Author: dhaka-admin

Prostate cancer is a cancer that occurs in the prostate gland of male. Prostate gland is a part of male reproductive system situated below the urinary bladder & in front of the rectum through which urethra passes. This gland secretes fluid that mixes with the semen ultimately helping in reproductive process.

This is the second most common cancer affecting male. One in every eight males have a risk to develop this cancer. Worldwide this is the fifth most common cause of cancer related death among males.

The risk of developing prostate cancer increases with advancing age. More prevalence is noticed among the siblings of the affected families. More common in some ethnic groups like black Americans. Unregulated lifestyles like obesity, consumption of unhealthy foods, environmental pollution may contribute to the causation of this disease.

Most worrisome feature of this disease is that many a time it remains asymptomatic & acts as a “silent killer”. Sometimes detected during routine examination for health check-ups, otherwise people may complain as disturbance in micturition, blood in urine, backache or bone pain etc.

With this scenario, a few simple tests can provide primary idea about the existence of this disease. Men over fifty preferably should check their status of prostate gland or if any people at this age group with above mentioned symptoms should consult a Urologist.

The urologist will suggest a S. PSA test and if needed, he will feel the prostate gland by putting his finger in patient’s rectum which is called Digital Rectal Examination (DRE). He may also suggest an USG of prostate. Any abnormalities are detected on these tests or if there is any suspicion the Urologist may ask for an MP-MRI of prostate and/or prostate biopsy.

If prostate biopsy is suggestive of cancer, then the next step is to ascertain whether this cancer is localized or metastatic. Then the Urologist will plan for treatment of these two groups.

Here, it is noted that all types of treatment facilities for this cancer are available in our country.
Another positive thing of this cancer is that, for localized cancer if treated adequately, survival rate is about 98%.
Most important aspect of this disease is that how to prevent it. In true sense till now no vaccine or any other preventive toll is discovered yet.

But if we follow measures described below then risk of death may be reduced to some extent.
• Early diagnosis: After fifty years of age yearly routine checkup aiming at prostate status.
• Prevention of obesity
• Regular exercise
• Healthy diet and nutrition: Adequate fresh green leafy vegetables, fruits, Whole grain cereals intake with minimizing animal protein and avoidance of preserved food, canned food, junk food etc.
• Stop smoking and moderation of alcohol intake.
• Lastly spirituality, calmness, meditation and adherence to the Creator is strongly believed to improve immune status and these may reduce the risk of genesis of cancer.

Author:
Prof. Brig. Gen. Dr. SM Shameem Waheed
MBBS, FCPS (Surg), FCPS (Urology)
Senior Consultant – Urology
Evercare Hospital Dhaka

Ovarian cancer is a formidable foe that silently affects thousands of women worldwide every year, life threatening in 1.6% of total female population. Often referred to as the “silent killer,” this cancer tends to go unnoticed in its early stages, making awareness and vigilance crucial for timely diagnosis and treatment.

Symptoms:

The challenge with ovarian cancer lies in its subtle symptoms, which can easily be dismissed or attributed to other conditions. Common indicators include persistent bloating, abdominal or pelvic pain, difficulty eating, and frequent urination. Additionally, unexplained fatigue, changes in bowel habits, and sudden weight loss can also be warning signs. Unfortunately, these symptoms are often vague and non-specific, making it challenging to identify ovarian cancer early on.

Risk Factors:

While ovarian cancer can affect any woman, certain factors increase the risk. Age, family history, and inherited gene mutations such as BRCA1 (40-60%) and BRCA2 (20-35%) play significant roles. Women who have never been pregnant, those who started menstruating at an early age or experienced late menopause, and those who have a history of endometriosis are also at a higher risk.

What to Do:

1. Listen to Your Body: Pay attention to your body and any changes in your health. If you experience persistent or unusual symptoms, consult your healthcare provider.

2. Regular Check-ups: Routine gynecological check-ups are crucial for early detection. Regular pelvic examinations and screenings can help identify any abnormalities in the ovaries.

3. Know Your Family History: Understanding your family’s medical history is essential. If there is a history of ovarian or breast cancer, inform your healthcare provider, as this may warrant more frequent screenings.

4. Genetic Counseling: If you have a family history of ovarian cancer or carry known genetic mutations, consider genetic counseling. This can help assess your risk and guide preventive measures.

5. Seek Medical Attention Promptly: If you notice persistent symptoms, do not hesitate to seek medical advice. Early diagnosis significantly improves the chances of successful treatment.

6. Imaging Tests: In cases where ovarian cancer is suspected, imaging tests such as ultrasounds, color flow doppler study and CT scans may be recommended to visualize the ovaries and surrounding tissues.

7. Consult a Gynecologic Oncologist: If ovarian cancer is diagnosed, it’s crucial to consult a gynecologic oncologist, as they specialize in the treatment of gynecological cancers. They can provide expert guidance on the most effective treatment options, which may include surgery, chemotherapy, and targeted therapies.

In conclusion, awareness and proactive healthcare are pivotal in the fight against ovarian cancer. Understanding the symptoms, recognizing risk factors, and taking prompt action can make a significant difference in the prognosis and treatment outcomes for those affected by this challenging disease. Regular check-ups, open communication with healthcare providers, and a commitment to early detection are essential steps in the battle against ovarian cancer.

Author:

Lt. Col. (Dr.) Nargis Nahar

Senior Consultant

Obstetrics and Gynaecology

Evercare Hospital Dhaka

Chronic obstructive pulmonary disease(COPD):

Chronic obstructive pulmonary disease, or COPD, refers to a group of diseases that cause airflow obstruction and breathing difficulties It includes emphysema and chronic bronchitis. Smoking and air pollution are the most common causes of COPD. Their long-term exposure can cause chronic obstructive pulmonary disease. Though the leading cause of COPD is smoking, however, 1 in 4 with COPD never smoked.

The most common symptoms of COPD are difficulty in breathing specifically on exertion, chronic cough (sometimes with phlegm), and feeling tired. COPD symptoms can get worse quickly. These are called acute exacerbations. These usually last for a few days and often require additional medicine to add like antibiotics.

People with COPD also have a higher risk for other health problems. These include lung infections, like the flu or pneumonia, lung cancer, heart problems, weak muscles and brittle bones, depression, and anxiety.

COPD can be diagnosed using a simple breathing test called spirometry & and sometimes with a Bronchodilator. Treatment of COPD, comprises the steps to reduce symptoms and improve quality of life are:

• Quit smoking. For people who smoke, the most important part of treatment is to stop smoking.
• Avoid tobacco smoke and other air pollutants at home and at work.
• Medicine. Symptoms such as coughing or wheezing can be treated with medicine like Bronchodilators, steroids, and antibiotics.
• Pulmonary rehabilitation, is a kind of treatment program that includes pharmacological treatment, breathing exercises, nutritional support, vaccination, and counseling targeting to improve the quality of life.
• Prevention and treatment of lung infections. Lung infections play a main role in COPD examination and hospitalization. Every year flu shots and pneumonia vaccines once, are especially important for people with COPD Respiratory infections should be treated with antibiotics accordingly.
• Supplemental oxygen. A portable oxygen tank may be needed to provide domiciliary O2 therapy if core pulmonary or heart failure is associated.

Author:

Dr. SM Abdullah Al Mamun

MBBS(DMC), MD (Chest), MCPS(Med), FRCP(Edin)

Senior Consultant

Respiratory Medicine

Evercare Hospital Dhaka

A high-risk pregnancy can be a daunting experience for expectant mothers, as it requires specialized care and attention due to potential complications that could arise both for the mother and the fetus.

In such cases, the expertise of feto-maternal medicine comes into play, offering comprehensive care to ensure the best possible outcomes for both mother and upcoming baby. In this blog post, we will explore the significance of feto-maternal medicine in managing high-risk pregnancies and its impact on maternal and fetal health.

Understanding High-Risk Pregnancy:

High-risk pregnancies are those that involve factors that may increase the likelihood of complications during pregnancy or childbirth. These factors can vary and may include maternal age (either too young or advanced), pre-existing health conditions like diabetes or hypertension, multiple pregnancies (twins, triplets), genetic disorders, and certain lifestyle choices, such as smoking or substance abuse.

The Role of Feto-Maternal Medicine:

Feto-maternal medicine, also known as maternal-fetal medicine, is a subspecialty of obstetrics that focuses on providing specialized care for pregnant women facing high-risk conditions. These specialists work collaboratively with obstetricians, neonatologists, and other healthcare professionals to monitor, diagnose, and manage high-risk pregnancies.

Diagnosis and Risk Assessment:

One of the essential aspects of feto-maternal medicine is risk assessment and diagnosis. Advanced prenatal screenings and diagnostic tests help identify potential complications early on, enabling the healthcare team to tailor a personalized care plan for each patient. Regular monitoring and follow-ups throughout the pregnancy ensure that any emerging issues are addressed promptly.

Management and Treatment:

Feto-maternal medicine specialists are equipped with the knowledge and skills to manage a wide range of high-risk conditions during pregnancy. Depending on the specific case, management may involve medical interventions, lifestyle modifications, or even surgical procedures. The ultimate goal is to optimize the health of both the mother and the fetus, reducing the risk of adverse outcomes.

Communication and Emotional Support:

High-risk pregnancies can take an emotional toll on expectant mothers and their families. Feto-maternal medicine specialists understand the importance of clear communication and emotional support throughout the journey. They provide guidance, answer questions, and address concerns, helping the expectant mother feel empowered and informed about her health and the health of her baby.

The Impact on Maternal and Fetal Health:

The interventions provided by feto-maternal medicine specialists have a significant impact on the health of both the mother and the baby. Timely detection and management of complications can lead to better pregnancy outcomes, reduced risks of preterm birth, improved neonatal health, and a lower likelihood of long-term health issues for the baby.

In conclusion, high-risk pregnancies require specialized care and attention to ensure the well-being of both the mother and the baby. Feto-maternal medicine plays a crucial role in managing these pregnancies, providing expert diagnosis, management, and emotional support.

By understanding the significance of feto-maternal medicine, expectant mothers can approach their pregnancy with confidence, knowing that they have a team of dedicated specialists working to ensure the best possible outcome for their little one.

Author:

Lt. Col. (Dr.) Nargis Nahar

Senior Consultant

Obstetrics and Gynaecology

Evercare Hospital Dhaka

In the ever-evolving landscape of healthcare, the “Golden Hour” has emerged as a critical time frame in acute heart attack cases. This vital sixty-minute window, following the onset of a heart attack, represents a race against time to provide immediate medical intervention.

In this article, we explore the profound importance of the Golden Hour in acute heart attack cases and how it continues to revolutionize emergency cardiac care, saving countless lives in the process.

Understanding Acute Heart Attacks:

An acute heart attack, or myocardial infarction, occurs when a coronary artery becomes blocked, leading to a sudden disruption of blood flow to a portion of the heart muscle.

The heart muscle, deprived of oxygen and nutrients, starts to suffer irreversible damage. The severity of the damage depends on the duration of the ischemic period before the artery is reopened.

The Golden Hour – A Race Against Time:

The term “Golden Hour” emphasizes the critical need for prompt action in acute heart attack cases. During this crucial hour, rapid medical intervention can significantly impact the patient’s prognosis, minimize complications, and improve long-term outcomes.

The sooner appropriate treatments are initiated, the greater the chances of preserving heart muscle function and saving lives.

Early Recognition and Response:

Early recognition of heart attack symptoms and immediate response are key to optimizing patient outcomes. Public awareness campaigns and education on heart attack symptoms play a crucial role in empowering individuals to identify warning signs promptly.

Common symptoms include chest pain or discomfort, shortness of breath, nausea, cold sweats, and pain radiating to the arms, back, neck, or jaw.

Role of Emergency Medical Services (EMS):

Emergency Medical Services (EMS) play a pivotal role in the Golden Hour by providing timely and efficient pre-hospital care.

EMS responders are trained to quickly assess and stabilize heart attack patients, initiate oxygen therapy, administer medications, and transport the patient to a specialized cardiac facility for further treatment.

Importance of Rapid Reperfusion:

Restoring blood flow to the affected heart muscle is the primary objective during the Golden Hour. Two main reperfusion strategies are employed: thrombolytic therapy and primary percutaneous coronary intervention (PCI).

Thrombolytic therapy involves administering clot-busting medications to dissolve the obstructing blood clot. PCI, on the other hand, involves mechanically reopening the blocked artery using a catheter and stent.

Primary Percutaneous Coronary Intervention (PCI):

Out of the two reperfusion strategies, the superior mode of delivering the treatment is doing a primary angioplasty of the blocked artery. Thrombolytic therapy has a high failure rate.

But urgent coronary angiography and primary angioplasty within six hours of chest pain, carries much better outcome and preservation of cardiac function.

The procedure can be extended up to twelve hours in certain circumstances. Therefore, primary angioplasty is the treatment of choice, if onsite facilities are available.

Impact on Patient Outcomes:

Studies consistently demonstrate that the time from symptom onset to reperfusion is directly correlated with patient outcomes. Those who receive correct treatment within the Golden Hour have higher survival rates and experience fewer complications.

Prompt medical intervention reduces the extent of heart muscle damage, lowers the risk of heart failure, and improves the patient’s overall quality of life.

In acute heart attack cases, the Golden Hour represents a race against time, where every minute counts. Rapid recognition of symptoms, prompt activation of emergency services, and swift access to appropriate medical care are crucial for saving lives and minimizing long-term complications.

Public education on heart attack symptoms and the importance of early intervention is vital to ensuring more individuals receive timely treatment during this critical window.

Emphasizing the significance of the Golden Hour in acute heart attack cases will continue to be instrumental in reshaping emergency cardiac care and fostering better patient outcomes.

Author:

Dr. Shams Munwar

Senior Consultant

Clinical & Interventional Cardiology

Evercare Hospital Dhaka

NCDs in Bangladesh: A Growing Public Health Crisis

In Bangladesh, non-communicable diseases (NCDs) are increasing rapidly and account for approximately 68% of mortality and 64% of disease burden – namely heart attacks, strokes, chronic respiratory disease, cancers & diabetes. Additionally, around 20% of the population suffer from hypertension, 10% from diabetes, and as much as 2 million people suffer from cancer each year in the country, with around 50,000 new patients joining the list annually.

NCD Risk Factors Worsen in Bangladesh

A study conducted by NCD Control unit at the Directorate General of Health Services (DGHS), published in June this year, stated that the NCDs risk factors have further worsened in the country compared to 2018 – with 44.9% of the population using tobacco products (smoke and smokeless), one of the leading risk factors for NCDs.

With close to 6.2 million adult smokers in the country, it is essential to embrace innovative measures and harm reduction alternatives rooted in science, to transform and save lives.

Harm reduction alternatives reduce the level of harmful toxins while providing the user with Nicotine. In the recent years, there has been a growing debate surrounding nicotine and its potential health risks. Misinformation and lack of awareness have clouded the understanding of nicotine’s true nature and its relationship with combustion, leading to misconceptions about its effects on human health. Contrary to popular belief, nicotine itself while addictive, does not cause diseases, and is present in various everyday products we use. The primary health risks associated with smoking, stem from the combustion of tobacco.

Nicotine vs. Combustion: What’s the Difference?

Understanding the distinction between nicotine and the combustion process is of particular importance. Research conducted by the U.S. Department of Health and Human Services reveals that the majority of toxic substances released during smoking are a direct result of the combustion process, including carbon monoxide, tar, and carcinogens. Nicotine, while it is highly addictive, it does not cause the myriad of health issues commonly associated with smoking.

Decades of research have led to the introduction of safer and better alternatives like heated tobacco products (HTPs)- that offer a way for those battling addiction and those who do not quit. HTPs have gained recognition as a promising safer alternative to traditional cigarettes. These devices operate by heating tobacco instead of burning it. Since the tobacco is not burned, the levels of harmful chemicals released are significantly reduced compared to cigarette smoke – hence provide a safer option for those seeking nicotine with significantly reduced detrimental health effects compared to smoking.

The Future of Smoking: Will HTPs Replace Cigarettes?

In conventional cigarettes, the combustion of tobacco at high temperatures not only releases nicotine, but also produces harmful byproducts that damage the respiratory system and contribute to various diseases, including lung cancer and cardiovascular ailments. In contrast, HTPs heat the tobacco at lower temperatures, reducing or eliminating the release of specific chemicals, thus providing a safer alternative, resulting in a more satisfying experience for smokers. 

Transition from conventional cigarettes to safer alternatives has the potential to reduce the risk substantially at both the individual and societal levels. This is best evidenced by the case of Japan. In recent years, Japan has experienced a significant decline in smoking rates as more individuals switch to HTPs.

The future of HTPs in public health

However, the introduction of these alternatives to the market has sparked discussions among public health experts, policymakers, and the tobacco industry. Some argue that promoting HTPs might inadvertently encourage smoking or deter current smokers from quitting altogether. It is critical for the government and the regulatory bodies to carefully consider the scientific evidence when formulating policies for harm reduction. Striking a balance and ensuring access to safer alternatives for current smokers and preventing non-smokers from initiating cigarette and nicotine consumption is important.

By educating consumers about safer and better alternatives, we can empower them to make informed choices and ultimately contribute to a healthier society. Encouraging further research into better alternatives and implementing science and evidence-based policies will be essential in tackling the global tobacco epidemic.

It is quite clear that the old “quit or die” approach to smoking control is no longer good enough on its own, as millions of lives are at stake.  We can work towards a future where the adverse health effects of smoking become a thing of the past, and individuals are empowered to make choices that contribute to their wellbeing. By providing consumers access to credible, evidence-based information, and science-based products we have an opportunity to benefit society at large. 

Author:

Dr. Ziaul Huq

Senior Consultant

Respiratory Medicine Department

Evercare Hospital Dhaka

The Importance of Breastfeeding in Bangladesh

In a world grappling with numerous health challenges, breastfeeding emerges as a simple yet powerful solution that can significantly impact the well-being of individuals and entire communities. As of 2023, Bangladesh stands at a critical juncture where promoting and supporting breastfeeding can foster a healthier, more resilient society. The evidence-backed benefits of breastfeeding extend far beyond infancy, making it a lifelong investment in health.

Need for Better Education and Support for Mothers in Bangladesh

In 2023, Bangladesh faces challenges in improving breastfeeding rates. According to recent data from the Bangladesh Demographic and Health Survey (BDHS), exclusive breastfeeding rates for infants under six months remain suboptimal, with only 35.9% of babies being exclusively breastfed. Furthermore, the initiation of breastfeeding within the first hour after birth stands at a mere 36%, indicating a need for better education and support for mothers.

Breastfeeding provides a myriad of immediate and long-term health advantages, both for the infant and the mother. In the short term, breast milk is a complete and easily digestible source of nutrition, protecting infants from infections, diarrhea, and respiratory illnesses. Longer-term benefits include a reduced risk of obesity, type 2 diabetes, and certain childhood cancers.

For mothers, breastfeeding lowers the risk of breast and ovarian cancer and contributes to postpartum weight loss. Investing in breastfeeding can alleviate the strain on Bangladesh’s healthcare system by reducing the burden of preventable diseases and minimizing healthcare costs.

Bangladesh faces significant challenges concerning malnutrition, especially among its young population. In 2023, stunting and wasting rates stand at approximately 12.5% and 27.5%, respectively, among children under five. Breastfeeding plays a crucial role in combatting malnutrition, as breast milk provides essential nutrients and immunological factors that promote healthy growth and development.

Research indicates that breastfeeding is linked to improved cognitive development in children. A study conducted in Bangladesh by the International Centre for Diarrheal Disease Research, Bangladesh (ICDDR,B), revealed that children who were breastfed for more extended periods showed higher scores in cognitive tests. Such findings underscore how breastfeeding can contribute to the nation’s human capital development and long-term economic prosperity.

Supporting breastfeeding extends beyond the home, with a pressing need for breastfeeding-friendly workplaces. Encouraging employers to provide lactation rooms and flexible break times for breastfeeding can enhance mothers’ ability to continue breastfeeding after returning to work. The benefits of this investment extend to the economy as well, with healthier, more productive workers and reduced absenteeism due to child illnesses.

In 2023, Bangladesh has the opportunity to embrace breastfeeding as a potent tool for improving the health and well-being of its population. By focusing on increasing exclusive breastfeeding rates, promoting early initiation of breastfeeding, and creating a breastfeeding-friendly environment, Bangladesh can pave the way for a healthier future.

Investing in breastfeeding is not just a short-term strategy but a lifelong commitment to building a resilient, prosperous nation. It is a collective responsibility of policymakers, healthcare providers, communities, and families to support breastfeeding and unlock its full potential for the health and development of every Bangladeshi citizen. By doing so, Bangladesh can create a legacy of lifelong health, prosperity, and success for generations to come.

Author:

Dr. Nusrat Farooq

Senior Consultant

Paediatrics & Neonatology

Evercare Hospital Dhaka

References:

https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-018-1076-0

https://www.sciencedirect.com/science/article/pii/S0899900723000266