A method for sensitivity analysis of deviation factor for geometric correction of cone-beam CT system / 南方医科大学学报

OBJECTIVE@#To propose a sensitivity test method for geometric correction position deviation of cone-beam CT systems.@*METHODS@#We proposed the definition of center deviation and its derivation. We analyzed the influence of the variation of the three-dimensional spatial center of the steel ball point, the projection center and the size of the steel ball point on the deviation of geometric parameters and the reconstructed image results by calculating the geometric correction parameters based on the Noo analytical method using the FDK reconstruction algorithm for image reconstruction.@*RESULTS@#The radius of the steel ball point was within 3 mm. The deviation of the center of the calibration parameter was within the order of magnitude and negligible. A 10% Gaussian perturbation of a single pixel in the 3D spatial coordinates of the steel ball point produced a deviation of about 3 pixel sizes, while the same Gaussian perturbation of the 2D projection coordinates of the steel ball point produced a deviation of about 2 pixel sizes.@*CONCLUSION@#The geometric correction is more sensitive to the deviation generated by the three-dimensional spatial coordinates of the steel ball point with limited sensitivity to the deviation generated by the two-dimensional projection coordinates of the steel ball point. The deviation sensitivity of a small diameter steel ball point can be ignored.

Effect of lag screw and support plate through axillary approach for the treatment of Ideberg typeⅡscapular pelvis fracture / 中国骨伤

OBJECTIVE@#To analyze the effect of lag screw and support plate through axillary approach for the treatment of Ideberg typeⅡscapular pelvis fracture.@*METHODS@#From January 2016 to June 2021, 26 patients with Ideberg typeⅡglenoid fractures were treated with trans-axillary lag screw combined with supporting plate, including 15 males and 11 females. The age ranged from 21 to 75 years, with an average of (43.12±6.56) years old. The Constant-Murley Shoulder joint Scale and University of California at Los Angeles (UCLA) score were used to evaluate the function and clinical efficacy of shoulder joint.@*RESULTS@#All patients were followed up, and the duration ranged from 19 to 42 months, with an average of (30.6±10.5) months. One year after surgery, the Constant-Murley score increased from preoperative 34.9±2.5(ranged, from 28 to 47) to 87.2±6.8(ranged, from 70 to 95). The UCLA score improved from preoperative 17.9±1.7(9 to 25) to 33.1±2.3(29 to 35). Seventeen patients got an excellent result, with 7 good, and 2 fair. None of the patients had infection, screw, and plate loosening, fracture, and other complications after surgery. Two patients had different degrees of Chronic pain in the shoulder during the follow-up period.@*CONCLUSION@#The treatment of Ideberg typeⅡscapular glenoid fractures through axillary approach with lag screws and supporting steel plates has the advantages of convenient exposure, direct visual restoration of the normal anatomical shape of the scapular glenoid, selection of suitable positions for screw and steel plate placement, achieving better treatment results, and fewer complications. It is an effective and reliable surgical method.

A case of high-temperature steel bar penetration injury from scrotum to buttocks / 中华烧伤杂志

On November 17, 2013, the Second Affiliated Hospital of Kunming Medical University admitted a 23-year-old male patient with a high-temperature steel bar penetration injury from scrotum to buttocks who was transferred from another hospital. Expanded debridement, suture, and drainage of the perineum, right thigh, and right hip were performed as soon as possible after admission. A sputum suction tube was used as the guide mark for expanded debridement during the operation to ensure the accuracy of the direction and scope of expanded debridement. The incision was treated with vacuum sealing drainage (VSD) and full drainage. On the 20th day after the operation (the 25th day after admission), the unhealed wound was transplanted with split-thickness skin graft from the right thigh, and the drainage of the operation area and dressing change were strengthened. On the 53rd day after injury, the patient was discharged after complete wound healing. This case suggests that VSD after early debridement is an effective means to treat high-temperature steel bar penetration injuries.

Treatment of comminuted fracture of inferior pole of patella with locking suspension and vertical fixation with three steel wires / 中国骨伤

OBJECTIVE@#To explore the clinical application of lockedge suspension combined with three steel wires vertical fixation in comminuted fracture of inferior pole of patella.@*METHODS@#From August 2016 to May 2019, 23 patients with comminuted fracture of the lower pole of the patella, including 14 males and 9 females, were treated with lockedge suspension combined with three steel wires vertical fixation. The age ranged from 34 to 68 (55.0±1.2) years. One year after operation, the pain and function were evaluated by pain visual analogue scale(VAS) and knee flexion and extension range of motion, and the clinical efficacy was evaluated by Lysholm knee score standard.@*RESULTS@#All 23 patients were followed up for 12 to 14, with a mean of(13.0±0.5) months. One patient had skin irritation by the tail of the steel wire, and the rest had no postoperative complications such as incision infection, internal fixation loosening and fracture displacement. The fractures of 23 patients were healed, and the healing time was 10 to 14 weeks with a mean of(12.0±1.1) weeks. The VAS score decreased from 7.96±0.93 before operation to 0.83±0.65 one year after operation. The range of knee flexion and extension activities increased from(20.30±8.69) ° before operation to 1 year after operation(127.39±6.55) °. Lysholm knee score increased from 18.48±4.00 before operation to 96.09±4.91 one year after operation(P<0.05).@*CONCLUSION@#The treatment of comminuted fracture of the lower pole of patella by lockedge suspension combined with three steel wires vertical fixation has reliable fixation and high fracture healing rate. It can meet the requirements of rapid rehabilitation and functional exercise, and the early clinical effect is satisfactory.

Saneamiento industrial: Biodisponibilidad de patógenos en superficies / Industrial sanitation: Bioavailability of pathogens on surfaces

En condiciones adecuadas como humedad, alcalinidad, o temperatura, determinados patógenos logran adherirse a las superficies y sobrevivir ciertos períodos fuera de un anfitrión, persistiendo en algunos casos a procesos deficientes de limpieza y desinfección, configurándose como un posible foco de transmisión. Por ello, el correcto saneamiento cumple un propósito vital en la protección de los trabajadores de la industria y otros sectores frente al riesgo de contaminación por contacto directo con las superficies contaminadas. La literatura científica muestra amplia evidencia de la supervivencia de patógenos sobre superficies que son habituales dentro de instalaciones industriales, como acero, aluminio, madera, plástico y vidrio. La supervivencia de microorganismos en las superficies puede configurarse como candidato a marcador de biodisponibilidad, que puede ser usado en la industria para establecer y auditar los planes de higienización y saneamiento industrial, permitiendo estudiar la eficacia de los compuestos usados en la desinfección, y variables como su concentración, temperatura, e intervalos de aplicación y remoción(AU)

Under suitable conditions such as humidity, alkalinity, or temperature, certain pathogens manage to adhere to surfaces and survive certain periods outside of a host, persisting in some cases to poor cleaning and disinfection processes, becoming a possible source of transmission. Therefore, proper sanitation serves a vital purpose in protecting workers in industry and other sectors from the risk of contamination by direct contact with contaminated surfaces. The scientific literature shows ample evidence of the survival of pathogens on surfaces that are common within industrial facilities, such as steel, aluminum, wood, plastic and glass. The survival of microorganisms on surfaces can be configured as a candidate for bioavailability marker, which can be used in the industry to establish and audit industrial sanitation and sanitation plans, allowing to study the efficacy of the compounds used in disinfection, and variables such as its concentration, temperature, and application and removal intervals(AU(

Case control study on anatomical locking plate and ordinary steel plate for the treatment of closed calcaneal fracture with SandersⅡand Ⅲ / 中国骨伤

OBJECTIVE@#To compare clinical efficacy between anatomical locking plate (ALP) and ordinary steel plate (OSP) in treating closed calcaneal fractures with SandersⅡ and Ⅲ.@*METHODS@#From May 2016 to May 2018, 68 patients with closed Sanders typeⅡ and Ⅲ calcaneal fractures were retrospectively analyzed, and were divided into anatomical locking plate group (ALP group) and ordinary steel plate group (OSP group) according to two kinds of plate fixation, and 34 patients in each group. In ALP group, there were 21 males and 13 females aged from 20 to 63 years old with average of (35.16±8.45) years old; 14 patients were typeⅡand 20 patients were type Ⅲaccording to Sanders classification;treated with ALP. In OSP group, there were 20 males and 14 females aged from 19 to 63 years old with average of (35.05±8.39) years old;19 patients were typeⅡand 15 patients were type Ⅲ according to Sanders classification;treated with OSP. Operative time, intraoperative blood loss and complications between two groups were observed and compared;preoperative and postoperative Böhler angle and gissane angle were also compared;American Orthopaedic Foot & Ankle Society (AOFAS) ankle and hind foot scores, foot and ankle disability index (FADI) scores were applied to evaluate clinical effect.@*RESULTS@#All patients were followed up from 11 to 14 months with an average of (12.06±0.81) months. There were no statistical differences in opertive time, intraoperative blood loss, incision infection and refracture rate in complications between two groups (@*CONCLUSION@#Compared with OSP, ALP in treating SandersⅡ and Ⅲ calcaneal fractures could achieve better therapeutic effect, avoid screw loosening, reduce complications, and improve limb function in further.

The Local Alternative Ti-6Al-4V Alloy Coating of Surgery Steel Instruments for Laser Deposition Forming / 中国医疗器械杂志

Aiming at the medical practice problems of the surgical steel medical instruments, such as the crevice corrosion, the poor mechanical compatibility and the Ni, Cr plasma exudation, the laser deposition of Ti-6Al-4V alloy cladding layer at the local functional area as alternative coating was proposed and realized as a new process method. The accurate element content and good formability Ti-6Al-4V cladding powder was chosen, the low power and high duty cycle optimized laser process was adopt, the alternative coating of good fusion and low dilution was prepared. Through the elemental line scanning, the interface microstructure analysis and the experiments of basic mechanical properties, the basic properties of the cladding were characterized and verified. The experiments results showed that, the Ti, Al and V contents of the top coating were respectively about 88%, 4.9% and 3.9%, no sensitizing ions such as Cr and Ni were detected. Initial equiaxed α phase, flake β phase dist were distributed in the coating and interface, the α' martensite was precipitated at the boundary of the flake β phase, some refined granular β phase dispersion pinned to the grain boundary of basket structure. The microhardness of cladding layer was 352.08~312.76 HV0.1. The friction coefficient of the cladding layer was about 0.22~0.65. A new technology and method reference for improving and upgrading the performance of surgical medical devices is provided by this research.

Surgical outcomes of sternal rigid plate fixation from 2005 to 2016 using the American College of Surgeons-National Surgical Quality Improvement Program database

BACKGROUND: Sternal rigid plate fixation (RPF) has been adopted in recent years in high-risk cases to reduce complications associated with steel wire cerclage, the traditional approach to sternal closure. While sternal RPF has been associated with lower complication rates than wire cerclage, it has its own complication profile that requires evaluation, necessitating a critical examination from a national perspective. This study will report the outcomes and associated risk factors of sternal RPF using a national database. METHODS: Patients undergoing sternal RPF from 2005 to 2016 in the American College of Surgeons-National Surgical Quality Improvement Program were identified. Demographics, perioperative information, and complication rates were reviewed. Logistic regression analysis was performed to identify risk factors for postoperative complications. RESULTS: There were 381 patient cases of RPF identified. The most common complications included bleeding (28.9%), mechanical ventilation >48 hours (16.5%), and reoperation/readmission (15.2%). Top risk factors for complications included dyspnea (odds ratio [OR], 2.672; P48 hours, and reoperation/readmission, each of which affected over 15% of the study population. Smokers remain at an increased risk for surgical site infection and sternal dehiscence despite RPF's purported benefit to minimize these outcomes. Complications of primary versus delayed sternal RPF are roughly equivalent, but individual patients may perform better with one versus the other based on identified risk factors.

Association between shift work and hyperhomocysteinemia in male workers

BACKGROUND: Shift work is associated with a higher risk of cardiovascular diseases. Here, we sought to assess the relationship between shift work and plasma homocysteine levels. Determining the correlations between shift work and homocysteine levels may provide a better understanding of the mechanisms underlying cardiovascular diseases. METHODS: This study was performed using data from routine health examinations of steel workers in 2017. In total, 431 male workers (70 daytime workers and 361 shift workers) employed on a rolling departure schedule were recruited. Plasma homocysteine levels > 15 μmol/L were considered elevated. The χ2, analysis of variance, and multiple logistic regression analyses were used to examine the association between shift work and plasma homocysteine levels. RESULTS: In comparison to daytime workers, the odds ratio (OR) of hyperhomocysteinemia in individuals with < 10 years of shift work was 1.14 (95% confidence interval [CI]: 0.64–2.03), compared to 2.01 (95% CI: 1.14–3.54) for workers with ≥ 10 years of experience. After adjusting for confounding variables, the adjusted OR for shift workers with < 10 years of experience was 0.95 (95% CI: 0.50–1.80), compared to 2.00 (95% CI: 1.07–3.74) for workers with ≥ 10 years of experience. CONCLUSIONS: The risk of hyperhomocysteinemia was significantly higher in shift workers compared to those working normal daytime hours, particularly among long-term shift workers.

An Analysis of Individual and Social Factors Affecting Occupational Accidents

BACKGROUND: Workforce health is one of the primary and most challenging issues, particularly in industrialized countries. This article aims at modeling the major factors affecting accidents in the workplace, including general health, work-family conflict, effortereward imbalance, and internal and external locus of control. METHODS: A cross-sectional study was conducted in Esfahan Steel Company in Iran. A total of 450 participants were divided into two groups—control and case—and the questionnaires were distributed among them. Data were collected through a 7-part questionnaire. Finally, the results were analyzed using SPSS 22.0 and Amos software. RESULTS: All the studied variables had a significant relationship with the accident proneness. In the case group, general health with a coefficient of −0.37, work-family conflict with 0.10, effort-reward imbalance with 0.10, internal locus of control with −0.07, and external locus of control with 0.40 had a direct effect on occupational stress. Occupational stress also had a positive direct effect on accident proneness with a coefficient of 0.47. In addition, fitness indices of control group showed general health (−0.35), work-family conflict (0.36), effort-reward imbalance (0.13), internal locus of control (−0.15), and external locus of control (0.12) have a direct effect on occupational stress. Besides, occupational stress with a coefficient of 0.09 had a direct effect on accident proneness. CONCLUSION: It can be concluded that although previous studies and the present study showed the effect of stress on accident and accident proneness, some hidden and external factors such as workefamily conflict, effortereward imbalance, and external locus of control that affect stress should also be considered. It helps industries face less occupational stress and, consequently, less occurrence rates of accidents.

Late complication of the Nuss procedure: recurrent cardiac tamponade / 영남의대학술지

Pectus excavatum (PE) is known as one of the most common congenital deformities of the anterior chest wall. The Nuss procedure is an effective surgical therapy to correct PE. Here, we report a case of recurrent cardiac tamponade due to hemopericardium that occurred after 16 months following the Nuss procedure. The cause of recurrent hemopericardium was thought to be local, repetitive irritation of the pericardium by the Nuss steel bar. We should keep in mind that this serious complication can occur after the Nuss procedure, even in the late phase.

Correction of Single Thoracic Adolescent Idiopathic Scoliosis Using Pedicle Screw Instrumentation: Comparison of Stainless Steel to Titanium Alloy Instruments / 대한정형외과학회잡지

PURPOSE: To compare the results of two different instruments made of stainless steel and titanium alloy for correction of single thoracic adolescent idiopathic scoliosis (AIS) using pedicle screw instrumentation. MATERIALS AND METHODS: A total of 141 patients with single thoracic AIS treated with pedicle screw instrumentation and selective thoracic fusion were retrospectively reviewed after a follow-up of 2 years. The patients had a main thoracic curve of 40° to 75° and were divided into two groups based on instrument materials; S group (stainless steel, n=90) and T group (titanium alloy, n=51). The diameter of the stainless steel rod used was 7.0 mm while that of the titanium alloy rod was 6.35 mm or 6.0 mm. Standing long-cassette radiographic measurements including various coronal and sagittal parameters for the preoperative, early postoperative and 2-year postoperative follow-up were analyzed. There were no significant differences in the preoperative curve characteristics between the two groups. RESULTS: In the S group, the preoperative main thoracic curve of 51.3°±8.4° was improved to 19.0°±7.6° (63.1% correction) and the lumbar curve of 32.3°±8.4° spontaneously decreased to 12.7°±8.2° (62.9% correction) at 2 years postoperatively. In the T group, the preoperative main thoracic curve of 49.5°±8.4° and the lumbar curve of 30.3°±8.9° was improved to 18.8°±7.4° (62.2% correction) and 11.3°±5.4° (63.3% correction), respectively. The corrections of coronal curves were not statistically different between the two groups (p>0.05). The thoracic kyphosis was changed from 16.8°±8.5° to 24.3°±6.1° in the S group and from 19.6°±11.2° to 26.6°±8.5° in the T group. There were no significant differences in the changes of sagittal curves, coronal and sagittal balances at the 2-year follow-up and the number of fused segments and used screws between the two groups (p>0.05). CONCLUSION: When conducting surgery for single thoracic AIS using pedicles screw instrumentation, two different instruments made of stainless steel and titanium alloy showed similar corrections for coronal and sagittal curves.

Assessment of Semen Quality among Workers Exposed to Heat Stress: A Cross-Sectional Study in a Steel Industry

BACKGROUND: This study was conducted to investigate the heat stress and semen quality among male workers in a steel industry in Iran and investigate the relationship between heat stress indices and semen parameters. METHODS: The study was conducted on workers exposed (n = 30) and unexposed (n = 14) to heat in a steel industry. After obtaining a brief biography of the selected employees, scrotal temperature, oral temperature, and environmental parameters were measured, and their semen samples were analyzed according to the procedure recommended by the World Health Organization. The heat stress indices, including wet-bulb globe temperature (WBGT) and predicted heat strain (PHS), in their workplace were calculated according to environmental parameters (ISO 7243:1989 and 7933:2004, respectively). RESULTS: Time-weighted averages of WBGT and PHS (35.76°C and 491.56 w/m2 w m 2 , respectively) for the exposed group were higher than threshold limit values. The mean difference of environmental, physiological, and semen parameters (exception: pH of semen), and also WBGT and PHS indices were statistically significant (p < 0.05) between the two groups. Mean semen parameters were in the normozoospermic range. WBGT and PHS indices showed significantly “negative” correlation with physiological parameters (scrotal and oral temperature) and most semen parameters (semen volume, sperm morphology, sperm motility, sperm count; p < 0.05); moreover, the correlation of WBGT with these parameters was stronger than PHS. CONCLUSION: Semen parameters of the studied workers exposed to heat were in the borderline level of normozoospermic range, and their semen parameters were significantly lower than controls. For better assessment of occupational environment concerning physiological and semen parameters in steel industries, WBGT can be a more useful index.

Prevalence of Multiple Sclerosis in a Turkish City Bordering an Iron and Steel Factory

BACKGROUND AND PURPOSE: Multiple sclerosis (MS) is an autoimmune disease characterized by inflammatory demyelination. Recent studies have shown that long-term exposure to air pollutants (including PM10 particulates) is potentially an environmental risk factor for MS. We aimed to determine the prevalence rates of MS in two cities with different levels of air pollution. METHODS: This door-to-door population-based study was conducted between April 2014 and June 2015. Two cities were screened for the prevalence rates of MS: 1) Karabük, which borders an iron-and-steel factory, and 2) Akçakoca, which is a coastal city located in the same region. A validated survey form was used for screening MS. The 2010 McDonald Criteria were used for diagnosing MS. The patients were examined twice, first by a neurology assistant in the field and then by a senior neurologist in public health centers in the cities. RESULTS: The prevalence of MS was 95.9/100,000 in Karabük and 46.1/100,000 in Akçakoca. In total, 33 patients were diagnosed with clinically definite MS. The female/male ratio was 1.5, and 21 patients were diagnosed with relapsing-remitting MS, 9 with secondary progressive MS, and 3 with primary progressive MS. CONCLUSIONS: We found that the prevalence of MS was more than two fold higher in Karabük than in Akçakoca, which supports a link between air pollution and the pathogenesis of MS. However, larger etiological and epidemiological studies are needed to confirm this hypothesis.

Influence of scaling procedures on the integrity of titanium nitride coated CAD/CAM abutments

PURPOSE: To determine the extent of treatment traces, the roughness depth, and the quantity of titanium nitride (TiN) removed from the surface of CAD/CAM abutments after treatment with various instruments. MATERIALS AND METHODS: Twelve TiN coated CAD/CAM abutments were investigated for an in vitro study. In the test group (9), each abutment surface was subjected twice (150 g vs. 200 g pressure) to standardized treatment in a simulated prophylaxis measure with the following instruments: acrylic scaler, titanium curette, and ultrasonic scaler with steel tip. Three abutments were used as control group. Average surface roughness (Sa) and developed interfacial area ratio (Sdr) of treated and untreated surfaces were measured with a profilometer. The extent of treatment traces were analyzed by scanning electron microscopy. RESULTS: Manipulation with ultrasonic scalers resulted in a significant increase of average surface roughness (Sa, P < .05) and developed interfacial area ratio (Sdr, P < .018). Variable contact pressure did not yield any statistically significant difference on Sa-values for all instruments (P=.8). Ultrasonic treatment resulted in pronounced surface traces and partially detachment of the TiN coating. While titanium curettes caused predominantly moderate treatment traces, no traces or detectable substance removal has been determined after manipulation with acrylic curettes. CONCLUSION: Inappropriate instruments during regular plaque control may have an adverse effect on the integrity of the TiN coating of CAD/CAM abutments. To prevent defects and an increased surface roughness at the transmucosal zone of TiN abutments, only acrylic scaling instruments can be recommended for regular maintenance care.

Occupational Noise Exposure and Serum Lipids in Manufacturing Company Workers

OBJECTIVE: The study aimed to examine the relationship between occupational cumulative noise exposure and serum lipids as risk factor of ischemic heart disease. METHODS: Participants (n=1,175) were workers of the steel product manufacturing factory exposed to more than 85 dB(A) of noise. We collected ambient noise and other materials monitoring data in workplace, laboratory test, and structured-questionnaires. Occupational noise exposure was defined as cumulative noise exposure calculated by duration of exposure and level of exposure. Serum lipids were total cholesterol, triglyceride, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, and total cholesterol/HDL cholesterol. We examined the relationship between serum lipids and occupational noise exposure. RESULTS: In a noise exposure environment, 657 people (56.8%) worked for more than 10 years. Cumulative noise exposure increased significantly as exposure duration and noise level increased. Cumulative noise exposure were related to total cholesterol (P=0.001), LDL cholesterol (P=0.002), total cholesterol/HDL cholesterol (P=0.005) in correlation analysis. We conducted multiple linear regression analysis using the serum lipids and significant variables including cumulative noise exposure. We identified that total cholesterol was significantly related to cumulative noise exposure (β=0.072). CONCLUSION: We propose occupational cumulative noise exposure may be significantly related to total cholesterol.

A Survey on Low Back Pain Risk Factors in Steel Industry Workers in 2015

STUDY DESIGN: This was a cross-sectional study. PURPOSE: The aim of this study was to determine the prevalence of low back pain (LBP) and its association with individual factors and current job status among steel industry workers in Mashhad, Iran. OVERVIEW OF LITERATURE: Several studies have been conducted on LBP and its related risk factors, some of which emphasized oc-cupational factors as the main etiology of LBP. Meanwhile, individual risk factors have been emphasized in other studies. Despite several published articles, there are still many unresolved, basic issues about developing LBP. METHODS: For this study, 358 male workers were selected by a random sampling method and divided into two groups: production workers (n=201) and administrative personnel (n=157). Data were collected using modified Nordic questionnaire and physical examination. Statistical analysis was performed to identify the correlation between individual factors and current job status with LBP. RESULTS: Despite the young age of participants and their short employment duration, the overall prevalence of LBP was high (32.4%) in this industry. The prevalence of non-specific LBP in production workers and administrative personnel was 26.8% and 21.0%, respectively. Disk herniation was observed in 10.4% of production workers and 6.3% of administrative personnel. Age, employment duration, body mass index and smoking status were similar in the two groups. There was no significant relationship between LBP and current job status; however, a significant relationship was found between prevalence of LBP with age, duration of employment, and leisure time physical activity (p<0.05). CONCLUSIONS: We have not found any relationship between LBP and current occupational status suggesting that the effects of general health-related factors such as weight, age, leisure time physical activity, and duration of employment are more important than occupational factors in developing LBP.

Open Reduction and Internal Fixation of Isolated Posterior Cruciate Ligament Avulsion Fractures: Clinical and Functional Outcome

PURPOSE: The posterior cruciate ligament (PCL) presents commonly with avulsion fractures of its tibial attachment. An avulsion fracture of the PCL, if not surgically fixed, may lead to secondary changes in the knee joint. Various fixation techniques have been explored with use of lag screws, steel wires, absorbable screws, suture anchors and straddle nails. The purpose of this study was to evaluate the clinical and functional outcome of open reduction and internal fixation of tibial avulsion injuries of the PCL using cannulated cancellous screws. MATERIALS AND METHODS: We performed open reduction and internal fixation using cannulated cancellous screws in 14 patients (mean age, 33.9 years) with isolated PCL avulsion injuries. Patients with a duration of injury more than 12 weeks were excluded. The minimum follow-up period was 12 months. Results were assessed radiologically and clinically. Final functional outcome was assessed using the Lysholm knee scoring system. RESULTS: The average follow-up period was 13.5 months. At the final follow-up, all 14 patients achieved fracture union. The average flexion was 121.7°±9.2° with full extension achieved in all patients. Mild instability (1+) was noted in 4 patients. The Lysholm functional score was excellent in 11 patients, good in 2 patients and fair in 1 patient with an average score of 97±7.6. CONCLUSIONS: Stable early fixation for PCL avulsion injuries with early controlled mobilization provided excellent to good results. However, fixation should not be discouraged for late-presenting patients because good to fair results can be achieved in such cases.

Heavy metals identification and exposure at workplace environment its extent of accumulation in blood of iron and steel recycling foundry workers of Lahore, Pakistan

The determination of heavy metals in blood is an important occupational environmental toxicology screening procedure. The aim of study was to determine the concentrations of Pb, Cd, Cr and Ni in blood samples of iron and steel foundry workplace exposed workers under routine clinical laboratory conditions. The method was employed for the quantitative determination of lead, cadmium, chromium and nickel in workplace environment particulate matter blood samples from iron and steel foundry workers and in unexposed controls. The results indicate that lead, chromium and nickel levels of the exposed workers are significantly higher those of the controls. Nickel Concentration [fig/L] in high P value=0.0306 and Chromium Concentration [microg/L] in P value=0.0295in worker population as compared to controls. Lead showed highest Absorption concentration in serum from particulate matter to Serum 47.3[microg/L]. Absorption concentration of nickel in serum 16.5[microg/L] was lower than lead observed in worker's population. Absorption concentration of cadmium and chromium in serum from particulate matter -152[microg/L] observed very low. The results also show the need for immediate improvements in workplace ventilation and industrial hygiene practices

Occupational Heat Stress Impacts on Health and Productivity in a Steel Industry in Southern India

BACKGROUND: Workers laboring in steel industries in tropical settings with high ambient temperatures are subjected to thermally stressful environments that can create well-known risks of heat-related illnesses and limit workers’ productivity. METHODS: A cross-sectional study undertaken in a steel industry in a city nicknamed “Steel City” in Southern India assessed thermal stress by wet bulb globe temperature (WBGT) and level of dehydration from urine color and urine specific gravity. A structured questionnaire captured self-reported heat-related health symptoms of workers. RESULTS: Some 90% WBGT measurements were higher than recommended threshold limit values (27.2–41.7°C) for heavy and moderate workloads and radiational heat from processes were very high in blooming-mill/coke-oven (67.6°C globe temperature). Widespread heat-related health concerns were prevalent among workers, including excessive sweating, fatigue, and tiredness reported by 50% workers. Productivity loss was significantly reported high in workers with direct heat exposures compared to those with indirect heat exposures (χ2 = 26.1258, degrees of freedom = 1, p < 0.001). Change in urine color was 7.4 times higher among workers exposed to WBGTs above threshold limit values (TLVs). CONCLUSION: Preliminary evidence shows that high heat exposures and heavy workload adversely affect the workers’ health and reduce their work capacities. Health and productivity risks in developing tropical country work settings can be further aggravated by the predicted temperature rise due to climate change, without appropriate interventions. Apart from industries enhancing welfare facilities and designing control interventions, further physiological studies with a seasonal approach and interventional studies are needed to strengthen evidence for developing comprehensive policies to protect workers employed in high heat industries.