 in children and 1.4 in adolescents) than girls.Cancer incidences were lower than expected most likely due to a low level of awareness about cancer among clinicians and the population, inadequate access to health care, lack of diagnostic equipment and incomplete recording of cases. Improvements on different levels should be made to get a better epidemiologic insight and to detect cancer earlier resulting in a better outcome for affected children and adolescents.

Hossain M.A.,National Institute of Cancer Research and Hospital
Mymensingh medical journal : MMJ | Year: 2011

Synovial chondromatosis rarely occurs in the foot. We have diagnosed such a case in National Institute of Cancer Research and Hospital, Mohakhali, Dhaka. The patient came to us with a swelling in the dorsum of left foot. He had a history of operation but one year later swelling reappeared in the same place. Fine Needle Aspiration Cytology (FNAC) of the swelling revealed few atypical cells and diagnosed as a case of malignant neoplasm. Later on surgical intervention was done in the form of wide excision and final histopathology report came as Synovial chondromatosis. No special treatment was given other than periodical follow up. The patient has been responding well. There was no clinical or radiographic evidence of recurrence.

Khan M.N.,Sher e Bangla Medical College | Sharfuzzaman A.M.S.M.,Sher e Bangla Medical College | Mostafa M.G.,National Institute of Cancer Research and Hospital
Journal of Neurosciences in Rural Practice | Year: 2014

Metastatic tumors are the most common tumors of the spine, accounting for 98% of all spine lesions. But spinal cord compression as the initial presentation of metastatic occult follicular carcinoma without any thyroid enlargement is unusual and relatively rare. This report describes a 35-years-old female patient presenting with paraplegia and urinary incontinence for the last two months. She had no thyroid enlargement; no thyroid related symptoms and her biochemical thyroid profile was normal. Magnetic resonance imaging (MRI) of spine shows a huge mass compressing the spinal cord at D11-D12 involving both the spinal and paraspinal areas. The patient was treated by surgery and radioiodine ablation as the histopathology showed metastatic follicular thyroid carcinoma. This case was reported because of the rarity of the disease. Early diagnosis and initiation of the treatment should promise a good prognosis for a patient with metastatic spinal cord compression.

Uddin M.T.,National Institute of Cancer Research and Hospital
IPAC 2012 - International Particle Accelerator Conference 2012 | Year: 2012

Quality Control (QC) data of modern linear accelerators, collected by NationalInstitute of Cancer Research and Hospital, Dhaka, Bangladesh between the years 2006 and2010, were analyzed. Three Linear Accelerators is included in this work. The goal was toprovide information for the evaluation and elaboration of QC of accelerator outputs and topropose a method for QC data analysis. Short- and long-term drifts in outputs werequantified by fitting empirical mathematical models to the QA measurements. Normally,long-term drifts were well (≤1.5%) modeled by either a straight line or asingleexponential function. A drift of 2% occurred in 18 ± 12 months. The shortestdrift times of only 2-3 months were observed for some new accelerators just after thecommissioning but they stabilized during the first 2-3 years. The short-termreproducibility and the long-term stability of local constancy checks, carried out with asealed plane parallel ion chamber, were also estimated by fitting empirical models to theQC measurements. The reproducibility was 0.3-0.6% depending on the positioning practice ofa device. Long-term instabilities of about 0.3%/month were observed for some checkingdevices. The reproducibility of local absorbed dose measurements was estimated to be about0.4%. The proposed empirical model fitting of QC data facilitates the recognition oferroneous QC measurements and abnormal output behavior, caused by malfunctions, offering atool to improve dose control. Copyright © 2012 by IEEE.

Begum M.,National Institute of Cancer Research and Hospital
Mymensingh medical journal : MMJ | Year: 2012

Acute lymphoblastic leukaemia (ALL) is the most common childhood leukaemia. On the other hand under-nutrition is a common problem in our country. This prospective study was conducted to see the outcome of induction of remission in undernourished children with acute lymphoblastic leukaemia. This study was carried out in the department of Paediatric hematology and oncology of Bangabandhu Sheikh Mujib Medical University (BSMMU) during the period from November 2002 to October 2004. A total of sixty (60) children who were diagnosed as acute lymphoblastic leukaemia in 1 to 15 years of age were included in this study. But the children with previous history of congenital disease and that of chemotherapy or steroid were excluded from this study. Patients were divided into two groups on the basis of Z score of weight for age. Thirty (30) children those with Z score- 2 or less were classified as undernourished and was labeled as Group A and another thirty (30) patient those Z score above-2 were classified as well nourished and was placed in Group B, After inclusion into the study, completion of induction of remission was monitored by physical examination and laboratory investigations. The result showed that mean age in Group A was 77.16 ± 7.07 months and that in Group B was 74.13 ± 5.09 months with male preponderance in both the groups. Mean body weight in Group A was 14.55 ± 0.76 Kg and that in Group B was 21.40 ± 1.05 kg (p<0.001). Children in Group A required 39.06 ± 0.72 days to complete induction but in Group B it required 31.63 ± 0.17 days (p<0.04). Hospital stay in Group A children was 52.10 ± 1.08 days and in Group B 42.37 ± 0.50 (p<0.002). The result suggested that under nutrition has an influence on the out come of induction of remission in undernourished children with acute lymphoblastic leukaemia. So appropriate measures are essential to improve nutritional status of children for successful management of ALL in children.

Golam M.,National Institute of Cancer Research and Hospital | Queen Z.,National Institute of Cancer Research and Hospital
Malaysian Journal of Medical Sciences | Year: 2015

Background: While intraoperative consultation has been used in Bangladesh for a long period of time, to date, there has been no published reporting on the performance of frozen sections. The current audit evaluates the performance of frozen sections in a well reputed medical center in Bangladesh, Anowara Medical Services. Objective: This retrospective study has been designed to measure the accuracy of frozen section diagnosis in a medical center in a third-world country, where many surgical procedures rely on intraoperative consultation. Methods: A series of 1379 intra- and peri-operative frozen section cases, from 2007 to 2014, was reviewed. Intraoperative tissue specimens received at Anowara Medical Services were processed for frozen sections. After examination of the frozen section that yielded the initial frozen section diagnoses, the frozen tissues were reprocessed for regular paraffin sectioning. These paraffin sections were examined by a second pathologist, and a final diagnosis was issued. The frozen section diagnosis and final diagnoses of all cases were retrospectively analysed to determine the accuracy of frozen section examination. Results: Overall, accurate diagnosis was made on frozen sections in 98.2% of the cases. The discrepant diagnoses were all clinically significant, i.e., there were discrepancies between benign and malignant diagnoses on frozen and paraffin sections. In 1% of the cases, diagnosis was deferred. Fifty percent of the deferred cases were benign. Two cases, received in formalin, were excluded. In both cases, the diagnosis was positive for malignancy. The number of false negative results (4 false negatives) was slightly lower than that of false positives (5 false positives). Specificity and sensitivity of 99.3% and 99.4% were achieved, respectively. In this study, the positive predictive value was 99.2% and the negative predictive value was 99.5%. Over the years, the number of discrepant diagnoses remained fairly constant. Conclusion: The present method has a satisfactory rate of accuracy of frozen section diagnosis, which is comparable to other remote and recent published series. The results of this study ofer a testament to the reliability of frozen section diagnosis rendered by qualified pathologists in Bangladesh and may serve as evidence in building confidence among the surgeons who use this service for improved patient care. © Penerbit Universiti Sains Malaysia, 2015.

Haque M.E.,National Institute of Cancer Research and Hospital
Mymensingh medical journal : MMJ | Year: 2012

The use of oral mucous membrane graft onlay urethroplasty represents the most widespread method of bulbar urethral stricture repair. We investigated the short term result of oral mucous membrane graft placed on the ventral surface for management of bulbar urethral stricture. Patients with Bulbar urethral stricture of any length, infection free urinary tract and informed consent for oral mucosa harvesting and urethroplasty were selected for study. We enrolled 108 cases of bulbar urethral stricture patients from January 2004 to July 2009. The mean ± SD preoperative maximum flow rate of 5.2 ± 2.6 ml/sec and mean ± SD PVR 87 ± 58.3 ml were treated by substitution urethroplasty with oral mucous membrane by a single surgical team in a private hospital. Causes of stricture were trauma 26(24.1%), infection 58(53.7%), catheter induced 8(7.4%), post TURP 11(10.2%) and unknown 5(4.6%). Oral mucous membrane was harvested from the cheek or from the inner side of lower lip. Defect of the urethra displayed by longitudinal ventral urethrotomy and the graft was sutured over the edges of the incised urethral mucosa over a 14 Fr latex Foley's catheter. Spongiosum tissue was closed over the graft. Pericatheter urethrogram was performed in all cases to check for the anastomotic leakage and the Catheter was removed after 2 weeks of the procedure. After removal of catheter uroflowmetry & ultrasound scan of bladder were performed to estimate the maximum flow rate and post voidal residue. The patient was followed-up every 3 months with uroflowmetry & ultrasonography. The median (range) age of the patients was 32(21-72) years. Mean follow up period was 36 months (range 12-54). Mean ± SD stricture length was 3.7 ± 2.6 cm. The overall success rate was 91.7%. Mean ± SD flow rate was 23 ± 4.2 ml/sec, mean ± SD post void residue was 25 ± 15.5 ml and patient quality of life (QOL) was excellent in almost all patients. Overall complications were seen in 9(8.3%) cases. Of which, restricture occurred in 6 patients; periurethral fistulae seen in 2 cases and per urethral bleeding in 1 patient. No significant complications were observed at the donor site. Oral numbness and mild discomfort complained by 67.6% patients which were managed by reassurance only. In our experience ventral placement of oral mucous membrane graft along with spongioplasty is a very easy procedure with very encouraging short term result.

Jabeen S.,National Institute of Cancer Research and Hospital
Mymensingh medical journal : MMJ | Year: 2014

Post obturation pain is the pain of any degree after endodontic treatment. There are different opinions regarding incidence of post obturation pain related to single and multi visit root canal treatment. This prospective study was conducted to evaluate the incidence of post obturation pain in single visit and multi visit root canal treatment and to compare the incidence of pain between the two treatment groups. A total of 120 cases of endodontically involved asymptomatic non vital single rooted teeth were selected for this study. The patients were assigned and divided in to two treatment groups, sixty patients each. In single visit group, all teeth were prepared and filled using the standardized preparation and lateral condensation filling technique. In the multi visit treatment group, at the first appointment, the teeth were prepared, and dressed with calcium hydroxide paste for 7 days. At the second appointment, the teeth were prepared and obturated by using lateral condensation technique. The frequency of post obturation pain was recorded as no pain, slight, moderate and severe pain and evaluated at the day 1 and at the day 7 after obturation. The data were analyzed statistically by using SPSS version-12. P value <0.05 was taken as significant. The study showed that the post obturation pain in the single visit treatment group was more than multi visit treatment group, which is significant (p value <0.044). Out of the 120 patients, 86(71.7%) patients had no pain, 19(15.8%) had slight pain and 15(12.5%) patients had moderate pain at the day 1 after obturation. At the day 7 after obturation, 108(90%) patients had no pain, 9(7.5%) had slight pain and 3(2.5%) patients had moderate pain. No patient noticed severe pain during the follow up period. Older patient had significantly more post obturation pain than the younger patient. There was higher incidence of post obturation pain following the single visit root canal treatment. In multi visit root canal treatment with intra-canal medicaments seems to reduce the post obturation pain.

Mostafa M.G.,National Institute of Cancer Research and Hospital | Cherry N.,University of Alberta
Occupational and Environmental Medicine | Year: 2013

Objectives: Data on the role of arsenic in renal cancer are suggestive but inconclusive. The present analysis aimed to determine whether renal cancers were more likely in Bangladeshi villagers exposed to high arsenic concentration in well water and, if so, whether this excess was limited to transitional cell cancers (TCC) or occurred also for renal cell cancers (RCC). Methods: Histology/cytology results from renal biopsies carried out at a single clinic in Dhaka, Bangladesh, from January 2008 to October 2011 were classified into four groups: RCC, TCC, other malignancy and benign. Patients aged ≥18 years using hand-pumped well water were identified by questionnaire, blind to diagnosis. Arsenic concentration was estimated from British Geological Survey reports for administrative area (thana) of residence. In a case-referent design (with benign results as referents), ORs were calculated by multilevel logistic regression adjusted for confounding. Time since well installation and smoking were examined by stratification. Results: Among 1489 cases included, 896 were RCC, 90 TCC and 503 benign. Arsenic concentration was estimated for 301 thanas with 63% of cases and 40% referents with arsenic concentration ≥50 μg/L (p<0.001). Risk increased monotonically with arsenic concentration ≥50 μg/L for both cell types (RCC and TCC). Risk estimates were greater in thana with early well installation where risk was increased for RCC in exposure stratum 10<50 μg/L (OR=2.47 95% CI 1.52 to 4.01). Stratification by 'ever smoked' confirmed the presence of risk in non-smokers. Conclusions: The relationship between arsenic concentration and both RCC and TCC suggests that arsenic is a causal factor in renal cancer.

PubMed | National Institute of Cancer Research and Hospital
Type: Journal Article | Journal: South Asian journal of cancer | Year: 2016

Malignancy is one of the leading causes of morbidity and mortality worldwide. According to GLOBOCAN 2012, an estimated 14.1 million new cancer cases and 8.2 million cancer-related deaths occurred in 2012. It is estimated that childhood malignancies are 0.5-4.6% of total malignancies. However, from the point of view of potential year lost due to childhood malignancies, it is more important than adult.To find out the probable components for the delay in diagnosis and treatment of childhood malignancies in Bangladesh, cross-sectional observational study was done at the National Institute of Cancer Research and Hospital, Dhaka, Bangladesh, from January 2014 to June 2014.A total of 171 patients were included in the study. They were divided into four age groups. The mean age was 8.422 years with standard deviation 5.381 years and their age ranged from 2 months to 18 years. In aggregate, about 70% of the cases had to wait for more than 90 days for the treatment. About 15% had to wait for 31-60 days. Negligible percentage of patients got treatment before 30 days. Among the three components of delay, patients delay was influenced by age of the child, economic status of the family, parental education, and awareness of the parents about malignancy.More than one-third of the pediatric patients had to wait three months or more for treatment to start for various reasons. By raising awareness among the stake holders this problem can be minimized. Further studies are recommended to explore the other factors which might cause delayed referral.

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