ABSTRACT
Background: Now a days, Cancer is a major health problemworldwide. Common malignant disease of digestive systemincludes carcinoma oesophagus, carcinoma stomach,carcinoma colon, hepatocellular carcinoma, carcinoma biliarytree, and pancreatic carcinoma. In Bangladesh, there are a fewstudies to evaluate diagnostic value of serum AFP as tumourmarker for GIT malignancies.Aim of the Study: To evaluate the diagnostic value(sensitivity, specificity, positive and negative predictive valuesas well as accuracy) of serum AFP in different malignancies ofdigestive system.Methods: This cross-sectional study was carried out at thedepartment of Gastroenterology of Bangabandhu Sheikh MujibMedical University, Dhaka, Bangladesh from October 2012 toJune 2014. A total of 200 patients with primary digestivesystem malignancies in the age group of 22 to 76 years wereincluded in this study. Malignancy of the included patients werehistologically proven and serum AFP level was measured byimmunoassay method. Serum AFP level >15 ng/ml wasconsidered as positive. Data was collected using questionnaireand clinical information data sheet. Sensitivity, specificity,positive and negative predictive values as well as accuracy ofserum AFP have shown.Results: Mean elevation of Serum AFP found to be muchhigher in advanced case than localized malignancy. Sensitivity,specificity, positive and negative predictive values as well asaccuracy of serum AFP for carcinoma stomach was 5%,73.75%, 4.55%, 75.64% and 60% respectively. Sensitivity,specificity, positive and negative predictive values as well asaccuracy of serum AFP for carcinoma colon was 0%, 72.15%,0%, 73.08% and 57% respectively. Sensitivity, specificity,positive and negative predictive values as well as accuracy ofserum AFP for hepatocellular carcinoma was 87.5%, 98.68%,95.45%, 96.15% and 96% respectively. Sensitivity, specificity,positive and negative predictive values as well as accuracy ofserum AFP for carcinoma Pancreas was 0%, 74.12%, 0%,80.77% and 63% respectively. Sensitivity, specificity, positiveand negative predictive values as well as accuracy of serumAFP for carcinoma gallbladder was 0%, 72.5%, 0%, 74.36%and 58% respectively.Conclusion: Serum AFP level has important role for diagnosisof hepatocellular carcinoma. But has no significant role for thecarcinoma of stomach, carcinoma colon, carcinoma pancreasand carcinoma gallbladder. This study stresses the need ofbroad-based work to detect the actual value of serum AFP fordifferential diagnosis of digestive system malignancies.
ABSTRACT
Objective: In this study our main goal is to evaluate themanagement of diabetes in diabetic patients attending at NHNsin Dhaka city.Method: This retrospective Cohort study was conductedamong 430 Diabetic population of adult age group (≥18 years)of all socioeconomic strata attending at different NHNs inDhaka city from August 2015 to October 2016.Results: During the study, Most of the respondents 345(80.23%) had FPG record at their initial visit. 208 (48.37%) hadHbA1C, 257 (59.76) had OGTT and 169 (39.30%) had PG2hABF. Most of the patients 178 (41.4%) are treated withcombined oral drugs at their initial visit and 117 (27%) were oninsulin. Only 24 (5.6%) patients advised for lifestylemodification. Approximately 40% patients presented withcomplications related to diabetes mellitus at initial visit.Conclusion: From our study we can conclude that, use ofHbA1c for initiation of management and follow the glycemiccontrol was poor. Short term and long-term glycemic controlare poor in all modalities of treatment. Non-adherence ofDiabetes Self-management and poor selection of treatmentregimen both were responsible for poor glycemic control.Further study is needed for better outcome.