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Md Shahadat Hossain,1,&ast; Sapia Akter,1,&ast; Mustafa Amimul Ehsan Siddique,2 Md Kaoser Bin Siddique,3 G M Reza,1 Foisal Mohammad Mosiul Alom,4 Mohammad Ali,5 Md. Obayadur Rahman Noman,6 M Mazibar Rahman,2 Md. Shofiqul Islam,6 K M Amran Hossain7,&ast; 1Bangladesh Institute of Manual Therapy & Research, Dhaka, Bangladesh; 2Department of Statistics, Jahangirnagar University, Dhaka, Bangladesh; 3Department of Research, Planning & Development, Grand Health Sector, TMSS, Bogura, Bangladesh; 4Department of Physiotherapy, National Institute of Traumatology & Orthopaedic Rehabilitation (NITOR), Dhaka, Bangladesh; 5Department of Physiotherapy and Rehabilitation, Uttara Adhunik Medical College and Hospital, Dhaka, Bangladesh; 6Department of Physiotherapy, Bangladesh Health Professions Institute (BHPI), Dhaka, Bangladesh; 7Department of Physiotherapy & Rehabilitation, Jashore University of Science & Technology (JUST), Jashore, Bangladesh&ast;These authors contributed equally to this workCorrespondence: K M Amran Hossain, Department of Physiotherapy & Rehabilitation, Jashore University of Science & Technology (JUST), Jashore, 7408, Bangladesh, Tel +8801735661492, Email kma.hossain@just.edu.bdBackground: The study aimed to determine the outcome of Multidisciplinary physiotherapist-led conservative treatment of lumbar disc herniation at an in-patient set-up of a specialized spine center in Dhaka, Bangladesh.Methods: This was a retrospective cross-sectional study of 228 cases completing treatment and follow-up sessions. The outcome was evaluated as pain at rest and five different functional positions, neurological recovery, and Magnetic resonance imaging (MRI) changes during discharge and follow-up.Results: 80.3% had a complete recovery with a typical motor and sensory status, no limitations in straight leg raise (SLR), no cauda equina symptom (CES), and no or < 3 pain during more than 30 minutes of daily living activities. Statistically significant changes were noted at all outcome measures at the follow-up (day 90), compared to baseline (day 1) P< 0.01. In the posthoc tests, pain, SLR, and CES had the most significant improvement at discharge (day 12) compared to the baseline (P < 0.01) and at follow-up compared to discharge (P < 0.01). No major adverse events noted.Conclusion: Physiotherapist-led in-patient treatment results in significant resting and functional pain outcomes in 12 days. Also, the improvements in neurological recovery and normalizing disc position are statistically significant in 90 days.Keywords: lumbar disc herniation, multidisciplinary, conservative treatment, physiotherapy

The influence of CD4(+) T cell nadirs on human immunodeficiency virus (HIV)-specific immune responses in subjects with apparently normal CD4(+) T cell counts is not known. We evaluated the frequency of HIV-1-specific immune responses in a cohort of patients with complete viral suppression (HIV-1 RNA load, <50 copies/mL) who were receiving highly active antiretroviral therapy and had a wide range of CD4(+) T cell nadirs. We found positive associations between CD4(+) T cell nadirs and the magnitude of HIV-specific CD8(+) T cell responses (P=.02) and of T cell helper responses (P=.04). These data show the CD4(+) T cell nadir to be an independent predictor of HIV-specific CD4(+) and CD8(+) T cell responses in HIV-1-infected subjects with optimal suppression of viremia. Copyright © 2006 Infectious Diseases Society of America [ABSTRACT FROM AUTHOR]