Arsenic is associated with lung disease and experimental models suggest that arsenic-induced degradation of the chloride channel CFTR (cystic fibrosis transmembrane conductance regulator) is a mechanism of arsenic toxicity. We examined associations between arsenic exposure, sweat chloride concentration (measure of CFTR function), and pulmonary function among 269 adults in Bangladesh. Participants with sweat chloride ≥ 60 mmol/L had higher arsenic exposures than those with sweat chloride < 60 mmol/L (water: median 77.5 µg/L versus 34.0 µg/L, p = 0.025; toenails: median 4.8 µg/g versus 3.7 µg/g, p = 0.024). In linear regression models, a one-unit µg/g increment in toenail arsenic was associated with a 0.59 mmol/L higher sweat chloride concentration, p < 0.001. Among the entire study population, after adjusting for covariates including age, sex, smoking, education, and height, toenail arsenic concentration was associated with increased odds of airway obstruction (OR: 1.97, 95%: 1.06, 3.67, p = 0.03); however, sweat chloride concentration did not mediate this association. Our findings suggest that sweat chloride concentration may serve as novel biomarker for arsenic exposure, warranting further investigation in diverse populations, and that arsenic likely acts on the lung through mechanisms other than inducing CFTR dysfunction. Alternative mechanisms by which environmental arsenic exposure may lead to obstructive lung disease, such as arsenic-induced direct lung injury and/or increase lung proteinase activity, require additional exploration in future work.
Background: Anti-Mullerian hormone (AMH) is a crucial marker for ovarian reserve, reflecting ovarian function due to its secretion by antral follicles. Obesity can adversely affect fertility, potentially altering AMH production. The aim of this study was to assess the correlation between body mass index (BMI) and serum anti-Mullerian hormone (AMH) level in subfertile women. Methods: This cross-sectional analytical study was carried out in the department of obstetrics and gynecology, BIRDEM General Hospital, Dhaka, over a period of 18 months from January 2023 to June 2024. Results: Between BMI≥25 kg/m2 and <25 kg/m2 groups there were no significant differences in age distribution (mean ages: 30.5 versus 30.4 years, p=0.912). There were no significant differences in education, occupation, or income distribution between two groups. Menstrual regularity and flow differed significantly, with more irregular cycles and heavier flow in the BMI≥25 group (p<0.0001 and p=0.049, respectively). Serum AMH levels were significantly lower in the BMI≥25 group (1.7 versus 3.1, p<0.0001). A negative correlation was found between serum AMH levels and BMI, indicated that serum AMH level decreases with increasing BMI (p<0.0001). Age and BMI were inversely significantly associated with serum AMH level adjusted for each other. Conclusions: Higher BMI was associated with lower serum AMH levels in subfertile women, suggesting that elevated BMI may negatively impact serum AMH level which is a potential marker of ovarian reserve.
Background: Acute Promyelocytic Leukemia (APL) is a well-defined subtype of AML accounting for 5-13% of all AML cases and is identified by a balanced reciprocal translocation between chromosome 15 and 17 [t(15;17)(q24;q21)] which ultimately causes formation of PML-RAR_ oncoprotein. This translocation results in 3 isoforms on the PML gene including L-long form (located at intron 3) termed bcr1, S-short form (located at intron 6) known as bcr2, and V form (located at exon 6) known as bcr3. To ascertain the pattern of different breakpoints of PML/RAR_ fusion gene among Bangladeshi APL patients was the aim of this study. Methods: In this study 60 APL patients diagnosed positive for PML-RAR_ fusion gene who were referred to AFIP, Dhaka Cantonment were included as subjects. They were analyzed for the detection of three possible PML-RAR_ isoforms by utilizing Real Time Polymerase Chain Reaction (RT-PCR) technology. Results: The patients included in this study have age ranged from 9 years to 72 years, 35 years is the mean of age. In the study group, 39 (65%) were male and female patients were 21 (35%). The bcr1 isoform was found in 4 (6.67%) patients. No single bcr2 isoform was found in any patient. But in 3 patients having bcr2 isoform were found along with bcr1 (5.0%) and in 1 (1.66%) patient it was present in addition to bcr3. The bcr3 isoform was found in 19 (31.67%) patients and in 33 (55.0%) patients all of the isoforms were present. Conclusion: The key elements for the proper management of APL include early diagnosis and treatment initiation, proper supportive care, and recognition and management of therapy associated complications. Genetic testing is one of the most accurate methods for the diagnosis of this disease and ultimately can help in advancement of the disease management. Bangladesh Armed Forces Med J Vol 58 No (1) June 2025, pp 55-60
Background: Perinatal morbidity and mortality are largely driven by preterm birth, intrauterine asphyxia from placental insufficiency, and complications related to operative deliveries and medication use. Therefore, this study aimed to assess the association between sociodemographic and clinical characteristics and perinatal outcomes across high and low cerebro-umbilical ratio groups. The aim of the study was to assess the association between sociodemographic and clinical characteristics and perinatal outcomes across high and low cerebro-umbilical ratio groups. Methods: This prospective cohort study at the department of obstetrics and gynecology, BIRDEM General Hospital, Dhaka (November 2022-February 2024) included 106 women at 29-38 weeks gestation undergoing third-trimester Doppler. Maternal (gestational age, delivery) and fetal outcomes (birth weight, APGAR, respiratory distress, FGR) were assessed in relation to C/U ratio (cutoff 1.01). Data were collected via questionnaire, examination, and ultrasound, analyzed in SPSS 26.0 (p<0.05). Results: C/U<1.01 was associated with lower education (24.0% versus 57.1% higher secondary), lower income (79,800 versus 68,357 BDT), higher BMI (35.1 versus 33.1 kg/m2), earlier delivery (33.9 vs 36.6 weeks), lower birth weight (1.9 versus 2.6 kg; 96% versus 12.5% LBW), more complicated outcomes (84.0% versus 21.4%), APGAR<7 (68.0% versus 19.6%), NICU admission (74.0% versus 21.4%), respiratory distress (60.0% versus 12.5%), and FGR (18.0% versus 0%). Maternal age, parity, and occupation were similar between groups. Conclusions: A low cerebro-umbilical ratio is strongly associated with adverse perinatal outcomes, including lower birth weight, earlier delivery, and increased neonatal complications.
Background: Polycystic ovary syndrome (PCOS) is the most common cause of anovulation in reproductive-age women. Anti-Mullerian hormone (AMH) was higher in PCOS women due to increased antral follicles. This study examined the relationship between Anti-mullerian hormone and ovarian response after letrozole in sub-fertile PCOS patients. Methods: This cross-sectional study was conducted in the Department of Obstetrics and Gynaecology, BIRDEM General Hospital, Dhaka, Bangladesh, from April 2022 to September 2023. 116 sub-fertile PCOS patients receiving Letrozole were purposively selected. Patients underwent transvaginal ultrasound (TVS) and were divided into two groups by follicle size: non-responder group (<16 mm) and responder group (≥16 mm). Data was analyzed using statistical package for the social sciences (SPSS) version 26.0. Result: Most women were aged 21-30 years, with a mean age of group I at 30.2±3.7 and group II at 29.9±5.1. Most were primary subfertile; group I 35(65.5%) and group II 41(70.7%). Mean serum FSH was higher in group II, 9.28±5.6, than in group I, 7.19±3.64 (p<0.001). Mean AMH was higher in group II, 5.82±1.4, than in group I, 5.2±1.8 (p=0.054) but statistically non-significant. ROC curve showed AMH cut-off value of 5.12 with 62.1% sensitivity and 65.5% specificity. Patients with AMH <5.12 ng/ml had 3.1 times more chance of ovarian response versus those with AMH >5.1 ng/ml (OR=3.1; 95% CI (1.5-6.6), p=0.003). Conclusion: Elevated serum AMH level is a risk factor for poor ovarian response in PCOS, which may require adjusting the letrozole dosage.
