randomized control trial evaluating the prevalence of obstetrical anal sphincter injuries in primigravida in routine versus selective mediolateral episiotomy

To evaluate the prevalence of obstetrical anal sphincter injuries [OASIS], which include third and fourth degree perineal tears in primigravida in routine versus selective mediolateral episiotomy. Secondly, to determine the rate of episiotomy in local settings. This randomized control trial was carried out in the labor ward of a tertiary hospital of the Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia between May and October 2009. The trial included 171 primigravida beyond 38 weeks gestation who achieved vaginal delivery, and randomly assigned to selective and routine episiotomy groups. The type of perineal injuries following childbirth among 171 women were evaluated. The overall episiotomy rate from both groups was 76.6%. The prevalence of third degree perineal tears was 3.7% in the routine compared with selective mediolateral episiotomy at 1.1%. There was no occurrence of fourth degree tears in both groups. However, selective mediolateral episiotomy was associated with an increased risk of periurethral and labial injury compared with the routine group [4.5% versus 0%]. Routine mediolateral episiotomy in primigravida is associated with a higher prevalence of obstetrical anal sphincter injuries. As anal sphincter injuries are known to have morbidities, selective mediolateral episiotomy in primigravida is therefore recommended in the implementation of new delivery practice, and in an attempt to reduce our high episiotomy rate

Work-related injuries among physiotherapists in public hospitals: a Southeast Asian picture

OBJECTIVES: A cross-sectional study was conducted to measure the prevalence of work-related injuries among physiotherapists in Malaysia and to explore the influence of factors such as gender, body mass index, years of work experience and clinical placement areas on the occurrence of work-related musculoskeletal disorders. METHODS: Self-administered questionnaires adapted from the Nordic Musculoskeletal Questionnaire were sent to 105 physiotherapists at three main public hospitals in Kuala Lumpur, Malaysia. The questionnaire had 12 items that covered demographic information, areas of musculoskeletal problems and physiotherapy techniques that could contribute to work-related musculoskeletal disorders. The data obtained were analyzed using the Statistical Package for Social Science version 14 software. RESULTS: The overall prevalence of work-related injuries during the past 12 months was 71.6 percent. Female therapists reported a significantly higher prevalence of work-related musculoskeletal disorders than the male therapists (73.0 percent, p,0.001). Significant differences were observed between the proportion of therapists who had work-related musculoskeletal disorders and those who did not for the group with a body mass index (BMI) .25 (x ² = 9.0, p = 0.003) and the group with a BMI of 18-25 (x ² = 7.8, p = 0.006). Manual therapy (58.6 percent) and lifting/transfer tasks (41.3 percent) were the two physiotherapy techniques that most often contributed to work-related musculoskeletal disorders. CONCLUSION: Work-related injuries are significantly higher among the physiotherapists in Malaysia compared with many other countries. Female therapists reported a higher incidence of work-related musculoskeletal disorders in this study, and work-related musculoskeletal disorders were more common among therapists working in the pediatric specialty. This study contributes to the understanding of work-related disorders among physiotherapists from a southeast Asian perspective where the profession is in its development stage.

Schoolbag Weight, its Content, and Incidence of Back Pain in Different Medium Primary Schools in Kuala Lumpur

Introduction: Schoolbag weight across different types of school and schoolbag content has not been studied in Malaysia.This cross sectional survey determines the weight of schoolbags, its content and occurence of back pain among primary school children in different medium primary school in Kuala Lumpur.Methods: Students' body weight, and schoolbags weight were measured using a calibrated scale. Schoolbag content was examined, and weighed according to necessary learning materials or unnecessary materials. Back pain in the past one week was assessed using a self-administered questionnaire, adapted from previous studies. Results: A total of 358 students (167 male, 191 female) were enrolled, of which 119 were from National School (NS), 122 from Chinese Medium School (CMS) and 117from Tamil Medium School (TMS). The mean schoolbag weight was 4.55 ± 1.62kg for NS, 8.53 ± 1.94kg for CMS and 6.06 ± 2.09kg for TMS, which was 11.7%, 22.0% and 16.6% of body weight, respectively. The mean weight of unnecessary schoolbag content was 0.64(0.91)kg for NS, 2.18 (1.49) kg for CMS and 1.96(1.56) for TMS students. Back pain was detected in 87.0% NS students, 68.0% CMS students and 66.7% TMS students. Significant asociation was found between occurence of back pain and types of school (X²=16.64,p=0.00). Conclusions: Students from all the three mediums primary school, in particular Chinese medium school carry school bag heavier than that generally recommended, with unnecessary materials weigh up to 2kg. The occurence of back pain is high and this is associated with the types of school.

Prevalence and distribution of soil-transmitted helminthiases among Orang Asli children living in peripheral Selangor, Malaysia.

Soil-transmitted helminthiases are a public health problem in rural communities. A cross-sectional study of the prevalence and distribution of Ascaris lumbricoides, Trichuris trichiura and hookworm was conducted in 281 Orang Asli children (aborigines) aged between 2 and 15 years, from 8 Orang Asli villages in Selangor, Malaysia. All the children were infected with soil-transmitted helminthes, with 26.3% of the children infected either with A. lumbricoides, T. trichiura or hookworm and 72.6% having mixed infection. The overall prevalences of A. lumbricoides, T. trichiura and hookworm were 61.9, 98.2 and 37.0%, respectively. Approximately 19.0, 26.0 and 3.0% of the children had severe infection of ascariasis, trichuriasis and hookworm infection, respectively. The prevalences and mean egg per gram (epg) counts for A. lumbricoides and T. trichiura were not significantly dependent on age, therefore age-dependent convexity was not seen in this study. However, the results of this study reveal an age-dependent prevalence and mean epg count in children with hookworm infection. We conclude that ascariasis, trichuriasis and hookworm infection are still prevalent and therefore a public health concern in Orang Asli communities. Severe ascariasis and trichuriasis may lead to other health and medical problems.