Category: Featured Article

Chronic Obstructive Pulmonary Disease (COPD) is a progressive lung disease characterized by difficulty breathing, chronic cough, and mucus production. It is primarily caused by long-term exposure to harmful particles and gases. One of the significant risk factors for developing COPD is air pollution, which exacerbates both the incidence and severity of the disease.

1. How Air Pollution Affects COPD
Air pollution, particularly in urban environments, contains harmful particles and gases such as:
Particulate Matter (PM2.5 and PM10): Tiny particles that can penetrate deep into the lungs, causing inflammation and damage to lung tissues.
Nitrogen Dioxide (NO₂): A gas emitted mainly from vehicle exhausts, which can irritate the airways and lead to reduced lung function.
Ozone (O₃): Ground-level ozone can trigger inflammation in the airways, worsening symptoms in COPD patients.
Sulfur Dioxide (SO₂): Emitted from burning fossil fuels, it can cause bronchoconstriction and worsen COPD symptoms.

2. Mechanism of Impact
Air pollutants can exacerbate COPD through several mechanisms:
Inflammation: Pollutants cause inflammation in the respiratory tract, leading to airway constriction and increased mucus production.
Oxidative Stress: Exposure to pollutants increases the production of free radicals, causing oxidative damage to lung cells.
Impaired Lung Defense: Pollutants can impair the lung’s natural defense mechanisms, making it easier for infections to take hold, which can worsen COPD symptoms.

3. Impact of Air Pollution on COPD Patients
Exacerbations: COPD patients exposed to high levels of air pollution are at a higher risk of exacerbations, which are episodes of worsening symptoms requiring medical intervention.
Hospitalization and Mortality: Increased exposure to air pollution is linked to higher rates of hospitalization and mortality in COPD patients.
Reduced Quality of Life: Chronic exposure can lead to a decrease in physical activity, increased breathlessness, and lower overall quality of life.
4. Preventive Measures
Avoid Outdoor Activities During High Pollution Days: COPD patients should minimize exposure during high pollution days, especially during peak traffic hours.
Indoor Air Quality: Using air purifiers, avoiding smoking indoors, and maintaining good ventilation can help reduce indoor air pollution.
Face Masks: Wearing protective masks (like N95) can help reduce exposure to harmful particles.
Monitoring Air Quality: Using air quality apps or devices can help COPD patients plan their activities based on pollution levels.

5. Public Health Strategies
Reducing Emissions: Governments need to implement stricter regulations to limit emissions from vehicles and industries.
Promoting Green Spaces: Increasing green spaces in urban areas can help reduce pollution levels.
Public Awareness Campaigns: Educating people about the impact of air pollution on respiratory health can help in reducing exposure and promoting protective behaviors.

6. Research Findings
Studies have shown a strong link between long-term exposure to pollutants and the risk of developing COPD. Additionally, short-term spikes in pollution levels have been associated with acute exacerbations of the disease, leading to increased hospital admissions.
In conclusion, air pollution is a critical environmental factor contributing to the development and progression of COPD. Addressing this issue requires a combined effort of individual preventive measures and broader public health policies aimed at reducing emissions and improving air quality.

Author:
Dr. SM Abdullah Al Mamun
Senior Consultant & Coordinator
Respiratory Medicine Department
Evercare Hospital Dhaka

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

Heart disease has long been associated with men, but the truth is that it affects women just as profoundly. In fact, heart disease is the leading cause of death for both men and women worldwide.

However, women often experience different symptoms and risk factors compared to men. This blog post aims to shed light on the unique aspects of heart disease in women, emphasizing the importance of early detection and prevention.

Understanding the Gender Difference

Heart disease manifests differently in women than in men, making it crucial to recognize the unique symptoms.

While men often present with the classic symptoms like chest pain or discomfort, women are more likely to experience subtler signs such as shortness of breath, nausea, vomiting, jaw pain, and back pain. These differences can lead to under diagnosis and delayed treatment for women.

Risk Factors for Women

Several risk factors increase a woman’s likelihood of developing heart disease. These include:

Hormones: Estrogen offers some protective effects on the cardiovascular system, but this advantage diminishes after menopause, increasing the risk for women.

Age: The risk of heart disease increases with age, and women over 55 are more susceptible.

Family History: A family history of heart disease can significantly elevate a woman’s risk.

Smoking: Smoking is a strong risk factor for heart disease, and women who smoke are at a higher risk.

High Blood Pressure and Cholesterol: Elevated blood pressure and cholesterol levels contribute to heart disease risk.

Diabetes: Women with diabetes have a higher risk of heart disease compared to men with diabetes.

Physical Inactivity: Lack of regular exercise can contribute to heart disease risk factors.

Early Detection: The Key to Prevention

Know the Symptoms: Being aware of both classic and atypical symptoms of heart disease is crucial. Women should not dismiss any unusual symptoms and seek medical attention if they experience discomfort or distress.

Regular Health Check-ups: Routine check-ups allow healthcare professionals to monitor blood pressure, cholesterol levels, and other risk factors. Early detection can lead to timely interventions.

Understanding Family History: Knowing the family’s medical history helps women understand their risk profile and take proactive measures.

Blood Pressure and Cholesterol Management: Managing blood pressure and cholesterol through lifestyle changes, medication, or a combination of both can significantly reduce heart disease risk.

Healthy Lifestyle Choices: A balanced diet, regular exercise, maintaining a healthy weight, managing stress, and avoiding smoking are all integral to heart health.

Prevention Strategies

Heart-Healthy Diet: Emphasize whole grains, lean proteins, fruits, vegetables, and healthy fats. Limit saturated and trans fats, sodium, and added sugars.

Physical Activity: Aim for at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous-intensity aerobic activity each week.

Stress Management: Engage in relaxation techniques like meditation, yoga, or deep breathing to manage stress effectively.

Avoid Smoking: Quitting smoking is one of the most significant steps to reduce heart disease risk.

Medication and Treatment: Follow prescribed medication regimens and treatment plans diligently if you have underlying conditions like high blood pressure or diabetes.

Women and heart disease are not mutually exclusive. Understanding the gender-specific symptoms and risk factors is essential for early detection and prevention.

By being proactive about heart health through regular check-ups, healthy lifestyle choices, and risk factor management, women can significantly lower their risk of heart disease and live healthier, more fulfilling lives.

It’s time to prioritize heart health and empower women to take charge of their well-being.

 

Author:

Dr. AQM Reza

Senior Consultant & Coordinator

Clinical & Interventional Cardiology

Evercare Hospital Dhaka

Pediatricians’ Role in Protecting Children’s Health in Extreme Weather

Bangladesh, a country prone to extreme weather events such as floods, cyclones, and heatwaves and faces significant challenges when it comes to protecting the health and well-being of its vulnerable population, particularly children. As frontline healthcare providers, pediatricians play a crucial role in developing strategies to mitigate the adverse effects of extreme weather on children’s health.

This opinion piece explores some key strategies that pediatricians in Bangladesh can adopt to safeguard the health of children in the face of these climatic challenges.

Pediatricians can act as advocates for public awareness campaigns on the impacts of extreme weather on children’s health. By collaborating with local authorities, community leaders, and media outlets, they can disseminate crucial information about the specific risks children face during floods, cyclones, and heatwaves.

They can educate parents, caregivers, and school staff about the necessary precautions, early warning signs, and emergency preparedness measures which is essential to ensure the safety and well-being of children.

Enhancing Pediatric Healthcare in Vulnerable Regions

Pediatricians should work closely with policymakers and healthcare administrators to strengthen the healthcare infrastructure in vulnerable regions. This includes ensuring the availability of well-equipped pediatric wards in hospitals, establishing telemedicine facilities to provide remote consultations during emergencies, and enhancing the capacity of healthcare workers to address weather-related health issues. Collaborating with international organizations and NGOs, can help and secure necessary resources and expertise.

Heatwaves and Children’s Health

Heatwaves pose a significant threat to children’s health, leading to dehydration, heat exhaustion, and heatstroke. Pediatricians can contribute to the development of heatwave action plans at national and local levels. These plans should include guidelines for early identification of heat-related illnesses, strategies for reducing exposure to extreme heat, provision of adequate hydration, and instructions on recognizing and responding to heat emergencies.

They can be get involved in school and community-based interventions, such as adjusting school hours and providing cool shelters.

Moreover, pediatricians can also advocate the construction and retrofitting of climate-resilient infrastructure, such as flood-resistant hospitals, schools, and community centers. By collaborating with urban planners and architects, pediatricians can ensure that these structures are designed to withstand extreme weather events and equipped with the necessary facilities to address children’s health needs during emergencies.

Additionally, they can support and help initiatives to improve water and sanitation systems to prevent waterborne diseases, particularly after flooding.

Pediatricians as Leaders in the Fight Against Climate Change

Additionally, pediatricians should actively engage in research efforts to better understand the long-term impacts of extreme weather on children’s health. This includes monitoring and documenting the prevalence of weather-related illnesses, studying the effectiveness of interventions, and identifying emerging health risks associated with climate change. By generating evidence-based data, pediatricians can contribute to the development of targeted interventions and policies that prioritize children’s health.

Afterall, protecting the health of children in Bangladesh’s extreme weather conditions requires proactive measures and collaboration among pediatricians, policymakers, communities, and international partners.

By raising public awareness, strengthening healthcare infrastructure, developing action plans, promoting climate-resilient infrastructure, and conducting research, pediatricians can play a pivotal role in minimizing the adverse impacts of extreme weather events on children. Their dedication and expertise are vital in building a more resilient healthcare system that safeguards the well-being of Bangladesh’s youngest and most vulnerable population.

 

Author:

Dr. Sabina Sultana

Senior Consultant – Paediatrics & Neonatology

Coordinator- Paediatrics

Evercare Hospital Dhaka