<h4> Editorial :</h4>
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For generations, the surgeon’s legacy was etched in the geometry of inci...
<h4> Editorial :</h4>
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For generations, the surgeon’s legacy was etched in the geometry of incisions and the fidelity of healed tissue. We were master technicians, our worth measured in operative time, complication rates, and the gratitude of the patient before us. This covenant, however, is being quietly but irrevocably rewritten. The operating theatre of the 21st century is no longer an isolated arena of individual skill; it is the most complex node in a vast technological, economic, and human system. Here, the introduction of a robotic platform is not merely a new tool, but a seismic event that reshuffles workflows, redefines team dynamics, and demands new ethical and economic calculations. In this new landscape, our most critical instrument may no longer be the scalpel or the console, but the capacity to design the system itself. It is time to embrace a fundamental evolution of our professional identity: from Surgeon as Technician to Surgeon as System Architect.
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Background: Autism Spectrum Disorder (ASD) is a neurodevelopmental condition with increasing pre...
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Background: Autism Spectrum Disorder (ASD) is a neurodevelopmental condition with increasing prevalence. The ‘atd’ angle, a palmar dermatoglyphic feature formed early in fetal development, may serve as a biomarker for prenatal disturbances. This study aimed to compare the ‘atd’ angle between children with ASD and typically developing controls, and to assess sex-based differences within the ASD group. Methods: A cross-sectional case-control study was conducted in Rangpur, Bangladesh, from January to December 2019. The sample included 100 children aged 5–15 years: 50 with ASD (38 males, 12 females) from two autism centers, and 50 typically developing controls (26 males, 24 females) from a local school. Palm prints were collected using the standard ink method, and the maximal ‘atd’ angle was measured bilaterally with a protractor. Statistical analysis was performed using SPSS version 23.0, with independent t-tests for group comparisons (pd”0.05 considered significant). Results: The mean ‘atd’ angle for children with ASD (41.31° ± 6.45°) was wider than that of controls (40.83° ± 5.75°), but this difference was not significant (p=0.275). Stratified by sex, autistic females had the widest mean ‘atd’ angle (45.66° ± 7.68°), which was greater than both autistic males (41.24° ± 5.77°; p=0.072) and control females (40.59° ± 5.57°; p=0.080). In the control group, 82% had an ‘atd’ angle <45°, compared to 75% in the ASD group. Conclusion: While the ‘atd’ angle did not show significant differences between the ASD and control groups, a trend toward a wider angle was observed, particularly in autistic females. The ‘atd’ angle may not serve as a standalone diagnostic biomarker for ASD, but could contribute to a broader dermatoglyphic assessment. Larger studies with standardized methods are needed to further explore these outcomes.
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Background: Mandibular fractures are common maxillofacial injuries causing functional, aesthetic...
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Background: Mandibular fractures are common maxillofacial injuries causing functional, aesthetic, and psychosocial impact. In Bangladesh, district hospitals manage the majority of cases; however, data on fracture patterns and treatment outcomes are limited. Understanding local epidemiology is crucial for optimizing trauma care and allocating resources effectively. Objectives: To evaluate the patterns, management approaches, and clinical outcomes of mandibular fractures treated at a district hospital in Bangladesh. Methods: This retrospective cross-sectional study was conducted at Pabna Medical College &Hospital, Pabna, covering the period from January 2023 to December 2024. A total of 57 mandibular fracture patients were included via purposive sampling. Data on demographics, injury etiology, fracture sites, treatment, and outcomes were collected from hospital records and analyzed using SPSS version 23.0. Results: Total of 57 patients with mandibular fractures were analyzed, with males comprising 78.9% and females 21.1% (p = 0.002). The highest affected age group was 21–30 years (36.8%). Road traffic accidents accounted for 56.1% of cases (p = 0.015). The body (31.6%) and angle (24.6%) were the most common fracture sites (p = 0.032). Closed reduction was performed in 63.2%, open reduction in 36.8% (p = 0.041), and satisfactory outcomes were achieved in 86.0% (p = 0.018). Conclusion: Mandibular fractures in this district hospital predominantly affected young adult males and were mainly caused by road traffic accidents. Most involved the body and angle, and treatment-primarily closed reduction resulted in favorable outcomes with minimal complications.
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Background: Blood donation is essential for healthcare systems worldwide, yet maintaining an ade...
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Background: Blood donation is essential for healthcare systems worldwide, yet maintaining an adequate donor pool remains challenging, particularly in developing countries like Bangladesh where only 30% of blood comes from voluntary donors. Understanding psychosocial and sociocultural factors influencing donor behavior is crucial for developing effective recruitment strategies. Objective: This study aimed to assess motivational factors, barriers, and sociocultural influences affecting blooddonation behavior among donors and non-donors in Sirajganj, Bangladesh. Methods: A cross-sectional comparative study was conducted from January to June 2024 at the Department of Transfusion Medicine, Shaheed M. Monsur Ali Medical College, Sirajganj. A total of 200 participants (100 donors, 100 non-donors) were enrolled using purposive sampling. Data were collected through face-to-face interviews using a structured questionnaire covering sociodemographics, motivations, barriers, and sociocultural beliefs. Statistical analysis was performed using SPSS version 26 with descriptive statistics, chi-square tests, t-tests, and binary logistic regression. Results: Donors were predominantly male (91.0% vs. 66.0%, p<0.001), educated (64.0%vs. 44.0%, p=0.012), and urban residents (56.0% vs. 42.0%, p=0.020). Altruistic motivation was the strongest domain (mean 4.40), with 92.0% reporting satisfaction from helping others. Among non-donors, primary barriers were lack of awareness (48.0%), lack of time (46.0%), fear of fainting (44.0%), and misconceptions about weakness (37.0%). Donors demonstrated significantly higher knowledge (3.42 vs. 2.18, p<0.001), greater public trust (4.12 vs. 3.24, p<0.001), and stronger social support (3.86 vs. 3.12, p<0.001). Independent predictors of donation were male gender (AOR=6.17), knowledge of blood group (AOR=5.37), public trust (AOR=3.45), knowledge score (AOR=2.89), and higher education (AOR=2.14). Conclusion: Blood donation in Sirajganj is driven primarily by altruism, intrinsic rewards, and religious beliefs, while lack of awareness, fear, and mistrust are major barriers. Public trust emerged as a critical independent predictor. Targeted interventions addressing knowledge gaps, leveraging religious motivation, and building institutional trust are essential for increasing voluntary blood donation in Bangladesh.
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Background: Femoral shaft fracture is an incapacitating paediatricinjury. It is common in our co...
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Background: Femoral shaft fracture is an incapacitating paediatricinjury. It is common in our country and also in orthopaedics OPD, DMCH. The best treatment between six and sixteen years of age is a matter of debate. There has been resurgence worldwide for operative fixation. Titanium flexible elastic intramedullary nailing has become a well-accepted method of treatment of paediatric femoral shaft fractures. Objective: To assess the success of fixation by Titanium Elastic Nail for fracture shaft of femur in children aged between 6-16 years. Methods: This prospective interventional study (quasi experimental type) was conducted over a period of one and half year from Jan 2015 to June 2016. Thirty children (23 boys, 7 girls) aged 6-16 years with femoral diaphyseal fractures were stabilized with retrograde titanium elastic nail. The results were evaluated by using Flynn’s TEN scoring criteria. Two nails were used in each fracture. Results: All thirty patients were available for evaluation and follow up for a mean duration of 10.1±2. 21months. The results were excellent in 23 patients (76.7%), successful in 7 patients (23.3%) and there was no poor result. No major per operative or postoperative complications. Conclusion: Titanium Elastic Nail fixation of paediatric femoral shaft fractures is a safe, simple and reliable method of treatment in children aged 6-16 years.
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Background: Suicide remains a major public health concern, with poisoning being a common method...
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Background: Suicide remains a major public health concern, with poisoning being a common method of self-harm. The easy availability of toxic substances and limited access to mental health care contribute to the growing burden of deliberate self-poisoning. This study aimed to assess the severity of suicidal intent, psychiatric morbidity, and associated sociodemographic factors among poisoning attempters. Methods: This observational study was conducted in the Medicine Inpatient Department of Brahmanbaria Sadar Hospital over seven months from June 2022 to December 2022. 84 patients admitted following deliberate self-poisoning were included. Suicidal intent was measured using Beck’s Suicidal Intent Scale (SIS), and psychiatric morbidity was assessed according to ICD-10 criteria. Sociodemographic data were collected and analysed using SPSS version 26, with a significance level set at p < 0.05. Results: Most participants were aged 11–20 years (39.3%) and female (53.6%). Low suicidal intent was observed in 94% of cases, with impulsive acts in 90.4%. Psychiatric morbidity was present in 9.6%, showing a significant association with higher suicidal intent (p/ </0.001). No significant associations were found between suicidal intent and age, gender, education, or income. Conclusion: Low suicidal intent and impulsivity predominated among poisoning attempters, while psychiatric morbidity strongly influenced higher intent.
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Background: Transfusion-transmissible infections (TTIs) remain a significant concern forblood sa...
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Background: Transfusion-transmissible infections (TTIs) remain a significant concern forblood safety, particularly in resource-limited settings. Nucleic acid testing (NAT) can detect infections during the window period before seroconversion, offering advantages over conventional serology. This study compared the efficacy of serological and molecular methods for detecting TTIs among blood donors in Bangladesh. Methods: A cross-sectional study was conducted at the Department of Transfusion Medicine, Shaheed M. Monsur Ali Medical College, Sirajganj, from January to December 2025. A total of 150 blood donors were enrolled through consecutive sampling. Blood samples were tested using both serological (ELISA for HBsAg, Anti-HCV, Anti-HIV, and malaria antigen) and molecular (real-time PCR for HBV DNA, HCV RNA, and HIV RNA) methods. Window period infections were identified as serology-negative but NAT-positive cases. Data were analyzed using SPSS version 26. Results: The study population was predominantly male (92.0%) and young adults (mean age 31.5 years). Voluntary donors comprised 65.3% of the sample. Overall TTI prevalence was 15.3% (23/150), with HBV most common (8.0%), followed by HCV (4.0%) and HIV (2.7%). NAT detected 25% more infections than serology (20 vs. 16), with significant differences for HBV (p=0.023), HCV (p=0.045), and HIV (p=0.032). Seven window period infections (4.7% of donors) were detected by NAT but missed by serology, including 3 HBV, 2 HCV, and 2 HIV cases. Serology demonstrated poor sensitivity (65.0%) but excellent specificity (99.3%). McNemar’s test confirmed significant overall difference between methods (p=0.023), with substantial agreement (ê=0.78). Conclusion: NAT detects significantly more TTIs than serology alone among Bangladeshi blood donors, with 7 window period infections identified that would have been missed by routine screening. Serology misses 35% of active infections, leaving unacceptable residual risk. These findings support phased implementation of NAT to improve blood safety in Bangladesh.
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Background: Having the right facilities and enough skilled staff is crucial for giving proper bu...
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Background: Having the right facilities and enough skilled staff is crucial for giving proper burn care, especially in places with limited resources. The National Institute of Burn and Plastic Surgery (NIBPS) is a significant step forward for Bangladesh’s healthcare system, aiming to tackle the serious issue of burn injuries. Objective: To evaluate the available infrastructure for burn care at the NIBPS and to assess the perceptions and challenges reported by its healthcare providers. Methods: We ran a cross-sectional study at NIBPS from January to December 2019. To gather information, we interviewed 20 service providers, mostly doctors, and used an observational checklist for the facilities. We analyzed the data on manpower, workload, working environment, training, and the availability of both physical and technical resources using descriptive statistics. Results: We discovered a serious shortage of human resources, with 95% of the providers saying they didn’t have enough staff. We did have some essential equipment, like burn tanks and advanced imaging, but unfortunately, it wasn’t working. Plus, dietary and ambulance services were missing. On a positive note, 80% of the providers had burn-specific training, and 95% were sticking to protocols. The main recommendation from 70% of the providers was to urgently bring in skilled workers. Conclusion: The NIBPS has a major operational issue due to a lack of staff and malfunctioning equipment. We really need to hire specialized personnel and get all our medical equipment up and running if we want to provide proper burn care.
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