A risk prediction model of the incidence of occupational low back pain among mining workers.

Background: Low Back Pain (LBP) is the most frequently reported musculoskeletal disorder in workers. This study was aimed to develop risk prediction model of low back pain that can be used to prevent the recurring low back pain attack. Methods: The study was case-control design based on the industrial community by using ergonomical approach. Total samples were 91 workers for cases and 91 workers for controls. Workers suffering for low back pain in the last 6 months served as cases, and those from the same age group and receiving the same amount of exposure without any symptoms of low back pain served as controls. Risk factors include socio-demographic factors, socio-ocupational factors, physical working environmental factors, non-physical environmental factors, and biomechanics factors. Receiver Operating Characreistics (ROC) was used to describe relationship between true positive value (in vertical axis) and false positive value (in horizontal axis) in order to discover a risk predictive value of LBP. Results: The determinant risk factors for low back pain (LBP) were bending work postures, waist rotation movement, manual lifting, unnatural work postures, those who had worked for more than 18 years, and irregular sport activities. By using ROC with 91.20% senstivity and 87.90% spesifi city, the calculated prediction value was 0.35. This is the cut-off point to discriminate workers with and without LBP. The risk predictors value of work-induced LBP calculated by linear equation of logistic regression varied between 0-11.25. Conclusion: The prediction model of work-induced LBP can be used for early detection of LBP to reduce the risk and prevent the recurrence of LBP.

Stroke Unit : Does it make a difference ? Assessment of the early effectiveness of a Stroke Unit in improving functional state in Dr Cipto Mangunkusumo Hospital.

Stroke unit has been believed as the best institutional care for stroke patients. Recent researches in 1990s indicated that stroke units can produce increasing survival rate and improving the functional state of the patients which can reduce the need for institutional care after stroke. In Indonesia, stroke unit is still new. Because stroke unit has educational role beside its clinical importance, the research about stroke unit especially in its value in managing stroke patients in Indonesia is needed. This study was evaluated the effectiveness of stroke unit care in managing stroke patients especially in improving the functional state of the patients in compared with conventional care of stroke corner in general neurology ward. This study indicated that both stroke unit (SU) and stroke corner in general neurology ward (SC) shows reduction in NIHSS score. In Stoke Unit, the reduction of NIHSS was 17.35 to 5.31 while in Neurology ward from 13.83 to 8.87.Using independent t-test, the reduction of NIHSS in stroke unit is more significance compared with stroke corner in general neurology ward (p=0,000).

Pattern of hospitalized-stroke patients in ASEAN countries an ASNA stroke epidemiological study.

To better understanding the demographic characteristics, admission time, clinical pattern, risk factors, stroke type, length of stay, and discharge outcome of hospitalized acute stroke patients in ASEAN member countries, ASEAN Neurological Association (ASNA) formed a Standing Commiltee for Stroke in 1996 and this is the first ASNA Stroke Epidemiological Study using the same stroke protocol. This prospective hospital based study was conducted in seven ASEAN countries (Brunei, Indonesia, Malaysia, Philippines, Singapore, Thailand, and Vietnam) by participating neurologists from October 1996 to March 1997. Of the 3723 consecutive hospitalized stroke patients (2030 males and 1660 females) from 44 participating hospitals in this study ie Brunei (n=53), Indonesia (n=2065), Malaysia (n=300),Philippines (n=545),Singapore (n=232), Thailand (n=244) and Vietnam (n=284), the mean age was 59.0 ± 13,8 years 16% of patients were younger than 45 years and 37% of patients were older than 65 years. There were no significant differences in age at onset among stroke subjects except in Vietnam (younger) and Singapore (older). The sex distribution showed a slight higher prevalence of women in Singapore and in the age group > 64 years. The mean adrnission time was 41.5 ± 87.0 hours, 19% of patients were admitted within 3 hours, 29% within 6 hours and 66% more than 6 hours (delayed admission) especially in Malaysia and Singapore (80% and 77% respectively). Motor disability was the most prevalent clinical feature in all countries and carotid bruit was the rarest (1%). Hypertension was the most common risk factor (68%) in all countries, followed by TIA (35%), smoking, diabetes mellitus, ischnemic heart disease and hypercholesterolemia. CT scan was performed on 76% of subjects. The diagnostic classification was non lacunar anterior circulation (32%), lacunar infarction (14%), hemorrhagic stroke (26%), SAH (4%). Mean length of stay was 11.4 ± 11.8 days. Most of the patients discharged from the hospital were alive improved (57%) and mean death rate was 22%, highest in Thailand (45%) and lowest in Brunei (8%). This hospital based stroke data showed the recent characteristics of stroke pattern in seven ASEAN member countries and it will be very important data for health policy maker in these countries and for further cooperative researches in the future.