Work-related musculoskeletal disorders (muscle, bone and joint), briefly called MSDs comprise a significant portion of workplace injuries and huge economic and physical burden. These disorders include pain and discomfort, unusual sensations like (burning, tingling and numbness), stiffness, fatigue and muscle weakness, tension headache etc. Sometimes, it becomes so severe that people have to leave their jobs. However, we can avoid or manage the conditions by following simple guideline.

The rapid changes of office design and technology from traditional to modern corporate style makes people inactive resulting in MSDs. Prolonged and repeated bad posture in front of computers during long office hour, in meeting after meeting, surfing the Internet and using laptops are usually the reasons behind it.

Here are some tips to help you prevent office work related MSDs.

-Confirm appropriate height adjustment of chair, table and computer screen in relation to your body, support your back completely and comfortably. Shoulders and wrists should be relaxed during use of keyboard and mouse. Adjust the level of computer screen satisfying your convenience; screen should be one arm length away, allowing sufficient room to move knees and legs under the desk. You can use foot rest to provide support.

-Laptop screens and keyboards cannot be optimally adjusted and consistent use of these for intense work is not recommended.

-Take a break for 5-10 minutes for every 2 to 3 hours spent at a workstation.

-Break up keyboarding tasks by doing other tasks that involve moving around or changing body position.

-Moving the whole forearm and not just the wrist side to side ensure better blood flow to the muscles and prevents fatigue while using mouse.

-Stand when talking on the telephone; remain standing when talking to other staff.

-Telephone should be on non-dominant side and avoid prolong holding the handset between the shoulder and ear to prevent excessive muscular tension in the shoulder and neck.

-Try to avoid intercom inside of office if within easy reach.

-Try to walk and use stairs instead of lift in the office if possible.

-Come and go from office by walking if it is within 1 or half hour distance.

-Avoid eating habits in the desk.

-Practice stretching and relaxation.

Writer: Dolilur Rahman.

Water is life. As we get it easily, we take it for granted. But this is the most essential element, next to the air for our survival. We lose water every minute through sweating, breathing, urinating and with bowel movements. For our body to function properly, we must replace the water we lose by consuming beverages and foods that contain water.

For sedentary adults, drinking approximately two to two and a half liters of water a day, might be sufficient. For hardworking people, the amount of intake should be much more. Here are some notable health benefits of drinking adequate water.

* Drinking water helps us lose weight because it flushes down the by-products of fat breakdown. Drinking water reduces hunger; it is an effective appetite suppressant.

* Helps to relieve headache and back pains due to dehydration.

* Water helps to replenish skin tissues, moisturizes skin, increase skin elasticity and helps look younger.

* Our brain is mostly made up of water, thus drinking water helps us think better, be more alert and more concentrate.

* Drinking water regulates our body temperature.

* Drinking water raises our metabolism because it helps in digestion.

* Proper hydration helps keep our joints and muscles lubricated, so we will less likely get cramps and sprains.

* Drinking plenty of water helps fight against flu and other ailments like kidney stones and heart attack. Water added with lemon is used for ailments like respiratory disease, intestinal problems, rheumatic arthritis etc. One of the major benefits of drinking water can improve our immune system.

* Drinking a healthy amount of water also may reduce the risks of bladder cancer and colon cancer.

Dr Mir Atiqur Rahman

Sinusitis, an inflammation of sinus and nasal passage is increasing among the population by and by due to environmental pollution. Until recently, along with medication, various ablative surgeries were being performed to eradicate sinus pathology. But these surgeries have several complications that distort the nasal physiology and drainage of the sinuses. Functional Endoscopic Sinus Surgery (FESS) is the most advanced method in the treatment of sinusitis that overcomes the obstacles and has good patient compliance.

Sinuses are air containing cavity in the bone of face and head that lighten the skull weight, helps in resonance in sound production; also have some protective action against body defense by secretion. When these sinuses are infected due to bacteria, virus, fungus, people experience headache, lethargy, loss of interest, running nose, pain in the face beside nose, nasal obstruction, occasional bleeding from nose etc.

90 percent sinusitis is due to bacterial infections and 10 percent may be due to infections spreading from upper gum or dental origin by anaerobic organisms.

Sinusitis may be of acute or chronic. In acute sinusitis there will be severe pain, fever and other constitutional symptoms. Treatments with medicine like appropriate antibiotics, analgesic, nasal decongestant, steam inhalation usually cure it. But when sinusitis becomes chronic and medicine fails to improve the condition, surgical manipulation will be needed.

Sinus washout is the commonly practiced treatment for chronic sinusitis. In addition to this, radical and ablative surgery of the nose and paranasal sinuses are also used to treat sinus pathology. Due to wider complication of these procedures, Functional Endoscopic Sinus Surgery (FESS) has become as the most recent advancement in the management of the nose and paranasal sinus diseases.

FESS helps to maintain function or physiology of the sinuses, ciliary activity (that wipes out foreign substance from nose) and drainage of the sinuses. Thereby it helps clear the sinus infection. It is less manipulative, safe and complication is almost nil in expert hand.

Although many people, especially children do not like Karella’s taste, but it is a very nutritious vegetable. It is a good source of vitamin C, containing most of the vitamin B complex and vitamin A in the form of carotene. It is also rich in calcium, potassium, phosphorus and iron.

Usually it is often prepared as vegetables dish with potatoes and other vegetables to balance the bitterness. But its health benefits are amazing. It is popular throughout the Indian subcontinent for its medicinal value. This is a popular medicinal food for diabetes. Many people make a mixture of equal amount of amla and karella juice with the belief that it helps reducing blood glucose level. It is also helpful in liver and spleen disorders.

Karella is also known as bitter gourd in English. From Colombia to China, there are different types of Karella throughout the world. But the medicinal value and taste are not the same. So, all types of available Karella do not bear the same medicinal quality. Concerned researchers can identify the real Karella that are really good for diseases like diabetes. For example, in Panama only the leaves of the plant (when ripe) are brewed in hot water to create a tea to treat malaria and diabetes. The leaves are allowed to steep in hot water before being strained thoroughly so that only the remaining liquid is used for the tea. This has been used in various Asian traditional medicine systems for a long time. Like most bitter-tasting foods, it stimulates digestion.

Pain in the knees is particularly a serious problem faced by the older people. Sometimes it becomes so severe that it incapacitates people in bed.

Age related wear and tear of the knee — known as Osteoarthritis (OA) is mainly responsible for this. Although common, many people are not aware of the solutions that are currently available. Proper medication, physiotherapy, lifestyle modification and sometimes surgery can help stop or lessen the pain.

In Bangladesh, approximately 10 million people are suffering from Osteoarthritis. Women suffer more — 2 out of 3 women over the age of 65 have osteoarthritis. More than half of all men over the age of 65 have osteoarthritis.

With the increasing longevity of life, the problem will multiply itself within a very short time. Osteo-arthritis occurs when the knee undergoes age-related wear and tear around its joint. Almost every one is affected by it to some extent, as they grow older.

Osteoarthritis can also occur in weight bearing joints mainly hips and ankles. This form of arthritis slowly and gradually breaks down the overlying bony ends which forms the joint.

With osteoarthritis, the smooth surface of bones becomes rough and pitted. In advanced stage it may wear away completely. Without the normal gliding surface the bones, eroded bones grind against one another causing pain, swelling, restricted knee motion, crispy sound inside the joint and sometimes bowing of the knees.

In addition to age related wear and tear, athletes, labourer and highly physically active persons often stress their knee joints that lead to prolong wear and tear, which places them at increase risk of developing arthritis.

Arthritis has been linked with joint injuries and damaging events like fractures and infections that can harm the internal tissues of the joints. Individuals who experience repeated knee injuries are much more likely to develop osteo-arthritis as they get older.

Lack of exercise can weaken the thigh muscles that support the knee joints, eventually making the under-used joint stiff, painful and dysfunctional. Lastly, heavy individuals are at increased risk of developing osteoarthritis, because their knees become strained by excessive weight. Research indicates that people who are overweight as young adults are likely to develop osteoarthritis of the knees as they age.

“When and how would I understand that I have osteoarthritis?” is a common question I face in my clinical practice. People start limping and the knee may become swollen with fluid. There may be a reduction in the range of motion of the affected knee — the knee bends less than normal and may lose the ability to completely straighten out. Finally, as the condition becomes worse, the pain persists all the time and may even keep you awake at night.

Repeated knee pain is the main symptom. It tends to be worse after activity. Knee stiffness occurs after rest, the joint feels stiff and it hurts to get going after sitting for any length of time. In time, the joint gets stiffer and you are unable to fully straighten or bend the joint. Knee swelling is also common especially after excessive activity. Knee bowing is seen if osteoarthritis is severe, your joint may become deformed what we call bowlegged.

Most people suffering from osteoarthritis can be treated by non-surgical means which include pain killer, physiotherapy, life style modification and injection in to the knees. Unfortunately if the medical measures are not successful in relieving pain, surgery may be considered. Among the surgical options, arthroscopic washout of the knees is relatively new method in Bangladesh used to relieve pain for sometimes.

When medical measures and arthroscopic washout fail; knees become progressively worsened both in pain and deformity, total knee joint replacement are the better option which is now being done in state-of-the-art hospitals under skilled care of experienced Knee Consultants.

Dr M Ali

Everyday, thousands of people undergoing major surgeries need blood transfusion. Many people suffering from various conditions like haemophilia (genetic disease that impair the body’s ability to control blood clotting), dengue, severe anaemia, blood cancer, thalaessemia need blood transfusion.

On an average, 3 to 3.5 lakh bags of blood are needed in our country every year. There is always strict advice to transfuse safe blood. But from where these amount of blood will come? Blood is not produced in a factory and yet there is no alternative source for blood. The only source of blood is human body.

Usually, blood from relative is encouraged for transfusion. But if a healthy relative of the same blood group is not available, blood from any healthy voluntary donor of that group may be transfused. In our country, people usually depend on the organisations like Sandhani, Redcresent, Badhon, Quantam etc. for safe and fresh blood. We should remember that these organisations or institutions do not manufacture blood. They are only the media to collect blood from healthy voluntary donors to provide it to the needy people. The more the voluntary donor, the more these organisations will make blood available.

Here the question comes — who can donate blood? Any person within the age group of 18-60 years with a body weight as minimum 45 kg for female and 48 kg for male and having a general well-health is an eligible blood donor. Healthy means that you feel well and can perform normal activities; your blood pressure, pulse, body temperature are normal; and you are free from any blood boarn diseases such as malaria, syphilis, gonorrhoea, hepatitis B, C, AIDS, haemophilia etc.

You may have chronic conditions like diabetes or high blood pressure; but in these cases, healthy means — you are being treated and the condition is under control. Such healthy people can donate one bag (350-450 ml) blood safely every 4 months.

After donating blood, the donor should take rest for 15-20 minutes. Routine work is absolutely fine after the initial rest. Rigorous physical work should be avoided for few hours. After resting for a while a donor should be given some liquid (fluid) to drink, such as water, ORS, milk or fruit juice. The donor needs no special diet other than a routine balanced diet. The body replaces blood volume or plasma within 24 hours.

It is very unfortunate that voluntary blood donation is still not so popular in our country. This is due to the lack of proper awareness, social movement, irrational fear and superstitions about donating blood. Some organisations are working in this field but still the number of voluntary blood donor is not keeping pace with the yearly requirement of blood.

In a study conducted by Sandhani, Dhaka Medical College Unit, it was seen that 62 percent of the population were unaware of the blood-transmitted diseases, 53 percent of people did not even know what their blood group was; 66 percent admitted that their knowledge about blood donation was not sufficient.

For the lack of adequate voluntary donors, many patients are being compelled to buy blood from professional blood donors. Such donors are more likely to carry dangerous infections and their blood is more likely to be of lower standard, as they tend to donate, better to say, trade more frequently.

In Bangladesh, mostly drug addicts sell their blood to get money to buy drugs for addiction. Usually they are under-nourished, having less haemoglobin in their blood. They also suffer from various blood transmissible diseases. So, the patient who is getting that blood, though initially may be benefited, is in risk of having many diseases.

In a research conducted in our country, 22 percent of the professional donor was found having Syphilis and 29 percent having Hepatitis-B. A study conducted in BSMMU showed that 60.1 percent of the patients suffered from hepatitis, who got transmitted unscreened blood from professional donors.

Again, many patients fail to get any kind of blood, not from voluntary donors, not from professional donors even. Voluntary donors’ safe blood and professionals’ unsafe blood collectively fail to fulfill the yearly requirements of Bangladesh.

If only 1% of the population donate blood once a year (though a healthy donor can donate blood 3 times a year safely), the yearly collection stands a satisfactory number which may fulfil the requirement smoothly.

Mathematically it is an easy task but it does not happen in reality. We all need come forward to save thousands of lives dying due to the shortage of blood.

With the advent of Valentine’s Day on this Sunday, millions of people are planning to give special gifts to their beloved. People sent flowers, red hearts, anonymous cards and offer a candle-lit dinner to surprise their valentines. On this Valentine’s day, you can make an exception by giving the greatest gift — a healthy heart that lasts forever. With little changes in your lifestyle that keep your heart healthy you can offer the big gift.

Research has shown that the leading cause of heart disease is related to behavioural choices such as eating habits, exercise, tobacco use, alcohol consumption and stress.

Maintaining a healthy body weight is crucial for the prevention of coronary heart diseases. Physical exercise even walking is good for heart. Blood pressure should be checked at regular interval and focus on lowering pressure by decreasing salt and low calorie diet. Alcohol, tobacco products and secondary exposure to tobacco smoke are important driving force behind heart diseases. We should make pledge to avoid it on this very occasion.

Following a heart healthy diet rich in vegetables, fruits and whole-grains are equally important. Consume fish, especially oily fish, at least twice a week. Limit your intake of saturated fat and minimise your intake of beverages and foods with added sugars.

On this Valentine’s Day, you can make the outstanding decision to change your lifestyle to give your beloved one, a healthy heart that creates love for life time.

The recent outbreak of H1N1 influenza epidemic which is better familiar as swine flu is a respiratory disease of pigs caused by type A influenza virus that causes regular outbreaks in pigs.

The human outbreak has created panic in the people due to some fatality. People are in a fix due to some reasons which include the disease is relatively new, healthcare setup is not completely equipped with adequate resources, medical professionals are not quite skilled handling the disease and so on.

When there was first outbreak of dengue haemorrhagic in Bangladesh, people were so worried similarly. But it is no longer a disease of panic.

To deal with the H1N1 influenza, we need keeping in mind several things. The best way to keep from spreading the virus through coughing or sneezing is to limit contact with other people as much as possible. Sick people should avoid work place and children should not go to schools. Concerned authority should be reluctant in this regard.

When coughing or sneezing, mouth and nose should be covered with tissue which should be discard immediately. If tissue is not available, hands are enough which must be washed afterwards. There is serious bad habit spitting and not covering mouth or nose while coughing or sneezing. Use of civic sense and simple courtesy can contribute a great deal here.

Most of the cases are self limiting and personal hygiene is of great value.

People with H1N1 influenza are potentially contagious as long as they are symptomatic with a ceiling of up to seven days following illness onset. Kids, especially younger children, might potentially be contagious for longer periods.

There is a dilemma about using the masks. Usually three types of masks are used — facemask, surgical mask and N95 mask. The N95 mask is effective in protection of H1N1 virus whereas surgical and facemask have almost no contribution for protection. But wearing facemask or surgical mask is of no harm. At least it protects others from spreading the disease. Sometimes, experts opt for double layered mask for resource poor settings.

Since the virus easily spread in crowded places, children are recommended to abstain from their schools where large outbreak occurs. Otherwise, only sick children are recommended to stay home to avoid spreading illness. Children also should not be brought to crowded places unnecessarily like shopping complexes, cinema halls etc.

Treatment is available in Bangladesh now and soon medical professionals will be used to hand H1N1 cases. Suspected cases should stay home and take home management. In case of developing warning signs or complications, individuals should seek emergency medical care in hospitals.

Antiviral drugs (Oseltamivir), which are available in the market can be stored at home for safety purpose, but it should not be readily taken without any clinical judgement or without prescription of physician, as it may develop resistance.

Fatality occurs due to misdiagnosis of the disease and accompanying other serious/chronic medical conditions — not as the disease is virulent too much. Early intervention with medication can cure the disease as usually.

The novel H1N1 influenza A virus spreads four times faster than other viruses and creates much panic all over the world. The rising number of cases every day and increase in death rate in some countries made it a serious concern. But experts in influenza and infectious disease are still saying the exact level of danger from the virus is still far from certain.

In most cases, the disease manifestation is just regular influenza. It is something that happens every year. It is self limiting and most people recover soon without any medication. H1N1 is a major concern for people with chronic diseases like diabetes, cancer and also for children and extreme aged.

The scientists who study outbreaks say that A(H1N1) is not the deadliest strain out there. The case-fatality (the percentage of people who got the disease and did not survive) is still very low. While case fatality for severe acute respiratory syndrome (SARS) reached more than 15 percent, bird flu reached higher to 60 percent, but it is only about 1 percent worldwide with a maximum fatality in Mexico is about 10 percent.

Moreover, we have drugs (Oseltamivir and Zanamivir) in our hand now to fight in the initial phase that we did not have in the previous large flu outbreaks.

Although there are positive reasons not to panic, we should be concern deeply with the risk and potential danger of H1N1 that may occur in near future. If we track back to Spanish influenza, we see that it began as a mild strain, and then turned horrifically virulent, killing 20 million to 100 million people in 1918-19.

The risk could be reduced or eliminated by exercising personal control like hygiene practice. It is worth remembering that worry itself is a risk, a stress that can undermine health and happiness. We need not to be panicked but always have to take these things seriously.

Swine flu, also called hog flu/pig flu is the scary names now a days. The recent outbreaks of swine flu or swine influenza A (H1N1) virus has created much panic in Bangladesh. It is heartrending but we have to be alert to contain the spread of the virus.

Simple influenza-like illness (fever, cough, sore throat) has been reported in many cases, mild respiratory illness (nasal congestion, rhinorrhea, shortness of breath) without fever and occasional severe disease also has been reported. Other symptoms reported with swine influenza A virus infection include vomiting, diarrhoea, myalgia (muscle ache), headache, chills, fatigue and shortness of breath. Conjunctivitis is rare, but has been reported. Severe disease (pneumonia, respiratory failure) and fatal outcomes have been reported with swine influenza A virus infection.

The potential for exacerbation of underlying chronic medical conditions or invasive bacterial infection with swine flu virus should be considered. To confirm a positive case, a simple throat or nasal swab is examined in laboratory. Follow the dos and don’ts to reduce the risk of catching or spreading.

* Stay home and limit contact with others as much as possible
* Cover your cough/ sneeze
* Rest and eat nutritious food and take plenty of liquids
* Get plenty of sleep and rest
* Seek medical advice if you have the symptoms
* It is better to cover mouth and nose. When coughing and sneezing, using a tissue and do not forget to throw the tissue away quickly and carefull

* Wash your hands regularly with soap and water
* Hands/Fingers are very important — even some people prefer to use gloves and stop doing hand shakes
* Clean hard surfaces (like door handles and remote controls) frequently with a normal cleaning product

Don’t forget to use tissue paper when sneezing and coughing and wash your hands regularly. Do not forget to carry tissue paper; catching the germs in a tissue paper could help limit the spread of the virus.

If you do have swine flu, you should contact a qualified doctor who is aware of its management rather than visiting a practitioner and ignorant about this disease. Recently several medical college hospitals in Bangladesh has opened special ward to treat swine flu cases.

Swine flu can be treated by the drugs — Oseltamivir and Zanamivir, according to WHO guideline. In some cases, antiviral medicine may cause side effects like nausea, vomiting, diarrhoea, stomach ache, headache. Even if you do feel these symptoms it is important that those prescribed antiviral medicine complete the course, even if symptoms of swine flu clear and you start to feel better quickly.