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.

Sufferers of chronic pain are often bombarded with well meaning friends and relatives offering tons of advice and tips about chronic pain. A great many of these are not true; in fact, you can call them myths. If you suffer from chronic pain, you should deal with the reality and know the actual cause and treatments that are involved, rather than listen to myths.

1. Myth: Your Pain Is Imagined

Pain is a reality. Even if your medical practitioner is not able to accurately diagnose the cause of your pain, your pain is not a product of your imagination. It is as real as you are.

2. Myth: When In Pain, Don’t Exercise

Nothing could be further from the truth. Unless you’ve been ordered by your doctor not to exercise at the risk of muscle injury, please get up and exercise. Lack of exercise will only further compound your condition.

3. Myth: Painkillers Should Be Avoided At All Costs

Your doctor will prescribe only the required strength of painkillers for your condition, with warnings of side effects. Use your judgment when it comes to taking strong painkillers, but know that not all of them are bad.

4. Myth: Back Pain Is Only Because Of A Slipped Disc

Slipped or herniated disks are responsible for only 1 to 3 percent of low back pain occurrences. Other causes for back pain include muscular injury, spinal injuries such as lumbar fracture and so on.

5. Myth: Taking Short Acting Pain Killers Instead Of Long Acting Ones Is Less Harmful

Chronic pain cannot be managed with a short acting pain killer here and there, just because you want to avoid drugs. Your doctor will perhaps give you long acting pain killers for the chronic pain along with short acting pain killers for the breakthrough pain.

6. Myth: It’s Necessary To Do An MRI To Diagnose Back Pain

MRIs are excellent when it comes to locating the exact source of pain. However, your physician is likely to try some basic diagnosis and treatments before recommending an MRI. You’ll need an MRI if you are to undergo a lumbar puncture, or surgery of the neck and back.

7. Myth: Surgery Is Unavoidable If There’s Back Pain

Back pain could be from myriad reasons, ranging from a slipped disk at the worst to strained muscles. Surgery is not the one-size-fits-all solution that people think it is. Surgery is unavoidable in certain cases such as a herniated disc, but your doctor will inform you either way.

8. Myth: Only Medicine Can Control Pain

As has been proved many times over in recent times, alternate and natural pain relieving techniques are extremely effective, such as yoga, meditation, visualization, acupuncture, tai chi, therapeutic massage and so on.

9. Myth: Back Pain Is Genetic

Pain is not genetic. Pain is as individual as your body is. If your mother suffered debilitating back pain in her life, it does not mean that you will, too. If indeed, your mother did suffer the same way, it’s no more than just a coincidence.

10. Myth: Your Body’s Weight Has No Impact On Back Pain

If underweight, your back is not supported by sufficient musculature and you will suffer pain. If overweight, then the extra weight will compress your spine and squeeze your discs.

11. Myth: Pain Will Be An Unavoidable Constant In Your Life

The truth is, if you’ve got reason to suffer chronic pain such as a cancer or debilitating muscular diseases, you won’t ever be 100% pain free. However, that does not mean that the pain is unavoidable; try natural pain relieving techniques.

12. Myth: Continuous Rest Will Heal Your Pain

Resting continuously will only weaken your muscles and when this happens, your fitness level goes down along with your pain tolerance. Even if you are in great pain, move around now and then, do some stretches and walk if you can.

13. Myth: Your Body Is Hurting And Therefore It Is In Danger

Sometimes, pain indicates ongoing harm, but not always. Sometimes nervous system overreacts, or the body’s natural defense mechanisms haven’t kicked in on time. Fear only increases the perception of pain.

14. Myth: There’s Got To Be A Magic Method To Relive Pain

When it comes to chronic pain, multiple diagnoses are possible. Your pain could be because of mechanical, neurological or chemical reasons. There is no one magic method; you’ll have to try and integrate several therapies to combat the pain.

15. Myth: Only Weak People Complain About Pain

It’s the centuries old belief that being stoic is the only way to deal with pain. In truth, being stoic and ignoring your pain will only make it worse. Consult a doctor and try to find a solution and don’t care about people who judge you weak; they don’t know better.

Alex works for Self hypnosis website where you can instantly download hypnosis Cds for pain management, stress and anxiety.

Acne occurs in the form of pimples that sometime brings along black and whiteheads on the face, neck, shoulders, and chest or even at the back of the body too. It is considered the most severe skin disease that last for a long period and strikes almost every teen or adult. They tend to get severe and can lead to permanent scarring of the face if precautionary measures are not taken.

Even though with the latest scientific technology, it is hard to find a single cure of acne that could prevent it from happening or could treat it quickly, without leaving any scar behind. On the contrary, one can see that acne treatments use age old herbal products to cure acne outbursts. We recommend that instead of using harsh over the counter chemical products, you practice basic home remedies that are not only cheap, but also very effective with no side effects at all.

The foremost thing to follow up as a regular routine is to exercise and make the habit of having water at least 8 – 10 glasses a day. You may not believe it but exercise and a good healthy diet is the first critical step to healing acne.  Certain people believe that apricot juice can help to defect acne to the great extent.  Honey is the natural substance that extremely harmful for bacteria in the shape of acne or pimples.  Raw papaya juice is quite soothing for the red pimples. The most widely known method is applying toothpaste to fight against the bacteria on skin. Rubbing with vinegar and salt then after sometime, wash with lukewarm water. It is advisable to use only medicated soap only. Lack of sleep also causes the acne to occur. By applying turmeric powder for some time and remove it after 30 minutes.  The most effecting way for getting rid of acne is by using home remedies for a consistent time period rather than just for a day or two.

About Author:

Alice has been an expert in skin health. Her work has been published on various websites and magazines and provides insightful advice for natural acne treatment and acne remedies skin regimes.

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

Health is not just absence of disease but it is a state of wellness in which a person enjoys physical, mental, social and spiritual health. Health is connected to the total well being of an individual. Apart form environmental and social factors, there are subtle factors that affect the health of a person. A clean and pure mind is a prerequisite for healthy life. A pure mind enables the use of time, energy and resources in the best way. Stress or negative thinking has been identified as a leading cause of quite a number of major illnesses.

Holistic health encompasses total health of a human being in all four aspects of life — physical health, mental health, social health and spiritual health. Meditation promotes health in all these areas of life. Meditation regulates the physical responses of the body by eliminating stress and stimulating healthy hormones. It creates self-control thus enabling a person to remain free from negative influences and give the best in every role and situation. It empowers a person to deal with challenges in equanimity and positivity. Meditation alters the physiological and psychological response of the body remarkably. Reduction in heart and respiratory rate, and a drop in blood pressure suggest reduction in the level of sympathetic activity. Meditation aids the secretion of ‘healthy’ hormones such as endorphins and encephalon’s, which help, in detaching oneself from various kinds of pains. Meditation helps sustain deep relaxation even during active states of mind. Brain wave recordings of Rajyogis have shown alpha and theta waves even while they performed various mental and intellectual tasks.

The benefits of meditation go beyond relaxation response. A number of studies have critically investigated meditation for effective treatment of hypertension, diabetes, headache, anxiety, depression and heart disease. Meditation reduces the requirement of medication for pain and sleep etc. It is reported to be effective in de-addiction from drugs; alcohol, tobacco and can increase decision-making skills, overcome irrational fears, phobias and expand spiritual life.

One of the most subtle but critical factors that affect health is quality of our actions. The law of action is infallible — you reap what you sow. If we use our body to perform good and right actions then we will enjoy good health. Body is the temple in which the divine self resides. If we treat our body well then it will perform well. The seed of good actions is pure feelings and thoughts; hence, we have to make a conscious choice to nurture only pure thoughts. Everything that we suffer through our body is a debt of bad action that the soul is paying off. To enjoy good health we have to accumulate a stock of good karma by sharing the qualities of peace, love and joy in every thought, word and action.

World Kidney day was observed on 11 March in more than 100 countries of the world. The slogan of World Kidney Day this year was “Protect your kidneys, control Diabetes”. World Kidney Days aims to raise awareness about the heavy burden of chronic kidney disease (CKD) on human lives.

The mission of World Kidney Day is to raise awareness of the importance of our kidneys to overall health and to reduce the frequency and impact of kidney diseases and its associated health problems worldwide. The objectives of the World Kidney Day 2010 were the followings:

* Raise awareness about our “amazing kidneys”

* Highlight that diabetes and high blood pressure are key risk factors for chronic kidney disease (CKD)

* Encourage systematic screening of all patients with diabetes and hypertension for CKD

* Encourage preventive behaviours

* Educate medical professionals about their key role in detecting and reducing the risk of CKD, particularly in high risk population

* Stress the important role of local and national health authorities in controlling CKD epidemics. Health authorities worldwide will have to deal with high and escalating costs if no action is taken to treat the growing number of people with CKD. On World Kidney Day all governments are encouraged to take action and invest in further kidney screening

* If detected early, CKD can be treated by reducing other complications and dramatically reduced the growing burden of deaths and cardiovascular disease worldwide

Kidney diseases are silent killers which largely affect the quality of life. There are, however, several easy ways to reduce the risk of developing this kidney disease.

Seven golden rules:
i) Keep fit and active
ii) Keep regular control of your blood sugar level
iii) Monitor your blood pressure
iv) Eat healthy and keep your weight in check
v) Do not smoke
vi) Do not take over the counter pills on regular basis
vii) Check your kidney function if you have one or more of the high risk factors

Diagnosis of CKD with Diabetes:
People with diabetes should be screened regularly for kidney diseases. The two key markers of kidney diseases are eGFR and urine albumin. Kidney diseases are present when eGFR is less than 60 ml/min.

The Americal Diabetic Association (ADA) and National Institute of Health (NIH) recommend that eGFR can be calculated from serum creatinine at least once a year in all people with diabetes.

Urine albumin is measured by comparing amount of albumin to the amount of creatinine in a single urine sample. When the kidneys are healthy, the urine will contain large amount of creatinine but almost no albumin. Even small increase in ratio of albumin to creatinine is a sign of kidney diseases. Kidney diseases is present when urine contain more than 30 mg of albumin per gram of creatinine, with or without decrease eGFR. The ADA and NIH recommend annual assessment of urine albumin excretion to assess kidney damage in all people with type 2 diabetes and people who have type 1 diabetes for 5 years or more.

Good care makes a differencePeople with diabetes should:
* Measure their HbA1C level at least twice a year which should be kept less than 7%

* Regular insulin injection, intake of other medicines, meal planning, physical activity and blood sugar monitoring

* Blood pressure should be checked several times a year which should be kept <130/80 mmHg

* Regular intake ACEI or ARB medicine for controlling high blood pressure

* To measure effective eGFR yearly

* To estimate urine albumin atleast once a year to check kidney damage

* To take reduce amount of protein in the died at to seek health from the dietitian regarding meal planning

In conclusion early detection and treatment of kidney diseases are the best way to prevent CKD in order to reduced substantial burden of health budget.

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.