ABSTRACT
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 (pâ¯=â¯0.042). The effect of corrective exercises on the intensity of pain in the shoulder (pâ¯=â¯0.002), hand/wrist (pâ¯=â¯0.001), upper back (pâ¯=â¯0.03), lower back (pâ¯=â¯0.02) and knee (pâ¯=â¯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.
Subject(s)
Internship and Residency , Musculoskeletal Diseases , Humans , Male , Female , Quality of Life , Surveys and Questionnaires , PainABSTRACT
The mobility and smooth surface of the ovaries can pose a challenge during laparoscopic cystectomy, with difficulties in manipulation and visualization. We describe assembling a device for ovarian lifting and immobilization that utilizes a nylon suture and a "scalp vein set" to create a loop. The loop can be passed into the pelvic cavity and then slid beneath the ovary, elevating and stabilizing it during surgery without the need to puncture the ovarian tissue or grabbing and damage the utero-ovarian infundibulopelvic ligaments. This device is inexpensive, and its components are easily accessible. This assembled device prevents repetitive falling of the ovary into the pelvic cavity, facilitates laparoscopic ovarian cystectomy, and saves operative time.
ABSTRACT
Modern surgical technologies allow gynecologists to treat most submucosal myomas hysteroscopically by some form of resection. What appears on imaging or direct visualization to be a submucosal myoma can be a single tumor, or may represent multiple smaller myomas appearing as one, compacted together in a typical pseudo capsule. During myoma resection, the effect of the media used to induce distension can vary, depending on the morphology of the myomas. After starting resection, the pressure of the distending media can push truly solitary myomas to somewhat flatten against the uterine wall. However, in the second type of myoma, the fluid can displace the myomas into the uterine cavity, an appearance similar to the blooming of a flower. The tip of the hysteroscope may enter the dissected spaces between the myomas, which impairs the panoramic view. This phenomenon may cause inadequate treatment of the myomas encountered during hysteroscopic myomectomy. In this study, the "Blooming phenomenon" is introduced, and the problems created by this phenomenon and solutions for its management are considered.
