HNC accounts for 21.2% of total body malignancy and 47% of all malignancies in males and 2.5% in females. Squamous cell carcinoma was the most common histological type (97%). Maximum incidence of HNC (>60%) was in 40-60 year of age. Male:female ratio was 16:1. Oral cancers were most common HNC in patients below 40 year age group, whereas carcinoma oropharynx and larynx were more common in patients above 40 year age group. Tobacco smoking was a most prevalent risk factor for carcinoma oropharynx, larynx, and hypopharynx. Tobacco chewing was a most prevalent risk factor in females, young males, and carcinoma buccal mucosa patients. Habit of tobacco consumption in HNC patients was much higher than their normal counterpart. Alcohols drinking alone was observed in <1% patient as a risk factor. In oral tongue cancer, smoking and tobacco chewing were equally prevalent. Habit of tobacco chewing and alcohol were significantly higher in carcinoma buccal mucosa than other HNC suggesting synergistic effect specific to this site.

Introduction:Amplification of airway inflammation and its destruction due to oxidative stress is a major step in the pathogenesis of chronic obstruction pulmonary disease (COPD). Exhaled carbon monoxide (eCO) may be quantified to evaluate the airway inflammation and oxidative stress in such patients.Objectives:To assess the disease severity of COPD and treatment response by measuring eCO as a biomarker.Materials and Methods:COPD patients diagnosed according to the global initiative for chronic obstructive lung disease guidelines and healthy individuals as controls were selected. One hundred and fifty patients with COPD and 125 controls were included in the study. Participants were further subdivided on the basis of their smoking habits. Clinical examinations and spirometry were done to diagnose COPD by following the standard protocol. eCO was measured using a piCO + Smokerlyzer (Breath CO Monitor, Bedfont Scientific Ltd., Kent, UK). It was a single-center cross-sectional study.Results:Mean (± standard error of mean) CO levels in ex-smokers with COPD were higher (5.21 ± 1.546 ppm; P < 0.05) than in nonsmoking controls (1.52 ± 0.571 ppm) but were lower than in current smokers with COPD (12.55 ± 4.514 ppm; P < 0.05). eCO levels were higher in current smokers with COPD (12.55 ± 4.514 ppm; P < 0.05) compared to healthy smokers (9.71 ± 5.649). There was a negative correlation between eCO and forced expiratory volume in 1 s (FEV1) in COPD (r = −0.28; P < 0.05). The mean eCO level was decreased (6.291–4.332; P < 0.001) with improvement in lung function (FEV1 38.75%–50.65%: P < 0.05) after treatment with inhaled steroid.Conclusion:Our study concludes that quantification of eCO level in COPD varies with different grades of airway obstruction and to measure the treatment response. Measuring the level of eCO can be used to assess the indirect assessment of airway inflammation, oxidative stress, and severity of airway obstruction in COPD patients.

Phrenic nerve palsy causing hemidiaphragm paralysis is a very uncommon feature of thoracic aortic aneurysm. In one case, a 30 year male complained of chronic dull aching chest pain, and hoarseness of voice; posteroanterior view chest radiograph revealed large spherical radiopacity on the left upper lung zone with smooth lobulated margin with elevated left hemidiaphragm. On Colour Doppler sonography, lesion was anechoic on gray scale sonography but on Doppler analysis revealed intense internal vascularity within it with characteristic “Ying Yang” sign. The finding favor the vascular origin of the lesion and a diagnosis of an arterial aneurysm was made Contrast-enhanced computed tomography (CT) of the thorax revealed a large well defined spherical lesion of 8 × 10 cm size with smooth well defined margin arising from the aortic arch and attenuation of impending rupture or dissection were lesion on immediate post contrast and delayed scan was similar to that of aorta. Left hemidiaphragm elevation was explained by the gross mass effect of the aneurysm causing right phrenic nerve palsy.

According to National Institute of Cancer Research and Hospital most frequently observed cancers in Bangladeshi population are lungs, breast, cervix, lymph node, esophagus, larynx and stomach. The point of epidemiological background, the rate of incidence and mortality are likely unavailable due to lack of population based cancer registry system in Bangladesh. This cross-sectional study was conducted from 2003 to 2012 with an aim to describe trends and pattern of cancer cases attended a specialized hospital in Dhaka city. A total of 29,999 cancer cases was enrolled and among them the male and female ratio was 1.2:1. The study revealed that around half of the patients attended from Dhaka division, followed by Chittagong division (22.9%) and Sylhet division (8.8%). According to the organ involvement most frequently reported malignancies in males were lung cancer (24.2%), followed by eight percent larynx cancer and six percent lymph node cancer, whereas in females were breast cancer (27.5%), followed by cervix cancer (19.5%) and five percent lung cancer. It has been found that the system involvement was observed of cancers among male's respiratory system (33.5%) followed by the digestive organs (20.0%) and oral cavity (14.2%) whereas in females were reproductive organs (26.3%), followed by fourteen percent digestive organs and eight percent oral cancer. The overall cancer trend showed a gradual rise of cancer cases in both sexes. The rate was higher in females rather than male. Without the availability of population based registries, incidence and mortality figures; studies like the present one may provide useful leads for health planning and future exploration.

No abstract

The occurrence of two or more primary malignant neoplasms in the same person is rare. We report a case report of a 45-year-old woman with triple malignancy involving breast, ovary, and uterine vault managed at our center for 5 years. Our patient presented as a postoperated case of two primary malignant neoplasms of carcinoma, breast and ovary. For carcinoma ovary, she underwent adjuvant chemotherapy and interval cytoreductive surgery. For carcinoma breast, she received adjuvant locoregional radiotherapy and chemotherapy. After 42 months, the patient was diagnosed with squamous cell carcinoma vault, for which she received pelvic radiotherapy. She is on regular follow-up. Our patient had two synchronous and one metachronous malignancy. She was diagnosed with carcinoma uterine vault when she was in regular follow-up, and the two previous primaries were controlled. This emphasizes the importance of a regular follow-up and the need of a meticulous workup for early diagnosis and prompt management of any metachronous malignancy.

The sustainable growth of EVs will have to be met with proportional growth in EV charging infrastructure. With limited urban spaces to place new charging stations, shrinking profitability, privately owned charging facilities need to be shared. WEcharge will allow privately owned charging infrastructure to be shared with public EV owners using a business model. We propose a resource matching algorithm that takes into account incoming EV preferences, hard constraints for such EV, and provides the best suited resource for charging. We demonstrate the applicability of the matching model by showing a realistic case study with a Nissan Leaf 40 kW EV and 25 company and publicly owned charging stations (DC fast charger, AC rapid charger, level 1 and level 2 charger) in Hasselt, Belgium. The case study shows that consumer preferences will govern resource matching.