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Thoracic spine pain (TSP) is defined as pain perceived anywhere in the region bounded superiorly by a transverse line through the tip of the spinous process of T1, inferiorly by a transverse line through the tip of the spinous process of T12, and laterally by vertical lines tangential to the most lateral margins of the erector spine muscles. One year prevalence of TSP ranged from 8.3-38.1% in different Asian countries. A longitudinal observational study was conducted to observe the clinical feature, demographic profile and clinical course of patients, with TSP attending at the Department of Physical Medicine and Rehabilitation (PMR) of Shaheed Suhrawardy Medical College Hospital (ShSMCH). Among the 100 study patients mean age ±SD was 34.76±13.26. Highest number of the patients (45%) belong to 16-30 years age group and male-female vatioo was 3:1. Highest frequency in the level of education 28% belonged to higher secondary or diploma. Twenty six percent (26%) patients were housewife, manual labor 20%, students 19%, sedentary worker 15%, manufacturing and industrial worker 8%, health professional 4%, driver 3% and 5% were in others group. Most of them (71%) belong to 6-12 weeks) 16% and chronic (>12 weeks) 38%. Upper TSP was found among 51% of the patients. Onset of pain among the patients 66% was gradual. Mild intensity of pain was reported in 54% patients, moderate 44% and severe in only 2% patients and 64% patients had no radiation. Aggravating factors were found in patients with prolong sitting in 42%. More than one third (36%) patients relieving factor were lying, 24% rest, activity 16% and no relieving factors in 24% patients. Morning stiffness and depression was found 20% and 25% patients respectively. Associated conditions were found as diabetes mellitus (DM) 25%, sleep disturbance 16%, dyspepsia 10%, hypertension (HTN) were in 7% patients and 42% patients had no associated condition. Large number of the patients’ was occupational 46%; rest of the factors were MFPS 16%, degenerative 14% (dorsal spondylosis 5%, cervical spondylosis 6% and lumbar spondylosis 3%, Ankylosing Spondylitis (AS) 7% and traumatic were 6%. Pott‘s disease 4% and 7% patients’ cause were others. According to Numeric Rating Scale in the first visit mild causes were in 54% patients, 44% moderate and 2% severe. In the last visit 69% patients were found mild and rest had no pain (p value=0.001). Assessment of joint tenderness in first visit; 56% patients were in grade 1, 20% grade 2 and 3% in grade 3, 21% patients had no tenderness. In the last visit it was found that only 21% patients in grade 1 and rest 79% had no tenderness (p value=0.001). According to Pain Disability Index in the first visit mild disability was found in 67% patients, moderate 31% and 2% had no disability. In the last visit mild were 74% and 26% had no disability (p value=0.001). Teenager, young adults and adults were the most commonly affected patients with TSP with M:F=1.5:1. Most of the patient of upper TSP presented before 6 weeks; common presenting features were gradual onset, pain was constant in nature, mild to moderate in intensity without radiation, aggravated by prolong sitting and leaning forward, relieved by lying and rest, with no depression and significant morning stiffness. Most of the factors were occupational and MFPS. Occupations were commonly housewife and manual labor. They were improved significantly (p value=0.001) with conventional treatment. Bangladesh Med J. 2021 Sept; 50(3): 26-35

Plantar fasciitis is a progressive degenerative condition of the plantar fascia which is reported to be one of the most common causes of lower heel pain in adults. Extracorporeal Shock Wave Therapy is being used for the management of plantar fasciitis now a day. The aim of the study was to find out the effects of Extracorporeal Shock-wave therapy in patients with chronic plantar fasciitis. A randomized clinical trial was conducted from May to October 2015, on 60 patients aged more than 18 years with plantar fasciitis attending in the department of Physical Medicine and Rehabilitation (PMR) in the Dhaka Medical College Hospital (DMCH) to observe the effectiveness of Extracorporeal shock-wave therapy (ESWT) in the treatment of plantar fasciitis and its therapeutic outcomes.60 patients were allocated randomly into intervention group (Group A) and control group (Group B). Data were composed through face to face interview using a questionnaire based on 1.Visual analogue scale, 2.Modified Roles and Maudsley score, and 3.100-point Scoring System for Plantar Fasciitis. But after 8 weeks, score was found lower in Group A than Group B (p

Introduction: Shoulder pain comes next to back and knee pain, considering the frequency of musculoskeletal ailments. The Shoulder Pain and Disability Index (SPADI) is considered a highly specific questionnaire for assessing shoulder pain and functions. The objective of the study was to assess the validity and reliability of the Bangla version of SPADI (B-SPADI) among the Bangla-speaking patients. Materials and methods: The B-SPADI was developed using a designed process that included forward translation and backward translation, authentication, response, and final rectification. Validity and reliability were conducted in 48 patients with shoulder pain. The reliability was appraised by executing internal consistency and test-retest analyses. Its validity was assessed by comparing the SPADI with the SF- 36, Disabilities of the Arm, Shoulder, and Hand (DASH), and American Shoulder and Elbow Surgeons (ASES) questionnaire. Results: The cross-cultural adaptation method was flawlessly aligned with the content or language. Internal consistency (Cronbach’s alpha) was 0.97 for the total SPADI score. Intraclass Correlation Coefficient (ICC) was 0.95 for the total SPADI with 0.92 for pain subtotal and 0.96 for disability subtotal. The SPADI total score showed a correlation of 0.63–0.71 with the SF-36 physical scales, of 0.89 with the DASH and of 0.94 with the ASES. All of the items were statistically significant (P

The study aimed to evaluate the association of recreational (habitual) physical activities with the osteoarthritis (OA) of the knee in the female. The case-control study was carried out at the Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka in the year 2016 and 2017. The total participants were 174 female selected purposively with the age range of 40 – 70 years, among them 87 were the cases with OA of the knee, and the same number of the same age group were included as the control without OA of the knee. A structured interviewer-administered questionnaire was used to collect data. High level of physical activities (20 or more miles per week) was associated with OA of the knee, whereas moderate level of physical activities (10-20 miles/per week) and low level of physical activities (

The study was attempted to explore the small scale broiler farming of Tangail district. Bhuapur, Ghatail, Kalihati, Shakhipur, Delduar and Basail Upazilas were selected purposively for this study. Primary data were collected through face to face interview with the respondents of broiler farmers during February to July, 2016. Secondary data were collected from the BBS, poultry production and marketing reports, journals, DAM, DLS and MS theses. A total of 30 broiler farm owners and 54 intermediaries were selected by applying purposive sampling technique. In the production and marketing system of broiler, many intermediaries were involved such as Bepari, Paiker, Wholesaler and Retailer. Marketing of broiler, produced in Tangail district, was moved from producers to the consumers through four separate chains. The average production cost of farmer for 500 birds was BDT 54781.25, and marketing cost of paiker, wholesaler and retailer were BDT 1230, BDT 1310 and BDT 440, respectively. However, beparies received highest marketing cost which was BDT 1370/500 birds. Transportation was found as the highest cost item which was 37.96%, 39.02% and 40.46%, in case of bepari, paiker, and wholesalers, respectively, but there was no transportation cost of retailer. Broiler farmers sold 90% of their broiler to paiker/bepari and remaining 10% to retailer (distance paiker) sold directly. Paikers sold 85.63% of their broilers to retailers and 14.34% to retailers through wholesalers. Consumer purchases100% of broiler from the retailers in the study areas. Broiler producers did not get fair price due to lack of economic storage facilities, existence of stronger middlemen, inadequacy of veterinary care and services, inefficient transportation facilities, and lack of proper marketing information. It could be concluded that institutional credits, timely supply of inputs and stable price of broiler should be ensured along with the provision of transport and market facilities. Res. Agric., Livest. Fish.7(2): 243-254, August 2020

Background: The exercise is a widely promoted way to improve and maintain health, and osteoarthritis (OA) is a major health problem also. The study was conducted to examine the impact of different types of leisure-time physical activity on the OA of the knee. Objective: The study was aimed to evaluate the association of recreational (habitual) physical activities with the osteoarthritis of the knee in the female. Methods: The case-control study was carried out on 174 female selected purposively with the age range of 40 – 70 years and above, from September 2016 to August 2017.Among them 87 were the cases with OA of the knee, and the same number of healthy females of the same age group were included as the control. Physical activity was assessed by self-reported regular exercise patterns. A structured interviewer-administered questionnaire was used to collect data. Results: Age, educational status, occupational status and BMI were not statistically significant (p>0.05) between the two groups. High level of physical activities (walking, running or jogging 20 or more miles per week) were associated with osteoarthritis of the knee, while low level of physical activities (

Diabetes mellitus is associated with several musculoskeletal (MSK) disorders. Due to increased incidence and life expectancy causes increased prevalence and clinical importance of MSK alterations in diabetic subjects. It is difficult to find out the direct relation with metabolic control. This study was conducted to explore the pattern of musculoskeletal disorders in the diabetic patients. A cross-sectional study was conducted from January' 2016 to June' 2016 at Department of Physical Medicine and Rehabilitation, Bangabandhu Sheikh Mujib Medical University, Dhaka with 190 cases divided in two groups. Patients aged 40-70 years with musculoskeletal disorder with diabetes mellitus (type 2) for five years attending in the department of Physical Medicine and Rehabilitation were included in group A. Patients with MSK disorder without diabetes aged 40- 70 years were included in group B. Main outcome measures were done by Chi square test and unpaired t test were calculated by using SPSS-20. Out of 190 patients, more than half (53.68%) patients were belonged to age 51- 60 years in group A and 49(51.58%) in group B. Majority (56.84%) patients were female in group A and 43(45.26%) in group B. Twenty three (24.21%) patients were house wives in group A and 25(26.32%) in group B. Fifty two (54.73%) patients had osteoarthritis of knee in group A and 26(27.36%) in group B. Twenty one (22.11%) patients had frozen shoulder in group A and 9(9.47%) in group B. Sixteen (16.84%) patients had Flexor tenosynovitis in group A and 04(4.21%) in group B. Fifteen (15.78%) patients had Fibromyalgia in group A and 05(5.26%) in group B. Twelve (12.63%) patients had Planter fascities in group A and 03(3.16%) in group B. Which were statistically significant (p0.05) between two groups. More than half patients were belonged to age 51-60 years and female were predominate in both groups. Common musculoskeletal disorders in diabetic patients were osteoarthritis of knee, frozen shoulder, Flexor tenosynovitis, Fibromyalgia, Planter fascities, Rheumatoid arthritis, Carpel tunnel syndrome, Lumbar spondylosis, Cervicalspondylosis and DISH. This study will also be helpful for different organizations working in this area including physiatrist in their program for delivering a comprehensive treatment service. As a result patients were more benefited. Bangladesh Med J. 2019 Jan; 48 (1): 5-12

Background: De Quervain's disease has been described as an entrapment of the extensor pollicis brevis and abductor pollicis longus tendons in the first dorsal compartment of the wrist is a common cause of wrist and hand pain Treatment of the disease consists of pharmacological & non-pharmacological. The non-pharmacological includes immobilization, therapeutic heat and cold, electrical nerve stimulator, thumb stabilizer splint, postural correction at work and the adjustment of tools and equipment. This randomized clinical trial was performed to find out the effects of UST with NSAIDs and without NSAIDs in the patients of De Quervain’s disease. Methods: This randomized clinical trial was performed in the Department of Physical Medicine and Rehabilitation, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, over a period of six months. Group A-experimental or interventional group and group B-control group by randomization with the help of lottery. Experimental group was managed by activities of daily living (ADLs) instructions, ultrasound therapy (UST) with non-steroidal anti-inflammatory agents (NSAIDs gel), along with thumb spica splint. Control group B received previous management except non-steroidal anti-inflammatory agents (NSAIDs gel). All patients received therapeutic ultrasound in a same dosage (1 watt/ cm 2/min) for 8 minutes. An evaluation was made at initial visit and two weeks interval for 6 weeks. So, there were three follow up visits and these evaluations were performed by the same investigator. In each visit, measurement of pain intensity and disability level were performed by using visual analogue scale (VAS), Tenderness Index and Patient rated wrist evaluation (PRWE) respectively. All results was recorded systematically. A post intervention result was compared with baseline result by SPSS-20 Results: Out of 60 total patients 60(100%) had Finkelstein test positive. Significant difference between Group A and Group B was found at week 4 and Week 6 follow up (P0.05). Significant difference between Group A and Group B was found at week 4 and week 6 follow up (P