Dhaka Medical College and Hospital

Background: Breast cancer remains significant health concern across the world and the leading cause of cancer related mortality and morbidity among females. Various trials have been performed to evaluate the chances of less extensive surgery in both breast and axilla, even omission of axillary surgery. So, it is paramount to identify the prognostic and predictive factors that may fulfill the goal in the future. Methods: This was a cross-sectional observational study which took place in the Department of Surgical Oncology, National Institute of Cancer Research and Hospital (NICRH), Mohakhali, Dhaka from January 2023 to December 2023 over a period of 12 months. A p<0.05 was considered statistically significant. Results: A total number of 76 patients were enrolled in the current study after fulfilling the inclusion and exclusion criteria. Mean age of the study population was 42.37±9.87 years. There is statistically significant relationship between tumor size and ALNM (p<0.05) where majority of the patients (n=47) presented with T2 lesion (61.84%). Results of the study also showed involved site of breast by cancer was significantly related to axillary lymph node metastasis (ALNM). The number of patients presented with upper and outer quadrant, Upper and Inner quadrant and lower and inner quadrant were 48 (63.2%), 13 (17.1%) and 6 (7.9%) respectively. Lower and outer quadrant was involved by 8 (10.5%) patients which was not significantly related with ALNM (p>0.05). Conclusions: The current study demonstrated quadrant involvement can emerge as a clinically useful prognostic factor in breast cancer as there is a higher incidence of lymph node positivity with increasing size of the breast tumor and for tumors located at the outer quadrants of the breast. So, the site of primary tumor and size may be an important characteristic finding affecting the prognosis and treatment of patients with breast cancer.

Takayasu’s arteritis is a rare, chronic form of large- and medium-vessel vasculitis, predominantly affecting the aorta and its primary branches. Histopathologically, it is characterized by mononuclear cell infiltration and granulomatous inflammation of the vascular media, resulting in progressive arterial wall thickening, stenosis, occlusion, or aneurysmal dilation. Involvement of the common carotid arteries is a notable but atypical manifestation, often contributing to diagnostic complexity. The disease can lead to serious complications, including stroke, ischemic heart disease, pulmonary hypertension, secondary systemic hypertension, and aneurysm formation. Diagnosis is primarily based on a combination of clinical presentation and angiographic findings. J MEDICINE 2026; 27(1): 55-57

Background: Early identification of patients requiring mechanical ventilation (MV), either invasive or non-invasive, is critical to reduce morbidity and mortality in community-acquired pneumonia (CAP). Cortisol,a primary stress hormone, may serve as a prognostic marker in CAP. Objective: To evaluate the association between admission serum cortisol levels and the need for MV in patients with CAP. Methods: This prospective study enrolled 92 adults with CAP admitted to Dhaka Medical College Hospital over 12 months. Serum cortisol was measured at 9:00 AM on the first available morning after admission using ELISA.All participants were categorized into high cortisol (>23 mcg/dL) and normal cortisol (< 23 mcg/dL) groups. The primary outcome was the requirement for MV. Logistic regression and receiver operating characteristic (ROC) analysis were applied to assess predictive value. Results: Patients with high cortisol had a significantly greater need for MV compared with those with normal levels (31.8% vs 4.2%, p = 0.001). High cortisol independently predicted MV (OR = 10.7, 95% CI: 2.28–50.6, p = 0.030). ROC analysis showed good discriminative ability for cortisol (AUC = 0.831), while CURB-65 (AUC = 0.972) and CRP (AUC = 0.947) performed better. Conclusion: Admission serum cortisol is independently associated with the need for MV in CAP patients and provides additional prognostic information beyond conventional severity scores. Incorporating cortisol measurement into early assessment may improve risk stratification and help guide timely escalation of care, especially in resource-limited settings.

Introduction: Multiple myeloma is a common plasma cell malignancy where kidney damage can limit treatment options and lead to poor outcomes. Conventional markers for renal impairment have several limitations whereas NGAL is an early and robust marker of kidney injury and can reflect renal function more accurately than creatinine. Objective: This study aims to explore the relationship between urinary NGAL and treatment response in patients with multiple myeloma with renal involvement. Materials and Method: This prospective observational study was conducted in the Department of Nephrology, BSMMU, Dhaka. A total of 54 diagnosed Multiple myeloma patients were included according to the selection criteria. Baseline Urinary NGAL, Serum β2 microglobulin, S. creatinine levels were measured. Bortezomib based regimen was administered according to NHS guidelines. Follow up was given in the third month of treatment. Data were collected using a predefined data collection sheet. Statistical analyses were performed using software SPSS v-26 Results: The mean age of the participants was 55.7 years. 51.9% of patients were male and 48.1% were female. 77.8 % patients had eGFR value <60 ml/min and Serum â2 microglobulin was raised in 73.2 % patients. The optimal cut-off value for NGAL is 1.54 pg/mL, demonstrating high diagnostic accuracy with a sensitivity of 81.8%, specificity of 81.2%, positive predictive value of 72.0%, and a negative predictive value of 86.2%. Good response was found in 60% and 58.5% in respect to eGFR and S. β2 Microglobulin respectively. ROC analyses with β2 microglobulin, and eGFR also revealed similar findings. Conclusion: This study demonstrates that urinary NGAL is a significant predictor of treatment response in multiple myeloma, particularly in advanced disease stages. Elevated urinary NGAL levels are more strongly linked to worsening renal function and disease burden than S. creatinine. With its high sensitivity and specificity, NGAL serves as a reliable biomarker for identifying patients at risk of renal impairment and monitoring treatment response. Bang. Renal J. 2026; 8(1): 16-23

Introduction: Infant mortality rate in Bangladesh (23 per 1000 live birth) is still high compared to international goals set by the UN. In Bangladesh, infectious diseases such as diarrhoea and the acute respiratory infections are major causes of infant mortality. Prelacteal feeding is the practice of feeding the newborn with foods other than breast milk before the starting of breastfeeding. It has been recognized as a major cause of developing diarrhoea and acute respiratory tract infections. This study was done to describe the practice of prelacteal feeding of mothers having newborn at or below six months of age in rural area of Dhamrai Upazilla, Bangladesh. Methods: A cross-sectional descriptive study was conducted among 141 mothers having newborns aged at or below 6 months, residing in Dhamrai Upazilla of Dhaka District from January 2020 to March 2020. Data were collected through face-to-face interviewing of mother by using a semi structured questionnaire. The collected data were analyzed both manually as well as by computer based software MS Excel. Results: The proportion of respondents who practiced prelacteal feeding was less than half (48.9%) of the total respondents. The two most popular items used as prelacteal feeding were honey (31.5%) and infant formula (30.2%). Around 34.8% had no knowledge about the outcome of prelacteal feeding practice. About 91.5% of the respondents had fed the colostrum to their newborn, but around 22.0% had no knowledge regarding the importance of colostrum. Among 141 respondents, about one third of the respondents (34.1%) replied that they had not received breastfeeding counselling during pregnancy. Conclusion: This study revealed that the lack of knowledge regarding prelacteal feeding is a major cause of the widespread practice of prelacteal feeding. Delivery of adequate information to pregnant women and lactating mothers through various channels can help reduce this practice. Journal of Green Life Med. Col. 2026; 11(1): 13-18

Background: Despite high survival rates, treatment and disease-related factors can significantly impact the quality of life (QoL) in thyroid cancer patients, underscoring the importance of identifying key predictors for targeted supportive care. This study aims to assess QoL and its predictors in thyroid cancer patients following thyroidectomy and radioactive iodine (RAI) ablation. Methods: A cross-sectional analytical study was conducted between August 2022 and July 2025 among purposively selected 218 thyroid cancer patients post-thyroidectomy followed by radioactive iodine therapy at a specialized hospital, Dhaka. Data were collected through face-to-face interviews using a validated, pretested, semi-structured questionnaire and checklist. Written informed consent was obtained, and all ethical principles were strictly followed. Results: The study reveals a female predominance (64.2%), with a mean age of 44.14 ± 15.41 years, and nearly half of participants being under 40. Most had SSC-level education (37.6%), were married (72.9%), and belonged to lower-income groups (74.3%), with a significant portion being housewives (34.9%). The study highlights the average QoL was 89±13. Significant predictors of QoL included age, education, marital status, and income. Older age and being married were linked to lower odds of good QoL (OR=0.100, p<0.05), while higher education (OR=1507.114) and income (OR=0.027) were associated with higher QoL scores (p<0.05). Age, education, and income significantly influence different domains of QoL after RAI ablation. Conclusion: Thyroid cancer patients report better quality of life across various domains after radioactive iodine therapy.The findings highlight that addressing age-related challenges and improving education and social support can significantly enhance quality of life in thyroid cancer patients after RAI therapy. These insights can inform strategies to policymakers, healthcare providers, and researchers in improving quality of life for diverse patient groups, with future research on RAI’s long-term impact and personalized survivor care. Bangladesh Armed Forces Med J Vol 58 No (2) December 2025, pp 1-10