North South University

Bangladesh, a lower-middle-income country in South Asia, faces a rapidly rising cancer burden. In the absence of a population-based cancer registry (PBCR), monitoring national patterns remains challenging and constrains evidence-informed policymaking. We analyzed temporal trends in cancer distribution at the country's largest national cancer hospital to inform priorities for a cancer control strategy. We conducted a retrospective analysis of 82,209 histologically and/or clinically confirmed cancer cases diagnosed or treated at the National Institute of Cancer Research & Hospital, between January 2014 and December 2020. Demographic and clinical data were extracted from hospital records, and cancers were grouped according to their primary anatomic site. Annual distributions and sex-specific patters of the 10 most common cancers were examined, and temporal changes were illustrated using trend diagrams. Over 7 years, the most common cancers were of the respiratory system (19.6%-22.5%), digestive organs (18.8%-22.8%), and breast (12%-14.9%). Comparison between 2014 and 2020 revealed notable increases in the proportion of digestive organ cancers (+3.6%), hematopoietic and reticuloendothelial malignancies (+1%), and breast cancer (+0.8%), whereas respiratory cancers (-2.3%), lymph node cancers (-1.1%), and bone and cartilage cancers (-1%) decreased. A marked spike in female genital cancers was observed in 2015 (11.84% v 9.9% average across other years). Findings should be interpreted in the context of hospital-based case mix and referral patterns. In this large tertiary cancer hospital in Bangladesh, respiratory system, digestive organ, and breast cancers represented the highest burden, with rising proportions of proportional increases in digestive, hematopoietic, and breast cancers and declines in respiratory and lymph node cancers, provide early signals of an evolving cancer landscape. While not population-representative, these trends highlight the urgent need to establish government-supported PBCRs in well-defined subnational regions to inform effective cancer control strategies for Bangladesh.

In 2025, liver cirrhosis, characterized by hepatic fibrosis and regenerating nodules, with over 185 million individuals infected globally (>3% of the world population), represented a significant global health challenge, with hepatitis B virus (HBV) being the primary cause. This review synthesizes the epidemiology, risk factors, consequences, and therapies of cirrhosis. The hepatitis B virus (HBV) is predominantly prevalent in the Asia-Pacific region, but in Western countries, HCV, alcohol misuse, and non-alcoholic fatty liver disease (NAFLD)—exacerbated by rising obesity rates—predominate. Additional risk factors exacerbate disease progression, including diabetes and familial predisposition. Cirrhosis progresses via compensated and decompensated stages; decompensation signifies severe outcomes such as variceal hemorrhage, hepatic encephalopathy (HE), hepatocellular carcinoma (HCC), hepatorenal syndrome, and bacterial peritonitis. Pathophysiological mechanisms include chronic inflammation leading to HCC, variceal rupture due to portal hypertension, and neurotoxicity from hyperammonemia in HE. Current treatment emphasizes etiology-specific techniques such as alcohol abstinence, NAFLD prevention, and antiviral therapies for HBV/HCV. While modifications to gut microbiota and nutritional supplementation target systemic inflammation and malnutrition, innovative strategies such as mesenchymal stromal cell therapy aim to rebuild hepatocytes. Liver transplantation, despite constraints in organ availability, is crucial for end-stage disease management. Despite advancements, the molecular mechanisms behind fibrosis and cirrhosis require further elucidation before the development of targeted therapies. Mitigating the global burden of cirrhosis necessitates addressing regional disparities in risk factors and healthcare accessibility. This analysis underscores the necessity of interdisciplinary, etiology-specific approaches to enhance therapy outcomes and reduce mortality in cirrhotic patients. • Over 185 million individuals were infected globally by liver cirrhosis, with hepatitis B (HBV) as the leading etiology. • Risk factors vary regionally: HBV dominates in Asia-Pacific, while HCV, alcohol, and NAFLD prevail in Western countries. • Disease progression involves compensated and decompensated stages, with decompensation increasing mortality by 80% within a year. • Major complications include hepatocellular carcinoma, variceal bleeding, hepatic encephalopathy, and hepatorenal syndrome. • Emerging therapies like mesenchymal stromal cell transplantation and gut microbiome modulation offer promising avenues for managing cirrhosis.

Diabetes mellitus is a chronic metabolic disorder characterized by persistent high blood sugar levels due to insulin deficiencies, leading to complications such as diabetic foot ulcers (DFUs). DFUs are associated with high morbidity and a significant risk of amputation, necessitating precise monitoring and management. Manual measurement of ulcer areas is labor-intensive and error-prone, prompting the need for automated, computer-aided methods. Deep learning (DL) techniques have shown promise in this domain, enhancing the accuracy and efficiency of ulcer detection and segmentation. This study investigates various methodologies for DFU segmentation, focusing on advanced DL models. We propose FootSegONN, an EfficientNet-based encoder and Self-organized Operational Neural Network (Self-ONN) and Feature Pyramid Network-based decoder for foot ulcer segmentation, evaluated on a publicly available chronic wound dataset consisting of 1010 diabetic foot images. Self-ONNs address the limitations of conventional Convolutional neural networks by achieving ultimate heterogeneity and boosting network diversity while maintaining computational efficiency. To ensure robust validation, fivefold cross-validation was applied, and more than 10 different segmentation models were utilized. The STAPLE algorithm is employed to combine mask predictions from top-performing models, and a post-processing approach is investigated to enhance performance further. The proposed method achieved a state-of-the-art Dice score of 91.55%. Furthermore, the combined FootSegONN model achieved a Dice score of 88.97% on the external validation dataset. Gradient-weighted class activation map (Grad-CAM) visualization was utilized to assess the model’s interpretability.

Introduction: Air pollution is the causative factor for considerable morbidity and premature death worldwide. This review critiques the WHO's Air Pollution Harm Reduction Strategy in Dhaka, Bangladesh, through the lens of the HBM by analysing its effectiveness and ethical implications. Materials and Methods: This critical review synthesises findings from WHO publications, peer-reviewed journals, and public health data on Dhaka's air quality management. The approach involves thematic analysis of health promotion strategies and behavioural change interventions. Discussion: The findings highlight that while the WHO strategy is successful in raising awareness and providing a policy direction, it continues to be hampered by economic barriers, weak enforcement, and absence of local engagement. HBM explains personal motivation toward cleaner practices but falls short on systemic inequities and gendered exposures. Conclusion: A multi-sectoral policy enforcement, equity-focused planning, and culturally sensitive communication are some of the basic tenets for structuring Dhaka's air pollution strategy toward sustainable impact. Strengthening community ownership and data-driven governance bridges the gap between global frameworks and local realities. Medicine Today 2026, Vol.38 (1): 137-141