Dhaka Medical College and Hospital (abbreviated DMCH) is a public medical college and hospital located in Dhaka, the capital city of Bangladesh. It houses medical school as well as a tertiary care hospital on one campus.The country's first ever autologous bone marrow transplant took place in its bone marrow transplant unit.
Aortic Dissection (AD) is a life-threatening condition and one of the major causes of death in the U.S. Despite its clinical significance, trends in AD related mortality remain understudied. We aim to analyze nationwide mortality trends in AD in the U.S. Data from CDC WONDER (1999–2024) identified U.S mortality rates in adults aged ≥ 25 years with AD (ICD-10: I71.0). Crude mortality rates (CMRs) and age-adjusted mortality rates (AAMRs) per 100,000 were calculated. Trends were analyzed using Joinpoint regression to estimate annual percent change (APC) and average annual percent change (AAPC). From 1999 to 2024, a total of 115,449 deaths from AD were recorded. The AAMR increased from 2.1 in 1999 to 2.4 in 2024 (AAPC of 0.46; 95
As the global prevalence of dementia rises, an increasing number of patients with cognitive impairment require Total Joint Arthroplasty (TJA). However, the specific impact of dementia on postoperative outcomes remains underreported. This systematic review evaluates the complications, mortality, and healthcare utilization associated with dementia in patients undergoing Total Hip (THA) and Total Knee Arthroplasty (TKA). A systematic search of PubMed, Scopus, Web of Science, Embase, and the Cochrane Library was conducted following PRISMA guidelines. Eligible studies included comparative cohorts of patients with and without a diagnosis of dementia undergoing primary TJA. Methodological quality was appraised using the Newcastle-Ottawa Scale (NOS). Data were synthesized regarding mortality, readmissions, implant-related complications, and discharge disposition. Seven retrospective cohort studies comprising 13,816 patients with dementia and 869,061 controls were included. The mean NOS score was 8.4/9, indicating high methodological quality. Patients with dementia exhibited significantly worse outcomes across both procedures, including higher rates of postoperative delirium (OR: 4.25–6.40), mortality (HR: 1.43–3.05), and discharge to skilled nursing facilities (OR: 1.87). Stratification by procedure revealed distinct risk profiles: while both cohorts faced high readmission rates, THA patients demonstrated specific vulnerability to mechanical complications, including increased risks of dislocation, periprosthetic fracture (OR: 2.07), and revision surgery. These mechanical failures were frequently driven by falls and poor compliance with postoperative precautions rather than infection alone. Dementia is a robust independent predictor of adverse outcomes after TJA. While both THA and TKA carry elevated systemic risks, THA poses unique mechanical challenges that may warrant the use of high-stability implants (e.g., dual-mobility cups) to mitigate dislocation risks. Perioperative strategies should prioritize caregiver-led surveillance and strict fall prevention protocols to improve safety in this vulnerable population.
Artificial Intelligence (AI) is shifting oral health care from a hardware-centric to a software-centric approach, with the potential to solve problems similarly to humans. It is transforming endodontics by enhancing diagnostic accuracy, improving treatment planning, increasing clinical efficiency, and supporting personalized care. This review explores AI applications in endodontics, including working length determination, periapical and caries detection, complex root anatomy segmentation, vertical root fracture identification, and surgical planning. AI models such as convolutional neural networks and artificial neural networks demonstrate high accuracy in interpreting cone-beam computed tomography and radiographic data. Benefits include improved workflow efficiency, reduced misdiagnoses, and individualized treatment strategies. However, challenges persist, such as limited high-quality datasets, regulatory gaps, and ethical considerations. Future directions emphasize technological advancements, collaborative AI-clinician integration, and AI-driven education and training tools. AI stands as a transformative force in endodontics, requiring responsible implementation and continued research to optimize its impact on patient care and clinical practice.
Introduction Chronic obstructive pulmonary disease (COPD) is a progressive lung disease marked by airflow limitation, impairing functional capacity and quality of life. Education, exercise, and medication are key components of COPD management, yet evidence on their combined impact remains limited. This study aimed to evaluate the impact of an educational intervention, alongside exercise and medication, on respiratory symptoms, exercise capacity, lung function, and quality of life in COPD patients. Method A quasi-experimental study was conducted at Dhaka Medical College Hospital from December 1, 2022, to September 30, 2023. A total of 52 COPD patients aged 40-80 years with mild to moderate disease were enrolled in this study. Patients were purposively allocated into two groups: group A received education, exercise, and medication; and group B received exercise and medication alone. Outcomes measured included dyspnea (mMRC), health status (CCQ), exercise capacity (six-minute walk test (6MWT)), oxygen saturation (SpO₂), and lung function (forced expiratory volume (FEV)₁/forced vital capacity (FVC)). Pre-post changes were analyzed using paired t-tests, and between-group comparisons were made using independent t-tests. Results Both groups showed significant improvements from baseline; however, group A demonstrated consistently superior outcomes. After 24 weeks, group A had significantly lower dyspnea scores (1.59 ± 0.50 vs 2.24 ± 0.83; p = 0.001) and better CCQ scores (3.04 ± 0.32 vs 3.31 ± 0.36; p = 0.006). Functional capacity improved more in group A (6MWT: 551.7 ± 32.7 m vs 526.8 ± 37 m; p = 0.01). Oxygen saturation was higher (97.2 ± 0.56% vs 96.2 ± 0.91%; p < 0.001), and pulmonary function improved more notably (FEV₁/FVC: 65.97 ± 2.65 vs 61.78 ± 4.17; p < 0.001) in group A compared to group B. Conclusion Educational intervention combined with exercise and medication significantly improved symptoms, functional capacity, oxygenation, and lung function in COPD patients. Structured education programs are recommended as an integral part of COPD management to enhance patient outcomes.
The global distribution and frequency of maturity onset diabetes of the young (MODY) vary, necessitating investigation across diverse ethnic groups. This study aimed to investigate MODY gene variants and phenotypic characteristics among young Bangladeshi individuals with nonobese, nonautoimmune youth-onset diabetes. Fifty participants with diabetes (onset < 35 years, BMI < 25 kg/m², negative for islet autoantibodies, detectable C-peptide, and a family history of DM) and 50 young individuals with normoglycemia were enrolled. Targeted next-generation sequencing (NGS) was performed on a panel of 14 known MODY genes. Candidate MODY-gene variants were identified in 20% (10/50) of the diabetes cohort. There were 11 heterozygous missense variants across eight genes: HNF1A, PDX1, NEUROD1, KLF11, PAX4 (three variants), BLK, ABCC8 (two variants), and KCNJ11. No variants met the ACMG/AMP criteria for ‘Pathogenic’ or ‘Likely Pathogenic’ classification; all identified variants were categorized as variants of uncertain significance (VUS). No significant phenotypic differences were observed between individuals with diabetes who carried identified variants and those who did not. In conclusion, this study identified candidate MODY variants (all classified as VUS) in one-fifth of the Bangladeshi nonobese, nonautoimmune youth-onset diabetes cohort. These findings provide a preliminary indication of a distinct genetic pattern characterized by a low frequency of common variants and a relative abundance of variants in rare MODY-associated genes. These findings are hypothesis-generating and highlight potential genetic targets for future functional validation to confirm pathogenicity and to support definitive MODY diagnoses.
