Clinicopathological pattern and risk factors of carcinoma breast in younger age group

Worldwide, breast cancer is the most frequently diagnosed life-threatening cancer and the leading cause of cancer death among women. Approximately 7% of all breast cancers are diagnosed in women <40 years of age. Young age at diagnosis influences prognosis negatively as they present with more advanced disease at diagnosis and a poorer 5-year survival than older patients. The present study includes breast cancer patients in the age group of 18 to 40 years to enrich our knowledge about clinical presentation and pathological characteristics of breast cancer. To find out the clinical presentation and pathological characteristics of breast cancer among the young age group.  This cross-sectional study was done over 100 cases of histopathologically proven breast cancer from structured Questionnaire was used as data collection tool. Mean age was 33.89 years. Among the respondents 88% are married. Among the total studied population 61 respondents had the history of oral contraceptive pill use. Family history of cancer presents in 13.0% respondents and absent in 87.0% respondents. Among the respondents 95% patients presented with lump in the breast. 97.0% had invasive carcinoma 90% were invasive ductal carcinoma in which 46.0% were moderately differentiated. 51.0% patients were in the stage IIa and stage IIb

External beam radiotherapy and intracavitary brachytherapy is an acceptable treatment for locally advanced carcinoma of the uterine cervix

Background: Cervical carcinoma is the second most common neoplasm in women worldwide and is the most frequent cancer among women in Bangladesh. In recent years, High Dose Rate (HDR) brachytherapy in combination with External Beam Radiotherapy (EBRT) has been popular in the management of cancers of uterine cervix.Objectives: To evaluate the effectiveness and acute toxicity of four fractions high dose rate intracavitary brachytherapy following pelvic external beam radiotherapy in the treatment of locally advanced cervical carcinoma. Methods: Bangabandhu Sheikh Mujib Medi­cal University & NICRH chosen as a research place for EBRT and HOR brachytherapy. A typical radiotherapy treatment involves daily inadiation for several weeks. Whole pelvis was treated with total dose of SO Gy in 5 weeks. Patients were treated once a day, 5 days a week with a daily fraction size of 2.0 Gy. EBRT: Pelvic radiotherapy dose is 50 Gy in 25 fractions (2.0 Gy per fraction) over 5 weeks. HDR brachytberapy dose is 7 Gy per fraction, total 4 fractions, each in a week over 4 weeks. Results: Ninety-eight patients were entered in the study. Three patients were excluded due to active non-malignant diseases. One patient had active tuberculosis, two patients had severe skin reactions and two patients withdrew following the first HDR application. The remaining Ninety patients were analyzed. Ninety patients completed the prescribed treatment and were evaluated. Eighty had complete response with relief of symptoms, negative Pap-smear and no clinical signs of persistence disease at 3 months. Ten patients had a positive Pap-smear with clinical signs of persis­tence disease. Patients were evaluated before statting treatment with EBRT and before starting treatment with HDR ICBT. Conclusion: It can be easily concluded that 4 fractions of HDR ICBT, 7 Gy each weekly and pelvic EBRT can effectively and safely control locally advanced carcinoma of the uterine cervix. So that EBRT and HDR ICBT is an acceptable treatment for locally advanced carcinoma of the uterine cervix. Careful attention to normal tissue doses such as the rectum, bladder, and small bowel is important in the treatment of locally advanced cervical cancer

Comparison of radiation therapy alone and concurrent chemoradiation therapy for in operable cervical cancer

Objectives: Concurrent chemoradiation therapy (CCRT) is the standard treatment for inoperable cervical cancer. The purpose of this study was to compare the outcomes of CCRT with cisplatin and radiotherapy (RT) for inoperable cervical cancer. Methods: From January 2O12 to June 2012, 60 female patients with FIGO stage IIB to IVA were enrolled in this randomized phase III trial to compare radiotherapy (RT) alone with chemo radiotherapy (RT 5 Fraction in a week and Cinplatin 40 mg weekly). External beam radiation therapy was delivered using a telecobalt-60 unit. This was followed by 21 Gy of intracavitary brachytherapy. Results: In total, 30 patients were recruited: RT alone (30) and CCRT (30). The age of patients ranged from 26-65 years. There was statistically significant (p value < 0.037) complete response (70.00%) CCRT group vs 43.30% RT group) in CCRT group. Conclusion: CCRT was seen to have better efficacy for patients with inoperable cervical cancer than RT alone.

The Incidence of Vaso-vagal Reactions Among Whole Blood Donors During or Immediately After Donation

Background: The incidence of vaso vagal reaction among the whole blood donors are common. Few percent of these reaction may progress to syncope. Objectives: To evaluate the incidence of vaso-vagal reaction (VVR) among whole blood donors. Methods: This prospective, observational study was done in the department of transfusion medicine in Bangabandhu Sheikh Mujib Medical University from 01-04-2008 to 31-03-2009. Total 19553 blood donors were observed for vaso-vagal reaction. Results: The incidence of vaso-vagal reaction was 0.37%, in male 0.33% and in female it was 0.67%. Female donors were significantly more prone to develop vasovagal reaction (p=0.001). 78.8% of donors were first time donor and 28.8% were repeat donor. The clinical character of the symptoms according to frequency was- Sweating (86.3%), Nausea/ Vomiting (80.8%), Pallor (67.1%), Dizziness (39.7%), Loss of consciousness and fainting, increased rate of respiration (30.1%), anxiety presented (16.4%) and vertigo (1.4%). Conclusion: Although the incidence of vasovagal reactions in our study is lower than other studies, it is important to follow strict donor selection criteria and ensure careful monitoring during and immediate after the donation process to avoid the fatal consequences. Key words: Vaso-vagal reaction; donor reaction; blood donation. DOI: http://dx.doi.org/10.3329/bsmmuj.v4i2.8640 BSMMU J 2011; 4(2):106-10

Clinicopathological pattern and risk factors of carcinoma breast in younger age group

Worldwide, breast cancer is the most frequently diagnosed life-threatening cancer and the leading cause of cancer death among women. Approximately 7% of all breast cancers are diagnosed in women <40 years of age. Young age at diagnosis influences prognosis negatively as they present with more advanced disease at diagnosis and a poorer 5-year survival than older patients. The present study includes breast cancer patients in the age group of 18 to 40 years to enrich our knowledge about clinical presentation and pathological characteristics of breast cancer. To find out the clinical presentation and pathological characteristics of breast cancer among the young age group.  This cross-sectional study was done over 100 cases of histopathologically proven breast cancer from structured Questionnaire was used as data collection tool. Mean age was 33.89 years. Among the respondents 88% are married. Among the total studied population 61 respondents had the history of oral contraceptive pill use. Family history of cancer presents in 13.0% respondents and absent in 87.0% respondents. Among the respondents 95% patients presented with lump in the breast. 97.0% had invasive carcinoma 90% were invasive ductal carcinoma in which 46.0% were moderately differentiated. 51.0% patients were in the stage IIa and stage IIb

Comparative outcome of cisplatin-capecitabine regimen with oxaliplatincapecitabine regimen in advanced gastric carcinoma: a quasi-experimental study

Chemotherapy is the primary therapeutic choice for advanced gastric cancer. The goal of this study was to assess the effectiveness and toxicity of the cisplatin-capecitabine regimen versus the oxaliplatin-capecitabine regimen in treating advanced gastric cancer. Between February 2021 and March 2022, this quasi-experimental study was conducted on 64 advanced gastric cancer patients. Purposive sampling was used to include those who met the inclusion criteria and distributed them evenly between the two arms. Arm A got an injection of cisplatin (80 mg/m2 on day 1) with oral capecitabine (1000 mg/m2 b.i.d. on days 1–14), whereas arm B received an injection of oxaliplatin (130 mg/m2 on day 1) plus oral capecitabine (1000 mg/m2 b.i.d. on days 1–14), every 3 weeks for 6 cycles. A final check-up was done at 12 weeks after the treatment. In arm A, 18 (56.2%) patients exhibited partial response compared to 15 (46.9%) in arm B. Stable diseases were also reported in both arms (18.8% in arm A and 21.9% in arm B). There were 8 (25.0%) cases of progressive disease in arm A and 10 (31.2%) cases in Arm B. The median progression-free survival in arms A (5.6 months) was almost similar to arm B (5.9 months). The most prevalent toxicities in both arms were vomiting, diarrhea, anemia, neutropenia, oral mucositis, paresthesia, handfoot syndrome, and renal toxicity. There were no statistically significant variations in outcomes between the two arms. In conclusion, the cisplatincapecitabine regimen is as effective as the oxaliplatin-capecitabine regimen in advanced gastric cancer. BSMMU J 2022; 15(3): 180-18

Association of clinico-epidemiological features with locally advanced stage of cervical cancer patients presenting at Bangabandhu Sheikh Mujib Medical University, Bangladesh

Cervical cancer is one of the most prevalent gynecological cancers in women in Bangladesh. The objective of this study was to assess the clincoepidemiological association with the histology of locally advanced cervical cancer. We have done this observational study in the department of Clinical Oncology at Bangabandhu Sheikh Mujib Medical University from July to December 2019. Sixty-six biopsy-proven locally advanced (stage IIB to IVA) squamous cell carcinoma of uterine cervix were included in this study. The mean age of patients at diagnosis was 48.5 (±8.6) years. Commonly observed epidemiological characteristics of locally advanced carcinoma cervix were illiteracy (46.9%), oral contraceptive use (62.1%), multi para (78.7%) and early marriage (74.2%). Most frequent clinical presentation was post-coital bleeding (37.87%). Most patients presented in stage IIB (65.1%). The association of the stages of the disease with age, parity, oral contraceptive use, age at marriage and clinical presentation were statistically nonsignificant, whereas illiteracy was statistically significant. Most women had poor awareness regarding their need for routine check-up and screening as indicated by the late medical care seeking. Social stigma might have played some role. Relevant programmes should create awareness among women, especially those with socioeconomic deprivation. BSMMU J 2022; 15(3): 175-17

External beam radiotherapy and intracavitary brachytherapy is an acceptable treatment for locally advanced carcinoma of the uterine cervix

Background: Cervical carcinoma is the second most common neoplasm in women worldwide and is the most frequent cancer among women in Bangladesh. In recent years, High Dose Rate (HDR) brachytherapy in combination with External Beam Radiotherapy (EBRT) has been popular in the management of cancers of uterine cervix. Objectives: To evaluate the effectiveness and acute toxicity of four fractions high dose rate intracavitary brachytherapy following pelvic external beam radiotherapy in the treatment of locally advanced cervical carcinoma. Methods: Bangabandhu Sheikh Mujib Medi­cal University & NICRH chosen as a research place for EBRT and HOR brachytherapy. A typical radiotherapy treatment involves daily inadiation for several weeks. Whole pelvis was treated with total dose of SO Gy in 5 weeks. Patients were treated once a day, 5 days a week with a daily fraction size of 2.0 Gy. EBRT: Pelvic radiotherapy dose is 50 Gy in 25 fractions (2.0 Gy per fraction) over 5 weeks. HDR brachytberapy dose is 7 Gy per fraction, total 4 fractions, each in a week over 4 weeks. Results: Ninety-eight patients were entered in the study. Three patients were excluded due to active non-malignant diseases. One patient had active tuberculosis, two patients had severe skin reactions and two patients withdrew following the first HDR application. The remaining Ninety patients were analyzed. Ninety patients completed the prescribed treatment and were evaluated. Eighty had complete response with relief of symptoms, negative Pap-smear and no clinical signs of persistence disease at 3 months. Ten patients had a positive Pap-smear with clinical signs of persis­tence disease. Patients were evaluated before statting treatment with EBRT and before starting treatment with HDR ICBT. Conclusion: It can be easily concluded that 4 fractions of HDR ICBT, 7 Gy each weekly and pelvic EBRT can effectively and safely control locally advanced carcinoma of the uterine cervix. So that EBRT and HDR ICBT is an acceptable treatment for locally advanced carcinoma of the uterine cervix. Careful attention to normal tissue doses such as the rectum, bladder, and small bowel is important in the treatment of locally advanced cervical cancer

Comparison of radiation therapy alone and concurrent chemoradiation therapy for in operable cervical cancer

Objectives: Concurrent chemoradiation therapy (CCRT) is the standard treatment for inoperable cervical cancer. The purpose of this study was to compare the outcomes of CCRT with cisplatin and radiotherapy (RT) for inoperable cervical cancer. Methods: From January 2O12 to June 2012, 60 female patients with FIGO stage IIB to IVA were enrolled in this randomized phase III trial to compare radiotherapy (RT) alone with chemo radiotherapy (RT 5 Fraction in a week and Cinplatin 40 mg weekly). External beam radiation therapy was delivered using a telecobalt-60 unit. This was followed by 21 Gy of intracavitary brachytherapy. Results: In total, 30 patients were recruited: RT alone (30) and CCRT (30). The age of patients ranged from 26-65 years. There was statistically significant (p value < 0.037) complete response (70.00%) CCRT group vs 43.30% RT group) in CCRT group. Conclusion: CCRT was seen to have better efficacy for patients with inoperable cervical cancer than RT alone.