BACKGROUND: Interventional pain management (IPM) is a branch of medical science that deals with management of painful medical conditions using specially equipped X-ray machines and anatomical landmarks. Interventional physiatry is a branch of physical medicine and rehabilitation that treats painful conditions through intervention in peripheral joints, the spine, and soft tissues. METHODS: A cross-sectional study was conducted using three years of hospital records (2006 to 2008) from the Physical Medicine and Rehabilitation Department at Chittagong Medical College Hospital in Bangladesh, with a view toward highlighting current interventional pain practice in a tertiary medical college hospital. RESULTS: The maximum amount of intervention was done in degenerative peripheral joint disorders (600, 46.0%), followed by inflammatory joint diseases (300, 23.0%), soft tissue rheumatism (300, 23.0%), and radicular or referred lower back conditions (100, 8.0%). Of the peripheral joints, the knee was the most common site of intervention. Motor stimulation-guided intralesional injection of methylprednisolone into the piriformis muscle was given in 10 cases of piriformis syndrome refractory to both oral medications and therapeutic exercises. Soft tissue rheumatism of unknown etiology was most common in the form of adhesive capsulitis (90, 64.3%), and is discussed separately. Epidural steroid injection was practiced for various causes of lumbar radiculopathy, with the exception of infective discitis. CONCLUSIONS: All procedures were performed using anatomical landmarks, as there were no facilities for the C-arm/diagnostic ultrasound required for accurate and safe intervention. A dedicated IPM setup should be a requirement in all PMR departments, to provide better pain management and to reduce the burden on other specialties.
Bangladesh ; Bursitis ; Cross-Sectional Studies ; Exercise ; Hospital Records ; Injections, Intralesional ; Joint Diseases ; Joints ; Knee ; Methylprednisolone ; Muscles ; Pain Management ; Physical and Rehabilitation Medicine ; Piriformis Muscle Syndrome ; Radiculopathy ; Rheumatic Diseases ; Spine

OBJECTIVE: We investigated the effects of antipsychotics on immune-challenged peripheral blood mononuclear cell (PBMC) cultures. METHODS: Blood samples were collected from twelve patients with first-episode schizophrenia. The PBMCs were separated and cultures were prepared and stimulated with lipopolysaccharide (LPS) or polyinosinic:polycytidylic acid (poly[I:C]), and then separately treated with a typical antipsychotic (haloperidol) or atypical antipsychotic (clozapine, quetiapine, or risperidone). Pro-inflammatory (interferon gamma [IFN-gamma]) and anti-inflammatory (interleukin [IL]-4 and IL-10) cytokine levels were measured in the LPS- or poly(I:C)-stimulated PBMC cultures treated with antipsychotics. RESULTS: Haloperidol and quetiapine significantly increased the IL-4 levels (p<0.05) in LPS-stimulated PBMC cultures, while clozapine and quetiapine significantly enhanced the IL-4 levels (p<0.05) in poly(I:C)-stimulated PBMC cultures. Only treatment with haloperidol resulted in a significant increase in IL-10 production (p<0.05) in LPS-stimulated PBMC cultures, whereas clozapine, quetiapine, and risperidone treatment significantly increased IL-10 production (p<0.05) in poly(I:C)-stimulated PBMC cultures. All of the antipsychotics reduced the IFN-gamma level significantly (p<0.05) in LPS- and poly(I:C)-stimulated PBMC cultures. CONCLUSION: Antipsychotic treatment altered immune function by raising the levels of anti-inflammatory cytokines (IL-4 and IL-10) and suppressing the levels of pro-inflammatory cytokines (IFN-gamma).
Antipsychotic Agents* ; Cell Culture Techniques* ; Clozapine ; Cytokines ; Haloperidol ; Humans ; Interleukin-10 ; Interleukin-4 ; Lipopolysaccharides ; Risperidone ; Schizophrenia* ; Quetiapine Fumarate

Objective: To evaluate the toxic effect of hydrose used in the molasses preparation in Bangladesh. Methods: Molasses were collected from open markets in different parts of Bangladesh. The presence of hydrose in selected molasses was detected using commercial kit. To evaluate the toxic effect of hydrose, Swiss albino male mice were divided into four groups. Group I was used as control, while Groups II, III and IV received hydrose mixing food (5, 10 and 25 g/ kg food), respectively, and these supplementations were continued to the end of the study (16 weeks). Blood was collected from thoracic arteries of the mice under ether anesthesia and then organs were taken. To determine the effect of hydrose on host, blood indices related to liver, heart and kidney dysfunctions were measured. Result: Creatinine and urea levels were significantly (P < 0.05) increased in a dose dependent manner in hydrose treated mice, whereas calcium level was significantly decreased in hydrose exposed mice compared to control mice. Histological study of kidney showed the glomeruler inflammation, increased diameter of renal glomeruli and enlargement of proximal tubular lumen of kidneys of mice exposed to hydrose compared to that of control animals. Conclusion: The results of this study indicated that use of hydrose in molasses and other food preparations in Bangladesh may cause kidney impairment.