Background: Ankylosing spondylitis (AS) is a common inflammatory rheumatic disease that affects the axial skeleton, causing inflammatory back pain and can lead to structural and functional impairments. On average, ankylosing spondylitis (AS) incidence rates range from 0.2% to 1% of the adult population. McKenzie exercise seems to be beneficial for those affected by AS, in particular when it is planned according to the needs of the individual aiming to maintain or improve the level of physical fitness. The prevalence of AS is generally believed to be between 0.1% and 1.4% globally. Aim of the study: The aim of this study was to evaluate the functional outcome of McKenzie exercise in patients with ankylosing spondylitis. Methods: This was a comparative experimental study which was conducted in the Department of Physical Medicine and Rehabilitation, BSMMU, Dhaka, Bangladesh from October 2019 September 2020. The study was approved by Institutional Review Board (IRB) of BSMMU on. A total of 112 patients with ankylosing spondylitis were selected who were divided into two groups. 56 patients were allotted in group A (NSAID group) and another 56 patients were allotted in group B (NSAID with McKenzie exercise). Collected data were processed, analyzed and disseminated by using MS Excel and SPSS version 23.0 program as per necessity. Results: The mean VAS score at baseline was 34.44 ±2.78 in group A and 34.03±2.23 in group B, at 4 weeks 28.89±3.67 in group A and 21.23 ±3.57 in group B, at 8 weeks 30.59 ±3.69 in group A and 16.95±3.62 in group B and at 12 weeks 28.08±3.34 in group A and 15.04 ±3.77 in group B. The mean BASFI at baseline was 3.19±0.15 in group A and 3.51±0.18 in group B, at 4 weeks 2.99±0.15 in group A and 2.15±0.05 in group B, at 8 weeks 1.99±0.09 in group A and 1.26±0.22 in group B and at 12 weeks 2.01±0.09 in group A and 1.25±0.2 in group B. The mean BASDAI at baseline was 5.01±0.39 in group A and 4.95±0.4 in group B, at 4 weeks 3.99±0.07 in group A and 3.43±0.09 in group B, at 8 weeks 3.97±0.09 in group A and 3.02±0.07 in group B and at 12 weeks 3.49±0.06 in group A and 1.98±0.09 in group B. The differences of VAS score, BASFI and BASDAI at 4, 8 and 12 weeks were statistically significant (p<0.05) between two groups. Conclusion: Ankylosing spondylitis (AS) causes pain and stiffness to affected joints and the spine and if the disease progresses, it can cause fusion of the joints, which can limit a person’s mobility and flexibility. In analyzing the outcomes of McKenzie exercise in patients with ankylosing spondylitis the differences of VAS score, BASFI and BASDAI at 4, 8 and 12 weeks were found as statistically significant (p<0.05) between NSAID group and NSAID with McKenzie exercise patient groups.

Patients can undergo lower extremity surgery by using the lumbar plexus block (LPB) technique. However, compared with central block, LPB problems were complex. For lower limb procedures, psoas compartment block is a suitable regional anaesthesia approach in place of central neuraxial blockade. As a peripheral nerve block, it is considered less dangerous than a central neuraxial block. However, it might result in some severe issues. Here, we describe a rare side effect of total spinal anaesthesia following psoas compartment block guided by a peripheral nerve stimulator.

This study assessed the knowledge level of breast cancer among secondary school female teachers in Rivers State. The study was guided by three objectives with equivalent research questions. Descriptive survey design was adopted, with a population comprising of seven thousand, nine hundred and thirty nine secondary school female teachers in Rivers State. A sample size of 720 respondents was selected from ten LGAs in the two areas (upland and riverine area) of Rivers State through a multistage sampling procedure. The instrument for data collection was a validated self- structured questionnaire titled Knowledge Level of Breast Cancer Questionnaire (KLBCQ) with reliability coefficients of 0.82. Data collected were analyzed using percentages, and chi-square. The result of the study indicated that; Secondary school female teachers in Rivers State have average knowledge level (60.6%) of breast cancer. 47.9% have poor knowledge of breast cancer risk factor, 65.7%, have average knowledge of breast cancer signs and symptoms and 74.4% have good knowledge of breast cancer preventive measures. It was concluded that secondary school female teachers in Rivers State have average knowledge level of breast cancer. It was recommended among others that Nollywood actors in collaboration with script writers and producers should constantly write and act dramas on breast cancer, in order to increase awareness and knowledge of breast cancer among the general population.

Aim: Hypoglycemia is a major barrier to achieving proper glycemic control in type 2 diabetes mellitus patients. This study aims to document the incidence of hypoglycemia in type 2 diabetes mellitus patients and assess its association with potential risk factors. Methods: This is a cross-sectional study conducted in the Medicine outpatient department of a tertiary care hospital in Gujarat, India. A total of 174 patients with confirmed type 2 diabetes mellitus were interviewed using a pretested semi-structured questionnaire- Stanford Hypoglycemia Questionnaire. Patients with hormone-secreting disorders or pregnant women were excluded. Another questionnaire recorded various potential risk factors. Statistical test for proportions was used to assess the association between incidence of hypoglycemia and the risk factors. Results: Majority (92.5%) had a positive history of hypoglycemic events. A significant association was established between frequency of hypoglycemia, and duration of disease, BMI, sedentary lifestyle and insulin usage. Regularity of food intake, drug compliance and alcohol consumption were not significant factors. Conclusion: Increased incidence of hypoglycemia was significantly associated with pharmacological and non-pharmacological factors including insulin therapy, sedentary lifestyle, obesity, and chronicity of the disease. This knowledge shall help medical practitioners to strategize individualized care and maintain glycemic control in diabetic patients.