Author: dhaka-admin

When most people hear the word “diabetes,” they often picture an older person managing their diet or insulin levels. However, the reality today is quite different—diabetes is an urgent concern for children and young people as well. In fact, diabetes is one of the most common chronic illnesses among children, and the numbers are on the rise. 

Misconceptions about childhood diabetes persist, leading to delayed diagnoses and inadequate care. On World Diabetes Day, it is crucial to dispel these myths and raise awareness about the realities of the disease in younger populations. To raise awareness about diabetes, we need to know a few things:  

Diabetes in children presents both immediate and long-term risks. Short-term risks include conditions such as diabetic ketoacidosis (DKA) and hypoglycemia, both of which can be life-threatening if not treated promptly. The long-term complications are equally concerning. Uncontrolled diabetes increases the risk of high blood pressure, high cholesterol, liver disease, and cardiovascular issues—even at a young age. Additionally, diabetes can lead to microvascular and macrovascular complications, such as retinopathy, nephropathy, neuropathy, and cardiovascular diseases. 

Diabetes in children primarily manifests in three forms: type 1, type 2, and monogenic diabetes. Type 1 diabetes, the most common form among children, accounts for over 90% of pediatric diabetes cases. It occurs when the body’s immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas, leading to an insulin deficiency. This autoimmune reaction can develop over time, with symptoms appearing suddenly. Type 1 diabetes can develop at any age. 

While traditionally thought to affect adults, around 10% of children are now diagnosed with type 2 diabetes. This condition can manifest at any age but is often associated with risk factors such as being overweight, having a family history of type 2 diabetes, leading a sedentary lifestyle, or experiencing polycystic ovary syndrome (PCOS) in girls. Dark patches on the skin, particularly around the neck (known as acanthosis nigricans), can also indicate insulin resistance in children. 

Monogenic diabetes, a rare form, affects a small percentage of children—about 1 to 6%. It is caused by a single gene mutation and can present very early in life. Neonatal diabetes mellitus, a form of monogenic diabetes, typically appears within the first year of life and requires specific management strategies. 

The symptoms of diabetes in children may vary depending on age and type. However, common signs include excessive thirst, frequent urination, unexplained weight loss, constant fatigue, and recurrent infections. These symptoms can be subtle and may be mistaken for other conditions, leading to delayed diagnoses. To ensure proper growth and development, children should be provided with a balanced, fiber-rich diet. Healthy eating, regular exercise, and maintaining a healthy weight are key to managing diabetes. 

Early recognition is crucial for effective disease management and minimizing complications. If any of these symptoms are observed, it is essential to seek medical attention immediately. 

For children with type 1 diabetes, insulin therapy is the cornerstone of treatment. The type and dosage of insulin are tailored to the child’s age, lifestyle, and overall health. Over time, children with type 1 diabetes may also need screening for related conditions such as thyroid issues or celiac disease, which are more common in this population. For children with type 2 or monogenic diabetes, the disease can often be managed with medications, lifestyle changes, and, in some cases, insulin to keep blood sugar levels under control. 

By educating ourselves and our communities, we can break the stigma associated with diabetes and ensure that children receive the care they need. Diabetes is a lifelong condition, but with proper management, children can lead full, healthy lives. It is time to recognize the growing prevalence of diabetes among young people and take action to protect the next generation from its impact. 

Author: 

Dr. Ahsanul Haq Amin 

Senior Consultant 

Diabetology & Endocrinology Department 

Evercare Hospital Dhaka 

Diabetes mellitus, commonly known as diabetes, is a chronic condition that exists in two primary forms: Type 1 and Type 2. If diabetes is left uncontrolled, it can severely affect various organs, including the kidneys. Uncontrolled diabetes is one of the leading causes of kidney failure worldwide. Research indicates that between 30% and 50% of people with diabetes (Lin et al., 2018) may develop kidney problems. The risk of kidney disease increases due to factors such as uncontrolled diabetes, chronic high blood pressure, a family history of kidney disease, and the prolonged duration of diabetes.

Kidney Complications Associated with Diabetes

The kidneys play a crucial role in filtering waste products from the body, which are then excreted through urine. When this filtering system is damaged—due to diabetes, high blood pressure, or other factors—important substances like protein may start leaking from the body through the urine. Although early detection and control of diabetes and blood pressure can help manage this condition, prolonged damage can lead to complete kidney failure. It is essential to adopt a healthy lifestyle, as well as manage diabetes and blood pressure under the guidance of a healthcare professional, to maintain kidney health.

How to Keep Your Kidneys Healthy

For diabetics, following specific guidelines is crucial for keeping the kidneys healthy. Controlling blood sugar and blood pressure within recommended limits is vital. Regular monitoring through blood tests, including urine tests to check for protein, can help assess kidney function and detect issues early. Dietary adjustments are also important, and following your doctor’s advice on diet, particularly regarding salt and protein intake, is key. It is advisable to limit animal protein and opt for plant-based sources when possible. Maintaining a healthy weight can reduce the strain on your kidneys, and avoiding smoking is essential since it can exacerbate kidney damage. Always consult with your doctor before taking any new medication to ensure it doesn’t harm your kidneys.

If the Kidneys are Damaged

If kidney damage progresses to the point of failure, a kidney transplant or dialysis may be required. Though beneficial yet both treatments are costly and carry some  risks, making it crucial to take preventive measures to protect kidney health. For those with existing kidney disease, lifestyle changes are essential. Engaging in regular exercise, avoiding raw or fried salt, meeting protein needs primarily through vegetable sources, and refraining from foods high in saturated fat, such as beef fat, are important steps. Additionally, avoiding painkillers that can harm the kidneys and quitting smoking are necessary for maintaining kidney health. Along with these lifestyle changes, taking appropriate medication as prescribed by a doctor can be beneficial. Regular check-ups to monitor kidney function are essential to managing the condition effectively.

Author:
Dr. Tabassum Samad
Consultant
Department of Nephrology
Evercare Hospital Dhaka

Radiation therapy is a highly effective and proven method for treating breast cancer. This treatment uses high-powered radiation to destroy cancer cells. Often used alongside surgery or chemotherapy, radiation therapy helps eliminate cancer cells entirely and reduces the risk of the disease returning.

How Does Radiation Therapy Work?

Radiation therapy uses a form of X-rays or gamma rays to damage the DNA of cancer cells. As a result, the cancer cells lose the ability to divide and spread, gradually leading to their destruction. Radiation therapy is generally administered in two ways:

1. External Beam Radiation Therapy: In this method, radiation is directed at the external part of the breast using a machine. Typically, this therapy lasts 10-15 minutes each day for 3-5 weeks.
2. Brachytherapy: In this method, a small radiation source is placed inside the breast, directly targeting and destroying the cancer cells.

When is Radiation Therapy Needed?

Radiation therapy is usually applied in the following situations:
– After Lumpectomy: After removing the cancer-affected part, radiation is applied to the remaining breast tissue to prevent cancer from recurring.
– After Mastectomy: If there is a risk of cancer spreading after the complete removal of the breast, radiation therapy is used.
– If Lymph Nodes are Affected: If cancer spreads to the lymph nodes, radiation therapy can be effective in destroying those cancer cells.

Side Effects of Radiation Therapy

Although radiation therapy is generally safe, some side effects may occur, such as:

Immediate (Acute) Side Effects:

– Redness or darkening of the skin at the treatment site.
– Feeling of fatigue or weakness.
– Increased sensitivity in the chest or skin.

Delayed Side Effects:

– Heart disease or lung problems (rare).

Doctor’s Advice and Care

It is important to follow the doctor’s advice both during and after radiation therapy. Proper rest, eating healthy food, and taking care of your skin are essential after treatment.

Radiation therapy is a vital part of breast cancer treatment. It helps improve the quality of life by reducing the risk of cancer recurrence. By following medical guidance and staying aware, you can fully benefit from this treatment process. With the right treatment and mental strength, it is possible to fight breast cancer.

Author:
Dr. Bishwajit Bhattacharjee 
Senior Consultant 
Clinical & Radiation Oncology 
Coordinator – Radiation Oncology 
Evercare Hospital Dhaka.

Breast cancer is a common but dangerous disease among women. Early detection and treatment can greatly reduce the risks. It is essential to have accurate knowledge about breast cancer, conduct regular self-examinations, and follow a doctor’s advice for proper testing.

Symptoms of Breast Cancer

There are several common signs of breast cancer and identifying them early can lead to faster treatment. These symptoms include:

– A hard or smooth lump appearing in or around the breast or armpit.
– Changes in the size or shape of the breast.
– Formation of dimples or indentations on the skin of the breast.
– Redness or swelling of the breast skin.
– Abnormal discharge from the nipple or changes in the shape of the nipple.
– Swollen glands in the armpit or around the neck.

Breast Self-Examination: How to Do It

To detect breast cancer early, it is recommended to perform a self-examination once a month. The best time to do this is a few days after your menstrual cycle ends. If your cycle is irregular, choose a specific day each month for the examination.

1. Stand in front of a mirror: Stand with your hands on your hips and observe the size, shape, and skin color of your breasts. Then, raise your arms above your head and examine your breasts in the same way.
2. Feel with your hands: Use the flat part of your palm to examine the breasts. Make small circular motions, starting from the top of the breast to the bottom, and from the armpit to the middle. Examine both breasts in the same manner.
3. Examine while lying down: Use a pillow to lift your right shoulder and place your right hand behind your head. Use your left hand to examine your right breast. Repeat the process for the left breast.

Consulting a Doctor

If you notice any abnormalities, it is essential to consult a doctor. Even if breast cancer is present, early detection can lead to complete recovery through treatment. Regular mammograms and doctor consultations are crucial.

Ways to Prevent Breast Cancer

– Eat healthy foods regularly and stay physically active.
– Avoid smoking and drinking alcohol.
– Maintain a healthy weight.
– Regularly consult with a doctor and undergo checkups.

Your health is in your hands. By becoming aware and leading a healthy lifestyle, you can significantly reduce the risk of breast cancer. So, conduct regular self-examinations and seek medical advice if needed. Your awareness is the key to your health!

Author:
Dr. Ferdous Shahriar Sayed 
Senior Consultant and Coordinator 
Medical Oncology 
Evercare Hospital Dhaka.

Obesity is a growing global health concern and a disease process, leading to various chronic conditions such as diabetes, hypertension, heart disease, and more. For individuals who have struggled to achieve significant weight loss through diet and exercise alone, bariatric surgery offers a viable, effective solution. This life-changing procedure not only helps in reducing weight but also in alleviating or even curing obesity-related health issues.

Bariatric surgery encompasses several types of procedures designed to limit food intake and alter the digestive process, leading to significant weight loss. The most common types include Sleeve Gastrectomy, Gastric Bypass, Adjustable Gastric Banding, and Biliopancreatic Diversion with Duodenal Switch (BPD/DS). Each procedure has its unique approach, but the ultimate goal remains the same: to help patients lose excess weight and improve their overall health.

Sleeve Gastrectomy is most popular procedure where a large portion of the stomach is removed, leaving a tube-shaped stomach or “sleeve.” This significantly reduces the amount of food you can consume and decreases hunger hormones.

Gastric Bypass Surgery involves creating a small pouch from the stomach and connecting it directly to the small intestine, bypassing most of the stomach and significant length of small bowel. This not only limits the amount of food you can eat but also reduces the absorption of nutrients, leading to substantial weight loss.

Adjustable Gastric Banding involves placing a band around the upper portion of the stomach to create a small pouch. The size of the opening between the pouch and the rest of the stomach can be adjusted, helping control the amount of food intake.

Biliopancreatic Diversion with Duodenal Switch (BPD/DS) combines aspects of sleeve gastrectomy and gastric bypass, offering one of the most effective weight loss solutions, particularly for those with severe obesity.

In Bangladesh, Evercare Hospital Dhaka is offering comprehensive bariatric surgery services. The hospital provides a multidisciplinary approach to bariatric surgery, combining the expertise of surgeons, dietitians, psychologists, and other healthcare professionals. This collaborative effort ensures that each patient receives personalized care tailored to their specific needs, from the initial consultation to post-surgery lifelong support. The hospital’s patient-centered approach ensures that each individual receives personalized care tailored to their specific needs. Whether you’re battling obesity or seeking to resolve related health issues, bariatric surgery at Evercare can be a life-changing solution.

Author:

Dr. Mohammad Farid Hossain

Senior Consultant

General & Laparoscopy Surgery

Evercare Hospital Dhaka

Helping patients and speaking up for them is really important when dealing with cancer, especially in countries that may not have a lot of resources, good infrastructure, or fair opportunities for everyone. Here are a few reasons that show why patient advocacy is crucial when it comes to managing cancer in these situations:

1. Getting Information:

People who support patients (patient advocates) can help share important information. They tell patients and their families about how to prevent cancer, find it early, and what treatments and support services are available. In some poorer countries, not many people know about cancer and how to deal with it. That’s why it’s so important for advocates to spread the word and give out information.

2. Getting Through Healthcare Systems:

In some poorer countries, healthcare systems may be confusing, with not enough access to specialized care and lots of bureaucratic challenges. Patient advocates can help navigate these difficulties, making it easier for patients to get the right medical care, attend follow-up appointments, and use support services.

3. Dealing with Shame:

Some communities may feel ashamed about cancer. People who support patients (patient advocates) are important in talking about and lessening this shame. They encourage open conversations and create a supportive space for patients and their families.

4. Making Patients Stronger:

Patient advocacy helps patients take an active role in deciding how they want to be treated. In places where healthcare is more top-down or like a parent telling you what to do, patient advocacy helps people speak up about what they want. This makes sure patients get care that is all about them and what they need.

5. Getting Resources:

When people speak up for something (advocacy), it can help gather resources for preventing, checking, and treating cancer. By making more people aware and talking to decision-makers, those who support patients can ask for more money, better facilities, and healthcare professionals who know a lot.

6. Lessening Health Differences:

People who support patients (patient advocates) can help make sure everyone gets the same good care for cancer. They speak up for equal access to quality healthcare, no matter how much money someone has, where they’re from, or their background. This is really important for making sure everyone has a fair chance at good health.

7. Spreading the Word:

When people speak up for something (advocacy), it helps others learn more about cancer, what can make it happen, and why finding it early is crucial. This can make everyone more proactive about taking care of their health and can improve how cancer is dealt with.

To sum up, helping and speaking up for patients is really important when dealing with cancer in poorer countries. It does many things like making more people aware, improving access to care, support systems, and decisions made by leaders. All of this together makes things better for people dealing with cancer.

Author:

Dr. Arman Reza Chowdhury

Cancer Specialist

Consultant, Radiation Oncology

Evercare Hospital Dhaka

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