Abstract: Worldwide, one in eight deaths is due to cancer. Projections based on the GLOBOCAN 2012 estimates predict a substantive increase new cancer cases per year by 2035 in developing countries if preventive measures are not widely applied. According to the World Health Organization (WHO), millions of lives could be saved each year if countries made use of existing knowledge and the best cost-effective methods to prevent and treat cancer. Therefore, the aim of this study is to estimate a provisional budget against cancer in low and middle incomes countries, according the GNI-PPP, the cancer incidence and the number of population. Economically country classification is determining with the Gross national income (GNI), per capita, Purchasing power parity (PPP), according the administrations of the International Monetary Fund (IMF), the World Bank (WB) and the Central Intelligence Agency (CIA). Cancer incidence data presented are based on the most recent data available at IARC. However, population compares estimates from the US Bureau of the Census. The provisional budget is establishing among the guidelines developed by WHO for regional and national cancer control programs according to national economic development. Provisional budget against cancer is estimated to 4,979.580 (thousands of U.S $) for a population of 200,108 persons in Samoa.

Abstract: Background: Left atrial enlargement (LAE) has been proven to be significantly related to stroke and cardiovascular diseases. Previous studies have shown a link between Left atrial enlargement (LAE) with the increase in the risk of stroke and cardiovascular diseases (CVD). Bangladeshi data is lacking on the exact prevalence of LAE. Aims and Objectives: To study the prevalence of LAE and its associated risk factors. Materials and Methods: Hundred patients having were studied in the Department of Vascular Surgery, Bangabandu Sheikh Mujib Medical University (BSMMU), and Dhaka, Bangladesh from January 2020 to December 2020. After a complete physical examination, echocardiogram was performed in all the patients. In present study LAE is defined if the LA diameter is more than 4.0 cm in men and 3.8 cm in women. We performed multivariable logistic regression analysis to identify risk factors for LAE. Results: Prevalence of LAE was 8%. The prevalence of LAE was higher in men (9.37%). On multivariable logistic regression analysis advancing age (OD;1.034), increased systolic blood pressure (SBP) (OR: 2.862), increased diastolic blood pressure (DBP) (OR: 1.32), abnormally high BMI (OR: 3.721), increased prevalence of diabetes (OR: 1.245), increased left ventricular myocardial index (LVMI) (OR: 1.023), and decreased left ventricular ejection fraction (LVEF), decreased heart rate (HR), and decreased estimated glomerular filtration rate (eGFR) were found to be the major risk factors of LAE. Conclusion: A significant number of patients had LAE. Among the risk factors advancing age, increased SBP, increased BMI, presence of diabetes mellitus, increased LVMI, decreased eGFR, decreased LVEF, and decreased HR were more common.

Abstract: Background: Bile duct injury is severe and potentially life threatening complication of cholecystectomy. It ruins the patient physically, mentally, socially and financially. The incidence of bile duct injury is alarming in our country. Management of such patients needs to be explained. Methods: It is a cross-sectional descriptive study carried out in the Department of Surgery, Mymensingh Medical College Hospital, Mymensingh, Bangladesh during the period January 2018 to July 2020. A total of 70 patients diagnosed as bile duct injury were included in the study. Bile duct injury that occurs during liver or pancreases surgery or accident was excluded. Data were collected using a predesigned data collection sheet and analyzed using computer software SPSS (Statistical Package for Social Sciences) version 22. Results: Young and female patients suffer more 44(62.9%) than male. Occurrence was common during laparoscopic cholecystectomy 42(60%). Most of bile duct injury occur when cholecystectomy done on acute condition of gall bladder 59(84.3%). Most of bile duct injury patient came to specialized center after several week of injury with billiary stricture 54 (77.14%) with jaundice, some patients presented with abdominal pain 48(68.6%), abdominal distension 18(25.7), biliary peritonitis 16(22.9) and biliary fistula 14(20%). Patients with bile duct injury were evaluated by USG, liver function test, ERCP and MRCP. Maximum BDI patients were Bismath Type II 32(45.7%) and Bismath Type III 18(25.7%). Out of 70 cases USG performed 68 cases (2 patients repair at the time of surgery) and these investigations provided valuable information about condition of biliary tree, hepatic parenchyma and ductal system also intra-abdominal collection. 14 patients were done ERCP. Billiary stricture in different level seen among most of the patients (10). Bile leakage seen among 4 patients and all were underwent ERCP stenting. Conclusion: The present study showed that bile duct injury occurs mostly in young female with acute cholecystitis. Common presentation was obstructive jaundice and biliary sepsis. Bismuth Type II and III were most common form of stricture. Biliary reconstruction (Roux-en-Y hepaticojejunostomy) was the treatment for biliary stricture. Peritoneal toileting, controlled fistula and later on biliary reconstruction was the treatment of biliary sepsis.