Cost-benefit analysis of ergonomic program for management of low back problems among office workers

Low back problems are emerging as important work-related health disorders especially among computer office workers with substantial cost. The most prominent feature, of these conditions, is low back pain [LBP].The present study was designed to investigate low back problems among office workers in relation to ergonomic factors at work and to analyze cost-benefit of a suggested ergonomic program for management of this problem. A cross-sectional study was conducted in the office work department in a petroleum company in the Western desert. The study included 120 office workers. All participants were subjected to a predesigned questionnaire emphasizing occupational history, clinical examination, anthropometric measurements, and ergonomic checklist for subjective assessment. The LBP was defined whether non-specific, radiating, persistent specific, or chronic. A parallel objective assessment of the computer desk workstations [n = 62], which were shared by workers, was carried out by experienced ergonomists with the same previous checklist. Medical records were reviewed for assessment of the cost of low back problems in the years [2007-2009]. The cost of a suggested ergonomic program was calculated for 3 years according to the market price in order to calculate cost-benefit ratio of such a program in prevention of LBP. Results showed that 61% of the examined workers gave history of LBP within the previous 3 years and clinical signs were detected in 32% of the workers. There were no significant differences between subjective and objective assessments of the different items scores of the ergonomic checklist. The lowest mean scores were reported for the chair and the work habits and training; both were negatively correlated with LBP intensity and duration. The suggested ergonomic program entails correction of the defective items to meet the standard ergonomic healthy criteria, provision of 6 periodic ergonomic training programs and enforcement of healthy work and life style habits. The final cost-benefit ratio of the ergonomic program for management of LBP among office workers of the present study was 1: 3.67 which is considered cost beneficial. Properly designed ergonomic programs are cost beneficial in management of LBP among office workers

Cardiovascular risk profile as related to type of work in Siwa

A cross-sectional study was carried out to study the conventional cardiovascular risk profile with special emphasis on hypertension and the relation to physical activity type of work, in Siwa community, as an example of underserved locations. A community based study targeting adult population of Siwa [25 years old and above] was conducted by members of the health convoy prepared by HIPH to Siwa Oasis. A cluster sampling technique was adopted randomly covering all districts of Siwa. The study included 202 respondents. The participants were interviewed using a predesigned questionnaire including personal and long term enquiry of medical data, and dietary habits. Using standard methods, blood pressure was measured and blood samples were taken to test for the levels of cholesterol and thyroid stimulating hormone [TSH]. Results showed that 48% of the studied population were hypertensives and 64% had less active work. Multiple regression models, with systolic blood pressure [SBP] and diastolic blood pressure [DBP] as quantitative dependent variables, showed that the physical type of work was a significant independent factor in both models [p=0.003]. Significant higher percents of smokers, overweight and obese, hyper-cholesterolemics, and hypothyroid cases were reported among less active work, in comparison to active work [p= 0.006, 0.0001, 0.002, and 0.004, respectively]. In conclusion, cardiovascular risk factors are emerging at high rates in this community. Type of work physical activity seems to be an important risk factor that should be considered in preventive programs

Cytogenetic abnormalities and herdetiry thrombophilias among the abortees: study of 1000 couples

Recurrent miscarriage affects only 1% of all couples. It is one of the most frustrating experiences for both patients and clinicians. The present study aimed at studying: the role of cytogenetic abnormalities and hereditary thrombophilias in repeated pregnancy losses [RPL], and the associated risk factors. Kuwait Medical Genetics Centre A cross section study for cytogenetic abnormalities followed by a nested case control was conducted for 1000 couples referred because of RPL. A control group was selected at random from female patients attending the outpatient clinics for a reason other than abortion for comparison with those who were proved to have chromosomal abnormalities. Asubgroup of 100 female partners, who had no cytogenetic abnormalities, were further tested for the presence of factor V Leiden [FVL; Arg506Gln] and prothrombin [FII] gene mutations [G20210A]. the prevalence of chromosomal abnormalities was 4.4%; most of them were structural aberrations [79.5%] represented mainly by inversion and translocation. Carriers of FVL mutation [G1691A] among the patient's group was significantly higher than that of the control group [10% vs. 2% respectively].One patient was heterozygous for FII G20210A mutations. This was nearly the same like that found in controls. The percentage of consanguineous marriages among patient group was less than that among the control group. Chromosome study for couple who have had RPL must be carried out. For complete and proper workup we have to investigate the presence of FVL, and FII G20210A mutations among patients with normal karyotype

Statistical analysis of referrals by general practitioner at health insurance organization clinics in Alexandria

Referral of patients generates significant economic costs for both physician fees and diagnostic tests. Variation in referral rates between general practices and between individual GPs has long been the focus of attention for policy makers. The present study aimed to analyze the referrals by General Practitioners [GP] at Health Insurance Organization [HIO] clinics in Alexandria. The study was conducted at 18 Health Insurance Organization [HIO] comprehensive clinics in Alexandria, distributed in the 6 districts of Alexandria HIO. Retrospective analysis of records and cross sectional interview to 180 GPs were carried out. Male GPs comprised 82.2% of the sample. On the average, GPs received 6.6 +/- 4.5 patients per working hour. Over the year 2002, 8.4% of consultations were referred to specialists, 5.4% referred to laboratory and only 0.09% were referred to hospital. The highest percent of referrals from GP to specialist were directed to internal medicine followed by orthopedics, general surgery, E.N.T, dermatology, neuropsychiatry, chest then urology clinics. Referral rate from GPs to specialists was found to have a 6.6-fold variation among clinics, and a 54.8-fold variation among individual GPs. Moreover, there was no homogeneity in variations in referral rates of clinics within 3 of the 6 districts. Using multiple regression analysis, the only significant factor was the indirect relation with workload. Comparison of referral rates of GPs with the limits set by HIO [8-17%] revealed that, 48.9% of GPs were within limits, 37.2% were lower and 13.9% were higher than limits. GPs who had diploma or master were average referrers in 51.5%, low referrers in 30.3% and high referrers in 18.2%, compared to 45.6%, 50.6% and only 3.8%, respectively for those with bachelor degree; the difference was statistically significant

Statistical process control for referrals by general practitioner at health insurance organization clinics in Alexandria

Quality control is the application of statistical techniques to a process in an effort to identify and minimize both random and non-random sources of variation. The present study aimed at the application of Statistical Process Control [SPC] to analyze the referrals by General Practitioners [GP] at Health Insurance Organization [HIO] clinics in Alexandria. Retrospective analysis of records and cross sectional interview to 180 GPs were done. Using the control charts [p chart], the present study confirmed the presence of substantial variation in referral rates from GPs to specialists; more than 60% of variation was of the special cause, which revealed that the process of referral in Alexandria [HIO] was completely out of statistical control. Control charts for referrals by GPs classified by different GP characteristics or organizational factors revealed much variation, which suggested that the variation was at the level of individual GPs. Furthermore, the p chart for each GP separately; which yielded a fewer number of points out of control [outliers], with an average of 4 points. For 26 GPs, there was no points out of control, those GPs were slightly older than those having points out of control. Otherwise, there was no significant difference between them. The revised p chart for those 26 GPs together yielded a centerline of 9.7%, upper control limit of 12.0% and lower control limit of 7.4%. Those limits were in good agreement with the limits specified by HIO; they can be suggested to be the new specification limits after some training programs