Nuclear medicine for affordable health care in Bangladesh

In Bangladesh, nowadays, atoms are not only providing healing touch to the patients suffering from diseases like Cancer to Thyroid malfunction but are aiding in diagnosis too.

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Atoms are well known for their destructive power, but many strides are being taken in the field of harnessing its power for the health sector to save lives.

In Bangladesh, nowadays, a large number of people are diagnosed with diseases like Cancer and Thyroid malfunction and many are treated through the use of atoms. Nuclear medical technologies have revolutionized the diagnostic services owing to its accuracy.

The National Institute for Nuclear Medicine and Allied Sciences (NINMAS), through a number of centers, is providing various nuclear medicine services throughout the country. The institute is an establishment of Bangladesh Atomic Energy Commission (BAEC) under the Ministry of Science & Technology of the government. Out of these different centers, Bangabandhu Sheikh Mujib Medical University (BSMMU) has the best state-of-the-art facilities in nuclear technology. NINMAS and BSMMU offer diagnosis, treatment; and concurrently conducts research and development activities.

NINMAS Director Dr. Nurun Nahar said that the doctors usually refer patients here after collecting their basic health data. “We diagnose the referred patients using various nuclear technologies and here at NINMAS the health care fees are affordable enough,” she told Nuclear Asia.

With the modern single and dual head SPECT cameras, the institute is now capable of performing most modern scanning in the oncology, cardiology, nephrology and cerebral studies. Keeping with an ever increasing importance of Positron Emission Tomography (PET), Institute has a project to establish a PET center. This gives a new dimension to the endeavor to represent the Institute as a “Centre of Excellence” in the field of nuclear medicine services in Bangladesh.

NINMAS has different divisions including Scintigraphy, Thyroid, Nuclear Cardiology, PET-CT, Nuclear Nephrology, In-Vitro, Ultrasound and Color Doppler, Research and Development. Scintigraphy division has modern gamma cameras which give accurate information about the organ or tissue as well as the functioning of different organs such as brain, bone, heart, breast, lung heart, kidneys and liver using radio isotopes.
Patients are no more needed to go abroad to detect certain cancers as PET-CT division is already offering this service at BSMMU. Thyroid division offers detection of thyroid cancer and various other treatments. NINMAS offers MPhil and MD courses for the students. Post Graduate students from different backgrounds gather here for training as part of their academic activities.

The peaceful use of atom in medical science was actually initiated much before its use for bombing Hiroshima and Nagasaki. However, the use of nuclear medicine flourished only in the twenty-first century. Radioactive atoms and radio isotopes are mostly used in the field of nuclear medicine technology to diagnose, treat and prevent different diseases. However, there are several well-known side-effects to the use of radioactive atoms in the human body.

Fortunately, in most of the cases, the side-effects are negligible.

While asking about the side effects Dr. Nahar remarked that, the side-effects are real but one needs to compare the benefits with the side-effects. If the benefits are found to be dominant over side-effects than the nuclear medicine service is applied, she added. Moreover, NINMAS uses modern technologies and maintains highest possible standards in Bangladesh which minimize the risk factors and side effects, she said. “Our only problem is the lack of manpower; we cannot utilize the facility to its full capacity due to the scarcity of enough manpower,” she rued.

The Project Director and Chief Scientific officer of NINMAS Dr. Md Nurul Islam said that the state-of-the-art services offered at the institute are unique in the South-Asian region and more development is expected. Besides, the costs of the services here is relatively lower than the neighboring countries. “The majority of the radiopharmaceuticals used in Bangladesh’s nuclear medicine centers now come from the radioisotope production laboratory housed in the BAEC’s Institute of Nuclear Science and Technology in Savar. Initiatives are being taken to produce more of the isotopes at home,” he said.

The very first use of nuclear medicine started at Dhaka in the name of ‘Radio isotope’ center set up in 1962. Society of Nuclear Medicine was formed in 1993 and NINMAS was first established in 1980 with a small extent in Block-A of the former Institute of Post Graduate Medicine & Research (IPGMR). It is now located in the newly constructed 18-storied Block- D of Bangabandhu Sheikh Mujib Medical University (former IPGMR). Country’s first computerized ultrasonography and gamma camera were installed at Institute in 1981 and 1983 respectively. The institute started offering diploma courses from 1987.

In Dhaka, there are three different publicly-funded facilities that offer nuclear medicine services including BSMMU, Dhaka Medical College and Sir Salimullah Medical College. Private owned United Hospital of Dhaka also offers some services with limited capacity. The services of nuclear medicine are also available out of Dhaka. Chittagong Medical College and the medical colleges of Mymensingh, Rajshahi, Sylhet, Rangpur, Khulna, Barisal, Faridpur, Bogra, Comilla also offers some services.

Professor Dr. Morshed Ali, the director of the nuclear medicine of Rangpur Medical College said that the medical college offers almost all the services like Dhaka including thyroid cancers. Every day 50 to 60 patients get health care at the nuclear medicine department. Dr. Ali pointed as the scarcity of skilled manpower as the main hindrance in the full utilisation of nuclear technology in the health sector. “We offer academic courses here as well. However, we have scarcity of skilled man power here which will be solved once all the medical colleges start academic courses on nuclear medicine,” he remarked. He informed that, International Atomic Energy Agency (IAEA) provides assistance in developing skilled manpower and using new technologies.