Prevalence and risk factors for work-related musculoskeletal disorder among female domestic workers employed in private homes in South India: A cross-sectional study

Objectives: Musculoskeletal disorders (MSDs) are the most common occupational health problem accounting for a larger number of compensation days and disability among workers. An invisible workforce of female domestic workers (FDWs) is involved in back-breaking jobs in the informal job sectors, and yet, there are no studies to quantify their work-related MSD’s (WMSDs). The objective of the study is to determine the prevalence of WMSDs among FDWs employed at private houses in Bengaluru, South India. Material and Methods: A cross-sectional study was conducted among 408 randomly selected FDWs with a comparative group. The trained interviewer assessed WMSDs using a standardized Nordic Musculoskeletal questionnaire and psychosocial distress using the general health questionnaire–12. Results: A high prevalence of WMSD was reported in the neck (19.6%), shoulder (23.8%), elbow (12%), upper back (31.9%), and ankle (26%) in domestic workers than the non-domestic workers. Age above 37 years (AOR: 1.77, 95% CI: 1.03–3.06), house cleaning ([>1715 h/year – AOR: 1.30, 95% CI: 0.60–2.84] [1714–555 h/year – AOR: 1.30, 95% CI:0.66–2.59]), and clothing ([Care >1460 h/year – AOR: 2.44, 95% CI: 1.12–5.35] [109–1459 h/year – AOR: 1.98, 95% CI: 0.95–4.10]) were factors associated with neck pain in FDW. Moreover, work experience of more than 10 years (AOR: 2.10, 95% CI: 1.32–3.34) and distress (AOR: 2.13, 95% CI: 1.25–3.61) was a factor associated with lower back pain in FDW. Conclusion: FDWs are substantially affected by WMSDs in the neck and lower back due to house cleaning and clothing care tasks performed in the workplace setting, respectively

Chronic psychosis associated with vitamin B12 deficiency.

B12 deficiency is widely prevalent and usually presents with haematologic and neuropsychiatric manifestations. Psychiatric symptoms seldom precede anaemia and present as the principal manifestation of B12 deficiency. A report an unusual presentation of long standing psychotic symptoms without anaemia in a 31 year old male, who presented to a tertiary care psychiatric facility. His physical examination revealed hyper pigmentation of extremities and posterior column involvement. Laboratory investigations confirmed normal haemoglobin and low serum B12 levels. He recovered dramatically with short term anti psychotic medication and intramuscular cobalamin supplementation. He remained asymptomatic and functionally independent at two years follow up.

Multi-drug overdose risperidone, ziprasidone, valproate, trihexyphenidyl, and clonazepam.

Risperidone and ziprasidone are commonly used as first line drugs for the treatment of psychotic disorders and overdose with these agents is increasingly being reported. Relatively few of these reports have involved co-ingestion of multiple psychotropic agents. We report a case of overdose with risperidone, ziprasidone, valproate, trihexyphenidyl and clonazepam in a 25 years female, who recovered uneventfully with supportive management. Notwithstanding the benign outcome in this instance, age, co-ingested drugs, active metabolites and medical co-morbidity are critical issues in overdose with atypical antipsychotics. As prescription of these drugs continues to increase in developing countries, systematic studies evaluating their clinical toxicity and management are necessary. The issues associated with overdose of multiple psychotropic agents and appropriate management policies are highlighted.