Rehabilitation of COVID 19 Patients, Bangladesh Perspective

The global outbreak of COVID 19 has created an unprecedented challenge to the society. America, Europe and India were catastrophic sufferers from this virus next to China. They had highest number of daily morbidity and mortality in the global context. Bangladesh is facing terrible experiences of dealing with this pandemic and making a tremendous turmoil in health and economic sector. Our healthcare system is overburdened with critically ill patients. Disability arising out of neurological, pulmonary, neuromuscular, and cognitive complications, need to be addressed by rehabilitation professionals. Many patients presenting with COVID-19 will have no specific airway clearance needs.There have been no reports of COVID-19 positive patients having high secretion loads that would require intensive chest physiotherapy or postural drainage. In Bangladesh in ICU settings physiatrist or physiotherapists are not directly involve in respiratory care management. In mild to moderate cases advice about a post-acute care breathing exercises, other musculoskeletal exercises, bed positioning and pressure sore care are helpful. In Bangladesh medical care facilities are not adequate in corona care hospitals especially in peripheral medical college or hospital. Many patients are dying of shortage in oxygen supplies and lack of availability of ICU. Post discharged plans of comprehensive rehabilitation are grossly neglected in discharged certificate. Our national guidelines on corona management do not have any instructions on rehabilitation management at any point. The objectives of this fast review article on corona pandemic are to highlight the global scenario and our limitations in the rehabilitation management of COVID 19 patients particularly post discharged patients and patients with long COVID complications. J Bangladesh Coll Phys Surg 2022; 40: 52-56

Asbestos rehabilitation project as a model of landscape sustainability

Greece was one of the biggest producers of asbestos in the world as well as a consumer. It took advantage of the asbestos rich Zidani mine, in the region of Western Macedonia in Greece. However, due to serious health problems caused by inhaling asbestos, it was banned in 1979 and the mine closed in March 2000. Rehabilitation management of the abandoned asbestos mining area, the depositions in the open - pit mining area and the tailings remnants was necessary in order to avoid health and environmental problems in the wider area The detailed soil protection and rehabilitation project of the degraded mining area was implemented taking all necessary and appropriate safety and health measures according to the requirements of the relevant E.U and National legislation, so that accidents would be prevented. Results show that the rehabilitation, soil protection and enhancement of the area help the ecosystems to be sustainable, ecologically and socially acceptable

Rehabilitation Management of Post Palatoplasty in Adolescent: Case Report

The objective of this study is to report comprehensive physical medicine and rehabilitation management of post-palatoplasty in an adolescent patient. The cleft palate repair is usually done in the first year of life in order to gain optimal speech function. To achieve normal communication development, normal hearing, normal oral and pharyngeal structures, adequate stimulation, and reinforcement from the environment for communication efforts are needed. Patient was assessed comprehensively using The International Classification of Functioning, Disability and Health (ICF) and by perceptual assessment for speech. The results showed that after one month intervention, the perceptions of hypernasality in plosive /b/ and affricates /c/ were found reduced significantly. There was improvement in articulation after one month of intervention.

EFFECTS OF FRAGILITY FRACTURE INTEGRATED REHABILITATION MANAGEMENT HIP FRACTURE IN PAKISTANI OLDER ADULTS

Objective: to evaluate the effectiveness of fragility Fracture Integrated Rehabilitation Management (FIRM) on older adults of Pakistan after hip fracture surgery. Methodology: A one-group pretest–posttest designwas conducted at the National Institute of Rehabilitation Medicine (NIRM), Islamabad from March 2020 to May 2021.. A n=11 participants with age above 55 years, both male and female, with confirming diagnosed cases of hip fracture were included. Every participats receveied 10 sesssions of Fragility Fracture integrated Rehabilitation Management (FIRM) program in two weeks. Data was collected at baseline at 2nd day and after 10th session on 15th day, through the KOVAL scale to assess the walking ability, the Functional Ambulatory Category (FAC) to assess the level of independence, the modified Barthel index (MBI) for activities of daily living (ADLs), and quality of life (QoL) was assessed by EQ-5D. Data were analyzed by using SPSS Version 21. Result: the mean age 76.45±9.32, of which n=6 (54.6%) were males and n=5(45.4%) were females. after 10th sessions the QoL on EQ-5D, ambulation on FAC and KOVAL scale and the ADL on MBI were significantly improved (p<0.05) with large effect size, except for the anxiety domain of EQ5D and subdomains of MBI; Personal hygiene, feeding, Bowel control, bladder control, Wheelchair, and Chair & bed transfer showed no significant change (p>0.05). Conclusion: FIRM care is found to be effective in improving the walking ability, functional status, ADLs and quality of life in geraiatric population following a hip fracture surgery

Video Counselling in Rehabilitation Management

Background Telemedicine can provide great benefits for patients, their physicians and other professionals in the health care system. We have asked ourselves whether a similar service could make a sensible contribution to the rehabilitation management of Germanyʼs statutory accident insurance? Patients/Materials and Methods In the present study, consultations of insured persons with their physicians and rehabilitation managers were transmitted via video conference. Patient satisfaction was determined by survey and potential benefits were analysed. Results The participants of the study were generally very satisfied with the telecounselling. In particular, 96% of their questions to the rehabilitation manager could be cleared up during the sessions. However, roughly a third of those surveyed prefer personal contact with the rehabilitation manager. Conclusion Telecounselling is well received by the insured in the rehabilitation management of occupational insurance associations and offers a useful alternative when, due to lack of resources – such as lack of time or great distance – the rehabilitation plan cannot be prepared locally together with the insured patient. Under the special circumstances of the coronavirus pandemic, it can also contribute to protecting the health of all involved.

Urinary Titin N-Fragment as a Biomarker of Muscle Atrophy, Intensive Care Unit-Acquired Weakness, and Possible Application for Post-Intensive Care Syndrome

Titin is a giant protein that functions as a molecular spring in sarcomeres. Titin interconnects the contraction of actin-containing thin filaments and myosin-containing thick filaments. Titin breaks down to form urinary titin N-fragments, which are measurable in urine. Urinary titin N-fragment was originally reported to be a useful biomarker in the diagnosis of muscle dystrophy. Recently, the urinary titin N-fragment has been increasingly gaining attention as a novel biomarker of muscle atrophy and intensive care unit-acquired weakness in critically ill patients, in whom titin loss is a possible pathophysiology. Furthermore, several studies have reported that the urinary titin N-fragment also reflected muscle atrophy and weakness in patients with chronic illnesses. It may be used to predict the risk of post-intensive care syndrome or to monitor patients’ condition after hospital discharge for better nutritional and rehabilitation management. We provide several tips on the use of this promising biomarker in post-intensive care syndrome.