The coronavirus disease 2019 (COVID-19) and its impact on human functioning are gaining increased interest. Like many other lower-income countries, the Bangladesh health and rehabilitation sector was adversely affected by COVID-19. Multiple challenges were identified for preparedness and medical rehabilitation during COVID-19 surges. Appropriate supervision of multispecialty long COVID clinics and attention to rehabilitation teamwork are important. Rehabilitation plays a key role in the management of patients with COVID-19 and can reduce the length of hospital stay and improve health outcomes. While waiting for people to be fully vaccinated; ensuring equitable access to COVID-19 vaccination, health care, and rehabilitation services among people with disabilities should be a part of the core mission during the pandemic. All levels of care including, critical, post-acute, or long covid clinic scale-up of rehabilitation services are needed. A physiatrist-led rehabilitation team approach is vital for the adaptation of rehabilitation interventions to improve the functional outcomes of persons with impairment and disability affected by COVID-19.
BackgroundPlantar fasciitis is the most common cause of foot pain. Patients with plantar fasciitis typically present with 'first step pain,' which tends to decrease with activity and worse with heavy use. This study determines the effect of ultrasound-guided, single-dose, platelet-rich plasma (PRP) injection in patients with chronic plantar fasciitis. Materials and methodsIt was a quasi-experimental trial carried out in the Department of Physical Medicine and Rehabilitation, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, from March 2019 to March 2022. A total of 148 patients diagnosed with chronic plantar fasciitis were selected as samples. A total of 75 patients were allocated to group A (intra-lesional injection of autologous PRP with conservative management) and 73 patients to Group B (only conservative management). Both groups of patients were allocated to conservative management with exercises, shoe modification, activities of daily living (ADLs) instruction, and oral paracetamol. ResultsThis study shows that in group A, the mean visual analog scale (VAS) score significantly reduced to 1.47±0.51 after six months of single-dose PRP injection (p<0.001). In group B, the VAS score also decreased substantially after conservative treatment. Though in groups A and B, pain reduction was significant, in group A, the pain was decreased more compared to group B and statistically significant differences were found between the two groups at the 12th week and 24th week. The foot function index (FFI) scores decreased significantly in group A after a single dose PRP injection, compared with group B treated with conventional therapy. In group A, FFI scores decreased from 49.09±5.72 to 7.67±3.41. The study revealed a significant difference between study groups in the 12th week and 24th week regarding FFI scores. ConclusionUltrasound-guided intra-lesional autologous PRP Injection is safe and effective and recommended in patients with chronic plantar fasciitis, especially in recalcitrant cases after the failure of conservative treatment and corticosteroid injection.
This article has no abstract. The first 100 words appear below: A 60-year-old diabetic male patient presented with persistent left shoulder joint pain for the last 6 months following coronary artery bypass graft (CABG) surgery. The pain was insidious onset, non-radiating, and dull which aggravated by movement as well as on left lateral position during sleep. However, the pain was not associated with morning stiffness. He had been treated with oral anti-diabetic medications for diabetes mellitus for the last 15 years. However, recently he required to switch to premixed insulin injection for good control of his glycemic status. Apart from post CABG status and diabetes mellitus, he was relatively well and had no other significant medical records like direct trauma over the shoulder joint.
Background: Osteoarthritis (OA) is the most prevalent chronic joint disorder worldwide and is associated with significant pain and disability. Introduction of platelet-rich plasma (PRP) injection has been viewed as an advance in the management of OA knee. Objective: To compare the effectiveness of PRP and Hyaluronic Acid (HA) in the treatment of mild and moderate OA knee Methods: The present randomized clinical trial had been conducted in the Department of Physical Medicine and Rehabilitation, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from 2018 to 2019. A total of 154 patients with mild and moderate OA knee were randomly allocated into two groups: group A (received PRP injection) and group B (received HA injection) where 133 patients completed the follow-up schedule. Outcomes were measured by OA specific translated and validated Bengali instrument- Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire and visual analogue scale (VAS 0-10). They were followed-up for 6 months. Results: There was no significant statistical difference at the baseline between the groups regarding age, sex, grading of OA knee, side involvement, mean duration of the disease, VAS scores and WOMAC scores. After one month, VAS score significantly decreased in PRP group compared to HA group (p<0.001). However, there was no statistical difference regarding total WOMAC scores between two groups (p=0.063). In third and sixth month, VAS score significantly decreased in PRP group compared to HA group (p<0.001). Though the stiffness and physical activity scores of WOMAC did not reduce significantly, the pain score reduced significantly in PRP group compared to HA group. In both groups, significant reduction of VAS and WOMAC total scores was observed after six months follow-up compared to baseline values (p<0.001). Conclusion: Intra-articular platelet-rich plasma improves pain and function of the knee in patients with osteoarthritis. Though intra-articular hyaluronic acid also improves pain and function in the foot, PRP is more effective than hyaluronic acid. Multi-centered clinical trial with long term follow-up should be conducted to see the effects of PRP and HA. Bangladesh Med Res Counc Bull 2021; 47(1): 62-69
Background: De Querveins’ tenosynovitis affects the abductor pollicis longus (APL) and extensor pollicis brevis (EPB) tendons in the first dorsal compartment of the wrist. Corticosteroid injection is the mainstay of treatment for those patients who do not respond to conservative management. Platelet-rich plasma (PRP) is a currently used strategy in the clinical practice to provide a regenerative stimulus for tendon healing. Objective: To evaluate the effects of Platelet-rich plasma in the treatment of DQVD in comparison with corticosteroid (CS) injection. Materials and Methods: The present randomized clinical trial had been conducted in the Department of Physical Medicine and Rehabilitation, Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbag, Dhaka. A total of 100 patients with pain and swelling over the radial aspect of the wrist with positive Finkelstein test were randomly allocated into three groups: group A (received platelet-rich plasma injection), group B (received corticosteroid injection) and group C (received conservative management). The severity of pain and functional status of the wrist joint were recorded according to VAS and Mayo’s wrist score both pre-procedurally on day 0 and post-procedurally at the end of 1st, 3rd and 6th month. Results: The mean age of the participants in group A, B and C were 45.6 (±10.4), 46.9 (±11.3) and 42.4 (±6.3) years respectively. In all groups, majority of the study participants were female and housewives. No significant statistical difference was observed among the groups regarding VAS scores and Mayo’s Wrist Scores at baseline. At the end of 6 months, the reduction of pain in group A was significantly lower than group B (p<0.001). Again, at the end of 6 months, the improvement of Mayo’s Wrist Scores in group A group was significantly higher than group B (p<0.001). In group A, 77.8% reduction of pain score was achieved while in group B, 68.4%reduction of pain score was achieved after 6 month of treatment (p<0.001). Conclusions: Platelet-rich plasma provides better functional outcome than corticosteroid in the treatment of de Quervain tenosynovitis. Bangladesh Medical Res Counc Bull 2023; 49(1): 32-38
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