Final Report of National Coordinator Bangladesh Nov. 2013, Hotel Yak and Yeti, Kathmandu, Nepal Prof. Dr. Raihan Hussain, NPC

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Participating Country: BANGLADESH National Project Coordinator (Name /Title/Organization /telephone no., , etc.) NameTitleOrganizationTelephone Raihan Hussain Professor & CMO National Institute of Nuclear Medicine and Allied Sciences (NINMAS), BAEC yahoo. com

Participating Country: BANGLADESH National Project Team NameTitleOrganization Dr. Faridul Alam Director & Dr. Ferdous Ara Hussain Dr. Nurun Nahar Dr. Sadia Sultana Assoc. Mrs. Ferdoushi Begum Assoc. ProfessorNINMAS,BAEC Dr. Zeenat Jabin Senior Medical Officer Mr. Nahid Hossain Senior Scientific Dr. Sharmin Reza Medical

Brief History of Nuclear Medicine in Bangladesh The first nuclear medicine center of the country was established in 1962 in Dhaka Medical College under the then PAEC. In 1970 two more Centres were established, one in Chittagong & one in Rajshahi. By 1980 we had centres in Dinajpur, Sylhet & the Institute of NM in IPGMR, Dhaka. First computerized gamma camera was established in INM in First single head SPECT installed in 1995 First double head SPECT installed in 2003 First SPECT-CT installed in 2008 First PET-CT installed in 2010 There are 15 different NM establishments under the umbrella of BAEC along with 7 other establishments. 6

Locations of Nuclear Medicine Establishments Under BAEC 1. National Institute of Nuclear Medicine & Allied Science(NINMAS), Dhaka 2. INMAS in different parts of the country: Dhaka, Mitford, Chittagong, Khulna, Sylhet, Rajshahi, Mymensingh, Rangpur, Dinajpur, Faridpur, Bogra, Comilla, Barisal and Cox’s Bazar. Govt. (But not under BAEC) Armed Forces Medical Institute. National Institute of Cardiovascular diseases National Institute of kidney diseases and urology Non-Govt. Apollo Hospital, United Hospital, Lab-aid Hospital, Medinova Hospital Planned (in near future) 1. CNMU Cancer Hospital, Dhaka,. 2. INMAS, Jessore, Kushtia, Pabna 3. Square Hospital, Khaja Yunus Hospital 7

NM Institutions in Bangladesh 8

Manpower in the Nuclear Medicine Centres Planar Gamma Camera Single headed SPECT Dual headed SPECT SPECT- CT PET-CT Total (p) Physician PhysicistRadiochemistTechnologist Number of gamma cameras in Bangladesh

Manpower At present there are about 95 nuclear medicine physicians, 20 medical physicists, 10 radiochemists and 150 technologists. The nuclear medicine physicians and physicists are mainly trained from abroad. A number of nuclear medicine physicians & physicists are currently completing MPhil /PhD. Isotope and Radiopharmaceuticals BAEC has a research reactor. It produces Tc-99m and I Sometimes we need to import. The kits are mainly imported. Cyclotron produces F-18

Different Equipments in the country Dual Head Camera SPECT-CT CameraCardiac Scanner BMD Dual Head Camera Single Head Camera

Activity Name When, Where No. of participant Results: MF Meeting of the NPT June 9, 2011, NINMAS, Dhaka 0306Plans for future programs were chalked out. Details of the feasibility, planning and schedules of the seminars were drawn. National seminar on the Project Oct 30, 2011, NINMAS, Dhaka 6540Purpose: This was based on the training course (Train the Trainers) in Korea. Some of the lectures delivered in Korea were presented by the participants of the course for dissemination of the knowledge and to enlighten the participants with current information in Nuclear medicine, especially in PET- CT. Organized by the Society of Nuclear Medicine Bangladesh, jointly with NINMAS. Output: The participants were able to learn the latest knowledge in the topics. National activities in 2011

Activity NameWhen, Where No. of participant Results: MF Weekly seminarsRegularly Held, NINMAS, Dhaka and other INMAS 1020Discussion, case presentation and journal review meetings – being held regularly at NINMAS. Hands-on training program for young physicians and fresh graduate trainees. Do2015Practical training, tutorials, case review, reporting sessions – being held regularly. Distance Assisted Training program (DAT) for the Technologist On-going program 0502Cooperating with the IAEA program to improve the expertise of the technologists. Symposium on “congenital hypothyroidism in newborn babies” A Govt. project. 30 Nov, 2011, Dhaka Medical College To aware the professionals about the scope and usefulness of screening of congenital hypothyroidism using TSH IRMA kit. National activities in 2011 (contd.)

Activity NameWhen, Where No. of participant Results: MF Annual Conf. of Society of Nuclear Medicine, Bangladesh 31 March, 2012, Sylhet, Bangladesh 9060Dissemination of the knowledge and to enlighten the participants with current and productive information on recent advancement in Nuclear medicine, especially in PET-CT. Creating awareness and interest for performing new procedures not yet performed. Seminar on “Radi oimmunoassay” Two speakers from Korea 29 March, 2012, NINMAS auditorium, Dhaka 4733Informing and orienting the participants about recent developments in RIA and IRMA. Weekly seminarsRegularly Held, NINMAS, Dhaka and other INMAS 3020Discussion, case presentation and journal review meetings – being held regularly at NINMAS National activities in 2012

Activity Name When, Where No. of participant Results: MF Hands-on training program for young physicians and fresh graduate trainees. Do2015Practical training, tutorials, case review, reporting sessions – being held regularly. Seminar on PACS. Speaker was from India Sep 26, To inform and orient the participants about recent developments PACS National seminar on the Project 01 Oct, 2012, NINMAS Dhaka 7535This was based on the training course (Train the Trainers) in Korea. Some of the lectures delivered in Korea were presented by the participants of the course for dissemination of the knowledge and to enlighten the participants with current information in Nuclear medicine, especially in PET-CT. Organized by the Society of Nuclear Medicine Bangladesh, jointly with NINMAS. The participants were able to learn the latest knowledge in the topics. National activities in 2012 (contd.)

Activity NameWhen, Where No. of participant Results: MF Annual Conf. of Society of Nuclear Medicine, Bangladesh 25 January, 2013, Dhaka, Bangladesh 10070Topics: A broad spectrum of application of Nuclear Medicine, especially in PET-CT. Output and accomplishments: Participants were able to learn about improved and latest knowledge in the topics. Local participants were enlightened by foreign lecturers. Weekly seminarsRegularly Held, NINMAS and other INMAS 3520Discussion, case presentation and journal review meetings – being held regularly. Dissemination of the knowledge and to enlighten the participants with current and productive information on recent advancement in Nuclear medicine. Creating awareness and interest for performing new procedures not yet performed. Hands-on training program for young physicians and fresh graduate trainees. Regularly Held, NINMAS and other INMAS 2515Practical training, tutorials, case review, reporting sessions – being held regularly. National activities in 2013

Activity NameWhen, Where No. of participant Results: MF Working Seminar on Ca thyroid management with radioiodine Sep. 24, 2013 Dhaka, Bangladesh 3235The participants were able to exchange views on the recent developments on Ca thyroid management with radioiodine National seminar on the Project Nov 06, 2013, NINMAS, Dhaka 10065This was based on the training course (Train the Trainers) in Korea. Some of the lectures delivered in Korea were presented by the participants of the course for dissemination of the knowledge and to enlighten the participants with current information in Nuclear medicine, especially in PET-CT. Organized by the Society of Nuclear Medicine Bangladesh, jointly with NINMAS. The participants were able to learn the latest knowledge in the topics. National activities in 2013 (contd.)

No. of patients treated by gained knowledge, skills and new technologies: No. of patients diagnosed and treated by participants in the project training (NPC/NPT) and doctors/ specialists using dis seminated /transferred knowledge, skills and new technologi es by participants in the project training : 32,600 (Female=16,800; Male = 12,600; Children = 3,200)

No. of treated or diagnosed patients : No. of Treated or diagnosed patients Female Male Children Total330010,

Analysis of project results – national activities Three years program of the RCA/UNDP project has been successfully implemented in Bangladesh. Six nuclear medicine specialists (five physicians and one physicist) have taken part in the regional training courses in Korea and given the positive feedback to the national activities and their center of nuclear medicine. Two major national conferences with a total of 320 participants were successfully completed (one in Dhaka and the other in Sylhet). Three major national seminars based on the training course in Korea under this RCA /UNDP project. The lectures were presented by the participants of that training course with a total of 380 participants were successfully held. A total of 32,600 patients have been treated by the participants Promoted awareness among the NM personals. Encouraged the NM personals to have regular contacts with the clinicians Encouraged the NM personals to attend international conferences and meetings Project on ‘Establishment of PET-CT & cyclotron facility’ at NINMAS is successfully progressing.

Long term benefits of national activities: Improvement in the nuclear SPECT/PET imaging technologies will contribute to better, faster and more accurate diagnosis of the disease process. Thus this will result in better clinical management With better and more specific imaging facilities we can avoid many investigations, which will reduce the time and cost. At present many paitents go abroad for better treatment, which drains a lot of monetary loss of the country. If we can provide better treatment facilities, there will be decrease in the numbers. We are now giving importance to develop therapeutic nuclear medicine

“Kick-Off” meeting of the project in Phuket, Thailand on May 2011

First training program of the project in Seoul, Korea on August 2011

Review meeting of the project in Kota Kinabalu, Malaysia (20-21 Dec 2011 and in Cebu, Philippines (7-8 Nov 2012)

Programmes in Bangladesh First National seminar on the project, held in Dhaka on Oct 30, 2011

Conference of Society of Nuclear Medicine, Bangladesh at Sylhet on 31 March 2012

Second National Seminar on the project, held in Dhaka on October 30, 2011

Annual Conference of Society of Nuclear Medicine, Bangladesh in Dhaka on 25 Jan 2013

Third National Seminar on the project, held in Dhaka on November 06, 2013

Recommendations: Due to the positive impact from our experience I would like to recommend as well as request to the concerned authorities that the project may be extended. I would like to recommend for arranging a Training Program in Bangladesh. This will be a great opportunity for the local participants to learn directly from the resource persons.

Thank you all

Keep on Smiling!!