Shaheed M. Monsur Ali Medical College, Sirajganj

BACKGROUND AND AIMS:Breast cancer is one of the most destructive diseases among females worldwide, especially in developing countries. XPC and ESR2 genes have been identified in multiple malignancies. Therefore, we aimed to determine the association of XPC (rs2228001) and ESR2 (rs1256030/rs4986938) polymorphisms with breast cancer susceptibility in the Bangladeshi population. METHODS:This case-control study was carried out on 220 breast cancer patients and 208 healthy volunteers. Genotyping was performed using the polymerase chain reaction (PCR)-restriction fragment length polymorphism (PCR-RFLP) technique. Analyses were conducted using the statistical software application SPSS (version 25.0). Logistic regression was employed to assess the genetic association, employing the odds ratio (OR) and 95% confidence intervals (CIs). RESULTS:The XPC rs2228001 polymorphism demonstrated a significant association with breast cancer risk, with the CC genotype (OR = 3.27, P = .009), dominant model (OR = 1.67, P = .011), recessive model (OR = 2.87, P = .019), and allelic model (OR = 1.69, P = .002). The ESR2 rs1256030 variant exhibited a significantly elevated risk of breast cancer across all genetic models (P < .05). Whereas, the ESR2 rs4986938 polymorphism showed a significant correlation with breast cancer susceptibility in the TT genotype under the additive model 2 (OR = 3.83, P = .011) and the recessive model (OR = 3.73, P = .021). CONCLUSION:Our study concluded that the XPC rs2228001, ESR2 rs1256030, and ESR2 rs4986938 gene polymorphisms might be associated with breast cancer risk in the Bangladeshi women. Larger studies across diverse populations are recommended to validate these findings.

Abstract Background: Despite advances in therapy, breast cancer remains the leading cause of cancer-related deaths among women worldwide. The most common invasive subtype, often presents at advanced stages. Rapid progression and therapeutic resistance contribute to such poor outcomes. Vimentin, a cytoskeletal protein linked to epithelial-mesenchymal transition (EMT), is associated with aggressive tumor behavior, poor prognosis, and drug resistance, making it a potential prognostic and predictive marker for IDC. Objectives: To evaluate vimentin expression in IDC-NOS of the breast and its association with clinicopathological features. Methods: This cross-sectional observational study was conducted in the Department of Pathology, Dhaka Medical College, from September 2022 to August 2024. Sixty histopathologically diagnosed IDC-NOS cases were examined. Immunohistochemistry for vimentin was performed on formalin-fixed, paraffin-embedded tissues at AI Khan Lab Ltd., Dhaka. Associations with clinicopathological features were analyzed; p < 0.05 was considered statistically significant. Results: Vimentin expression was positive in 43.3% of cases. It was significantly higher in Grade 3 tumors (65.4%, p < 0.001) and in the triple-negative subtype (57.7%, p = 0.003). No significant association was observed with age, tumor size, stage, or lymphovascular invasion. Conclusion: Vimentin expression showed significant associations with aggressive breast cancer phenotypes, particularly higher grade and TNBC subtype. These findings suggest that vimentin may serve as a useful supplementary prognostic marker to aid in risk stratification and management of breast cancer.

ABSTRACT Background Type 2 diabetes mellitus (T2DM) is a rapidly growing public health crisis in Bangladesh, where an estimated 13.1 million adults were living with the condition in 2021, with projections suggesting this figure will nearly 22.3 million by 2045. Poor medication adherence and impaired health-related quality of life (HRQoL) are recognized consequences of long-term T2DM management, yet data from northwestern Bangladesh remain scarce. This study aimed to assess treatment adherence, HRQoL and identify their associated factors among T2DM patients in Rajshahi, Bangladesh. Methods We conducted a cross-sectional study between January and December 2021 among 205 T2DM patients from two tertiary-level hospitals in Rajshahi. Treatment adherence was assessed using the eight-item Morisky Medication Adherence Scale (MMAS-8), and HRQoL was measured using the EuroQol-5 Dimensions Questionnaire (EQ-5D-5L). Results The mean age of participants was 54.43 (±10.75) years; 50.73% were female. The majority (85.85%) had HbA1c ≥6.5%, reflecting widespread poor glycaemic control. Regarding treatment adherence, 40.98% of patients had low adherence, 26.83% had medium adherence, and 32.19% had high adherence. In terms of HRQoL, only 6.83% were in perfect health state, while 52.68% had slight/moderate problems and 40.49% had severe/extreme problems across EQ-5D-5L domains. The association between treatment adherence and HRQoL was not statistically significant (p=0.265). Multiple regression analysis (Adjusted R²=0.620) identified diabetic complications, illiteracy, primary education, female gender, higher BMI, joint family type, treatment adherence, older age, and two antidiabetic medications as significant predictors of poorer HRQoL, while urban residence and family history of DM were independently associated with better HRQoL. Conclusions A substantial proportion of T2DM patients exhibited low treatment adherence and markedly impaired HRQoL. While adherence and HRQoL were not directly associated, diabetic complications emerged as the strongest independent predictor of poor quality of life. These findings highlight the urgent need for multidisciplinary interventions to prevent complications in this population.

Background: Thoraco-abdominal trauma is a leading contributor to preventable mortality in medico-legal practice, yet region-specific autopsy-based evidence from Bangladesh remains scarce. Objective: This study characterises the demographic, circumstantial, and pathological profile of fatal thoraco-abdominal trauma among medico-legal autopsy cases at a tertiary teaching institute. Methods: A retrospective cross-sectional analysis was conducted on 125 medico-legal autopsy records at the Department of Forensic Medicine & Toxicology, Sirajganj Medical College, Sirajganj, from January to December 2025. Demographic, injury, and circumstantial variables were extracted from autopsy registers and analysed using SPSS v26.0, with chi-square testing and sensitivity analysis applied to categorical associations. Results: The mean age was 47.0 ± 16.3 years, with a male predominance of 80.0% (male-to-female ratio 4.0:1). Manner of death was equally distributed between homicide and accident (42.4% each), with suicide accounting for 15.2%. Fall (22.4%) and road traffic accidents (20.0%) were the leading mechanisms. Rib fractures (30.4%) and bowel perforation (28.0%) were the commonest thoracic and abdominal findings respectively, with combined thoraco-abdominal trauma present in 72.0% of cases. Hemorrhagic shock (28.0%) and cardiopulmonary arrest (26.4%) were the predominant causes of death; 39.2% died within one hour. Age group was significantly associated with manner of death (χ²=19.83, df=8, p=0.011), whereas sex, residence, and alcohol involvement showed no significant association with manner of death (p>0.05). Conclusion: Combined thoraco-abdominal injury dominates fatal trauma presentations at this centre, disproportionately affecting working-age rural males, underscoring urgent targeted prevention needs.

Background: Regular red-cell transfusion is essential for patients with transfusion-dependent thalassemia (TDT) but causes progressive iron loading. Where MRI-based tissue iron assessment is not routinely available, serum ferritin remains a practical marker. This study evaluated the association between transfusion burden and serum ferritin in patients with TDT. Methods: This cross-sectional study included 150 patients with TDT at Sirajganj Medical College Hospital, Bangladesh, from July 2025 to June 2026. Transfusion exposure, pre-transfusion hemoglobin, thalassemia phenotype, chelation adherence, splenectomy status, and serum ferritin were assessed. Associations were examined using Spearman correlation and multivariable linear and logistic regression. Results: Mean age was 17.06±6.87 years; 60.7% were male. Median annual transfusion burden was 144.08 ml/kg/year (IQR 126.95–161.41) and median ferritin was 1965.00 ng/mL (IQR 1329.28–2723.51); 31.3% had ferritin ≥2500 ng/mL. Annual transfusion burden correlated positively with ferritin (coefficient=0.231, p=0.004). After adjustment, each additional 10 ml/kg/year was associated with 5.9% higher ferritin (B=0.057, 95% CI 0.030–0.083; p<0.001) and 27% higher odds of ferritin ≥2500 ng/mL (aOR 1.27, 95% CI 1.08–1.50; p=0.004). Poor chelation adherence was strongly associated with ferritin ≥2500 ng/mL (aOR 6.92, 95% CI 2.84–16.85; p<0.001). Conclusions: Greater transfusion burden and poor chelation adherence were independently associated with higher serum ferritin. Tracking transfusion volume, serial ferritin, and chelation adherence may improve iron-overload monitoring in resource-constrained TDT care.