Rajshahi Medical College

Inclusion has emerged as a central concern in contemporary global discourse, yet its conceptualization remains fragmented and often limited to access or representation. This article reconceptualizes inclusion as a multidimensional structural phenomenon encompassing social, economic, political, cultural, educational, digital, organizational, institutional, crisis-resilient, environmental, affective, and international dimensions. It advances an integrated analytical perspective that identifies these core typologies while examining the structural barriers that reproduce exclusion across institutional, normative, economic, organizational, and discursive domains. The study demonstrates that exclusion is not incidental but embedded within systemic arrangements that shape access, recognition, and meaningful participation. Moving beyond sectoral interventions, the article articulates a multilayered set of pathways toward sustainable integration by analyzing the interaction between structural reform, policy instruments, and sociocultural transformation. By synthesizing theoretical perspectives and comparative global insights, this work clarifies the concept of inclusion, highlights its structural determinants, and offers a concise analytical lens for understanding how multidimensional inclusion can foster long-term social cohesion, resilience, and equitable participation in globalized societies.

Background: Ventral incisional hernia repair commonly utilizes onlay or retro-rectus sublay mesh placement. Comparative evidence on early postoperative outcomes remains limited in low-resource surgical settings. Objective: This investigation aims to evaluate one-year postoperative outcomes, complication profiles, operative characteristics, and recurrence patterns following open onlay versus retro-rectus sublay mesh repair among patients with ventral incisional hernia. Methods: A quasi-experimental study was conducted from July 2022 to June 2024 at Rajshahi Medical College Hospital, enrolling 60 patients randomized into onlay (n=30) and sublay (n=30) groups. Data on demographics, BMI, defect size, operative duration, postoperative complications, hospital stay, and recurrence were collected. Statistical analyses employed the Student’s unpaired t-test for continuous variables and Chi-square tests for categorical outcomes with significance at p<0.05. Results: Mean age was slightly higher in the sublay group (52.3 ± 7.9 years) than the onlay group (51.1 ± 6.8 years, p=0.42). Normal BMI distribution differed significantly (56.6% vs. 83.3%, p=0.018). Larger defects (>2 cm) were more frequent in sublay repairs (80.0% vs. 66.6%, p=0.21). Operative duration was significantly longer for sublay (132 ± 14 minutes) versus onlay (104 ± 11 minutes, p<0.001). Postoperative seroma (43.3% vs. 6.6%, p<0.001), wound infection (30% vs. 6.6%, p=0.012), sepsis (13.3% vs. 3.3%, p=0.04), and mesh extraction (10% vs. 0%, p=0.041) were markedly higher in the onlay group. Recurrence rates favored sublay repair (3.3% vs. 6.6%, p=0.55). Conclusion: Sublay mesh repair demonstrates lower complication rates, reduced infectious morbidity, and improved recurrence outcomes compared with onlay repair, supporting its preferential use when surgical expertise and operative resources permit.

Introduction with Objective: The aim of the present study was to assess the Histopathological Evaluation of Post-Operative Biopsies in Oral Squamous Cell Carcinoma. Materials and Methods: This cross-sectional study was conducted from January 2020 to December 2021 in the oral and maxillofacial surgery department, DDCH. A total 85 cases were selected as study population as per inclusion and exclusion criteria. After data collection and processing, all statistical analysis were done by SPSS software windows version 29. Result: A large proportion of patients were diagnosed at an advanced stage, with 62.35% in Stage IV. Perineural invasion was present in 30.5% of cases, and lymphovascular invasion was seen in 31.8%. Histologically, the majority of cases were Grade I (76.4%), and Anneroth's Grade II (40%) was the most common. Adjacent bone involvement was found in 37.6% of cases, while 20% of patients exhibited tumor necrosis. Salivary gland involvement was noted in 17.6% of cases. Pathological TNM staging revealed the highest number of patients in the PT4aN0Mx group (19.10%) and the N0 group (48.23%). The study also examined the depth of invasion, with most cases falling between 1-9 mm (18.82%) and 10-19 mm (18.82%). Extranodal extension was present in 12 cases, and several statistically significant associations were found between histopathological features, such as the highly significant relationship between perineural invasion and bony involvement. Conclusion: In conclusion, this study identifies key socio-demographic and clinical traits of oral cancer patients, revealing frequent perineural, lymphovascular, and bone involvement that indicate the disease’s aggressive nature. Medicine Today 2026, Vol.38 (1): 60-64

Abstract not available

Suicide remains a pressing public health concern, with psychological and socio-demographic factors playing a critical role in its occurrence. In Bangladesh, where mental health resources are limited, understanding the profiles of completed suicide victims is essential for targeted prevention strategies. Despite increasing suicide rates, comprehensive local data on victim characteristics remain scarce. A retrospective, cross-sectional study was conducted in the Department of Forensic Medicine and Toxicology, Sir Salimullah Medical College, Dhaka, Bangladesh, from July 2023 to June 2024, to analyze the psychological attributes and socio-demographic profiles of completed suicide victims in Dhaka. Using purposive sampling, 137 completed suicide cases were analyzed based on autopsy reports, medical records, and family interviews. Our study that young adults aged 20-35 years accounted for 45% of cases, with males (58%) outnumbering females. Unmarried individuals (52%), the unemployed (35%), and low-income groups (60%) showed highest vulnerability. Psychological autopsies identified depression (40%), family conflicts (30%), and financial stress (25%) as predominant triggers. Hanging (50%) and pesticide poisoning (30%) emerged as the most frequent methods, reflecting the means of accessibility. A significant seasonal pattern (p=0.021) showed peak incidence during monsoon months (40%). This study identified that young, economically disadvantaged males with mental health concerns as Bangladesh's highest-risk suicide group. The findings underscore the urgent need for targeted prevention strategies combining mental healthcare, poverty alleviation, and means restriction to address this growing public health crisis. CBMJ 2026 January: vol. 15 no. 01 P:84-88

Homicide represents a critical public health and legal challenge in Bangladesh, claiming numerous lives and reflecting underlying social tensions. A precise understanding of its patterns is crucial for informing violence prevention strategies and guiding effective policy and policing interventions. A cross-sectional study was conducted in the Department of Forensic Medicine & Toxicology of Cumilla Medical College, Cumilla, Bangladesh, between July 2024 and June 2025, to assess the patterns of homicidal deaths based on autopsy findings. We analyzed 197 purposively selected homicide cases from autopsy procedures. Data was analyzed using MS-Excel to generate descriptive statistics on victim demographics and injury patterns. Our data revealed that young males (75.6%), particularly in 21–40 years age group (62.4%) were the most common victims. Sharp weapon injuries were the predominant cause of death (47.2%), followed by firearms (24.4%). Most incidents occurred outdoors (51.8%) during night hours (39.6%) and were motivated by interpersonal disputes (41.1%). No significant association was found between the victim's age and the cause of death (p=0.961). To conclude, young males are the primary victims of homicide, predominantly from sharp weapon injuries in interpersonal disputes. Targeted interventions, including stricter weapon regulation and community conflict resolution programs, are urgently recommended to mitigate this public health burden. CBMJ 2026 January: vol. 15 no. 01 P:121-126

Background: Breast cancer, a leading malignancy in women, is influenced by hormonal and reproductive factors. Early menarche and late menopause increase breast cancer risk due to prolonged estrogen exposure. Objective: To investigate associations between reproductive factors (early menarche, late menopause) and breast cancer risk. Methods: This cross-sectional study at Dhaka Medical College (June 2023 to May 2024) included 32 breast cancer patients. Data were collected via questionnaires and medical records. Statistical analysis was performed using SPSS version 26. Ethical approval and informed consent were obtained. Results: The study included 32 participants with a mean age of 45.2 ± 10.5 years. Early menarche (≤11 years) was observed in 28.1%, and 56.2% were postmenopausal. A positive family history was reported in 37.5%, with 58.3% having an affected mother. Ductal carcinoma (75.0%) was the most common histological type, and 62.5% were ER-positive. Most cases were diagnosed at Stage II (37.5%) or Stage III (28.1%), emphasizing late detection. Conclusion: This study underscores the role of reproductive factors and family history in breast cancer risk, emphasizing the need for early screening. Mediscope 2026;13(1): 16-21

<sec><title>BACKGROUND</title>This study aimed to explore the factors associated with TB preventive therapy (TPT) uptake among household contacts of TB patients in the southern region of Bangladesh, a high-TB-burden country.</sec><sec><title>METHODS</title>This cross-sectional study was conducted among household contacts of pulmonary TB cases who were eligible for TPT in Khulna District, Bangladesh, between September and October 2023. A total of 378 participants were selected randomly from six organisations providing Directly Observed Therapy Short-course (DOTS) services, using DOTS centre record books. Data were collected through face-to-face interviews using a pretested semi-structured questionnaire digitised in Kobo Toolbox.</sec><sec><title>RESULTS</title>Among the participants, 64.8% had initiated TPT. Age above 16 years (adjusted odds ratio [aOR]: 3.61, 95% confidence interval [CI]: 1.88-7.02), education level of SSC and above (aOR: 4.27, 95% CI: 2.36-7.87), knowledge about TPT (aOR: 2.55, 95% CI: 1.27-5.13), and receiving TPT counselling (aOR: 16.3, 95% CI: 4.03-112.0) emerged as strong positive predictors of TPT uptake. Urban residence showed lower odds (aOR: 0.25, 95% CI: 0.09-0.59) compared to semi-urban areas. The primary barriers to TPT uptake were fear of side effects (40.6%), drug unavailability (36.1%), and lack of interest (29.3%).</sec><sec><title>CONCLUSION</title>Successful TPT implementation requires strengthening health communication, ensuring drug availability, and addressing socio-economic barriers, particularly in urban areas.</sec>.

Background: Cirrhotic patient develops esophageal varix due to portal hypertension also increase the risk of developing encephalopathy. Hepatic encephalopathy is a neuropsychiatric syndrome caused by liver disease that occurs in 30-40% of patients with cirrhosis. Minimal hepatic encephalopathy (MHE) is a state in which patients with cirrhosis of liver regardless of its cause show a number of quantifiable abnormal psychometric tests. This study aimed to see the association of severity of esophageal varix with Minimal Hepatic Encephalopathy in patients with Cirrhosis of Liver. Methods: This hospital based observational analytical study included 40 patients with Cirrhosis of liver admitted to the Department of Medicine, Rajshahi Medical College Hospital from July-December 2012. Complete history was taken either from patients or accompanying attendants. Thorough clinical examination was done. Relevant investigations report was collected. All the information’s were recorded on the fixed protocol. Collected data was classified, edited, coded and entered into the computer for statistical analysis by using SPSS. Results: Severity of liver disease according to Child-Pugh Grading, Grade-A was 02(5%), Grade-B was 30(75%) and Grade-C was 08(20%). Prevalence of number connection tests positive was 15(37.5%), line tracing test positive were 15(37.5%), serial dotting test positive were 16(40.0%) and two test positives were 15(37.5%). Association between line tracing test with Child-Pugh Grading, out of 15 positive line tracing test, 09 had Grade-B and 06 had Grade-C, p value was (p&lt;0.05) that was statistically significant. Association between serial dotting tests with Child-Pugh Grading, out of 16 positive serial dotting tests, 09 had Grade- B and 07 had Grade- C, p value was (p&lt;0.05) that was statistically significant. Association between psychometric tests with esophageal varix by Paquet’s grading, out of 40 patients 15 patients were grade-III, who were psychometric test positive groups and 16 patients were grade-III and 09 patients were grade-II who were psychometric test negative groups, p value was (p&lt;0.05) statistically significant. In psychometric test positive groups mean duration of disease were 7.25(1.12) months and psychometric test negative groups were 5.09(1.99) months, p value were (&lt;0.001) that was statistically significant. Conclusion: Minimal hepatic encephalopathy (MHE) is common in patients with stable cirrhosis of liver. There is a good relationship between MHE with advanced liver disease by Child-Pugh Grading. Esophageal varix with high grade severity is common in cirrhotic patients who have MHE and longer duration of disease.

Background: Latent iron deficiency (LID), defined as iron depletion without anemia, frequently precedes iron deficiency anemia in pregnancy and is associated with adverse maternal and fetal outcomes. Serum ferritin is the gold standard for assessing iron stores but is often unavailable in low-resource settings. Readily obtainable red cell indices may serve as practical alternatives for identifying early iron deficiency. This study aimed to evaluate the relationship between red cell indices and serum ferritin levels among pregnant women with latent iron deficiency. Methods: This cross-sectional analytical study was conducted at Sir Salimullah Medical College Mitford Hospital, Dhaka, including 205 non-anemic pregnant women in their second trimester. Complete blood count and serum ferritin were assessed using automated analyzers. Participants were categorized as latent iron-deficient (ferritin &lt;30 µg/L) or non-deficient (≥30 µg/l). Group differences were compared using independent t-tests, and correlations between red cell indices and ferritin levels were analyzed using Pearson’s test. Results: Mean MCV and MCH were lower in the latent iron-deficient group, though not significantly (p&gt;0.05). RDW-CV% was significantly higher in LID women (15.3±1.6 vs 14.1±1.6, p&lt;0.001). A significant negative correlation was observed between RDW-CV% and serum ferritin (r = -0.347, p&lt;0.001). Conclusions: RDW-CV% demonstrates a strong negative correlation with serum ferritin and may be used as a sensitive hematologic marker for early detection of latent iron deficiency in pregnancy. Integrating RDW interpretation into routine antenatal blood count assessments can improve screening and management of iron deficiency in resource-limited settings.