Effects of Corrective Exercises on Work-Related Musculoskeletal Disorders and Quality of Life in Surgical Residents: A Pilot, Quasi-Experimental Study.

PURPOSE: Work-related musculoskeletal disorders (WMSDs) are one of the most important reasons for absenteeism, high costs of health care and human injuries; the latter are very common in medical staff. The present study was designed to evaluate the effects of corrective exercises on quality of life and work-related musculoskeletal disorders in surgical residents. METHODS: In a quasi-experimental study with a one-group pretest-posttest design, we assessed the eligibility of 135 surgical assistants. All recruited participants performed corrective exercises and were followed for 12 months. The primary outcome of the study was any change in the surgical residents' work-related musculoskeletal disorders, which was assessed using the Nordic Musculoskeletal Questionnaire (NMQ) and the Numerical Pain Rating Scale (NPRS) prior to, and 3, 6, and 12 months after intervention. The secondary outcome was any change in the surgical residents' quality of life (QOL) score, which was assessed at baseline, 6 and 12 months after the intervention using the World Health Organization Quality of Life - BREF (WHOQOL-BREF) questionnaire. RESULTS: One hundred eligible surgical residents were enrolled, of whom 67 (67%) completed the study. At baseline the majority of the participants were female and >30 years of age. Fifty-five percent of them used analgesic drugs. The use of analgesic drugs per week fell by 14.7% from baseline to 12 months; the change was statistically significant (p = 0.042). The effect of corrective exercises on the intensity of pain in the shoulder (p = 0.002), hand/wrist (p = 0.001), upper back (p = 0.03), lower back (p = 0.02) and knee (p = 0.01) was significant. Corrective exercises also led to a significant rise in the quality-of-life score (p < 0.019). CONCLUSIONS: This study demonstrated the effectiveness of corrective exercises in reducing work-related musculoskeletal disorders and improving quality of life among surgical residents.

Babu and Magon uterine closure technique during cesarean section: A randomized double-blind trial.

AIM: We compared the effectiveness of the Babu and Magon uterine closure technique and unlocked double-layer uterine closure on the integrity and thickness of the uterine scar. METHODS: A randomized double-blind trial was performed at Hazrat-e Rasoul -e-Akram Hospital, Tehran, Iran, from March 2018 to December 2019, in 72 pregnant women who were candidates for cesarean section for the first time. Women were randomly assigned to the Babu and Magon uterine closure technique (intervention group, n = 34) or double-layer closure of the uterine incision (control group, n = 38). The primary outcome of the study was the frequency of myometrial defects at the site of the scar (niche), and a large niche. Secondary outcomes, including the time taken for uterine closure and postpartum hemorrhage (early and late), were compared between groups. RESULTS: Adjacent myometrium thickness (AMT) between the two groups was not statistically significant. A niche was reported in 23.5% (8/34) and 50% (19/38) of women in the intervention and controls, respectively (p = 0.02). A large niche was reported in 2.9% (1/34) and 23.7% (9/38) of women in the intervention and controls, respectively (p < 0.01). The duration of uterine closure was not statistically significant between the two groups. Hemoglobin levels did not differ significantly between groups during the first 24 h post-surgery. CONCLUSION: The results of the study showed that the technique of uterine closure is one of the main potential determinants of myometrial healing. The Babu and Magon uterine closure technique seems to lead to tissue alignment during suturing and consequently cause better myometrial healing, although this issue calls for well-founded longer studies of appropriate design.

Deposition of Crystalline Hydroxyapatite Nanoparticles on Y-TZP Ceramic: A Potential Solution to Enhance Bonding Characteristics of Y-TZP Ceramics.

OBJECTIVES: Many advantages have been attributed to dental zirconia ceramics in terms of mechanical and physical properties; however, the bonding ability of this material to dental structure and/or veneering ceramics has always been a matter of concern. On the other hand, hydroxyapatite (HA) shows excellent biocompatibility and good bonding ability to tooth structure, with mechanically unstable and brittle characteristics, that make it clinically unacceptable for use in high stress bearing areas. The main purpose of this study was to introduce two simple yet practical methods to deposit the crystalline HA nanoparticles on zirconia ceramics. MATERIALS AND METHODS: zirconia blocks were treated with HA via two different deposition methods namely thermal coating and air abrasion. Specimens were analyzed by scanning electron microscopy, energy dispersive spectroscopy (EDS) and X-ray diffraction (XRD). RESULTS: In both groups, the deposition techniques used were successfully accomplished, while the substrate showed no structural change. However, thermal coating group showed a uniform deposition of crystalline HA but in air abrasion method, there were dispersed thin islands of HA. CONCLUSIONS: Thermal coating method has the potential to significantly alter the surface characteristics of zirconia. The simple yet practical nature of the proposed method may be able to shift the bonding paradigm of dental zirconia ceramics. This latter subject needs to be addressed in future investigations.

Deposition of crystalline hydroxyapatite nano-particle on zirconia ceramic: a potential solution for the poor bonding characteristic of zirconia ceramics to resin cement.

The poor bonding strength of zirconia to different dental substrates is one of the challenging issues in restorative dentistry. Hydroxyapatite is an excellent biocompatible material with fine bonding properties. In this study, it was hypothesized that hydroxyapatite coating on zirconia would improve its bond strength. Forty-five zirconia blocks were prepared and randomly divided into three groups: hydroxyapatite coating, sandblasting, and no preparation (control). The blocks were bonded to cement and the micro-shear bond strength was measured following load application. The bond strength values were analyzed with the Kruskal-Wallis test in 3 groups and paired comparisons were made using the Mann-Whitney U test. The failure patterns of the specimens were studied by a stereomicroscope and a scanning electron microscope and then analyzed by the chi-square test (significance level = 0.05). Deposition of hydroxyapatite on the zirconia surface significantly improved its bond strength to the resin cement in comparison with the control specimens (p < 0.0001). Also, the bond strength was similar to the sandblasted group (p = 0.34). The sandblasted and control group only showed adhesive failure, but the hydroxyapatite coated group had mixed failures, indicating the better quality of bonding (p < 0.0001). As a final point, hydroxyapatite coating on the zirconia surface improved the bond strength quality and values.

Ultrastructural Investigation of Pelvic Peritoneum in Patients With Chronic Pelvic Pain and Subtle Endometriosis in Association With Chromoendoscopy.

STUDY OBJECTIVE: To evaluate the pelvic peritoneum under chromoendoscopy by scanning electron microscopy (SEM) as well as light microscopy with hematoxylin and eosin staining and immunohistochemistry (IHC) assays in patients with chronic pelvic pain (CPP) associated with subtle endometriosis. DESIGN: Case series study (Canadian Task Force classification II). SETTING: A referral academic community tertiary medical center. PATIENTS: Three women aged 29 to 37 years were referred to the obstetrics and gynecology clinic of the tertiary university hospital with CPP. They were suspicious for endometriosis, were not responding to medical treatments, and had undergone previous pelvic laparoscopy to determine the stage of endometriosis and preparation of peritoneal samples under the guidance of staining with methylene blue in 0.25% dilution. INTERVENTIONS: Comparison of stained and unstained pelvic peritoneal samples after the instillation of 0.25% methylene blue into the pelvic cavity. MEASUREMENTS AND MAIN RESULTS: In 3 patients, laparoscopic examination showed minimal endometriosis. A total of 18 samples (9 stained and 9 unstained) from the 3 patients were prepared for SEM. Ten of the samples (55.6%) showed microstructural peritoneal destruction (7 of 9 stained [77.7%] and 3 of 9 [33.4%] unstained). Eighteen samples (9 stained and 9 unstained) from the 3 patients were also prepared for IHC. Six of these samples (33.3%) were S-100-positive, including 4 of 9 (44.4%) stained samples and 2 of 9 (22.2%) unstained samples. CONCLUSIONS: In general, in the context of CPP and endometriosis, there is no established relationship between the severity of pain and stage of endometriosis. In the pathophysiology of CPP associated with endometriosis, ultrastructural changes can play a significant role. Under methylene blue staining, some destroyed areas were detected, but the stained areas do not necessarily correlate with increased microstructural peritoneal destruction.

Cytotoxicity assessment of adipose-derived mesenchymal stem cells on synthesized biodegradable Mg-Zn-Ca alloys.

Magnesium (Mg)-based alloys have been extensively considered as biodegradable implant materials for orthopedic surgery. Mg and its alloys are metallic biomaterials that can degrade in the body and promote new bone formation. In this study, the corrosion behavior and cytotoxicity of Mg-Zn-Ca alloys are evaluated with adipose-derived mesenchymal stem cells (ASCs). Mg-2Zn and Mg-2Zn-xCa (x=1, 2 and 3wt.%) alloys were designated. Mg alloys were analyzed with scanning electron microscopy and potentiodynamic polarization. To understand the in-vitro biocompatibility and cytotoxicity of Mg-2Zn and Mg-2Zn-xCa alloys, ASCs were cultured for 24 and 72h in contact with 10%, 50% and 100% extraction of all alloys prepared in DMEM. Cell cytotoxicity and viability of ASCs were examined by MTT assay. Alloying elements including Zn and Ca improved the corrosion resistance of alloys were compared with pure Mg. The cytotoxicity results showed that all alloys had no significant adverse effects on cell viability in 24h. After 72h, cell viability and proliferation increased in the cells exposed to pure Mg and Mg-2Zn-1Ca extracts. The release of Mg, Zn and Ca ions in culture media had no toxic impacts on ASCs viability and proliferation. Mg-2Zn-1Ca alloy can be suggested as a good candidate to be used in biomedical applications.