Combined effect of Brunnstrom's hand rehabilitation and functional electrical stimulation for improving hand function in patients with chronic stroke: A randomized controlled trial

BACKGROUND

Motor recovery of the upper extremity is one of the most common challenging outcomes after stroke.

OBJECTIVE

To find out the combined effects of Brunnstrom hand rehabilitation (BHR) and functional electrical stimulation for improving hand functions in patients with chronic stroke.

STUDY DESIGN

Randomized controlled trial.

METHOD

25 participants, both male (n = 11) and female (n = 14), age group between 40 and 70 years were randomly divided into control group (n = 12) and experimental group (n = 13). The treatment protocol was continued 5 days per week, for 4 weeks. The experimental group received Brunnstrom hand training and functional electrical stimulation (FES) along with conventional physiotherapy. The control group received only conventional physiotherapy. Participants were evaluated at baseline and after 4 weeks of intervention.

OUTCOME MEASURES

Fugl Meyer Assessment scale-upper extremity, Modified Ashworth scale, Handheld Dynamometer, and Jabsen Taylor Hand Function Test. Paired t-test was used to compare within-group variables and an independent t-test was used for between-group comparisons. P-value was set as 0.05 to minimize type-1 error.

RESULTS

Statistically significant difference was obtained in favor of the experimental group undergoing FMA (p < .001), MAS (p = .004), JTHF (p = .018), and HHD (p < .001) in between-group analysis. However, both groups showed significant improvement [experimental group; FMA-UE (p < .001), MAS (p < .001); JTHF (p < .001), and HHD (p < .001), and control group; FMA-UE (p < .001), MAS (p < .001), JTHF (p < .001) and HHD (p < .001)] in within-group analysis at post-intervention.

CONCLUSION

Brunnstrom hand rehabilitation and FES in combination were found to be more effective in improving hand function than conventional physiotherapy treatment.

CLINICAL TRIAL REGISTRATION

URL: http://www.ctri.nic.in. No: CTRI/2019/06/019,905.

Fitness Trainers' Educational Qualification and Experience and Its Association with Their Trainees' Musculoskeletal Pain: A Cross-Sectional Study

This is a cross-sectional study that examined the association between fitness trainers’ educational qualifications and experience, and the risk of their trainees’ musculoskeletal pain. The study included 1177 trainees (aged 15−60 years) from 74 fitness centers in Bangladesh. Data were collected by using the Nordic musculoskeletal questionnaire, including potential confounders such as demographic factors (e.g., age, occupation), and training-related factors (e.g., workout knowledge, overweight lifting). Multiple logistic regression was performed for a binary outcome (pain—yes or no), and a generalized linear model was fitted for the ordinal outcome (pain—sites of the body). The trainers’ lower experience (no or ≤1 year) was associated with higher odds of their trainees’ musculoskeletal pain (OR: 2.53, 95% CI: 1.18−5.44) compared to trainers with >5 years of experience; however, no association was found between the trainers’ education and the risk of their trainees’ musculoskeletal pain, after controlling for potential confounders. Similarly, the trainees trained by trainers with lower experience had more than two-time the risk of having pain in different sites (IRR: 2.04, 95% CI: 1.50−2.79). The trainers’ experience may play a pivotal role in the trainees’ musculoskeletal pain. Further study is warranted in this regard.

Smartphone addiction and its impact on musculoskeletal pain in neck, shoulder, elbow, and hand among college going students: a cross-sectional study

Introduction

Prolonged physical exposure during smartphone usage results in poor posture causing pain in neck, shoulder, elbow, and hands. So, our aim was to investigate the effect of smartphone addiction on musculoskeletal pain.

Methods

This cross-sectional study was carried out by a random sampling method from recognized institute in Bangladesh and India. Three hundred twenty-six participants, including male and female, aged between 18 and 30 years participated in this study. Candidates were requested to fill-up a performa containing demographics, Smartphone addiction scale-short form (SAS-SF), Shoulder pain and disability index (SPADI), Neck disability index (NDI), Oxford elbow score (OEC), and Cornell Hand Discomfort Questionnaire (CHDQ).

Results

The mean age were 22.58 ± 3.19 years, weight 60 ± 11.30 kg, height 162.83 ± 9.74 cm, and body mass index (BMI) of the participants were 22.69 ± 4.36 kg/m2. 43.3% participants reported neck pain, 42.9% shoulder pain, and 27.9% reported pain on their elbow while prolonged smartphone use. There was major difference in NDI (p = 0.047), SPDI (p = 0.005), OES (p = 0.002), and CHDQ (p = < 0.001) among Bangladeshi and Indian population. The SAS has a significant association with NDI; p < 0.001, SPDI; p < 0.001, OES; p < 0.001, and CHDQ; p < 0.001.

Conclusion

Smartphone addiction negatively impacted and positively related with the musculoskeletal pain in neck, shoulder, elbow, and hand. Care should be given towards the proper use of smartphone and increase public awareness regarding the negative consequences of this serious issue.

Impact of lockdown on musculoskeletal health due to COVID-19 outbreak in Bangladesh: A cross sectional survey study

BACKGROUND

During the nationwide lockdown implemented by the government of Bangladesh due to the coronavirus, has led to the various changes in the overall activities and lifestyle. Most of the people began living a sedentary lifestyle, spending more time on their phone, watching television and excessive sleeping. Reduction of physical activity level had profoundly negative impact on musculoskeletal health.

AIM

This study aims to investigate the impact of lockdown on musculoskeletal health, association between leisure and musculoskeletal pain during this period.

METHODS

A cross sectional study was conducted among general populations living in a specific area of Bangladesh by simple random sampling methods. A total of 230 participants both male (182) and female (48) age group between 18-60 years have participated. The study was carried out by sending the Google Form link containing demographic questionnaire, numeric pain rating scale and Nordic musculoskeletal Questionnaire. Wilcoxon sign rank t and Chi squire test was used to analyze the data.

RESULTS

The mean height, weight and BMI of the participants were 164.17 ± 8.40 cm, 63.82 ± 10.70 kg and 23.74 ± 3.97 kg/m2 respectively. There was significant increase in time spent in watching television (p= < 0.0001), using smartphone (p= < 0.0001) and sleeping (p= < 0.0001) during the lockdown period. 33.9% participants had pain before the lockdown which increased by 57% during the lockdown periods. There was a significant association between pain intensity and sleeping time (X2 = 54.84; p= < 0.0001), time spent watching television (X2 = 83.70; <0.0001), time spent on smartphone (X2 = 58.39; <0.0001) during the lockdown period.

CONCLUSION

The result of this study concluded that the lockdown has negatively impacted the musculoskeletal health of the participants. The musculoskeletal pain might be short term initially, but can develop to be a long-term problem and burden if proper measures are not taken.

Chlamydia psittaci: a suspected cause of reproductive loss in three Victorian horses

Chlamydia psittaci was detected by PCR in the lung and equine foetal membranes of two aborted equine foetuses and one weak foal from two different studs in Victoria, Australia. The abortions occurred in September 2019 in two mares sharing a paddock northeast of Melbourne. The weak foal was born in October 2019 in a similar geographical region and died soon after birth despite receiving veterinary care. The detection of C. psittaci DNA in the lung and equine foetal membranes of the aborted or weak foals and the absence of any other factors that are commonly associated with abortion or neonatal death suggest that this pathogen may be the cause of the reproductive loss. The detection of C. psittaci in these cases is consistent with the recent detection of C. psittaci in association with equine abortion in New South Wales. These cases in Victoria show that C. psittaci, and the zoonotic risk it poses, should be considered in association with equine reproductive loss in other areas of Australia.

Comparison among Different Culture Media for the Detection of Dermatophytes

Dermatophytes are a group of closely related fungi that have the capacity of invading the keratinized tissue of human to produce infections known as dermatophytosis which is commonly referred to as ringworm. Other than routine microscopy, different culture media are available for the detection of dermatophytes from patient's specimen. This cross sectional study was designed to evaluate the outcome of three different culture media and microscopy for the detection of dermatophytes from clinical samples. Skin, hair and nail samples from 84 clinically suspected cases of dermatophytosis who attended at OPD of Dermatology Department, Sylhet MAG Osmani Medical College Hospital, Sylhet, Bangladesh from July 2014 to June 2015 were screened by direct microscopic examination using potassium hydroxide (KOH) mount. All the samples were inoculated for culture in Sabouraud's Dextrose Agar (SDA), Dermatophytes Test medium (DTM) and Sabouraud's Cycloheximide Chloramphenicol Agar (SCCA). The percentage of samples positive by microscopy was 37.5%, whereas the rate of positivity by culture was 47.6% which showed that culture was more sensitive than microscopy for the diagnosis of dermatophytosis. The efficiency of SDA and SCCA was found to be almost equal. There was no statistically significant difference between SDA and DTM in primary isolation of dermatophytes, though isolation rate was slightly higher in DTM. Though direct examination by microscopy is an efficient screening technique, culture should be done for accurate diagnosis. As DTM is easy to evaluate even without handling the growth of culture in the laboratory, it is recommended to use as screening medium for the detection of dermatophytes.

Effect of Obesity on Hemoglobin Concentration

Obesity is a disorder of body weight regulatory systems characterized by an accumulation of excess body fat. World Health Organization recommended that 66% of deaths now occur in developing countries and recognizes obesity as a leading risk factor. Obesity is associated with chronic, low grade, systemic inflammation. The inflammatory state play a causal role in the development of insulin resistance, type 2 diabetes and the metabolic syndrome. This descriptive type of cross sectional study will design to evaluate the relation between obesity with hemoglobin concentration. One hundred obese and 100 normal weight persons from both sexes, aged between 25 to 60 years will be selected from Mymensingh Medical College, Mymensingh and locality from July 2014 to January 2016. Data are collected through a simple questionnaire after informed consent taken. The result was calculated and analyzed by using SPSS (statistical package for social science, version 11.5). Statistical significance of difference between two groups were evaluated by unpaired Student's 't' test. Data were expressed as Mean±SE. P value less than 0.05 was taken as the level of significance. Anthropometric measurements such as height and weight were taken in meter and kilogram respectively. Pulse, systolic and diastolic blood pressure was measured by aneroid sphygmomanometer (ALPK2, Japan), laboratory analysis of hemoglobin was done by Cyanmethemoglobin Method. In this study we found that hemoglobin concentration is significantly increased in both male and female obese persons.

Serum Zinc Status among Acute Myocardial Infarction Male Patients in Bangladesh

This case-control study was carried out in the Department of Biochemistry, Mymensingh Medical College in collaboration with the Department of Cardiology, Mymensingh Medical College Hospital, Mymensingh, Bangladesh from January 2015 to December 2015. The aim of the study was to explore the serum zinc status among acute myocardial infarction (AMI) patients as a means to monitor the possibility of management of these patients. A total of 120 subjects were included in this study. Among them 60 were diagnosed AMI patients denoted as case group and 60 were normal healthy individuals denoted as control group. Serum zinc was determined by colorimetric method from each sample. Statistical analysis was performed by SPSS windows package, version 20. Among the study groups the Mean±SD values of serum zinc were 64.98±18.86μmol/L and 97.14±7.97μmol/L in case and control group respectively. Analysis showed that the mean serum zinc level was significantly (p<0.01) decreased in AMI patients in comparison to that of control group.

Effect of Obesity on Fasting Blood Sugar

Obesity is a disorder of body weight regulatory systems characterized by an accumulation of excess body fat. World Heath Organization recommended that 66% of deaths now occur in developing countries and recognizes obesity as a leading risk factor. Obesity is associated with chronic, low grade, systemic inflammation. The inflammatory state plays a causal role in the development of insulin resistance, type 2 diabetes and the metabolic syndrome. This study will design to evaluate the relation between obesity with fasting blood sugar (FBS). This descriptive type of cross sectional study had been performed to investigate the relationship between obesity with serum fasting glucose, of 100 obese and 100 normal weight persons from both sexes, aged between 25 to 60 years will be selected from Mymensingh Medical College, Mymensingh, Bangladesh and locality from July 2014 to January 2016. Data are collected through a simple questionnaire after informed consent taken. The result was calculated and analyzed by using SPSS (statistical package for social science, version 11.5). Statistical significance of difference between two groups was evaluated by unpaired Student's 't' test. Data were expressed as Mean±SE. P value less than 0.05 was taken as the level of significance. Anthropometric measurements such as height and weight were taken in meter and kilogram respectively. Pulse, systolic and diastolic blood pressure was measured by aneroid sphygmomanometer (ALPK2, Japan), laboratory analysis of serum fasting glucose will be estimated by GOD-PAP Method. In this study we found that fasting serum glucose is significantly increased in both male and female obese persons 4.07±0.79mmol/l & 5.58±0.64mmol/l respectively. In obese the values of FBS indicate the subjects are prone to develop cardiovascular & metabolic diseases. That has high morbidity and mortality. Therefore, by this study we recommended that routine estimation of fasting blood sugar is important for prevention of complication related to obesity for leading a healthy life.

Body Mass Index in Adult Asthmatic Patients

Asthma is a chronic inflammatory disorder of the airways, in which many cells and cellular elements play a role. Asthma is one of the most common diseases globally and currently affects 300 million people. Asthma and obesity have an enormous impact on public health. Since the 1990s, various studies have shown a correlation between an increase in body mass index (BMI) and asthma prevalence. This descriptive type of cross sectional study was done to find the levels of BMI in adult asthmatic patients and carried out in the Department of Physiology, Mymensingh Medical College, Mymensingh, Bangladesh from July 2014 to January 2016. Fifty male and 50 female adult asthmatic patients aged 18-60 years were included in the study group. They are enrolled from the Department of Medicine, Mymensingh Medical College, Mymensingh and also from locality. For comparison age matched 50 male and 50 female apparently healthy persons were also studied as control. BMI were calculated by weight in kg divided by height in square meter (m²). For statistical analysis unpaired Student's 't' test was used. Mean BMI were significantly increased in both study group in comparison to control group and the result was statistically significant (p<0.001). From this study, it may be concluded that increase body mass index that is overweight or obesity can increase the prevalence and incidence of asthma. Obesity, by means of inflammatory mechanism or changes in lifestyle can trigger asthmatics symptoms in susceptible individuals.

Serum Copper Status among Acute Myocardial Infarction Male Patients in Bangladesh

This case control study was carried out in the Department of Biochemistry, Mymensingh Medical College in collaboration with the Department of Cardiology, Mymensingh Medical College Hospital, Mymensingh, Bangladesh from January 2015 to December 2015. The aim of the study was to explore the serum copper status among acute myocardial infarction (AMI) patients as a means to monitor the possibility of management of these patients. A total of 120 subjects were included in this study. Among them 60 were diagnosed AMI patients denoted as case group and 60 were normal healthy individuals denoted as control group. Serum copper determined by colorimetric method from each sample. Statistical analysis was performed by SPSS windows package, version 20. Among the study groups the mean serum copper levels were 150.30±26.16 and 103.65±9.38 in case and control group respectively. Analysis showed that the mean serum copper level was significantly (p<0.01) increased in AMI patients in comparison to that of control group.

Fasting Serum Glucose Level in Postmenopausal Bangladeshi Women

The study was done to find out the causes that changes the fasting serum glucose level in postmenopausal women. This was descriptive type of cross sectional study carried out over a period of one year from July 2014 to June 2015 in the department of physiology, Mymensingh Medical College, Mymensingh. Women of reproductive age (25-45 years) and clinically diagnosed 100 menopausal women (45-70 years) were included for this study. Convenience type of sampling technique was used for selecting the study subjects. Measurement of fasting serum glucose was done by GOD-PAP method. Data were expressed as mean±SD and statistical significance of difference among the groups were calculated by unpaired student's 't' test. The mean±SD of serum glucose in menopausal women were significant at 1% level of probability than women of reproductive age. This study revealed that postmenopausal women showed higher levels of fasting serum glucose level. Fasting blood sugar level between the study & control group were 7.69±2.37 and 4.59±0.73 and the difference was statistically significant.

Effect of Diclofenac Sodium in Broilers

This study was conducted to determine the effects of diclofenac sodium in broiler chicks during the period from 20th July /2012 to 1st september/2012. The broiler chicks were divided into four groups A, B, C and control with ten day old bird in each. Group A was treated with @ 5mg/kg body weight, group B was treated with @ 10mg/kg body weight and Group C was treated with 20 mg/kg body weight given orally mixing with drinking water. Histopathological, hematological and biochemical tests were performed on 42th days of age to evaluate diclofenac-induced changes between control and treated groups. Mortality rate and pathomorphological changes were observed in dead birds. The acute toxicity was assessed by observing the clinical signs and symptoms, mortality, alterations in blood biochemistry, and necropsy findings. The birds of Group A showed only mild symptoms of diarrhea and 30% mortality. In Group B, 60% and Group 70% of birds died in between 24 and 36 h post-treatment showing the symptoms of segregatory behavior, lethargy, terminal anorexia, and severe bloody diarrhea. Observation of hematological parameters like TEC, Hb, PCV and ESR on 42th days of age showed significant (p<0.01) decrease in treatment group compare to control group. Observation of biochemical parameters (serum urea, serum creatinine) on 42th days of age showed significantly increased (p<0.01) serum urea and serum creatinine indicating nephrotoxicity in broilers. At 12 and 24 h post-treatment this returned to the normal levels. The dead birds of the high-dose group also showed similar pattern of biochemical changes at 12 and 24 h post-treatment and revealed extensive visceral gout with characteristic histopathological lesions in liver, kidney, heart, spleen and intestine on post-mortem. The results indicate that diclofenac sodium has hepatotoxic, nephrotoxic, and visceral gout inducing potentials in broilers (cob-500), especially at higher dose.DOI: http://dx.doi.org/10.3329/bjvm.v13i1.23710Bangl. J. Vet. Med. (2015). 13 (1): 19-24

Sedative and anxiolytic effects of different fractions of the Commelina benghalensis Linn

The present study was designed to investigate sedative and anxiolytic properties of the four different fractions (chloroform, pet ether, n-butanol and hydromethanol soluble fractions, coded as CFCB, PECB, NBCB and HMCB, respectively) of the aerial parts of Commelina benghalensis using rodent behavioral models, such as hole cross, open field and thiopental sodium induced sleeping time tests for sedative property and elevated plus-maze (EPM) test for anxiolytic potential, respectively. All fractions, at the doses of 200 mg/kg, p.o. and 400 mg/kg, p.o., displayed dose dependent suppression of motor activity, exploratory behavior (in hole cross and open field tests) and prolongation of thiopental induced sleeping time in mice; maximum effect was shown by chloroform (CFCB) and pet ether (PECB) fractions. In EPM test, chloroform (CFCB) and pet ether (PECB) fractions with similar doses significantly (p < 0.05) increased exploration to and time spent by the treated mice in EPM open arms in a way similar to that of diazepam while the effect of NBCB and HMCB fractions on entry to and time spent in open arms was not found to be statistically significant. These findings provide in vivo evidence that aerial parts of C. benghalensis in general, and chloroform (CFCB) and pet ether (PECB) soluble fraction has significant sedative and anxiolytic effects. Furthermore, these results may justify the scientific basis for the use of this plant in traditional medicine as a modality for anxiety and related disorders.

In vitro free radical scavenging activity of methanol extract of the leaves of Mimusops elengi Linn

In the present study, antioxidant potential of the methanol extract of the leaves of Mimusops elengi Linn. was evaluated by using 1, 1-diphenyl-2-picrylhydrazyl (DPPH) scavenging assay, reducing power and total antioxidant capacity. The extract showed significant activities in all antioxidant assays compared to the reference antioxidant ascorbic acid in a dose dependent manner. In DPPH scavenging assay the IC50 value of the extract was found to be 43.26μg/ml while the IC50 value of the reference standard ascorbic acid was 58.92 μg/ml. Total antioxidant activity was also found to increase in a dose dependent manner. Moreover, M. elengi extract showed strong reducing power. These results suggest that Mimusops elengi may act as a chemopreventative agent, providing antioxidant properties and offering effective protection from free radicals. Key words: Mimusops elengi, antioxidant, reducing power, total antioxidant capacity, reactive oxygen species   doi: 10.3329/bjvm.v6i2.2336 Bangl. J. Vet. Med. (2008). 6 (2): 197-202