PhD Thesis

Study of Radiation-Induced Peripheral Neuropathy of Cancer Survivors

2025-04-10T00:00:00Z

Study of Radiation-Induced Peripheral Neuropathy of Cancer Survivors Hussain, Syed Md Akram Cancer remains a critical global health challenge, accounting for nearly 10 million deaths in 2020, with approximately 1.5 million in Bangladesh alone. While radiation therapy is a cornerstone of cancer treatment, it often leads to complications like radiation-induced peripheral neuropathy (RIPN), including specific conditions such as radiation-induced brachial plexopathy (RIBP) and lumbosacral plexopathy (RILSP). Electrophysiological tests—namely nerve conduction velocity (NCV) and electromyography (EMG)—are essential for evaluating these conditions. In Bangladesh, limited research and awareness of RIPN pose challenges to accurate diagnosis and effective management, affecting the quality of life for many survivors. This study seeks to compare nerve conduction parameters between irradiated cancer survivors and matched controls at a premium hospital in Bangladesh, utilizing statistical analysis to deepen understanding of the incidence of RIPN in Bangladesh which may lead to increased awareness among radiotherapy providers for taking up steps towards improved cancer care. Particularly, this study explores motor nerve conduction in patients who received spinal radiation, focusing on the Median and Ulnar nerves of the Brachial Plexus and the Tibial and Common Peroneal nerves of the Lumbosacral Plexus. Experimental participants were selected based on criteria such as confirmed cancer diagnosis and a WHO performance status of up to 2, with exclusions for pregnant women, those with metastatic disease, and individuals with a history of diabetic neuropathy. Due to time constraints, sensory nerve conduction was not included, and data were collected from patients who had undergone treatment between two months to 30 months prior to the measurements. Control data were retrospectively sourced from individuals with no history of cancer or radiotherapy. Primary measurements included Nerve Conduction Velocity (NCV), Response Amplitude (AMP), and Area Under the Curve (AUC), averaged bilaterally and grouped by 10-year age intervals. EMG/EP equipment with supramaximal stimulation was used for accurate measurements across the above mentioned four nerves. One tailed test model was used for all the nerve conduction parameters as these are normal if above a certain respective critical value. v For the first analysis, Mann-Whitney U-test was used to assess if there are significant differences between the experimental and control groups, as this appeared to be more appropriate in view of non-Gaussian distribution of the experimental data. However, t-tests were also performed in order to assess whether this more popular test may provide useful assessment of neuropathy, the outcomes compared with that obtained using MWU tests. Then the control data, which were assumed to be normally distributed, were used to obtain critical values to identify individual cases of potential neuropathy using which an evaluation of the incidence of RIPN were obtained for each nerve conduction parameter tested, for each age group. Mann Whitney U test results showed that except for Common Peroneal nerve for the age groups of 51-60 and 61-70, the null hypothesis was rejected for all other nerves tested for all the three age groups. These results suggest that there exist significant differences in the nerve conduction parameters tested between the experimental and the control groups. These tables also indicate how a combination of the three nerve conduction parameters, NCV, AMP, and AUC, used in this study gives a higher incidence of neuropathy than could have been obtained using a single parameter, such as NCV, which has been performed by most the researchers around the globe. This may have been the reason for obtaining low incidences of RIPN by different research groups. Of course, diagnosis, treatment planning and application of radiotherapy, all may have contributions which need to be highlighted. Again, t-tests in comparison to MWU test (which we considered as the gold standard) with regards to acceptance or rejection of the null hypothesis, the overall agreement was about 77.8%, which is a good value and speaks of the robustness of the t-test even in cases where the experimental group may not have a Gaussian distribution. Considering the whole age group of 41-70 years combined, the incidences of neuropathy in the experimental groups were obtained as 69.8% for RIBP and 48.5% for RILSP. The corresponding figures were, 78.3% and 81.8% for age group 41-50, 84.6% and 66.7% for age group 51-60, and 47.1% and 18.8% for age group 61-70, which seems to indicate that the values got lowered mainly due to the oldest age group. It may be that even control subjects of this age vi group had neuropathy due to other factors which lowered the critical values, which then possibly contributed to the lower incidence of neuropathy in the experimental group. This work appears to set an example of a thorough study on nerve conduction measurements in irradiated cancer survivors in order to assess RIPN which may have significant contribution in the future for improved awareness and improved treatment planning in Bangladesh and in other countries, specially the LMICs. vii This thesis is submitted for the degree of Doctor of Philosophy.

Calculation accuracy and quality assurance of computer aided radiation therapy planning.

2025-03-12T00:00:00Z

Calculation accuracy and quality assurance of computer aided radiation therapy planning. Alam, Md. Jahangir This thesis is submitted for the degree of Doctor of Philosophy.

Chemical and biological studies of leaves and twigs of anogeissus rivularis and some hypoglycemic herbal formulations

2019-04-25T00:00:00Z

Chemical and biological studies of leaves and twigs of anogeissus rivularis and some hypoglycemic herbal formulations Hosen, Md. Anowar Hexane and Ethyl acetate extracts of leaves and twigs of Anogeissusrivularis and their sub-fractions were tested for anticancer activities on the six common human cancer cell lines; P-388, KB, HT-29, MCF-7, A549and two normal human kidney cell lines ASK and Hek293. Sub-fractions, 1F-3, 1F-5, Et-1F-2, Et-1F-3, and Et-1F-4 were found to possess significant anticancer activities (ED50 <4, 3.40, 4.50, 4.60 and 6.37 µg/mL respectively) on P-388 cell lines. The same extracts and their sub-fractions were also tested for anti-HIV-1 RT. The two extracts showed moderate activity but the two sub-fractions, 1F-5& Et-1F-7 were found to be very active (growth inhibition 97% & 92%, respectively). From the active extracts four new compounds namely, 2-(3՜,4՜-Dimethoxy-phenyl)-3-methyl-5-propenyl-2,3-dihydro-benzofuran (20), Dimer of 4,6-Dihydroxy-2-(4՜-hydroxy-benzyl)-benzofuran-3-one (21), 2-[(3՜,4՜-Dihydroxy-phenyl)-hydroxy-methyl]-4,6-dihydroxy-benzofuran-3-one (22), 2,5-Bis-[(4՜-hydroxy-phenyl)(4՜՜-hydroxy-phenyl)]-3,4-dimethyl-tetrahydro-furan-3-ol (23), together with thirteen known compounds namely, betulinic acid (3β-Hydroxy-19β-hydrogen-lup-20-(29)-en-28-oic acid)(3), 3β-Hydroxy-20(29)-en-lupan-30-al (6),29-Nor-20-oxolupeol (7), 3β,6β-Dihydroxylup-20(29)-ene(8),3,3՜,4՜-Tri-O-methylellagic acid (9),3,3՜-Di-O-methylellagic acid(12), (S)-naringenin(4՜,5,7-Trihydroxyflavanone) (13),p-Cumaric acid ((E)-3-(4՜-Hydroxyphenyl)-2-propenoic acid)(14),2,3-dihydro-p-cumaric acid(3-(4՜-Hydroxyphenyl)-propanoic acid)(15), protocatechuic acid (3,4-Dihydroxybenzoic acid)(16), Stigmast-5-en-3-O-β-glucoside(17),loliolide (6-Hydroxy-4,4,7a-trimethyl-5,6,7,7a-tetrahydro-4H-benzofuran-2-one) (18),vanillic acid (3-Methoxy 4-hydroxybenzoic acid) (19) were isolated by chromatographic techniques. The structure of this compounds were elucidated by spectroscopic methods using UV, FTIR, high resolution 1H &13C NMR and Mass spectrometry (HRMS-ESI-TOP) and Single Crystal X-ray Diffraction. This dissertation for the degree of Masters of Philosophy.

Study of the relative, free diffusion velocities of electrolytes in aqueous medium

2016-01-18T00:00:00Z

Study of the relative, free diffusion velocities of electrolytes in aqueous medium Hossain, Md. Masud A novel liquid diffusion tube closed and cylindrical termed Diffusimeter was fabricated from glass tube and straight bore stopcocks to measure relative velocities of electrolytes in free diffusion. Solutions of two electrolytes known to give characteristic reaction were put one above each of two stopcocks and then released concurrently to diffuse head on through water in the diffusion path and finally to produce a precipitate or color as indicator at the encounter. Experimental objective required entry of time elapsed for the reaction mark to appear and the distances traveled by the electrolytes. The velocity ratio termed distance traveled ratio (DTR) was found to match with the Molar Mass Ratio Square Root (MMRSR) of the electrolyte pair taken in order. A direct proportionality between the velocity and the square root of molar mass was thus revalidated. The heavier electrolyte moved faster contrary to the gaseous diffusion. The results hinted hydration numbers of the diffusing electrolytes. Diffusion velocities of thirty salts were determined using this novel, innovative Diffusimetric Method named DTR model. Surprisingly NH4Cl and NH4SCN showed similar velocities. HCl and LiCl showed low diffusion rates due to their cation’s high charge to size ratio. Apparently MgCl2, CaCl2, and SrCl2 diffused with one H2O each but BaCl2, AgNO3, and FeIII alum with none. NaCl showed relatively high rate which traces its fitness as antibacterial agent and bio-salt in human. Na2SO4 and K2SO4 showed identical velocities which together with metatheses hypothesize sylvite mineral formation mechanism over geological periods. Close diffusion rates of ZnCl2 and CdCl2 traces reasons for cadmium’s presence in zinc ores. Diffusion controlled effects are shown in FeIII salt’s reactions with NH4SCN; the DTR reveals reactant pair’s encounter nature at their conjunction. Manipulating electrolyte’s concentrations crystalline precipitates were obtained. This dissertation submitted to the University of Dhaka for the degree of Master of Philosophy in Chemistry.