Bangladesh University of Health Sciences is a private university in Dhaka, Bangladesh. It is the first health sciences university in Bangladesh and was established by Diabetic Association of Bangladesh in 2012. Faridul Alam is the vice-chancellor of the university.
Abstract This focused ethnography was conducted between March-August 2021 at the Médecins Sans Frontières (MSF) Goyalmara Mother–Child Hospital in Cox’s Bazar, Bangladesh, which serves the Rohingya refugee and Bangladeshi host community. Data collection involved participant-observation, individual interviews (22), focus group discussions (5), and analysis of protocols and other documents. In this paper, we present three composite stories which explore the meaning of empathy to international, Bangladeshi, and Rohingya MSF staff and their moral experiences of attempting to provide empathetic palliative care to children and their families in a humanitarian context. Empathy, as well as related Bangla concepts such as shohanubhuti and shohomormita, were central to how MSF staff understood good palliative care. These concepts informed how MSF staff experienced their relationships with the children and caregivers receiving palliative care. In the story “their suffering also plagues us”, Haawa (pseudonym) tries to support a woman whose newborn baby is dying. In “if it were my child”, the team struggles when Layla’s (pseudonym) parents decide to leave the hospital. Finally, in the story “becoming a mechanical person”, the team wrestles with how to maintain empathy as they share difficult news with a family. Innovative approaches to education and mentorship are needed to ensure that humanitarian healthcare workers have the capacity to engage empathetically with their patients. Considering the moral experiences of front-line staff and incorporating local empathy-like concepts and practices may contribute to the development of organizational strategies that are more relevant in diverse humanitarian crisis contexts.
Improper healthcare waste (HCW) management in resource-constrained municipalities creates environmental exposure pathways, yet quantitative risk-monitoring data from secondary urban centers in Bangladesh remain limited. This cross-sectional observational study integrated waste quantification, compositional analysis, compliance assessment, and multi-dimensional environmental risk profiling across 10 healthcare establishments (302 beds; five government and five private facilities) in Gaibandha Municipality, Bangladesh, from August to October 2023. Waste from three consecutive 24-hour collection periods per facility was segregated into eight categories and weighed using a calibrated digital scale (±0.01 kg). Waste-management performance and risk across seven domains were assessed through facility observations and structured interviews. Mean HCW generation was 1.344 ± 0.298 kg bed⁻1 day⁻1 (95% confidence interval [CI]: 1.130–1.557) and 1.620 ± 0.458 kg patient⁻1 day⁻1 (95% CI: 1.292–1.948), with no statistically significant government–private differences (independent t-tests; all p > 0.05). Within this municipal sample, patient census explained 97.2% of the variation in total waste generation (Waste = 16.97 + 0.675 × Patients; R2 = 0.972; p < 0.001), indicating its preliminary potential as a planning variable while requiring validation in larger and seasonally stratified samples. Organic waste dominated the stream (82.6%; 918.8 kg over 30 facility-days), while the operationally classified potentially hazardous fraction was 17.4%, slightly exceeding the World Health Organization (WHO) estimate of approximately 15%; however, low verified segregation limits interpretation of this fraction. The study-defined Multi-Dimensional Risk Score (MDRS) classified four domains as CRITICAL (Risk Gap Index ≥ 6.0) and three as HIGH; overall verified compliance across the eight core indicators was only 21.6%. Observed domain risk scores exceeded the indicative author-assigned benchmark scores derived from WHO guidance (Wilcoxon signed-rank test, p = 0.022). These findings indicate widespread HCW management weaknesses across the sampled facilities and support targeted interventions in flood-prone municipalities where inadequate storage and co-collection of untreated HCW with municipal waste may increase exposure risks during monsoon high-flow events.
Abstract Introduction Although cardiac rehabilitation (CR) is recognised as a cornerstone of heart disease management, its availability in low- and middle-income countries (LMICs) remains limited, highlighting a critical evidence gap. To address this, we conducted an updated systematic review and meta-analysis of randomised controlled trials (RCTs) evaluating exercise-based CR in LMICs. Methods We initially identified RCTs of exercise-based CR programmes in LMICs from a previously published systematic review and updated with searches of bibliographic databases from May 2020 through to June 2025. Study quality was assessed using the Cochrane risk of bias tool. Mortality, hospitalisation, exercise capacity, health-related quality of life (HRQoL), and mental health outcomes were pooled using random-effects meta-analyses. Safety, cost, and cost-effectiveness data were narratively synthesised. Meta-regression was used to explore potential effect modification and the certainty of evidence assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. Results Twenty-nine RCTs (6,682 participants) from South Asia (10 studies), East Asia & Pacific (7 studies), Europe & Central Asia (6 studies), Latin America & Caribbean (4 studies), and Middle East & North Africa (2 studies) were included; overall risk of bias was moderate to high. Trials varied in their patient populations, CR interventions, and delivery modes. Pooled analysis showed that exercise-based CR was associated with a moderate improvement in exercise capacity (standardised mean difference: 0.71, 95% CI: 0.47 to 0.96) compared to control. Despite high levels of statistical heterogeneity (I2: 72%), there was no evidence of effect modification by study-level factors, including CR delivery model, exercise dose, duration of follow-up, or risk of bias. CR participation was associated with improvements in some HRQoL measures (SF-12/36 physical component: mean difference 5.0, 95% CI: 0.5 to 9.4) and mental health outcomes (HADS-Anxiety: mean difference 1.19, 95% CI: 0.97 to 1.42; HADS-Depression: mean difference 1.03, 95% CI: 0.20 to 1.85); however, other measures (PHQ-9, GAD-7) showed no consistent effect. Few trials reported data on mortality, hospitalisation, safety, costs, or provided details of CR programme delivery. Conclusions This updated review indicates that exercise-based CR in LMICs improves exercise capacity and HRQoL consistent with evidence from high-income settings. However, due to substantial statistical heterogeneity, risk of bias, and inconsistent data collection, the overall certainty of these findings is low. High-quality RCTs that collect patient-relevant outcomes from CR programmes appropriately designed for the low-resource and cultural contexts of LMICs remain a strategic priority.
OBJECTIVES:To assess the feasibility and acceptability of the home-based Bangla Heart Manual of Cardiac Rehabilitation (CR) programme for people with coronary heart disease (CHD) following revascularisation living in Bangladesh. DESIGN AND SETTINGS:Tertiary level cardiac hospital in Dhaka city; a single-centre feasibility pilot study, with a mixed-methods single arm pre-post design. PARTICIPANTS:The study involved 33 patients with CHD admitted for revascularisation (coronary artery bypass graft or percutaneous coronary intervention) between June and July 2024, selected from 72 screened. Two physiotherapists and one nurse conducted the research, focusing on patients deemed suitable for CR. INTERVENTION:Selected patients received the Bangla Heart Manual intervention that consisted of a 6-week programme of home-based CR including exercise training, self-care, relaxation, risk factor management and psychological support facilitated by a healthcare professional. PRIMARY AND SECONDARY OUTCOMES:The primary outcomes focused on feasibility, assessing patient recruitment, retention and adherence to the intervention using quantitative and qualitative methods, including interviews with patients, caregivers and healthcare professionals. Secondary outcomes measured patient-reported metrics like health-related quality of life (HeartQoL, EQ-5D-5L), psychological well-being, exercise capacity (Hospital Anxiety and Depression Scale), and serious adverse events (hospitalisation and mortality) before and after the Bangla Heart Manual intervention. RESULTS:The 33 patients recruited included 29 (88%) males with a mean age of 55 years. The following feasibility outcomes were achieved: 46% (33 patients from 72 screened) recruited, 91% (30/33) retention (complete outcome data at follow-up) and 75% intervention adherence (≥6 sessions attended of 8 sessions). Improvements following CR participation were seen in patient-reported outcomes and exercise capacity. Two deaths and one rehospitalisation occurred during the study. CONCLUSIONS:This study showed that the Bangla Heart Manual home-based CR programme was acceptable and feasible for people with CHD in Bangladesh and healthcare professional staff to deliver. Our results also support the feasibility of recruitment and data collection processes for a future multicentre randomised trial to formally test the clinical and cost effectiveness of the adapted Bangla Heart Manual. TRIAL REGISTRATION NUMBER:ISRCTN1545620.
Female university students are generally more vulnerable to body image dissatisfaction and eating disorders than their male counterparts. This study aimed to investigate the association between body image perception and the risk of eating disorders among female university students in Bangladesh. A cross-sectional study was conducted among 362 female students from September 2024 to March 2025 using a convenience sampling technique. Data were collected through a structured questionnaire, consisting of socio-demographic information, the Eating Attitude Test -26 (EAT-26) to assess eating disorder symptoms, and the Body Shape Questionnaire (BSQ) to evaluate body image perception. Results showed that 17.4
