The Effect of Head Loading on Cervical Spine in Manual Laborers

Methods@#The study comprised 62 subjects. Of this number, 32 subjects (group A) were unskilled laborers from the construction industry; the other 30 subjects (group B) were in the control group and had never previously carried heavy weights on their heads. Cervical spine radiographs were taken for all the 62 subjects. Subjects in group A were asked to carry a load (approximately 35 kg) on their heads and walk for about 65 m, with their cervical spine radiographs taken afterward. @*Results@#The mean ages of patients in groups A and B were 27.17 and 25.75 years, respectively. The mean cervical lordosis observed in group A (18.96°) was dramatically less compared with group B (25.40°), showing a further decrease in head loading (3.35°). Five subjects had a reversal of lordosis (−5.61°). A statistically significant reduction in disc height and listhesis was observed when the load was carried on the head with a further decrease after walking with the load. Accelerated degenerative changes, particularly affecting the upper cervical spine, were observed in head loaders. @*Conclusions@#Carrying a load on the head leads to accelerated degenerative changes, which involve the upper cervical spine more than the lower cervical spine and predisposes it to injury at a lower threshold. Thus, alternative methods of carrying loads should be proposed.

Age - Does it really count? A study of the Perioperative Morbidity and Long-Term Outcome in Patients Above 70 Years of Age Undergoing Spine surgery for Lumbar Degenerative Disorders / Idade - Deve ser levada em conta? Estudo da morbidade perioperatória e a evolução no longo prazo dos pacientes acima de 70 anos submetidos à cirurgia da coluna vertebral, devido a doenças degenerativas lombares

Abstract Objective To assess the long-term outcome and perioperative morbidity in spine surgeries for lumbar degenerative disorders and, thereby, to evaluate the safety of surgery in the aging population. Methods Retrospective study of patients aged > 70 years, operated for degenerative lumbar disorders between 2011 and 2015. We evaluated patient demographic, clinical and surgical data; comorbidities, perioperative complications, pre & postoperative pain scores and Oswestry disability index (ODI) scores, patient satisfaction and overall mortality. Results A total of 103 patients (Males: Females55:48) with mean age 74.6 years (70-85yrs) were studied. 60 patients (58.2%) had decompression alone, while 43 (41.8%) had decompression & fusion. Mean hospital stay was 5.7days. Mean follow-up was 47.6months (24-73mnths). Patients reported significant improvement in backpain (Numerical pain score 7.7 vs 1.6; p < 0.001), leg pain (Numerical pain score 7.4 vs 1.7; p < 0.001), disability (ODI 82.3 vs 19.1; p < 0.001) and walking distance (p < 0.001). 76% patients were satisfied with the results at the time of final follow-up. 26 patients (25.24%) had perioperative complications which were all minor, without mortality. Most common intraoperative & postoperative complications were dural tear (6.79%) & urinary tract infection (6.79%) respectively. Conclusions With meticulous perioperative care lumbar spine surgery is safe and effective in elderly population. Patients had longer mean hospital stay in view of the gradual and comprehensive rehabilitation program. Presence of comorbidities or minor perioperative complications did not increase the overall morbidity or affect the clinical outcomes of surgery in our study.

Resumo Objetivos Avaliar o resultado no longo prazo e a morbidade perioperatória em cirurgias da coluna vertebral, devido a doenças lombares degenerativas e, assim, avaliar a segurança da cirurgia na população idosa. Métodos Estudo retrospectivo de pacientes com idade superior a 70 anos, submetidos à cirurgia em virtude de distúrbios lombares degenerativos, entre 2011 e 2015. Foram avaliados os dados demográficos, clínicos e cirúrgicos dos pacientes; comorbidades; complicações perioperatórias; escores de dor no pré e no pós-operatório; índice de incapacidade de Oswestry (ODI, na sigla em inglês); satisfação do paciente e a mortalidade geral. Resultados Foram estudados 103 pacientes (homens:mulheres, 55:48) com idade média de 74,6 anos (70 a 85 anos). 60 pacientes (58,2%) apresentaram somente descompressão, enquanto 43 (41,8%) apresentaram descompressão e fusão. O tempo médio de internação foi de 5,7 dias. O tempo médio de acompanhamento foi de 47,6 meses (24-73 meses). Os pacientes relataram melhora significativa da dor nas costas (pontuação numérica da dor 7,7 versus 1,6; p < 0,001), dor nas pernas (pontuação numérica da dor 7,4 versus 1,7; p < 0,001), incapacidade (ODI 82,3 versus 19,1; p < 0,001) e distância percorrida a pé (p < 0,001). Um total de 76% dos pacientes estavam satisfeitos com os resultados no momento do acompanhamento final. 26 pacientes (25,24%) apresentaram complicações perioperatórias, todas sem relevância e sem mortalidade. As complicações intra e pós-operatórias mais comuns foram ruptura dural (6,79%) e infecção do trato urinário (6,79%), respectivamente. Conclusões Com meticulosos cuidados perioperatórios, a cirurgia da coluna lombar é segura e eficaz na população idosa. Os pacientes tiveram um maior tempo médio de internação hospitalar, em virtude do programa de reabilitação gradual e abrangente. A presença de comorbidades ou complicações perioperatórias sem relevância, não aumentou a morbidade geral, nem afetou os resultados clínicos da cirurgia em nosso estudo.

Evaluation of Autologous Platelet Rich Plasma Injection in the Treatment of Rotator Cuff Tendinopathy

Background: Rotator cuff tendinopathy (RCT) is a significantsource of disability and loss of work. As commonly usedsubacromial corticosteroid injection for treatment of chronicrotator cuff tendinopathy has adverse effects especially inelderly people, new treatment options such as Platelet-RichPlasma (PRP) can be considered for managing of thispathology. The aim of the present study was conducted toevaluate the effectiveness of autologous platelet rich plasmainjection in the treatment of rotator cuff tendinopathy.Materials and Methods: The present study was conductedamong adults of age 30-70 years over the period of 1 year fromFeb 2018 to Jan 2019. The primary outcome measure for allparticipants was a score on a 0–10 visual analog scale (VAS)assessing current resting pain at baseline and at 8, 12, and 52weeks. Demographics and information about duration of RCTpain and prior therapies for RCT were collected. Eachparticipant underwent a single injection of PRP. In-personassessment occurred at 2, 8, and 12 weeks and by phone at52 weeks. Statistical analysis was done using SPSS 21software. P values less than .05 were considered statisticallysignificant for main and interaction effects.Results: In the present study total sample size was 46 inwhich 32 were males and 14 were females. VAS score wasevaluated for the treatment of Rotator cuff Tendinopathy atbaseline, 8 week, 12 week, 52 weeks after the injection ofautologous platelet rich plasma. The result shows that VASscore was less after 8 weeks and after 12 weeks and 52 weeksit was almost same.Conclusion: Our study concluded that pain was less in thepatients of Rotator cuff Tendinopathy after the injection ofautologous platelet rich plasma.

Knowledge of anganwadi workers about integrated child development services: a study in Sitamarhi district of Bihar, India

Background: The anganwadi worker (AWW) is the backbone of integrated child development services (ICDS) for delivering the services of the program. Being a key functionary, her level of knowledge regarding various components of ICDS is linked to the ultimate outcome of the ICDS program. Thus, this study was aimed to assess the level of knowledge among AWW regarding services of ICDS.Methods: This was a cross sectional study in which level of knowledge regarding ICDS among anganwadi worker was assessed using structured questionnaire. The primary outcome of the study is the knowledge of AWW about ICDS component services. Descriptive statistics was presented as frequency and percentage for categorical variable. The knowledge of AWW was assessed by knowledge score made under all the themes of the questionnaire and was presented as mean and median score. Analysis was done in STATA version 14.2.Results: Nearly 55% of the respondents were not aware about ICDS services. Whereas majority had knowledge on growth monitoring and immunization respectively, above the median score, only 39% of AWW had knowledge on nutritional supplementation above median score. The variables such as education level and training of AWW showed significant association with the knowledge of ICDS components.Conclusions: There is need for improving knowledge and awareness about various ICDS components and the training quality provided to AWWs.

A Study of the Awareness of Oral Cancer and its Associated Risk Factors Amongst O.P.D. Attendees at a Teaching Hospital of Bhubaneswar, India

Background: Oral cavity cancer is amongst the most prevalent cancers in India and incidence rates are higher in men than women. In India use of the smokeless tobacco product called gutkha /paan, is extremely popular especially in Northern part of India. Age-adjusted rates of oral cancer in India are high, which is, 20 per 100,000 population and accounts for over 30% of all cancers in the country (2) along with oral cancer there is high risk of sub-mucosal fibrosis causing sever morbidity and lifetime disability. Delayed presentation of oral cancer is mainly due to lack of awareness of the public about oral cancer and its associated risk factors. Methods: A cross section study was carried out in OPD of Medical Teaching Hospital and patients were accessed for their socio-demographic profile, awareness and knowledge about early signs of cancer. Results: Out of 450 participants 68% were male and rest females. Level of awareness about early signs of oral cancer was poor i.e. 35% whereas 49% of the studied population had one or more behavioral risk factor associated with oral cancer. Only 18% of participants who regularly take professional help for oral health. Conclusions: The awareness level is not satisfactory and presence of behavioral risk factor for oral cancer is significant among studied population. There is a need of IEC among the general population about pre-cancerous/cancerous lesions and association of smoked/smokeless tobacco or alcohol with oral cancer.

Practice of Pesticides Use Among The Farmers of Kangrali Village In Belgaum - A Cross-sectional Study.

Pesticides are widely used throughout the world, especially in agriculture for crop protection. Agriculture work is one of the most prevalent types of employment in the world. The objective of study is to assess socio-economic demographic characteristics influencing Knowledge Attitude and Practice of farmers regarding the pesticides use.A cross-sectional study was conducted among the farmers of kangralli village in Belgaum district. 100 farmers were enrolled in the study. Out of 100 farmers, who participated in the study, 81% were male farmers and 19% were female farmers. Majority 82% of farmers were literate and 85% of farmers were using pesticides for their crops cultivation. Knowledge regarding the personal protective equipment was known to 100% used mask, 16.3%used apron, 14% used gloves, 8.1% used goggles and only 3.5% used special boots during spraying pesticides in field. Knowledge of farmers on personal hygiene and sanitation was known to 100% who washed their hands where only 67.44% took bath after spraying pesticides. Majority of the farmers neither smoked nor drank or ate anything during spray of pesticides.The present study showed that majority of the farmers had knowledge regarding pesticides use, storage and disposal and precautions to be taken during spraying pesticide but some of them who were illiterate they were lacking the knowledge regarding the use of pesticides and precautions to be taken during spray of pesticides and due to this various health hazards can happen to farmers health which may be chronic or acute health hazard. Keywords: Pesticides, human health, environment, KAP, personal protective equipment.

Aberrant myeloid antigen co-expression is correlated with high percentages of CD34-positive cells among blasts of acute lymphoblastic leukemia patients: an Indian tertiary care center perspective

BACKGROUND: Aberrant myeloid antigen (MA) co-expression and high expression of CD34 antigen on the blasts of acute lymphoblastic leukemia (ALL) patients are independently reported to have a role in pathogenesis and prognosis. This study was conducted to determine whether these two parameters are related. METHODS: A total of 204 cases of ALL were included in an analysis of blast immunophenotypic data. CD34 expression was categorized as low when less than 50% of blasts were CD34-positive (CD34low) and as high when 50% or more were CD34-positive (CD34high). RESULTS: Of 204 cases of ALL, 163 and 41 were of B-cell origin (B-ALL) and T-cell origin (T-ALL), respectively. Of all cases, 132 (64.7%) showed co-expression of MA and among these, 101 (76.51%) were CD34high, while the remaining 31 (23.48%) were CD34low. Of 72 cases without MA co-expression, 25 (34.72%) were CD34high and 47 (67.25%) were CD34low. Furthermore, of 163 cases of B-ALL, 111 showed co-expression of MA and 84 of these were CD34high. Of 52 cases of B-ALL without MA expression, 22 were CD34high. Among 41 cases of T-ALL, 21 co-expressed MA, 17 of which were CD34high. Moreover, all 20 cases of T-ALL without co-expression of MA were CD34low. These differences were statistically significant. CONCLUSION: We observed a strong correlation between aberrant MA expression and CD34high expression on the blasts of ALL. We hypothesize that these different patient subsets may represent unique prognostic characteristics.