Non-chemical Risk Assessment for Lifting and Low Back Pain Based on Bayesian Threshold Models

BACKGROUND: Self-reported low back pain (LBP) has been evaluated in relation to material handling lifting tasks, but little research has focused on relating quantifiable stressors to LBP at the individual level. The National Institute for Occupational Safety and Health (NIOSH) Composite Lifting Index (CLI) has been used to quantify stressors for lifting tasks. A chemical exposure can be readily used as an exposure metric or stressor for chemical risk assessment (RA). Defining and quantifying lifting nonchemical stressors and related adverse responses is more difficult. Stressor–response models appropriate for CLI and LBP associations do not easily fit in common chemical RA modeling techniques (e.g., Benchmark Dose methods), so different approaches were tried. METHODS: This work used prospective data from 138 manufacturing workers to consider the linkage of the occupational stressor of material lifting to LBP. The final model used a Bayesian random threshold approach to estimate the probability of an increase in LBP as a threshold step function. RESULTS: Using maximal and mean CLI values, a significant increase in the probability of LBP for values above 1.5 was found. CONCLUSION: A risk of LBP associated with CLI values > 1.5 existed in this worker population. The relevance for other populations requires further study.

Immunomodulatory activity of methanolic leaf extract of moringa oleifera in animals.

Aim: The aim of the present study was to investigate the immunomodulatory action of methanolic extract of Moringa oleifera (MEMO) in an experimental model of immunity. The cellular immunity was evaluated using neutrophil adhesion test, cyclophosphamide induced neutropenia and carbon clearance assay, whereas, humoral immunity was tested by mice lethality test, serum immunoglobulin estimation and indirect haemagglutination assay in animals. Administration of MEMO (250 and 750 mg/kg, po) and Ocimum sanctum (100 mg/kg, po) significantly increased the levels of serum immunoglobulins and also prevented the mortality induced by bovine Pasteurella multocida in mice. They also increased significantly the circulating antibody titre in indirect haemagglunation test. Moreover, MEMO produced significant increase in adhesion of neutrophils, attenuation of cyclophosphamideinduced neutropenia and an increase in phagocytic index in carbon clearance assay. From the above results, it can be concluded that MEMO stimulate both cellular and humoral immune response. However, low dose of MEMO was found to be more effective than the high dose.

Ion pairs in non-redundant protein structures.

Ion pairs contribute to several functions including the activity of catalytic triads, fusion of viral membranes, stability in thermophilic proteins and solvent-protein interactions. Furthermore, they have the ability to affect the stability of protein structures and are also a part of the forces that act to hold monomers together. This paper deals with the possible ion pair combinations and networks in 25% and 90% non-redundant protein chains. Different types of ion pairs present in various secondary structural elements are analysed. The ion pairs existing between different subunits of multisubunit protein structures are also computed and the results of various analyses are presented in detail. The protein structures used in the analysis are solved using X-ray crystallography, whose resolution is better than or equal to 1.5 A and R-factor better than or equal to 20%. This study can, therefore, be useful for analyses of many protein functions. It also provides insights into the better understanding of the architecture of protein structure.

Evaluation of three topical anaesthetic agents against pain: a clinical study.

AIM: To compare pain responses of children during local anaesthetic infiltration at bilateral buccal sites prepared with topical application of EMLA 5% cream, benzocaine 18% gel or lignocaine 5% ointment and also to find out the rapidity of onset of action of these agents. METHODS: 60 healthy children aged 6 to 12 years old, received bilateral buccal infiltration following application of topical anaesthetic agents applied in a double blind design. Pain responses were compared based on subject self report using visual analogue scale (VAS) and operator assessment using Sound -Eye -Motor (SEM) scale. RESULTS: Benzocaine gel had the rapidest onset of action. EMLA 5% cream proved to be superior in pain reduction compared to benzocaine and lignocaine. Taste acceptance was better with benzocaine gel. Further studies are required for EMLA cream with an improved formulation more suitable for mucosal application before its routine use in dentistry.

Chair side simple caries activity test: Ora test.

Oratest, a caries activity test was performed on 48 school going children of Mangalore city to estimate efficacy of the test. High statistical significance was found when the means of control and test group were compared [gamma = 0.913]. The Oratest is found to be a simple chair side, less time consuming and inexpensive caries activity test.

Dental caries prevalence among preschool children of Hubli: Dharwad city.

The prevalence of dental caries and treatment needs in the age group of 3-5 years was estimated among 1500 children of Hubli-Dharwad city. The attitude of mothers towards their children's oral health and its relation with caries prevalence was noted among 200 subjects. The prevalence of dental caries was 54.1%. The attitude of mothers towards children's oral health made a statistical difference in the mean dmft levels.

Estimation of salivary bacteria capable of inhibiting and stimulating Streptococcus mutans and its correlation to dental caries and untreated carious teeth.

Bacteriocins are bacteriocidal proteinaceous molecules produced by the Gram-positive bacteria not active against the produced strain. Many investigations have revealed that certain bacteria using antibacterial or the inhibitory substance inhibit some other bacteria. A study was conducted in a group of 60 children to ascertain whether any correlation exists between the proportion of salivary bacteria inhibiting and stimulating Streptococcus mutans and the oral health indices (DMFT, deft and Community Periodontal Index of Treatment Needs). A definite inverse correlation was observed between the percentage of salivary inhibiting S. mutans and untreated carious teeth (UCT).

Prevalence of dental caries among 5-13-year-old children of Mangalore city.

A study of prevalence of dental caries was undertaken in 5-13-year-old children from Mangalore city. A total of 524 children were examined. The sample consisted of 193, 160, and 171 children in the 5-7, 8-10 and 11-13 years of age group, respectively. Dental caries was examined visually and observations were recorded. Silness and L phie plaque index, L phie and Silness gingival index were used to record the periodontal status. The prevalence of dental caries was highest in 5-7-year-age group compared to 8-10 years and 11-13 years age groups. The increasing prevalence of dental caries needs dental health programmes, which target the specific segments of the population.

Idiopathic gingival fibromatosis - a case report.

A case of 4 a year old girl with the complaint of delayed eruption of teeth is presented. She had moderate to severe, diffuse gingival enlargement in the maxilla and mandible. No deciduous teeth had erupted even at the age of five years except for incisal edges of upper, and lower anterior teeth. The diagnosis was made based on clinical examination and after ruling out drug and family history. Surgical removal of the hyperplastic tissue was done under general anesthesia.

Late postpartum eclampsia without prodroma.

Late postpartum eclampsia is an increasingly recognized entity. We describe a patient who developed postpartum eclampsia on the 6th day of delivery without any preceding pre-eclampsia. A high index of suspicion and close follow-up will help in the early detection of this condition. Awareness of this condition will also save the patient from unnecessary investigations. This may be all the more relevant in developing countries where eclampsia contributes to one-third of maternal mortality and the resources for patient investigation and management are limited.

Supplemental premolars in a 13 year old child--a case report.

A case of 13 old year is presented with supernumerary maxillary premolars one on either side. Radiograph revealed presence of five more supernumerary teeth unerupted in both maxilla and mandible. The implications of early diagnosis and management to prevent further complications are discussed.

A comparative evaluation of sealing ability of rootcanal sealers.

The importance of apical seal has always been stressed in endodontic therapy. Root canal sealers have been used along with gutta percha to enhance the seal. The apical sealing ability of AH26/silverfree, a modified version of AH26, a resin based sealer was compared with tubliseal, a zincoxide eugenol based sealer using methylene blue dye penetration method. AH26/silverfree showed superior sealing ability.

A comparative evaluation of four adhesive tooth coloured restorative materials. An invitro study.

Four adhesive tooth colored restorative materials, Fuji II, Fuji II LC, Dyract and TPH composite resin were evaluated for the amount of microleakage in enamel and cementum. The TPH composite resin showed maximum microleakage, significantly higher than Fuji II, which showed least microleakage. All the four materials showed more micro leakage in cementum when compared to enamel.

A comparative evaluation of sealing ability of restorative materials used for coronal sealing after root canal therapy.

In the past few years the importance of coronal seal following root canal therapy has been emphasised. Adhesive restorative materials have been used, considering their good bond strength and their sealing ability. In this study, the sealing ability of resin modified glass ionomer has been compared with composite resin used with fifth generation bonding agent (in vitro), using methylene blue dye penetration method. Resin modified glass ionomer showed greater leakage than composite resin, although it was not statistically significant. Further studies are needed to asses the sealing efficacy in clinical situations.

Cephalometric norms for Bunt and Brahmin children of Dakshina Kannada based on McNamara's analysis.

Computerised cephalometrics, the key technique in measuring skeletal and dental relationship was used in order to establish norms for Bunt and Brahmin children of Dakshina Kannada using McNamara's analysis. A new landmark App-Bpp distance was also evaluated and taken as a norm for both Bunt and Brahmin children.

Nasal carriage of methicillin resistant Staphylococcus aureus in a cardiovascular tertiary care centre and its detection by Lipovitellin Salt Mannitol Agar.

Ecological niches of Staphylococcus aureus are the anterior nares. Carriage of Staphylococcus aureus in the nose appears to play a key role in the epidemiology and pathogenesis of infection. Numerous studier have shown that elimination of nasal carriage using Mupirocin also eliminated hand carriage and the spread of infections in hospitals. Lipovitellin-Salt-Mannitol Agar was used for screening, isolation and presumptive identification of Staphylococcus aureus from nasal carriers. From November; 97 to August'98, 724 nasal swabs were cultured and 18.23% of health care workers were found to be nasal carriers of Staphylococcus aureus. Of these 12.15% were carriers of MRSA. The carrier rate was highest in December' 97 (32.07%). All MRSA carriers were treated with local application of Mupirocin for three days. A study of the antibiogram of the clinical isolates during the corresponding period showed 100% susceptibility of MRSA to Vancomycin. Susceptibility of MRSA to Clindamycin, Netilmycin, Rifampicin & Ofloxacin was 86.6%, 69.5%, 66% & 64.7% respectively.

A case of stapler pin in the root canal--extending beyond the apex.

There have been several reports describing the placement, by patients, of foreign objects into exposed pulp chambers and canals. In the present case, a 13-year-old patient reported with complaints of pain and a history of inserting a foreign object into the root canal of the left central incisor. On examination the foreign body was found to be a stapler pin which was projecting 5 millimeters from the apical foramen. Foreign bodies discovered from the root canal have varied from radiolucent objects like wooden tooth picks or tooth brush bristles to radioopaque materials like paper pins, needles, pencil leads etc. In the present case, despite our best efforts, the patient did not agree to undergo any treatment except for the extraction of the left central incisor.

Cryopreservation of cardiac homografts.

A homograft valve bank for cryopreservation of cardiac homografts was established at the Institute of Cardiovascular Diseases in July 1995. From July 1995 to February 1999, 169 donor hearts were processed. All except four hearts were procured post mortem. Aortic valves (149) and pulmonary valves (139) were the common homografts dissected out for use. The valves were immersed in a cocktail of five broad spectrum antibiotics and antifungals for an average of 48 to 72 hours before cryopreservation. Fifty-three (35.57%) aortic and 42 (30.21%) pulmonary valves had to be discarded for various reasons like fungal contamination, failure to sterilise, HBsAg positivity etc.; 153 homografts have been released for use so far. Analysing the usual methods of procurement, sterilisation protocol, culture and cryopreservation used for cardiac homografts at this centre, this paper recommends observance of timeliness, use of appropriate media for preservation of heart parts, administration of specific drugs and safeguards necessary for cryopreservation procedure.

Central venous catheter related infections.

Infusion therapy carries a substantial risk of producing iatrogenic sepsis, bacteremia or fungemia originating from the device used for vascular access or from the contaminated infusate. This study, a semiquantitative assay of the central venous catheter tips (CVC) was carried out and correlated with the blood culture results to determine the probable cause of sepsis in our post operated patients. One thousand six hundred and thirty one surgeries were performed in the Institute of Cardio-Vascular Diseases from January to December 1997. We received 150 CVC tips which were in place for more than five days for culture. Fifty one (51) CVC tips showed growth in either contents or roll. There was associated blood stream infection in 23 patients. The age groups of patients ranged from two months to 67 years and male to female ratio was 109:41. Children below the age of 12 years were 62 in number. Candida spp. (32.4%) and Staphylococcus spp. (33.9%) formed the predominant isolates from the CVC tips.