Bangladesh University of Health Sciences

Robotic-assisted surgery has transformed modern operative care by enhancing precision, dexterity, visualization, and minimally invasive capabilities. This review explores the evolution of robotic surgery and examines its future prospects in developing countries. Beginning with early computer-assisted surgical systems and progressing through telesurgery innovations, robotic platforms-particularly the da Vinci system-have demonstrated improved surgical accuracy, reduced complications, and faster patient recovery in selected procedures. Despite these advantages, adoption in low- and middle-income countries remains limited due to high acquisition and maintenance costs, infrastructure constraints, limited technical expertise, and disparities in healthcare access. Challenges such as inadequate training programs, unreliable power supply, insufficient digital connectivity, and lack of policy support further restrict widespread implementation. However, emerging developments in telecommunication technologies, virtual reality integration, and telesurgery offer promising solutions to bridge geographic and resource gaps.The future of robotic-assisted surgery in developing regions depends on strategic investment, cost-reduction initiatives, international collaboration, and capacity-building in surgical education.Public private partnerships, locally adapted robotic platformsand tele mentoring models may facilitate equitable access and strengthen surgical systems.

BackgroundFor patients with poor glycemic control of adult type 1 diabetes mellitus (T1DM), in addition to managing blood glucose levels, it is worth exploring further as an early warning indicator of blood glucose control.Methods56 adults with T1DM, aged between 18 and 70 years, were included in the study. Data on body composition and laboratory indicators, including phase angle values and HbA1c levels, were collected. Statistical analysis was conducted to determine the correlation and the strength of association between the phase angle, and HbA1c levels.ResultsPearson’s correlation and linear regression models indicated a negative correlation between phase angle and HbA1c levels, even after controlling for age and weight in both males and females.ConclusionThe results indicate a significant negative relationship between Phase angle and HbA1c levels. Beyond being a simple body composition parameter, Phase angle can be used as a clinical indicator of improved blood glucose control.

Background: Type 2 diabetes mellitus (T2DM) is a major metabolic disorder frequently associated with abnormalities in other endocrine systems, particularly the thyroid gland. Thyroid dysfunction may adversely affect glycemic control, lipid metabolism, and cardiovascular risk, yet comparative data between diabetic and non-diabetic individuals remain limited in many populations. Objective: To evaluate and compare thyroid function parameters and the prevalence of thyroid dysfunction between patients with type 2 diabetes mellitus and non-diabetic individuals, and to assess their association with glycemic control and sex. Methods: This cross-sectional study was conducted at a tertiary care hospital between June and August 2024. A total of 200 adults were enrolled, including 100 patients with T2DM and 100 non-diabetic controls. Fasting blood glucose, 2-hour postprandial glucose, HbA1c, lipid profile, serum creatinine, thyroid-stimulating hormone (TSH), and free thyroxine (FT4) were measured. Thyroid dysfunction was categorized as subclinical or overt hypothyroidism. Statistical analyses included independent t-tests, chi-square tests, and Pearson correlation analysis. Results: Patients with T2DM had significantly higher fasting glucose (156.4 ± 38.2 vs 92.6 ± 10.4 mg/dL), HbA1c (8.4 ± 1.2% vs 5.4 ± 0.4%), and adverse lipid profiles compared to controls (all p < 0.001). Thyroid dysfunction was significantly more prevalent in the T2DM group than in non-diabetic individuals (32.0% vs 14.0%, p = 0.003), with subclinical hypothyroidism being the most common abnormality (22.0%). Mean TSH levels were higher in patients with T2DM (4.2 ± 1.6 vs 2.6 ± 1.1 mIU/L; p < 0.001), while FT4 levels were lower (p = 0.01). Female patients with T2DM showed a higher prevalence of thyroid dysfunction compared to males (42.9% vs 24.1%, p = 0.04). TSH demonstrated a significant positive correlation with HbA1c (r = 0.46, p < 0.001), while FT4 showed a negative correlation (r = −0.29, p = 0.004); no such associations were observed in non-diabetic individuals. Conclusion: Thyroid dysfunction, particularly subclinical hypothyroidism, is significantly more prevalent among patients with type 2 diabetes mellitus and is associated with poorer glycemic control, with a higher burden observed in female patients.

Background Elevated liver enzymes, such as alanine aminotransferase (ALT) and aspartate aminotransferase (AST), are early indicators of liver dysfunction in non-alcoholic fatty liver disease (NAFLD). The prevalence of NAFLD is increasing in Bangladesh, with studies indicating a higher prevalence among women. Additionally, rapid dietary transitions toward energy-dense foods rich in fat and sugar have contributed to the rising burden of non-communicable diseases. This study aimed to investigate the association between dietary intake, diet quality indicators, and elevated liver enzymes (ALT and AST) among women of reproductive age in Bangladesh. Methods A cross-sectional study was conducted among 240 women of reproductive age (15-49 years) randomly selected from community households in three selected districts ofBangladesh. Anthropometric and socioeconomic data were collected using standardized tools. Dietary intake was assessed using a single 24-hour dietary recall method and a Food Frequency Questionnaire (FFQ). Three complementary indices were applied to evaluate diet quality: Dietary Diversity (DD), Food Consumption Score (FCS), and the Bangladesh Healthy Eating Index (BD_HEI).The participant's blood was collected after overnight fasting. Serum ALT and AST levels were measured using a biochemical analyzer, and elevations in liver enzymes were defined according to standard clinical cut-off values. Descriptive and inferential statistics were performed using STATA version 15.1 (Stata Corp LLC, College Station, TX, USA). Results Among the 240 participants, 69 (28.7%) exhibited elevated ALT and/or AST levels, while 171 (71.3%) had normal values. Participants with elevated liver enzymes had higher intake of saturated fat (5.89 vs. 4.41 g, IQR: (3.84-9.63 vs. 2.98-7.15),p=0.010), cholesterol (55.21 vs. 30.41 mg, IQR: (15.21-137.92 vs. 0-106.61),p= 0.015). Participants with elevated liver enzymes had significantly lower FCS scores (23.2% vs. 9.4%,p= 0.014) but higher DD (27.5% vs. 15.8%,p= 0.036) as compared to normal liver enzymes. Multivariable logistic regression revealed that low FCS significantly increased the odds of elevated liver enzymes (AOR = 3.64, 95% CI: 1.53-8.62,p= 0.003). Conclusion This study highlights a significant association between poor FCS and liver enzyme abnormalities among Bangladeshi women of reproductive age. Integrating dietary quality interventions into reproductive health and noncommunicable disease(NCD) prevention programs could play a vital role in maintaining liver health and metabolic well-being in this vulnerable population.

Seedling quality is a critical determinant of vegetable crop productivity, yet conventional soil-based nurseries in Bangladesh are frequently associated with high seedling mortality, soil-borne diseases, and excessive agrochemical use. This study assessed the agronomic performance and adoption potential of cocodust-based seedling nurseries compared with traditional soil-based practices across eight major vegetable crops in northern Bangladesh. Using a farm-level comparative mixed-methods design, data were collected from 80 vegetable farmers selected through stratified random sampling and grouped into cocodust users and traditional nursery users. Crop-wise differences in yield, harvesting time, and seedling mortality were analyzed using independent two-sample Welch’s t-tests. Cocodust application significantly increased yields of bitter gourd (17%), bottle gourd (18%), brinjal (23%), chili (23%), country bean (44%), and tomato (25%), while yield increases in cabbage (15%) and cauliflower (12%) were not statistically significant. Across all crops, seedling mortality was reduced by 68–82% under cocodust-based nurseries. Harvesting time was significantly shortened for all crops, with reductions of 8–15% in most cases and reaching 43–47% in chili and country bean. Cocodust use was associated with significantly reduced chemical fertilizer application in bitter gourd and marginally in tomato, and with reduced pesticide use in bitter gourd, country bean, and tomato, while organic fertilizer use remained high irrespective of nursery practice. Incidence of soil-borne diseases was significantly lower in bottle gourd and cauliflower under cocodust-based nurseries. Overall, cocodust-based seedling nurseries improved vegetable productivity, reduced early-stage seedling losses, shortened production cycles, and lowered reliance on chemical inputs in selected crops, highlighting cocodust as a low-cost and environmentally sustainable option for smallholder vegetable production systems.

Artificial intelligence (AI) has emerged as a promising tool in radiology, particularly chest radiography, where timely and accurate diagnosis is critical for patient care. This study aimed to compare the diagnostic performance of a deep learning model, DenseNet-121, with radiologist reports of chest X-ray (CXR) images in a hospital setting in Dhaka, Bangladesh. A total of 50 posteroanterior (P/A) chest X-rays were collected from a single hospital and analyzed independently using the DenseNet-121 algorithm and radiologists. The AI system reported 42 images as normal and eight as abnormal, identifying findings such as pneumonitis, pleural effusion, cardiomegaly, lung opacities, nodules, and tracheal shift. In contrast, radiologists classified 37 images as normal and 13 as abnormal using standard reporting formats that assessed lung fields, heart, basal angles, diaphragm, bony thorax, and tracheal position. The comparative analysis revealed areas of concordance, particularly in normal findings, where both the AI and radiologists demonstrated similar interpretations. However, discrepancies were noted in the abnormal cases. While AI occasionally fails to localize specific pathologies, radiologists also miss abnormalities in a few instances, possibly due to workload or reporting variations. These differences underscore the complementary role of AI, which, despite requiring further training and refinement, can provide significant support for diagnostic accuracy and efficiency. Overall, this study highlights the potential of DenseNet-121 as an assistive diagnostic tool for chest radiography in resource-constrained health care settings. By enhancing radiologists’ confidence and reducing diagnostic oversight, AI can contribute to improved clinical decision making and patient outcomes in Bangladesh and beyond.

Background: Distal radius fractures are one of the most common orthopedic conditions and intra-articular types (AO/ASIF type C) are difficult to treat. While various treatment options exist, external fixation remains valuable, particularly in the developing world. The present study evaluated the efficacy of the Ayjaz Azim foundation (AAF) mini external fixator for the treatment of closed, complete articular distal radius fractures. Methods: This study evaluated outcomes in 32 patients with closed intra-articular distal radial fractures by purposive sampling. Patients between 18 and 60 years, within two weeks of injury, received standardized surgery. Structured questionnaires were used to collect data, and outcomes at 12 weeks after surgery were assessed using Sarmiento's radiological criteria and the Green and O'Brien functional scoring system. Statistical analysis was performed with SPSS v26, and significance was at p<0.05. Results: The study population (41.63±12.39 years) had a predominance of males (78.1%), and the most common injury mechanism was motor vehicle accidents (68.75%). Surgery was performed in 90.6% of patients within 24 hours of trauma. Radiologically, 62.5% had excellent results, 31.3% good, and 6.3% fair. The mean loss of volar tilt was 5.03°±3.84°, radial shortening 2.47 mm±2.27 mm, and radial inclination 4.03°±3.27°. Functionally, 62.5% had excellent results, 21.9% good, 12.5% fair, and 3.1% poor. Pin tract infection occurred in 16% of the cases and post-removal stiffness in 62.5% of patients. Radiological and functional results had a good correlation (r=0.876, p<0.001). Conclusions: AAF mini external fixator is a useful tool for the treatment of AO/ASIF type C distal radius fractures, with 94% patients showing satisfactory results. The technique is reliable for anatomical reconstruction and functional rehabilitation with acceptable complication rates and is a well-suited treatment method worthy of consideration, particularly in regions with limited resources.