Stent thrombosis & Restenosis.pptx
•Download as PPTX, PDF•
1 like•16 views
This slides contains case based detaileddiscussion on stent thrombosis and ISR , causes and how to handle these complications.
Report
Share
Report
Share
Recommended
Small cell lung carcinoma
This document summarizes information about small cell lung carcinoma (SCLC). It discusses:
- SCLC accounts for 15-20% of lung cancers and is strongly associated with tobacco exposure.
- Pathologically, SCLC arises from neuroendocrine precursor cells and displays characteristics like scanty cytoplasm and high mitotic count. Genetic abnormalities include frequent p53 and RB1 mutations.
- SCLC is clinically aggressive, often presenting with widespread metastases. Standard treatment involves platinum-based chemotherapy such as etoposide with cisplatin or carboplatin. The timing and sequencing of chemotherapy and thoracic radiotherapy is important.
Small cell lung cancer staging and management
This document provides information on the management of small cell lung cancer (SCLC). It begins with defining SCLC and describing its typical clinical presentation and features. It then discusses the epidemiology and etiology of SCLC, noting that it is caused primarily by tobacco smoking. The document outlines the recommended workup, staging, and prognostic factors for SCLC. It provides details on the evidence-based management of limited-stage and extensive-stage SCLC, including the use of chemotherapy, radiotherapy, surgery, and protocols for concurrent and sequential chemo-radiotherapy treatment.
Revisi 1 PPT Death Case SAH + PE.pptx
1) The patient presented with sudden loss of consciousness and was diagnosed with subarachnoid hemorrhage complicated by acute pulmonary embolism based on imaging and clinical findings.
2) Subarachnoid hemorrhage is bleeding in the subarachnoid space caused most commonly by ruptured aneurysms. It can cause severe headaches and has high mortality.
3) Complications of subarachnoid hemorrhage include rebleeding, hydrocephalus, and pulmonary embolism which the patient presented with and was treated for.
Ultrasound Diagnosis Of Appendicitis
Ultrasound should be the first-line imaging modality for diagnosing acute appendicitis according to the authors. While ultrasound has excellent specificity, its sensitivity is limited. For cases where ultrasound is non-diagnostic due to non-visualization of the appendix, clinical reassessment and complementary MRI or CT imaging may be used if needed for diagnosis. Using ultrasound as the primary imaging tool can help decrease radiation exposure and healthcare costs while maintaining low rates of negative appendectomies and perforations.
Role of nm imaging in acute chest pain syndromes
This document discusses the role of nuclear medicine imaging in evaluating patients presenting with acute chest pain. It outlines how nuclear imaging techniques like acute rest myocardial perfusion imaging (MPI) can help distinguish between cardiac causes like acute coronary syndrome from non-cardiac causes. MPI provides high sensitivity and negative predictive value in detecting acute myocardial ischemia. The document compares the diagnostic accuracy of MPI to electrocardiograms and cardiac biomarkers in evaluating acute chest pain.
Cuaj 3-373
This document provides guidelines for follow-up surveillance after nephrectomy for renal cell carcinoma (RCC) based on the current literature. It recommends risk-stratified surveillance based on pathological tumor stage, with more frequent monitoring for higher risk groups. For stage pT1 tumors, annual clinical exams, blood tests and chest x-rays are recommended, plus abdominal CT scans at 2 and 5 years. For pT2-3 tumors, tests are more frequent initially then tapering, with abdominal CT also recommended at 1, 3, 5, 7 and 10 years for pT2 and more frequently for pT3. Patients with lymph node involvement require intensive monitoring, especially in the first 3 years. The guidelines aim to detect recurrence early to facilitate
Approach to the Solitary Pulmonary Nodule - New Staging System for NSCLC - Ly...
Approach to the Solitary Pulmonary Nodule - New Staging System for NSCLC - Ly...Bassel Ericsoussi, MD
1. The document discusses the evaluation and management of solitary pulmonary nodules (SPNs). It outlines the clinical factors that influence the pre-test probability of malignancy for SPNs and diagnostic tools used in evaluation.
2. Management options for SPNs depend on the assessed risk of cancer, ranging from serial CT imaging for low-risk nodules to surgical resection for high-risk nodules to biopsy or PET scan for indeterminate risk. The key is determining the individual patient's risk through clinical and radiological factors.
3. The document also summarizes changes to the TNM staging system for lung cancer implemented in 2010, including revisions to T, N, and M descriptors and stage groupingsKshivets O. Lung Cancer: Optimal Treatment Strategies
This document describes a study examining optimal treatment strategies for non-small cell lung cancer (NSCLC) patients. The study reviewed data from 535 NSCLC patients who underwent complete surgical resection between 1985-2008. Patients received one of three treatments: surgery alone (316 patients), surgery plus postoperative radiotherapy (102 patients), or surgery plus adjuvant chemoimmunoradiotherapy (117 patients). The study found that adjuvant chemoimmunoradiotherapy resulted in significantly higher 5-year survival rates compared to radiotherapy or surgery alone, especially for patients with lymph node involvement. Overall 5-year survival for the entire group was 63.6%, demonstrating the benefit of aggressive surgical resection and adjuvant therapies.
Recommended
Small cell lung carcinoma
This document summarizes information about small cell lung carcinoma (SCLC). It discusses:
- SCLC accounts for 15-20% of lung cancers and is strongly associated with tobacco exposure.
- Pathologically, SCLC arises from neuroendocrine precursor cells and displays characteristics like scanty cytoplasm and high mitotic count. Genetic abnormalities include frequent p53 and RB1 mutations.
- SCLC is clinically aggressive, often presenting with widespread metastases. Standard treatment involves platinum-based chemotherapy such as etoposide with cisplatin or carboplatin. The timing and sequencing of chemotherapy and thoracic radiotherapy is important.
Small cell lung cancer staging and management
This document provides information on the management of small cell lung cancer (SCLC). It begins with defining SCLC and describing its typical clinical presentation and features. It then discusses the epidemiology and etiology of SCLC, noting that it is caused primarily by tobacco smoking. The document outlines the recommended workup, staging, and prognostic factors for SCLC. It provides details on the evidence-based management of limited-stage and extensive-stage SCLC, including the use of chemotherapy, radiotherapy, surgery, and protocols for concurrent and sequential chemo-radiotherapy treatment.
Revisi 1 PPT Death Case SAH + PE.pptx
1) The patient presented with sudden loss of consciousness and was diagnosed with subarachnoid hemorrhage complicated by acute pulmonary embolism based on imaging and clinical findings.
2) Subarachnoid hemorrhage is bleeding in the subarachnoid space caused most commonly by ruptured aneurysms. It can cause severe headaches and has high mortality.
3) Complications of subarachnoid hemorrhage include rebleeding, hydrocephalus, and pulmonary embolism which the patient presented with and was treated for.
Ultrasound Diagnosis Of Appendicitis
Ultrasound should be the first-line imaging modality for diagnosing acute appendicitis according to the authors. While ultrasound has excellent specificity, its sensitivity is limited. For cases where ultrasound is non-diagnostic due to non-visualization of the appendix, clinical reassessment and complementary MRI or CT imaging may be used if needed for diagnosis. Using ultrasound as the primary imaging tool can help decrease radiation exposure and healthcare costs while maintaining low rates of negative appendectomies and perforations.
Role of nm imaging in acute chest pain syndromes
This document discusses the role of nuclear medicine imaging in evaluating patients presenting with acute chest pain. It outlines how nuclear imaging techniques like acute rest myocardial perfusion imaging (MPI) can help distinguish between cardiac causes like acute coronary syndrome from non-cardiac causes. MPI provides high sensitivity and negative predictive value in detecting acute myocardial ischemia. The document compares the diagnostic accuracy of MPI to electrocardiograms and cardiac biomarkers in evaluating acute chest pain.
Cuaj 3-373
This document provides guidelines for follow-up surveillance after nephrectomy for renal cell carcinoma (RCC) based on the current literature. It recommends risk-stratified surveillance based on pathological tumor stage, with more frequent monitoring for higher risk groups. For stage pT1 tumors, annual clinical exams, blood tests and chest x-rays are recommended, plus abdominal CT scans at 2 and 5 years. For pT2-3 tumors, tests are more frequent initially then tapering, with abdominal CT also recommended at 1, 3, 5, 7 and 10 years for pT2 and more frequently for pT3. Patients with lymph node involvement require intensive monitoring, especially in the first 3 years. The guidelines aim to detect recurrence early to facilitate
Approach to the Solitary Pulmonary Nodule - New Staging System for NSCLC - Ly...
Approach to the Solitary Pulmonary Nodule - New Staging System for NSCLC - Ly...Bassel Ericsoussi, MD
1. The document discusses the evaluation and management of solitary pulmonary nodules (SPNs). It outlines the clinical factors that influence the pre-test probability of malignancy for SPNs and diagnostic tools used in evaluation.
2. Management options for SPNs depend on the assessed risk of cancer, ranging from serial CT imaging for low-risk nodules to surgical resection for high-risk nodules to biopsy or PET scan for indeterminate risk. The key is determining the individual patient's risk through clinical and radiological factors.
3. The document also summarizes changes to the TNM staging system for lung cancer implemented in 2010, including revisions to T, N, and M descriptors and stage groupingsKshivets O. Lung Cancer: Optimal Treatment Strategies
This document describes a study examining optimal treatment strategies for non-small cell lung cancer (NSCLC) patients. The study reviewed data from 535 NSCLC patients who underwent complete surgical resection between 1985-2008. Patients received one of three treatments: surgery alone (316 patients), surgery plus postoperative radiotherapy (102 patients), or surgery plus adjuvant chemoimmunoradiotherapy (117 patients). The study found that adjuvant chemoimmunoradiotherapy resulted in significantly higher 5-year survival rates compared to radiotherapy or surgery alone, especially for patients with lymph node involvement. Overall 5-year survival for the entire group was 63.6%, demonstrating the benefit of aggressive surgical resection and adjuvant therapies.
ANCA vasculitis and Renal Diseases
This document describes a case of a 70-year-old male farmer who presented with decreased urine output, leg swelling, and facial puffiness for one week. Laboratory tests revealed severe iron deficiency anemia, proteinuria, and impaired kidney function. A renal biopsy showed necrotizing and crescentic glomerulonephritis. P-ANCA was positive. The patient was diagnosed with ANCA-associated necrotizing crescentic glomerulonephritis and treated with steroids, cyclophosphamide, and plasma exchange. His kidney function improved but he later died at home for unclear reasons.
Sinonasal Malignancy.pptx
This document presents a case of a 21-year-old female who presented with right nasal obstruction and discharge for two years. Imaging showed total opacification of the right sphenoid sinus and a polypoidal mass in the right nasal cavity. The patient underwent endoscopic sinus surgery where the mass was excised. Histopathology revealed secretory carcinoma (SC), previously known as mammary analogue secretory carcinoma (MASC). The patient had a second surgery for clear margins and is currently in remission with regular follow ups. The document then discusses SC/MASC as a rare salivary gland carcinoma that can rarely affect the sinonasal tract, and outlines its clinical features, diagnosis, treatment and prognosis.
Adrenal ca dr.sharfuddin chowdhury
This document summarizes a case of adrenocortical carcinoma in an 18-year-old male. Laboratory and imaging findings confirmed the diagnosis of metastatic adrenocortical carcinoma. The patient was discharged on palliative chemotherapy with ketoconazole. Adrenocortical carcinoma is a rare and aggressive cancer with poor survival outcomes. Surgical resection offers the only chance of cure but recurrence is common. Palliative treatments provide limited benefits.
Adrenal ca dr.sharfuddin chowdhury
A 18 year old male presented with features of Cushing's syndrome including weight gain, facial puffiness, and striae. Laboratory tests confirmed ectopic cortisol secretion from an adrenal tumor. Imaging revealed a large right adrenal mass invading nearby structures with lung metastases. Biopsy supported a diagnosis of metastatic adrenocortical carcinoma. Surgery was not possible and the patient was started on palliative chemotherapy with ketoconazole.
Adrenal ca dr.sharfuddin chowdhury
A 18 year old male presented with features of Cushing's syndrome including weight gain, facial puffiness, and fatigue. Laboratory tests confirmed excess cortisol production and imaging found a large adrenal tumor with metastases. He was diagnosed with unresectable metastatic adrenocortical carcinoma and started on palliative chemotherapy with ketoconazole.
Hepatoblastoma- Investigations and management
This document summarizes information about hepatoblastoma, a rare type of liver cancer that mostly affects young children. It discusses the history and terminology of hepatoblastoma. Key points include: hepatoblastoma typically affects children under 3 years old and accounts for about 1% of childhood cancers. Complete surgical resection is the main treatment when possible but less than 50% of patients are resectable at diagnosis. The addition of cisplatin-based chemotherapy has improved outcomes by increasing resectability. Prognosis remains suboptimal for patients with unresectable or metastatic disease after chemotherapy. Chemoembolization and liver transplantation are promising alternative treatments in these cases.
Chemotherapy in rhabdomyosarcoma
This illustrates the role of chemotherapy in rhabdomyosarcoma along with brief description of pathology, staging etc.
Surgical and endovascular treatment of Paget-Schroetter
This document discusses Paget-Schroetter syndrome, also known as effort thrombosis, which is thrombosis (blood clot) of the axillary and subclavian veins caused by repetitive arm motions. It affects young, active individuals and causes swelling and pain in the arm. Treatment options discussed include anticoagulation alone versus thrombolysis or decompression of the thoracic outlet through surgery. Follow up of surgical patients found low complication rates, satisfactory long-term outcomes with patent veins, and good post-operative quality of life scores.
New and Emerging Biomarkers in Patient-Centered MS Management: The Future of ...
New and Emerging Biomarkers in Patient-Centered MS Management: The Future of ...PVI, PeerView Institute for Medical Education
Chair and Moderator, Jiwon Oh, MD, PhD, FRCPC, Jacci Bainbridge, PharmD, FCCP, MSCS, FAES, and Kathleen M. Costello, RN, MS, NP, MSCN, prepared useful Practice Aids pertaining to multiple sclerosis for this CME/NCPD/CPE/IPCE activity titled “New and Emerging Biomarkers in Patient-Centered MS Management: The Future of Personalized Patient Care Begins Now.” For the full presentation, downloadable Practice Aids, and complete CME/NCPD/CPE/IPCE information, and to apply for credit, please visit us at https://bit.ly/3L4Wdjl. CME/NCPD/CPE/IPCE credit will be available until July 2, 2024.Defining sepsis - Journal Club (Jason Wu)
Presentation by Dr Jason Wu - resident in Critical Care at TWH, for the critical care journal club report findings of a paper by Kaukonen KM, et al. N Engl J Med. 2015 & update from the recent SMACC conference in Chicago #FOAMed #SMACC (http://www.ncbi.nlm.nih.gov/m/pubmed/25776936/)
Management of crpc
It highlights the the treatment options currently available for the management of castrate resistant prostate cancer.
Lung cancer overview-JTL
An Overview of Lung Cancer:
Epidemiology
Screening
Histology/Pathology
Pathogenesis
Invasive and Noninvasive Staging
Management
Servikal Displazi -Pap Smear - Serviks Kanseri - www.jinekolojivegebelik.com
This document provides guidelines for managing abnormal Pap smears, cervical dysplasia, and cervical cancer. It discusses evaluating Pap test results using the Bethesda system and determining appropriate follow up. It also outlines treatment options for cervical dysplasia like cryotherapy, LEEP, and cone biopsy. For invasive cervical cancer, it describes staging and evaluating and treating the disease in consultation with a gynecologic oncologist.
RRBP1 Expression in Paired Central and Peripheral Astrocytoma Tissue Microarray
RRBP1 Expression in Paired Central and Peripheral Astrocytoma Tissue MicroarrayANALYTICAL AND QUANTITATIVE CYTOPATHOLOGY AND HISTOPATHOLOGY
This study investigated the expression of RRBP1 in central and peripheral astrocytoma tissue samples. The results found that RRBP1 expression was higher, though not statistically significantly, in peripheral astrocytoma tissues compared to central tissues. RRBP1 expression was significantly correlated with proliferation marker Ki-67 and invasion marker MMP9 expression. This suggests that high RRBP1 expression may regulate astrocytoma proliferation and invasion. Further research is needed to understand the underlying mechanisms.Lapatinib in Breast Cancer
Lapatinib is an oral tyrosine kinase inhibitor that is effective for HER2-positive breast cancer patients, including those with brain metastases. A phase II trial found that lapatinib led to partial responses in 6% of patients with HER2-positive breast cancer and brain metastases who progressed on prior trastuzumab therapy. Volumetric reductions of at least 20% in brain lesions on MRI were associated with improved progression-free survival. The most common adverse events were diarrhea and rash, which were primarily grades 1-2 in severity. Lapatinib is an important treatment option for HER2-positive breast cancer patients with brain metastases.
Issues in radiological pathology
The document discusses the radiological pathology of various cerebral conditions. It focuses on cerebral infarction, providing details on the pathophysiology and timeline of ischemic changes. Key CT findings of acute infarction include the hyperdense middle cerebral artery sign indicating vessel occlusion, and subtle early parenchymal edema visible as hypoattenuation. The significance of accurate early detection by CT for determining treatment eligibility for thrombolysis is emphasized.
Polyarteritis nodosa
Polyarteritis nodosa (PAN) is a systemic necrotizing vasculitis predominantly affecting medium arteries. It can be idiopathic or associated with hepatitis B virus (HBV) infection. The document discusses the epidemiology, pathogenesis, clinical presentation, diagnostic criteria and tests, imaging findings, and prognosis of PAN. It highlights that PAN affects medium-sized arteries and is differentiated from other vasculitides by the absence of glomerulonephritis, ANCA positivity, or involvement of arterioles/capillaries. HBV vaccination and certain drugs have been associated with PAN in some cases.
Vol1Issue3_8OA
This document summarizes a study that evaluated the use of 256 slice MDCT pulmonary angiography (MDCT-PA) to diagnose pulmonary embolism (PE) in 100 unselected patients with clinically suspected PE. The study found that 35% of patients had thromboembolic disease, with 32% having acute PE and 8% having acute deep vein thrombosis (DVT). MDCT-PA allowed direct visualization of thrombi in the pulmonary arteries and veins. The study concludes that MDCT-PA is an effective first-line imaging method for evaluating patients suspected of having a PE due to its non-invasive nature and ability to directly identify thrombotic material.
Angiosarcoma Review
This document summarizes the key differences between primary and secondary angiosarcoma (AS) of the breast. Primary AS typically affects younger women (median age 40) and presents as masses within the breast parenchyma, while secondary AS affects older women (median age 67-71) and develops in irradiated breast skin and subcutaneous tissue 7-10 years after radiation therapy. Both forms have a poor prognosis. Surgical management often involves mastectomy but optimal margins are unclear. Adjuvant chemotherapy and radiation have shown mixed results, and larger randomized trials are needed to determine their effectiveness for AS of the breast.
24. ACLS Protocol.pptx
The document appears to be a presentation on cardiology topics including sudden collapse and bradycardia management. It was presented by Dr. Azim Anwar, a resident in cardiology at BSMMU, under the chairpersonship of Prof. Jahanara Arzu, the unit chief of cardiology at BSMMU. The presentation covers algorithms for responding to sudden collapse, guidelines for breathing and CPR, and medications for treating conditions like bradycardia. It concludes with asking if there are any questions.
22. CTO 2.pptx
Mr. M, age 55, presented with 8 hours of chest pain. ECG and echo showed normal findings except for inferior wall hypokinesia and EF of 50%. The target vessel for intervention was the proximal right coronary artery (RCA), which showed a visible proximal cap but distal vessel not visible, with Rentrop class 2 collaterals. The document discusses techniques for chronic total occlusion percutaneous coronary intervention including antegrade and retrograde approaches, tools used such as guidewires, balloons, microcatheters and imaging catheters. Challenges of CTO PCI include procedural failure and complications, though successful procedures can improve regional contractility. Experience and suitable anatomy are needed for acceptable outcomes.
More Related Content
Similar to Stent thrombosis & Restenosis.pptx
ANCA vasculitis and Renal Diseases
This document describes a case of a 70-year-old male farmer who presented with decreased urine output, leg swelling, and facial puffiness for one week. Laboratory tests revealed severe iron deficiency anemia, proteinuria, and impaired kidney function. A renal biopsy showed necrotizing and crescentic glomerulonephritis. P-ANCA was positive. The patient was diagnosed with ANCA-associated necrotizing crescentic glomerulonephritis and treated with steroids, cyclophosphamide, and plasma exchange. His kidney function improved but he later died at home for unclear reasons.
Sinonasal Malignancy.pptx
This document presents a case of a 21-year-old female who presented with right nasal obstruction and discharge for two years. Imaging showed total opacification of the right sphenoid sinus and a polypoidal mass in the right nasal cavity. The patient underwent endoscopic sinus surgery where the mass was excised. Histopathology revealed secretory carcinoma (SC), previously known as mammary analogue secretory carcinoma (MASC). The patient had a second surgery for clear margins and is currently in remission with regular follow ups. The document then discusses SC/MASC as a rare salivary gland carcinoma that can rarely affect the sinonasal tract, and outlines its clinical features, diagnosis, treatment and prognosis.
Adrenal ca dr.sharfuddin chowdhury
This document summarizes a case of adrenocortical carcinoma in an 18-year-old male. Laboratory and imaging findings confirmed the diagnosis of metastatic adrenocortical carcinoma. The patient was discharged on palliative chemotherapy with ketoconazole. Adrenocortical carcinoma is a rare and aggressive cancer with poor survival outcomes. Surgical resection offers the only chance of cure but recurrence is common. Palliative treatments provide limited benefits.
Adrenal ca dr.sharfuddin chowdhury
A 18 year old male presented with features of Cushing's syndrome including weight gain, facial puffiness, and striae. Laboratory tests confirmed ectopic cortisol secretion from an adrenal tumor. Imaging revealed a large right adrenal mass invading nearby structures with lung metastases. Biopsy supported a diagnosis of metastatic adrenocortical carcinoma. Surgery was not possible and the patient was started on palliative chemotherapy with ketoconazole.
Adrenal ca dr.sharfuddin chowdhury
A 18 year old male presented with features of Cushing's syndrome including weight gain, facial puffiness, and fatigue. Laboratory tests confirmed excess cortisol production and imaging found a large adrenal tumor with metastases. He was diagnosed with unresectable metastatic adrenocortical carcinoma and started on palliative chemotherapy with ketoconazole.
Hepatoblastoma- Investigations and management
This document summarizes information about hepatoblastoma, a rare type of liver cancer that mostly affects young children. It discusses the history and terminology of hepatoblastoma. Key points include: hepatoblastoma typically affects children under 3 years old and accounts for about 1% of childhood cancers. Complete surgical resection is the main treatment when possible but less than 50% of patients are resectable at diagnosis. The addition of cisplatin-based chemotherapy has improved outcomes by increasing resectability. Prognosis remains suboptimal for patients with unresectable or metastatic disease after chemotherapy. Chemoembolization and liver transplantation are promising alternative treatments in these cases.
Chemotherapy in rhabdomyosarcoma
This illustrates the role of chemotherapy in rhabdomyosarcoma along with brief description of pathology, staging etc.
Surgical and endovascular treatment of Paget-Schroetter
This document discusses Paget-Schroetter syndrome, also known as effort thrombosis, which is thrombosis (blood clot) of the axillary and subclavian veins caused by repetitive arm motions. It affects young, active individuals and causes swelling and pain in the arm. Treatment options discussed include anticoagulation alone versus thrombolysis or decompression of the thoracic outlet through surgery. Follow up of surgical patients found low complication rates, satisfactory long-term outcomes with patent veins, and good post-operative quality of life scores.
New and Emerging Biomarkers in Patient-Centered MS Management: The Future of ...
New and Emerging Biomarkers in Patient-Centered MS Management: The Future of ...PVI, PeerView Institute for Medical Education
Chair and Moderator, Jiwon Oh, MD, PhD, FRCPC, Jacci Bainbridge, PharmD, FCCP, MSCS, FAES, and Kathleen M. Costello, RN, MS, NP, MSCN, prepared useful Practice Aids pertaining to multiple sclerosis for this CME/NCPD/CPE/IPCE activity titled “New and Emerging Biomarkers in Patient-Centered MS Management: The Future of Personalized Patient Care Begins Now.” For the full presentation, downloadable Practice Aids, and complete CME/NCPD/CPE/IPCE information, and to apply for credit, please visit us at https://bit.ly/3L4Wdjl. CME/NCPD/CPE/IPCE credit will be available until July 2, 2024.Defining sepsis - Journal Club (Jason Wu)
Presentation by Dr Jason Wu - resident in Critical Care at TWH, for the critical care journal club report findings of a paper by Kaukonen KM, et al. N Engl J Med. 2015 & update from the recent SMACC conference in Chicago #FOAMed #SMACC (http://www.ncbi.nlm.nih.gov/m/pubmed/25776936/)
Management of crpc
It highlights the the treatment options currently available for the management of castrate resistant prostate cancer.
Lung cancer overview-JTL
An Overview of Lung Cancer:
Epidemiology
Screening
Histology/Pathology
Pathogenesis
Invasive and Noninvasive Staging
Management
Servikal Displazi -Pap Smear - Serviks Kanseri - www.jinekolojivegebelik.com
This document provides guidelines for managing abnormal Pap smears, cervical dysplasia, and cervical cancer. It discusses evaluating Pap test results using the Bethesda system and determining appropriate follow up. It also outlines treatment options for cervical dysplasia like cryotherapy, LEEP, and cone biopsy. For invasive cervical cancer, it describes staging and evaluating and treating the disease in consultation with a gynecologic oncologist.
RRBP1 Expression in Paired Central and Peripheral Astrocytoma Tissue Microarray
RRBP1 Expression in Paired Central and Peripheral Astrocytoma Tissue MicroarrayANALYTICAL AND QUANTITATIVE CYTOPATHOLOGY AND HISTOPATHOLOGY
This study investigated the expression of RRBP1 in central and peripheral astrocytoma tissue samples. The results found that RRBP1 expression was higher, though not statistically significantly, in peripheral astrocytoma tissues compared to central tissues. RRBP1 expression was significantly correlated with proliferation marker Ki-67 and invasion marker MMP9 expression. This suggests that high RRBP1 expression may regulate astrocytoma proliferation and invasion. Further research is needed to understand the underlying mechanisms.Lapatinib in Breast Cancer
Lapatinib is an oral tyrosine kinase inhibitor that is effective for HER2-positive breast cancer patients, including those with brain metastases. A phase II trial found that lapatinib led to partial responses in 6% of patients with HER2-positive breast cancer and brain metastases who progressed on prior trastuzumab therapy. Volumetric reductions of at least 20% in brain lesions on MRI were associated with improved progression-free survival. The most common adverse events were diarrhea and rash, which were primarily grades 1-2 in severity. Lapatinib is an important treatment option for HER2-positive breast cancer patients with brain metastases.
Issues in radiological pathology
The document discusses the radiological pathology of various cerebral conditions. It focuses on cerebral infarction, providing details on the pathophysiology and timeline of ischemic changes. Key CT findings of acute infarction include the hyperdense middle cerebral artery sign indicating vessel occlusion, and subtle early parenchymal edema visible as hypoattenuation. The significance of accurate early detection by CT for determining treatment eligibility for thrombolysis is emphasized.
Polyarteritis nodosa
Polyarteritis nodosa (PAN) is a systemic necrotizing vasculitis predominantly affecting medium arteries. It can be idiopathic or associated with hepatitis B virus (HBV) infection. The document discusses the epidemiology, pathogenesis, clinical presentation, diagnostic criteria and tests, imaging findings, and prognosis of PAN. It highlights that PAN affects medium-sized arteries and is differentiated from other vasculitides by the absence of glomerulonephritis, ANCA positivity, or involvement of arterioles/capillaries. HBV vaccination and certain drugs have been associated with PAN in some cases.
Vol1Issue3_8OA
This document summarizes a study that evaluated the use of 256 slice MDCT pulmonary angiography (MDCT-PA) to diagnose pulmonary embolism (PE) in 100 unselected patients with clinically suspected PE. The study found that 35% of patients had thromboembolic disease, with 32% having acute PE and 8% having acute deep vein thrombosis (DVT). MDCT-PA allowed direct visualization of thrombi in the pulmonary arteries and veins. The study concludes that MDCT-PA is an effective first-line imaging method for evaluating patients suspected of having a PE due to its non-invasive nature and ability to directly identify thrombotic material.
Angiosarcoma Review
This document summarizes the key differences between primary and secondary angiosarcoma (AS) of the breast. Primary AS typically affects younger women (median age 40) and presents as masses within the breast parenchyma, while secondary AS affects older women (median age 67-71) and develops in irradiated breast skin and subcutaneous tissue 7-10 years after radiation therapy. Both forms have a poor prognosis. Surgical management often involves mastectomy but optimal margins are unclear. Adjuvant chemotherapy and radiation have shown mixed results, and larger randomized trials are needed to determine their effectiveness for AS of the breast.
Similar to Stent thrombosis & Restenosis.pptx (20)
Surgical and endovascular treatment of Paget-Schroetter
Surgical and endovascular treatment of Paget-Schroetter
New and Emerging Biomarkers in Patient-Centered MS Management: The Future of ...
New and Emerging Biomarkers in Patient-Centered MS Management: The Future of ...
Servikal Displazi -Pap Smear - Serviks Kanseri - www.jinekolojivegebelik.com
Servikal Displazi -Pap Smear - Serviks Kanseri - www.jinekolojivegebelik.com
RRBP1 Expression in Paired Central and Peripheral Astrocytoma Tissue Microarray
RRBP1 Expression in Paired Central and Peripheral Astrocytoma Tissue Microarray
More from Dr. A. F. M. Azim Anwar
24. ACLS Protocol.pptx
The document appears to be a presentation on cardiology topics including sudden collapse and bradycardia management. It was presented by Dr. Azim Anwar, a resident in cardiology at BSMMU, under the chairpersonship of Prof. Jahanara Arzu, the unit chief of cardiology at BSMMU. The presentation covers algorithms for responding to sudden collapse, guidelines for breathing and CPR, and medications for treating conditions like bradycardia. It concludes with asking if there are any questions.
22. CTO 2.pptx
Mr. M, age 55, presented with 8 hours of chest pain. ECG and echo showed normal findings except for inferior wall hypokinesia and EF of 50%. The target vessel for intervention was the proximal right coronary artery (RCA), which showed a visible proximal cap but distal vessel not visible, with Rentrop class 2 collaterals. The document discusses techniques for chronic total occlusion percutaneous coronary intervention including antegrade and retrograde approaches, tools used such as guidewires, balloons, microcatheters and imaging catheters. Challenges of CTO PCI include procedural failure and complications, though successful procedures can improve regional contractility. Experience and suitable anatomy are needed for acceptable outcomes.
19. CTO 1.pptx
This document discusses strategies for chronic total occlusion (CTO) percutaneous coronary intervention (PCI). It begins by defining a CTO as a coronary artery occlusion of at least 3 months. It then reviews angiographic analysis, guidewires, balloons, microcatheters, and imaging tools used in CTO PCI. Special techniques like antegrade and retrograde wiring are presented. Challenges of CTO PCI include high failure rates. However, successful CTO PCI can improve regional heart function. Experience is important for optimal outcomes of this complex revascularization.
18. Cardiac Onco Guideline 2022.pptx
This document outlines the agenda and guidelines for assessing cancer patients from a cardiac perspective before starting chemotherapy. It discusses performing a history, clinical exam, and investigations including ECG, echocardiogram, biomarkers and stress testing. Based on risk factors and test results, patients may be referred to a cardiologist. It also covers monitoring patients after chemotherapy, managing cardiovascular risks and treating acute cardiac issues that could arise during cancer treatment.
17. CRT & Echo.ppt
This document discusses the use of echocardiography in selecting and evaluating patients for cardiac resynchronization therapy (CRT). It defines CRT as a biventricular pacemaker that sends electrical signals to both lower chambers of the heart. Guidelines recommend CRT for patients with heart failure, reduced ejection fraction, and prolonged QRS duration. Echocardiography can assess dyssynchrony through parameters like septal-to-posterior wall motion delay, left ventricular electromechanical delay, and apical rocking. CRT success is defined as ≥10-15% reduction in end-systolic volume after 3-6 months. The document reviews echocardiographic techniques for evaluating dyssynchrony and
16. MVP EDS.ppt
Dr. Azim Anwar presents the case of a 19-year-old male, Mr. Sabbir, with progressive shortness of breath over 15 days and bilateral ventricular failure, mitral regurgitation, tricuspid regurgitation, and severe pulmonary hypertension. The patient's symptoms worsened despite treatment at multiple centers. Examination revealed signs of right and left heart failure. The working diagnosis was biventricular failure, mitral regurgitation, tricuspid regurgitation, and severe pulmonary hypertension. The patient's history was reviewed which showed hypothyroidism and iron deficiency anemia but no rheumatic fever. The cause of mitral valve prolapse was discussed, which can occur in
14. DAPT VKA OAC.pptx
This document discusses four clinical cases involving patients on antiplatelet and anticoagulant therapy:
1. A STEMI patient with LV thrombus found on echocardiogram who is currently on dual antiplatelet therapy (DAPT). The document recommends adding prophylactic anticoagulation with a vitamin K antagonist (VKA) or non-vitamin K oral anticoagulant (NOAC).
2. An NSTEMI patient currently on long-term DAPT who underwent PCI years ago. The document recommends continuing prasugrel as part of DAPT in this high thrombotic risk patient.
3. An NSTEMI patient who developed deep vein thrombosis while
15. Stent thrombosis & Restenosis.pptx
Dr. Azim Anwar presented on a 59-year-old male patient with uncontrolled diabetes mellitus and refractory angina who previously underwent PCI to the LAD artery in March 2021. The patient's investigations showed elevated HbA1c and ECG changes. Echocardiography revealed anterior wall hypokinesis with 40% ejection fraction. Coronary angiography demonstrated in-stent restenosis of 60% within the drug-eluting stent in the LAD artery, as well as 95% stenosis in the OM2 artery. Treatment options for in-stent restenosis were discussed, including balloon angioplasty, restenting, cutting balloon, and vascular brachytherapy. Risk
Trials in Cardiology.pptx
This document summarizes two upcoming cardiovascular trials to be presented at the ESC 2023 Congress. The STOP DAPT-3 trial will compare P2Y12 inhibitor monotherapy with dual antiplatelet therapy after PCI and found monotherapy is not superior due to higher rates of ischemic events. The FIRE trial found complete revascularization guided by full physiology to lower complications compared to culprit-only PCI in myocardial infarction patients. Both trials provide new insights into antiplatelet regimens and revascularization strategies after cardiovascular procedures.
A Curious Case Of Ortners Syndrome
A Case of dysphagia was evaluated properly and was diagnosed as a case of Ortners syndrome. This slides discuss the litereture review of ortners syndrome also
Bifurction PCI- In A Nutshell.pptx
This document discusses strategies for percutaneous coronary intervention (PCI) of coronary artery bifurcation lesions. It outlines considerations for revascularization versus medical optimization and discusses stenting techniques including provisional stenting, T/V/Culotte techniques, crush techniques (classic, mini, double kissing crush), and the importance of final kissing balloon inflation. Guidelines, wiring sequence, predilation, and intravascular ultrasound guidance are also reviewed. Successful results and unsatisfactory results are defined.
12. Right Heart Catheterization - Pros, Cons & Calculations
This slides discuss the indication, procedures, instruments and calculations to determine Right heart Catheterization values
14. DAPT, VKA, OAC- Case Based Approach
This document discusses four clinical cases involving patients on antiplatelet and anticoagulant therapy:
1. A STEMI patient with LV thrombus found on echocardiogram who is currently on dual antiplatelet therapy (DAPT). The document recommends adding prophylactic anticoagulation with a vitamin K antagonist (VKA) or non-vitamin K oral anticoagulant (NOAC).
2. An NSTEMI patient currently on long-term DAPT who underwent PCI years ago. The document recommends continuing prasugrel as part of DAPT in this high thrombotic risk patient.
3. An NSTEMI patient who developed deep vein thrombosis while
A Case of MVP disgnosed as EDS
Dr. Azim Anwar presents the case of a 19-year-old male patient named Sabbir who has been experiencing shortness of breath for 15 days that has progressively worsened. Upon examination, the patient shows signs of bi-ventricular failure, mitral regurgitation, tricuspid regurgitation, and severe pulmonary hypertension. The working diagnosis is acute congestive heart failure exacerbation with underlying mitral valve prolapse likely caused by a connective tissue disorder such as Ehlers-Danlos syndrome. Treatment was started including medication, oxygen supplementation, and fluid management.
Echo assessment of CRT Candidates
This document discusses the use of echocardiography in selecting and evaluating patients for cardiac resynchronization therapy (CRT). It defines CRT as a biventricular pacemaker that sends electrical signals to both lower chambers of the heart. Guidelines recommend CRT for patients with left ventricular dysfunction, prolonged QRS duration, and left bundle branch block morphology. Echocardiography can assess dyssynchrony through parameters like septal-to-posterior wall motion delay, left ventricular electromechanical delay, and apical rocking. CRT success is defined as ≥10-15% reduction in end-systolic volume after 3-6 months. The document reviews echocardiographic techniques for evaluating dyssynchron
Anti hypertensive drugs.pptx
This slides contains brief description of choice of antihypertensive medication in general and special situation.
Intra Aortic Balloon Pump - All you need to know
This slide contains the basic principle of IABP, indication and contraindications in a very brief and precise manner
How To Present A Death Case
A 62-year-old hypertensive man presented with 18 hours of chest pain and breathlessness and was found to have an extensive anterior STEMI; despite receiving oxygen, medications, and consideration for rescue PCI, his condition deteriorated with recurrent cardiac arrest and he ultimately passed away.
A Patient of Anasarca- Road to Diagnosis
This slide contains the approach to a patient of generalized body swelling, discussion on need of renal biopsy & Management of glomerulo nephritis.
Evaluation & Management of a case of Peripheral Neuropathy
This slide contains case based discussion of how to evaluate a case of peripheral neuropathy, how to investigate and manage according to cause.
More from Dr. A. F. M. Azim Anwar (20)
12. Right Heart Catheterization - Pros, Cons & Calculations
12. Right Heart Catheterization - Pros, Cons & Calculations
Evaluation & Management of a case of Peripheral Neuropathy
Evaluation & Management of a case of Peripheral Neuropathy
Recently uploaded
How to Fix the Import Error in the Odoo 17
An import error occurs when a program fails to import a module or library, disrupting its execution. In languages like Python, this issue arises when the specified module cannot be found or accessed, hindering the program's functionality. Resolving import errors is crucial for maintaining smooth software operation and uninterrupted development processes.
ANATOMY AND BIOMECHANICS OF HIP JOINT.pdf
it describes the bony anatomy including the femoral head , acetabulum, labrum . also discusses the capsule , ligaments . muscle that act on the hip joint and the range of motion are outlined. factors affecting hip joint stability and weight transmission through the joint are summarized.
How to Manage Your Lost Opportunities in Odoo 17 CRM
Odoo 17 CRM allows us to track why we lose sales opportunities with "Lost Reasons." This helps analyze our sales process and identify areas for improvement. Here's how to configure lost reasons in Odoo 17 CRM
Beyond Degrees - Empowering the Workforce in the Context of Skills-First.pptx
Iván Bornacelly, Policy Analyst at the OECD Centre for Skills, OECD, presents at the webinar 'Tackling job market gaps with a skills-first approach' on 12 June 2024
BÀI TẬP BỔ TRỢ TIẾNG ANH 8 CẢ NĂM - GLOBAL SUCCESS - NĂM HỌC 2023-2024 (CÓ FI...
BÀI TẬP BỔ TRỢ TIẾNG ANH 8 CẢ NĂM - GLOBAL SUCCESS - NĂM HỌC 2023-2024 (CÓ FI...Nguyen Thanh Tu Collection
https://app.box.com/s/y977uz6bpd3af4qsebv7r9b7s21935vdMain Java[All of the Base Concepts}.docx
This is part 1 of my Java Learning Journey. This Contains Custom methods, classes, constructors, packages, multithreading , try- catch block, finally block and more.
BÀI TẬP DẠY THÊM TIẾNG ANH LỚP 7 CẢ NĂM FRIENDS PLUS SÁCH CHÂN TRỜI SÁNG TẠO ...
BÀI TẬP DẠY THÊM TIẾNG ANH LỚP 7 CẢ NĂM FRIENDS PLUS SÁCH CHÂN TRỜI SÁNG TẠO ...Nguyen Thanh Tu Collection
https://app.box.com/s/qhtvq32h4ybf9t49ku85x0n3xl4jhr15clinical examination of hip joint (1).pdf
described clinical examination all orthopeadic conditions .
The History of Stoke Newington Street Names
Presented at the Stoke Newington Literary Festival on 9th June 2024
www.StokeNewingtonHistory.com
LAND USE LAND COVER AND NDVI OF MIRZAPUR DISTRICT, UP
This Dissertation explores the particular circumstances of Mirzapur, a region located in the
core of India. Mirzapur, with its varied terrains and abundant biodiversity, offers an optimal
environment for investigating the changes in vegetation cover dynamics. Our study utilizes
advanced technologies such as GIS (Geographic Information Systems) and Remote sensing to
analyze the transformations that have taken place over the course of a decade.
The complex relationship between human activities and the environment has been the focus
of extensive research and worry. As the global community grapples with swift urbanization,
population expansion, and economic progress, the effects on natural ecosystems are becoming
more evident. A crucial element of this impact is the alteration of vegetation cover, which plays a
significant role in maintaining the ecological equilibrium of our planet.Land serves as the foundation for all human activities and provides the necessary materials for
these activities. As the most crucial natural resource, its utilization by humans results in different
'Land uses,' which are determined by both human activities and the physical characteristics of the
land.
The utilization of land is impacted by human needs and environmental factors. In countries
like India, rapid population growth and the emphasis on extensive resource exploitation can lead
to significant land degradation, adversely affecting the region's land cover.
Therefore, human intervention has significantly influenced land use patterns over many
centuries, evolving its structure over time and space. In the present era, these changes have
accelerated due to factors such as agriculture and urbanization. Information regarding land use and
cover is essential for various planning and management tasks related to the Earth's surface,
providing crucial environmental data for scientific, resource management, policy purposes, and
diverse human activities.
Accurate understanding of land use and cover is imperative for the development planning
of any area. Consequently, a wide range of professionals, including earth system scientists, land
and water managers, and urban planners, are interested in obtaining data on land use and cover
changes, conversion trends, and other related patterns. The spatial dimensions of land use and
cover support policymakers and scientists in making well-informed decisions, as alterations in
these patterns indicate shifts in economic and social conditions. Monitoring such changes with the
help of Advanced technologies like Remote Sensing and Geographic Information Systems is
crucial for coordinated efforts across different administrative levels. Advanced technologies like
Remote Sensing and Geographic Information Systems
9
Changes in vegetation cover refer to variations in the distribution, composition, and overall
structure of plant communities across different temporal and spatial scales. These changes can
occur natural.
The Diamonds of 2023-2024 in the IGRA collection
A review of the growth of the Israel Genealogy Research Association Database Collection for the last 12 months. Our collection is now passed the 3 million mark and still growing. See which archives have contributed the most. See the different types of records we have, and which years have had records added. You can also see what we have for the future.
Chapter 4 - Islamic Financial Institutions in Malaysia.pptx
Chapter 4 - Islamic Financial Institutions in Malaysia.pptxMohd Adib Abd Muin, Senior Lecturer at Universiti Utara Malaysia
This slide is special for master students (MIBS & MIFB) in UUM. Also useful for readers who are interested in the topic of contemporary Islamic banking.
How to deliver Powerpoint Presentations.pptx
"How to make and deliver dynamic presentations by making it more interactive to captivate your audience attention"
Your Skill Boost Masterclass: Strategies for Effective Upskilling
Your Skill Boost Masterclass: Strategies for Effective UpskillingExcellence Foundation for South Sudan
Strategies for Effective Upskilling is a presentation by Chinwendu Peace in a Your Skill Boost Masterclass organisation by the Excellence Foundation for South Sudan on 08th and 09th June 2024 from 1 PM to 3 PM on each day.Recently uploaded (20)
How to Manage Your Lost Opportunities in Odoo 17 CRM
How to Manage Your Lost Opportunities in Odoo 17 CRM
Beyond Degrees - Empowering the Workforce in the Context of Skills-First.pptx
Beyond Degrees - Empowering the Workforce in the Context of Skills-First.pptx
BÀI TẬP BỔ TRỢ TIẾNG ANH 8 CẢ NĂM - GLOBAL SUCCESS - NĂM HỌC 2023-2024 (CÓ FI...
BÀI TẬP BỔ TRỢ TIẾNG ANH 8 CẢ NĂM - GLOBAL SUCCESS - NĂM HỌC 2023-2024 (CÓ FI...
Liberal Approach to the Study of Indian Politics.pdf
Liberal Approach to the Study of Indian Politics.pdf
BÀI TẬP DẠY THÊM TIẾNG ANH LỚP 7 CẢ NĂM FRIENDS PLUS SÁCH CHÂN TRỜI SÁNG TẠO ...
BÀI TẬP DẠY THÊM TIẾNG ANH LỚP 7 CẢ NĂM FRIENDS PLUS SÁCH CHÂN TRỜI SÁNG TẠO ...
LAND USE LAND COVER AND NDVI OF MIRZAPUR DISTRICT, UP
LAND USE LAND COVER AND NDVI OF MIRZAPUR DISTRICT, UP
Chapter 4 - Islamic Financial Institutions in Malaysia.pptx
Chapter 4 - Islamic Financial Institutions in Malaysia.pptx
Your Skill Boost Masterclass: Strategies for Effective Upskilling
Your Skill Boost Masterclass: Strategies for Effective Upskilling
Stent thrombosis & Restenosis.pptx
- 1. Presenter: Dr. Azim Anwar Phase-B Resident, Cardiology BSMMU
- 2. Dr. Rasul Amin ASSO. PROFESSOR & UNIT HEAD (RED-2 UNIT) , BSMMU
- 3. Mr. Ibrahim Khalil, 59 Years CCS III DM (Uncontrolled) 3 On Query, PCI to LAD on March, 2021. No Documents on Stent details
- 4. Ongoing Management………… ▸ SAPT ▸ Statins ▸ PPI ▸ Bb ▸ Mononitrates ▸ S/L Nitrates ▸ Ramipril ▸ Nicorandil ▸ Ranolazone 4
- 5. Investigations Trop I CK MB NORMAL S. Creatinine HBA1C – 8.9 5
- 6. ECG : T inv in V1-V4 6
- 7. Echocardiography ▸ Anterior, A/S, A/L ▸ 40% 7
- 8. CCS III with Refractory Angina with Uncontrolled DM CAG with Intend to Revascularization
- 9. “ ▸ LAD –- T4. Stent ▸ Insitu in P & M. 9
- 10. “ ▸ ISR Pattern III ▸ Proliferative 10
- 11. “ ▸ . ▸ 60% ISR. dLAD 80% 11
- 12. “ 12 ■ OM 2 – 95%
- 13. “ 13 ▸ dRCA – Non Critical
- 14. HOW TO TREAT ? 14
- 15. ISR Treatment Type 1 : Balloon Angio/DEB T 2/3/4: Restenting/CABG (Sirolimus, Paclitaxel)
- 16. Head to Head Trial with Balloon Angio: #Cutting Balloon #Excimer laser angio #Atherectomy #Vascular brachytherapy 16
- 17. What to DO ?n Syntax Scoring ?? 17
- 18. 18
- 19. In two or three columns Yellow Is the color of gold, butter and ripe lemons. In the spectrum of visible light, yellow is found between green and orange. Blue Is the colour of the clear sky and the deep sea. It is located between violet and green on the optical spectrum. Red Is the color of blood, and because of this it has historically been associated with sacrifice, danger and courage. 19
- 20. 20
- 21. 21
- 22. 22
- 23. 23
- 24. 24
- 25. 25
- 26. 26
- 27. A picture is worth a thousand words A complex idea can be conveyed with just a single still image, namely making it possible to absorb large amounts of data quickly. 27
- 28. ISR, Why So Important ? 28 1 5 6 2 Balloon Angioplasty 50% Acute Recoil & Acute Vessel Closure DES <10% Pharmaco logical supression of Neointimal Hyperplasia BMS : 20-40% Neointimal hyperplasia Whats Next ??
- 29. Definition of ISR 29 Typically 6-9 month after, on followup ancgiography 03 Either within the stent, Or, 5 mm Prox or distal to the stent margin. 02 Luminal Narrowing of > 50% 01
- 30. Pathophysiology…… Early, < 3 months Neointimal Hyperplasia Intermediate, 8-13 months: Neointimal Hyperplasia 30 Late, After Years Very Early, <24 H Acute Elastic Recoil or Plaque Prolapse.
- 31. In Stent Restenosis : RISK FACTORS 31
- 32. Procedural & Device Factors: 32
- 33. Procedural & Device Factors: 33
- 34. Procedural & Device Factors: Stent 34
- 35. Procedural & Device Factors: Stent 35
- 36. Procedural & Device Factors: Stent Gaps 36
- 37. Biological Factors: #Genetic Resistance to Rapamycin. #Altered metabolism of Paclitaxel . #Hypersensitive reaction to nickel, cobalt, platinum, chromium. 37
- 38. Patient Factors: #IDDM #ESRD #Small reference vessel diameter #Long lesion length #Ostial lesions # Calcified Lesions #Bifurcation lesion # CTO 38
- 39. 39
- 40. Credits ▸ Special thanks to Asso. Professor Dr. Rasul Amin UNIT HEAD (RED-2 UNIT) , BSMMU. And My Colleagues 40