Clinicopathological Assessment of Colorectal Carcinoma in Mymensingh Medical College Hospital, Bangladesh.

Colorectal carcinoma (CRC) is the third most commonly diagnosed cancer and the third leading cause of cancer death in both men and women in the US. It is mainly a disease of the developed countries with a western culture, yet the disease is not uncommon in developing countries. There is substantial geographical variation in the incidence and demographic characteristics of the disease. Variations are also observed in the risk factors, mode of presentation, sub site distribution and stage of the disease at presentation. This cross-sectional, descriptive study was intended to explore the age and sex distribution, pattern of presentation, sites and histological types of colorectal carcinoma. This cross-sectional, descriptive study was conducted in the department of surgery, Mymensingh Medical College Hospital, Bangladesh from October 2011 to September 2012. Purposively selected sixty patients irrespective of age and sex with histologically proven colorectal cancer were included in the study. A pre-tested, structured case record form was used for collection of data. Most of the patients (80.0%) were above 50 years of age. Mean age was 60.83 years with an SD of 11.2 years. Male to female ratio was almost equal (1.3:1). Positive family history was present in 3.3% cases. More than half of the patients (53.3%) were smokers, 76.7% patients had the history of taking fresh fruits irregularly. Pain in abdomen was the leading symptom followed by alteration of bowel habit and weight loss. Anaemia was found in 71.6% patients followed by wasting in 70.0% cases. Proctosigmoidoscopy was the principal diagnostic modality (61.7%) followed by double contrast barium enema (30.0%). Patients with rectal growth were detected by digital rectal examination (23.3%). Rectum was the principal site of cancer (36.7%) followed by sigmoid colon (33.3%). Cancer in caecum and ascending colon were in 15.0% and 6.7% patients respectively. Adenocarcinoma was the principal histological type (88.0%) and 36.7% were well differentiated carcinoma. Majority of the patients (63.3%) were in advanced stage (stage III and stage IV). Some forms of palliative surgical treatment were offered to all colorectal cancer patients in the study. Postoperative outcome was uneventful in most of the patients. However, there was wound infection in (13.3%) patients. Colorectal cancer was found mainly in elderly. Male and females were affected almost equally. Smoking was the most commonly found risk factor. Colorectal carcinoma involved rectum and sigmoid colon in majority of the patients. Adenocarcinoma was the principal histological type and the most of which were well differentiated. Majority of the patients were diagnosed at an advanced stage and palliative treatment was offered to them. Postoperative period was uneventful in most of them. Policies should be taken to promote health education & screening programmes which will lead to early diagnosis, affordable and effective treatment and better prognosis.

A Comparative Study between FNAC and Histopathology in Diagnosis of Breast Lump.

Worldwide a large number of patients have been suffering from breast lump and this trend is gradually increasing. It is difficult to determine whether a lump is benign or malignant from clinical assessment. Thus the need for microscopic tissue analysis arises. This study was designed to determine the value of fine needle aspiration cytology in the diagnosis of breast lumps and to compare the result of FNAC with histopathological diagnosis to assess its accuracy. A prospective study in the period of January 2009 to December 2010 was done. One hundred and ten (110) patients who came to the Department of Surgery in Mymensingh Medical College Hospital, Bangladesh in two years for their palpable breast masses were chosen for the study. There were 70(63.63%) benign, 33(30.00%) malignant and 07(6.36%) suspicious smears in FNAC. Inadequate samples were repeated. The number of repeats increased the diagnostic accuracy of aspirates which is statistically significant when compared with histopathology. In histopathology Invasive ductal carcinoma was the most commonly reported lesion with maximum incidence in the 4th, 5th, and 6th decades followed by invasive lobular carcinoma and other malignant lesions. FNAC serves as a rapid, economical and reliable tool for the diagnosis of palpable breast lesions and its reliability is influenced by the skillness of the aspirator. So physician should use this tool with clinical experience.

Evolution of phytoplankton cultures after ultraviolet light treatment.

Introducing invasive species in new environments through ballast water is a specific problem of contamination and has recently become one of the main concerns of Maritime Organizations. Ultraviolet-C radiation (UV-C) is a technological alternative to prevent this maritime pollution. This study addresses the effect of UV-C on different phytoplankton cultures and also the ability to recover following exposure to damage. A UV-C low-pressure lamp irradiates the cultures. The distance from the source and the thickness of the layer prevent part of the energy from reaching the culture and the disinfective process is diminished. Some cultures such as Chlorella autotrophica and Chaetoceros calcitrans can easily recover from UV-C damage. However, Phaeocystis globosa does not have this ability. C. calcitrans forms cysts and exhibits two different behaviours depending on the dose applied.

Drop-out and admission cancel rate among the students in a selected medical college.

A record based descriptive type of study was carried out among the under-graduate students of Mymensingh Medical College from the session 1966-67 to 2006-07. The academic years were divided into four decades and admission was followed into three categories such as retained, cancellation and drop-out. Total number of the students was 5892. Among them 3848(65.30%) were male and 2044(34.69%) were female. Out of 5892 students drop-out was 282(4.78%) and admission cancel was 304(5.15%). It was also found that drop-out in male was 232(6.02%) and in female was 50(2.44%) and admission cancel in male was 266(5.87%) and in female was 78(3.81%). The difference was found statistically significant (p<0.001). It was observed that gradually the drop-out and admission cancel rate is decreasing from the very beginning to till now. It was also observed that all drop-out and admission cancellation were in first & second year students. There was no continuation of their class roll numbers in third year registration.

Jejunogastric intussusception.

Retrograde Jejunogastric Intussusception (RJGI) is a rare but potentially very serious complication of gastrectomy or gastrojejunostomy. It was first described by Bozzi in 1914 in a patient with gastrojejunostomy. Clinically it is of two types acute and chronic. Anatomically it is of three types. The acute form is a surgical emergency. In the acute form there is chance of strangulation of the intussuscepted loop if early intervention is not done. To avoid mortality, early diagnosis and prompt surgical intervention is mandatory. There is no medical treatment for jejunogastric intussusception and surgical intervention is required for the definite treatment. It usually presents with abdominal pain, nausea, vomiting, haematemesis and a palpable diffuse lump in the upper abdomen. A history of gastric surgery can help in making a diagnosis. X-ray can occasionally be diagnostic. Endoscopy performed by someone familiar with this rare entity, is certainly diagnostic. We herein report a case of jejunogastric intussusception who presented with acute abdomen, haematemesis and abdominal lump.

Persistence of low serum iron and high total iron binding capacity in pregnant women.

A cross sectional descriptive type of study was done in 98 women of reproductive age. Among them 25 were in control group of non pregnant women and 73 were pregnant women of 1st, 2nd and 3rd trimester of pregnancy with and without iron supplementation. The period of study was July 2004 to June 2005. The main objective of our study was to compare serum iron and total iron binding capacity in pregnant and non pregnant women. In present study serum iron was significantly increased in 2nd and 3rd trimester of pregnancy that was supplemented with iron when compared with the same category of women who were not supplemented with iron. On the other hand serum total iron binding capacity (TIBC) was significantly increased in 3rd trimester of pregnancy that was not supplemented with iron when compared with the same category of women who were supplemented with iron. It is evident that the significantly low serum iron and high TIBC in pregnant women is due in part to dietary iron deficiency. Therefore, iron therapy in pregnancy is helpful to maintain the serum iron and TIBC nearer to that of non pregnant normal women.