Moving Beyond Cancer: Immediate Impact on-the Health-Related Quality of Life of Breast Cancer Patients After Mastectomy.

During the last decade, survival rates for breast cancer have increased as a result of earlier detection and increased use of adjuvant therapy. Limited data exist on the post mastectomy quality of life in the process of transition from health to cancer in its different phases of treatment. The aim of current study was to evaluate the changes of health-related quality of life (HRQoL) after mastectomy and to measure their impression about future perspectives in Bangladeshi Breasts cancer patients. A group of 250 women with a diagnosis of primary breast cancer who was admitted in the department of surgical oncology in National Institute of Cancer Research and Hospital, Dhaka were enrolled in this study from January 2012 to March 2013. Two-point interview like pre(MI) and post mastectomy(M2) was taken using the structured questionnaire made by European Organization for Research and Treatment of Cancer (EORTC)- EORTC Q30 and BR23. The mean age of the patients was 44.7?9.87 years, 52.6% were locally advanced. HRQoL scores of breast cancer patients deteriorated after mastectomy, general features like presence of fatigability, nausea, apatite loss, sleeplessness and pain has got tremendous effect on the quality of life(p<.005). Financial difficulties and sleep disorders did not affect much. Four of the Global Health status/QOL parameters like physical functioning, role functioning, emotional functioning, cognitive functioning deteriorated but only physical functioning status affected significantly(p<0.005). Breast symptoms like body image problem, general breast symptoms like pain, arm swelling and sexual feeling affected their (HRQOL) after mastectomy. A diagnosis of cancer and associated treatments affects multiple domains of life. The complicated transitions between health, illness and living with cancer can often be challenged with a preoperative information for the patient confronted with breast cancer should include possible psychological effects of cancer diagnosis, surgery, and other treatment. Breast conservation particularly in the young group may give a better outcome in the treatment protocol of breast cancer patients.

Sonographic evaluation of thyroiditis with color flow study.

This cross sectional study was carried out in the Department of Radiology and Imaging, Bangabandhu Sheikh Mujib Medical University, Bangladesh in collaboration with the Department of Endocrinology and Department of Histopathology of the same hospital during the period of March 2007 to February 2008 to determine efficacy of ultrasonogram in the evaluation of thyroiditis and to compare its results with color flow Doppler study. For this purpose, a total of 50 patients having clinical suspicion of thyroiditis were enrolled in this study. Ultrasound and color Doppler were done in all these patients. Then all patients underwent for FNAC in the Histopathology department. Correlation between sonographic diagnosis and histopathological diagnosis were observed. Out of these 50 patients 10(20%) were male and 40 (80%) were female with age ranging from 12 to 50 years, highest between 21 to 30 years. The mean age of the patients was 30.42±9.57 years. On unltrasonographic findings of thyroid gland 42.0% patients had regular and 58.0% had irregular margin. Seventy percent had fibrosis, 14.0% had feature of necrosis, 48.0% had lymphadenopathy. Out of all patients 6.0% had normal echogenic feature, 16.0% had increased and 78.0% decreased echogeneic feature. Twelve percent (12.0%) patients had homogeneous and 88.0% had heterogeneous pattern of echogenecity. Thirty eight percent (38%) patients had focal nodules. Sixty percent (60.0%) patients had focal swelling and 40.0% had diffuse swelling. On color flow Doppler 28.0% had normal, 38.0% had increased and 34.0% decreased vascular flow pattern. USG reports revealed that 48.0% had thyromegaly, 36.0% had thyroid nodule, 10.0% had multinodular goiter and 6.0% had thyroid abscess. FNAC diagnosis revealed that 34.0% patients had Hashimoto's thyroiditis, 24.0% had lymphocytic thyroiditis, 18.0% had granulomatous thyroiditis, 6.0% had abscess, 8.0% had goitre and 10.0% nonspecific. USG and CFD are recommended modalities for the diagnosis of thyroiditis as these cost-effective and non invasive procedures.

Role of sonohysterography in evaluation of abnormally thickened endometrium causing abnormal uterine bleeding with histopathological correlation.

This prospective randomized study was carried out in the department of Radiology and Imaging in collaboration with the department of Obstetrics and Gynecology of Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbag and Dhaka Medical College Hospital (DMCH) during the period of January 2003 to December 2004. The aim of this study was to establish sonohyterography as a sensitive tool and superior to Transvaginal Sonography (TVS) for detection of endometrial pathology in women with abnormal uterine bleeding (AUB) and its validity by determining sensitivity, specificity, accuracy, positive predictive value and negative predictive value. For this purpose, a total number of 40 patients who had thickened endometrium (cut off level < 15 mm for pre menopausal and < 5 mm for post menopausal patients) detected on transabdominal or transvaginal sonography were selected. TVS and TV-SH were done in all these patients and findings were then compared with the final histopathological diagnosis. In our study, we found TV-SH has sensitivity of 100%, specificity of 80% and accuracy of 97.5% compared to TVS (94%, 66.66% and 90% respectively) in detection of endometrial pathology in women with AUB. TV-SH can thus be regarded as one of the most sensitive, specific and accurate modality in detecting and excluding endoluminal masses as the cause of AUB. It can be considered as the initial examination in the evaluation of all women with AUB.

Leiomyoma of esophagus presenting as huge posterior mediastinal mass: 2 case reports.

Smooth muscle tumors presenting as mediastinal soft tissue masses are rare and are often mistaken for other neoplasms. Benign tumors of the esophagus account for fewer than 1% of all esophageal tumors, the most common of which are leiomyomas. They are frequently located in the lower third of the esophagus. We report two cases of esophageal leiomyoma in the thoracic esophagus which were firstly presented as huge mediastinal mass with intermittent dysphagia and radiologically flecks of calcification.

Interventional radiology for the treatment of hepatic malignancy.

Hepatic malignancies are commonly faced clinical problem. Non surgical minimally invasive therapies are current treatment goal. Interventional radiologists are going forwards with such minimally invasive but effective therapies by transarterial chemoembolization, radiofrequency ablation, percutaneous ethanol injection, cryoablation, laser ablation and upcoming promising procedures like focused ultrasound & gene therapy. Response rates of transarterial chemoembolization for primary and most metastatic tumors are 60-80% with survival rates of 70% at 1 year, 40% at 3 years, and 10% at 5 years. Percutaneous ethanol injection ablation is the most accepted minimally invasive method worldwide, for hepatocellular carcinomas less than 5 cm in diameter, the complete ablation rate is about 70-75%; in 5-8 cm diameter, encapsulated hepatocellular carcinomas, the rate is about 60%. RFA is becoming a widely used ablative technique for primary and secondary liver tumors, with a 52-67% complete ablation rate at 1 year and survival rates of 96%, 64%, and 40% at 1, 3 and 5 years, respectively. Meticulous patient selection, careful planning and execution are imperative and should be carried out with the participation of interventional and diagnostic radiologists, nuclear medicine specialists, and medical, surgical, and radiation oncologists. In terms of cost, equipment, technical efficiency, efficacy & repeated applicability percutaneous procedures particularly PEI & RFA can be carried out in Bangladesh.

Juvenile onset ankylosing spondylitis with ankylosing tarsitis: a rare combination.

Ankylosing spondylitis is the most common whereas ankylosing tarsitis is the least common subgroup of juvenile onset spondyloarthritides. In our recent study a male presented with ankle joint pain and swelling with limited movements and characteristic radiological changes including; periarticular swelling, thickened heel pad, hyperostosis and reduced ankle, calcaneo-cuboid and talo-navicular joint space for ankylosing tarsitis. He also had persistent inflammatory low back pain with radiological sacroilitis satisfying the clinical features for ankylosing spondylitis. The patient was treated with different anti-inflammatory agents including intra-articular methyl-prednisolone with short-term relief. Associated back pain was improved with spine mobilizing exercise.

Growth and production of biomass of Rhodovulum sulfidophilum in sardine processing wastewater.

AIMS: Rhodovulum sulfidophilum was grown in sardine processing wastewater to assess growth characteristics for the production of bacterial biomass with simultaneous reduction of chemical oxygen demand. METHODS AND RESULTS: Growth characteristics were compared in diluted and undiluted, settled and non-settled wastewater growing in anaerobic light and aerobic dark conditions; and also at different agitation speeds. The highest biomass (8.75 g l(-1)) and a reduction in chemical oxygen demand of 71% were obtained in unsettled, undiluted wastewater after 120 h culture with 15% inoculum. In settled wastewater, highest biomass (7.64 g l(-1)) and a COD reduction of 77% was also obtained after 120 h. Total biomass was higher (4.34 g l(-1)) after 120 h culture in anaerobic light compared to (3.23 g l(-1)) in aerobic dark growth. CONCLUSIONS, SIGNIFICANCE AND IMPACT OF THE STUDY: Better performance, mean of total biomass (6.97 g l(-1) after 96 h), total carotenoids (4.24 mg g(-1) dry cell from 24 h) and soluble protein (431 microg ml(-1) after 96 h) were obtained from aerobic dark culture at 300 rev min(-1). The COD reduction, however, was lower (69%) after 96 h culture. Thus, the benefits in the production of bacterial biomass in non-sterilized sardine processing wastewater with the reduction of chemical oxygen demand could be achieved.

Rhodovulum sulfidophilum in the treatment and utilization of sardine processing wastewater.

AIMS: Rhodovulum sulfidophilum was grown in settled undiluted and nonsterilized sardine processing wastewater (SPW). The aims were to evaluate the effects of inoculum size and media on the biomass production with simultaneous reduction of chemical oxygen demand (COD). METHODS AND RESULTS: Three levels of inoculum size (10, 20 and 30% v/v) developed in glutamate-malate media (GMM) or settled and undiluted SPW were compared. The highest biomass (4.8 g l-1) was obtained after 96-h culture with 20% (v/v) inoculum size, but the reduction in COD of SPW was the highest (85%) after 120-h culture with a 30% (v/v) inoculum developed in GMM. In cultures with inoculum developed in SPW the COD reduction in SPW was 79-83%. CONCLUSIONS, SIGNIFICANCE AND IMPACT OF THE STUDY: Inoculum developed in GMM supported good growth of Rv. sulfidophilum in settled undiluted SPW and subsequent reduction in COD. A conceptual model was proposed for the treatment and utilization of SPW.