A comprehensive scenario of heavy metals pollution in the rivers of Bangladesh during the last two decades.

For decades, rivers have been used for transporting pollutants loaded with heavy metals (HMs) causing severe pollution in downstream. The current study aimed to review the levels and sources of 10 HMs, viz. As, Pb, Cd, Cr, Fe, Mn, Cu, Co, Ni, and Zn in the surface water of the rivers in Bangladesh. The PRISMA criteria were used to conduct a systematic review of the available literature published between 2001 and 2020, and thus a total of 55 documents were finally selected for review. The mean concentration of each HM exceeding the threshold limits as per World Health Organization (WHO), the United States Environmental Protection Agency (USEPA), and Department of Environment (DoE), Bangladesh standards were higher in the last decade (2011-2020) than in the previous one (2001-2010). Most HM concentrations in water were found above the threshold limits in three divisions (Dhaka, Rajshahi, and Chattogram). The Buriganga River in Dhaka has been the top polluted river in Bangladesh. Among the 10 HMs, six metals (As, Pb, Cd, Cr, Fe, and Mn) exceeded the limit set by WHO, USEPA, and DoE in all three seasons, where mean values of most of the HMs were found to be the highest in the summer season. Statistical analyses identified possible sources of HMs such as natural weathering, electroplating, fertilizers and pesticides, mining and manufacturing, textiles, coal mining and burning, batteries, and paint industries. Strong legislations and regulations, awareness programs, continuous monitoring, and comprehensive research are urgently needed to control riverine HMs pollution in Bangladesh.

Role of 3D Ultrasound and Doppler in Differentiating Clinically Suspected Cases of Leiomyoma and Adenomyosis of Uterus.

INTRODUCTION: Adenomyosis and Leiomyoma are common disorders affecting females in their reproductive age. They mimic each other in clinical presentation. Due to similarities in clinical symptoms and signs, missing one diagnosis in favour of the other is not very uncommon. Accurate diagnosis of these two conditions is important for their management. In this study we evaluated role of 3D Ultrasound and Doppler in differentiating clinically suspected cases of leiomyoma and adenomyosis of uterus. MATERIALS AND METHODS: A total of 100 patients with symptoms of abnormal uterine bleeding (with or without dysmenorrhoea), lump abdomen, chronic pelvic pain or dysparaunia who were clinically diagnosed as leiomyoma of uterus and/or adenomyosis were enrolled in to the study. These patients underwent transvaginal sonography (TVS), trans abdominal sonography (TAS) along with color and spectral Doppler sonography. Scanning was done in follicular phase of the menstrual cycle to avoid bias due high vascularity of endometrium in secretory phase. The morphology of the lesion, its vascularity, and Pulsality Index (PI), Resistive Index (RI) and Vmax (maximum velocity) were measured. Only those patients who were chosen for operative treatment were included in the study. Radiological diagnosis was then correlated with intra-operative and histopathological diagnosis. RESULTS: On imaging, while using morphological criteria and Doppler for diagnosing leiomyoma, it was found that "peripheral vascularity" was seen in 52 (89%) cases, which was the highest. Similarly while diagnosing adenomyosis it was, the criteria "central vascularity" was seen in 28 cases (93%) and "ill defined junctional zone in 3D ultrasound" was seen in 26 cases (86%), which was also observed to be highest. With the cut off values taken for PI,RI and Vmax, diagnosis of leiomyoma was found to be 93.4% sensitive, 95.6% specific and with a positive predictive value of 97.6% and negative predictive value of 88.6%. Diagnosis of adenomyosis showed a sensitivity of 95.6%, specificity of 93.4% and a positive predictive value of 88.6% and negative predictive value of 97.6%. Imaging dignosed the co-existence of both the conditions correctly in 8 (66%) cases. CONCLUSION: The parameters of blood flow impedance (that is PI, RI, and Vmax) of arteries within or around the uterine lesions revealed a consistent and significant difference between leiomyoma and adenomyosis. So apart from morphological criteria used in 3D TAS and TVS, aid of color Doppler can more accurately differentiate and diagnose these conditions.

Fibrous tumor of the breast: case report of an underrecognized entity.

Fibrous tumor of the breast is an underappreciated, distinctive, benign, nonrecurrent lesion of the breast. The cytological features of this condition are not well characterized. We present a case report of a 30-year-old female presenting with a hard mass in her right breast. Fine needle aspiration showed smears of low cellularity showing a few clusters and sheets of mostly uniform benign epithelial cells, some of which were lined by myoepithelial cells. Scattered bipolar bare nuclei or stromal fragments were not seen. Excision with subsequent histopathological examination revealed a well-circumscribed, heavily collagenous tumor with atrophy and replacement of the epithelial and ductal elements of the breast, and diagnosed as fibrous tumor. Being nonrecurrent, it is important to distinguish this lesion from fibromatosis of the breast.